Cipro, Levaquin, Avelox, etc, dissolving tendons

[timtom]

Warning: Lost post ahead

TL;DR Fluoroquinolone antibiotics cause cartilage and tendons to dissolve over time, probably from an upregulation of MMPs (matrix metalloproteinases), which is maybe mediated by oxidative stress, which is maybe mediated by mineral chelation. I can't lift anymore because of these drugs. What (possibly gray market) supplements, etc can I apply here, if any?

Cipro/ciprofloxacin, Levaquin/levofloxacin, and any antibiotic ending in *ofloxcain, are part of the family of antibiotics called fluoroquinolones, abbreviated FQs. These are some of the most powerful and dangerous drugs on the market. That's not hyperbole, as we shall see. If you've taken an antibiotic you've probably had a fluoroquinolone as they are given out regularly. You were probably also given the antibiotic directly violating the advice of FDA and the drug manufacturer (Bayer), both of whom have released statements saying "Do NOT use these drugs for normal infections because they are too dangerous."[1]

Why are they dangerous? They have a long list of horrific side effects, and they way they work biologically is a nightmare. They aren't normal side effects either. They aren't treatable by doctors. Permanent, irreversible nerve damage. Full body DNA mutations, both cells and mitochondria. Permanent mitochondria damage. Teeth decaying and shattering at the gum line. Even retinal detachment leading to blindness. There are dozens more. Today I'm asking about the most well known side effect, tendon rupture.

Antibiotics cause tendon ruptures? Yes, and these drugs favor the Achilles tendon to cause ruptures. But not just ruptures! These drugs can cause full body tendon pain for years after stopping the drugs, and for some, permanently. I know what you're thinking, "side effects are rare, this guy is full of shit." I'm not going to spend too much time trying to convince anyone, but the incidence of Achilles tendon rupture alone is 1 in 5,958[2], not including other ruptures and other tendon disorders.

How do these drugs damage tendons? That's the million dollar question. They cause tendons, cartilage, and even teeth, to break down over time without use. There are reports of Achilles tendons snapping while standing in the kitchen, or in the middle of the night in bed. There are reports of people's teeth shattering at the gum line. These drugs chemically damage your body and cause tendons to dissolve and cleave from bone (again, not hyperbole). The FDA has even coined a special term for people who have to go on disability for ruptures, FQAD (Fluoroquinolone Associated Disability).

I've been doing heavy research on the mechanisms of damage. One likely culprit are matrix metalloproteinases, abbreviated MMPs. Don't let the name scare you, they're fairly easy to understand.

Crash course: Most cells all sit in a web called the "extracellular matrix (ECM)," which is a big word meaning the stuff between cells. It contains a lot of things, including collagen (connective tissue) and elastin (stretchy tissue, think your bladder). In a healthy person there's a process to tear down the matrix, which is useful when cells need to migrate, or a wound needs to be cleared for healing. The enzymes that tear down the ECM are called "matrix metalloproteinases." The name is simple enough if we break it down:
- "matrix" - Acts on the extracellular matrix
- "metallo-" Needs metal (zinc) to activate
- "-proteinase" Eats protein
This teardown and rebuilding of the ECM is normally in a balanced state. There's equal teardown and buildup, mostly. Teardown of the ECM is responsible for things like wrinkles (MMPs tearing down elastin, so your skin gets saggy instead of stretchy), but mostly it's in balance.

In a FQ victim, the balance is disrupted. FQs case an "upregulation" of MMPs, meaning cells make too many MMPs [3][4]. This is how tendons, cartilage and even teeth dissolve slowly over time, without use. This is why tendons separate from bone in FQ victims. There's no chance for the body to rebuild damaged tendons over time because it's in a constant state of slow teardown. Are MMPs the only cause of tendon teardown in FQ damage? I doubt they're the only player, but my hypothesis based on research is they're a big player.

Another piece of the puzzle is that FQs cause massive oxidative stress (which is involved in DNA mutations, permanent mitochondria damage, and mass cell death) [5]. And oxidative stress directly leads to the upregulation of MMPs [6]. Is this how FQs cause MMP upregulation? I can only speculate, but it's suspicious.

I took Cipro and four months later I'm still facing serious side effects. It hurts to walk and I can't lift anything heavier than a glass of water without pain. These drugs are slowly taking my tendons (among many other fun side effects). I'd obviously love to be back in the gym again some day. I can't even ride a bike right now though I haven't tried a stationary bike yet.

Not sure what kind of supplements / chemicals could apply here to prevent breakdown and encourage healing. A friend mentioned TBsomething injections? I know steroids actually have the opposite effect on FQ victim tendons and cause them to break down further.

[1] "FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections" fda.gov/Drugs/DrugSafety/ucm500143.htm
[2] "Evidence of tendinitis provoked by fluoroquinolone treatment: a case-control study." ncbi.nlm.nih.gov/pubmed/16970512
[3] "Fluoroquinolones cause changes in extracellular matrix, signalling proteins, metalloproteinases and caspase-3 in cultured human tendon cells." ncbi.nlm.nih.gov/pubmed/15890441
[4] "Effect of topical fluoroquinolones on the expression of matrix metalloproteinases in the cornea." ncbi.nlm.nih.gov/pubmed/14529574
[5] "Oxidative Stress Induced by Fluoroquinolones on Treatment for Complicated Urinary Tract Infections in Indian Patients" ncbi.nlm.nih.gov/pmc/articles/PMC3249743/
[6] "Activation of MMP-2 as a key event in oxidative stress injury to the heart" biosccience.org/2009/v14/af/3274/fultext.php?bframe=2.htm

 

[stonetag]

So the reason for this post is........? Kind of sounds like a page out of a college thesis.

 

[timtom]

I'm asking for how to stop, reverse, or improve tendon breakdown due to chemical injury in the body. It's all there. I don't expect many people are well versed in the specifics of the damage nor MMPs in general so I wanted to give the information i've found as a primer.

 

[mugzy]

I'm asking for how to stop, reverse, or improve tendon breakdown due to chemical injury in the body. It's all there. I don't expect many people are well versed in the specifics of the damage nor MMPs in general so I wanted to give the information i've found as a primer.

Doc is probably best to answer this question however I would research things like MSM, glucosamine, aflutops, pentosan. Also Eq and Deca could help.

 

[timtom]

I have talked to 6 separate doctors about it so far, but doctors don't know anything about FQ toxicity. None of the studies on it show any methods of healing either. All I've been able to get is one X-ray to rule out a bone issue, for an actual MRI (which would show any physical tendon damage) they said my arm basically has to be hanging out of its socket first.

 

[Bro Bundy]

I have talked to 6 separate doctors about it so far, but doctors don't know anything about FQ toxicity. None of the studies on it show any methods of healing either. All I've been able to get is one X-ray to rule out a bone issue, for an actual MRI (which would show any physical tendon damage) they said my arm basically has to be hanging out of its socket first.

doc is a mod here

 

[IHI]

I'm tuning in because I get bigger annual, take me out of the game sinus infections. A few yes back an urgent care doc gave me prednisone and leviquin for 7 days and within a few days in was night and day better, and since then instead of running me thru 3 antibiotics that never work and finally leviquin, they just do the leviquin straight away and within a week I'm done until spring or fall transition.

Got a infection in my prostate, side effect of sinus infection, and urologist ran me on 14 days of leviquin and said it's mainly elders that see any side effects, because I've read how bad it can be, and was nervous of a 2 week region. Bright side, I was able to pass normal again after a week, but she said since there's such limited blood flow to prostate they default to a 2 week cycle to be sure the infection is taken care of

 

[DocDePanda187123]

I have talked to 6 separate doctors about it so far, but doctors don't know anything about FQ toxicity. None of the studies on it show any methods of healing either. All I've been able to get is one X-ray to rule out a bone issue, for an actual MRI (which would show any physical tendon damage) they said my arm basically has to be hanging out of its socket first.

You don't necessarily need an MRI. An ultrasound, plain radiography, and ultrasonography are also viable, less expensive, options to assess tendinitis/tendonopathy and much more likely to be written a script by your doctor for it.

 

[DocDePanda187123]

how long and what dose did you take these medications for? What was the reason for taking these medications, the underlying condition?

Judging by the available literature, most people (about 50%), will get better within a month. About 25% have lingering symptoms after 2 months. For some, rehab and PT is the best route while for others strict bed rest or even orthopedic surgery will be needed (generally for the elderly and the worst of the worst). Which option is best for you really relies upon how bad your tendons are which some sort of imaging beyond an X-ray is needed.

 

[timtom]

I would research things like MSM, glucosamine, aflutops, pentosan. Also Eq and Deca could help.

Thanks. Currently doing MSM and glucosamine. Aflutops seems like an interesting substance, some of my research has led me to seafood in general and I'm trying to eat lots more of it.

An ultrasound, plain radiography

Yup, I've specifically asked docs for an ultrasound, but won't let me get one yet, they have to go through a flowchart basically. First step was X-Ray, which I got. Second step is supposed to be PT but literature shows PT makes tendon damage worse. Waiting on results of X-Ray now, which will show nothing, before docs will take next step.

I only took 12 pills, 6 days, had to stop because I had constant pins and needles in arms and legs, which I now know was nerve damage (neuropathy). None of the docs I spoke to were aware pins and needles were an issue, even though it's on the warning handout for the drug as "if you have pins and needles stop this drug immediately because you are experiencing potentially permanent nerve damage."

Got a infection in my prostate, side effect of sinus infection, and urologist ran me on 14 days of leviquin

This is a common story in the online FQ support groups, and my story as well. Lots of young healthy men given cipro/levaquin for "prostatitis" (a BS diagnosis), and then the FQs caused much worse symptoms than the prostate pain. No infection was ever found in my prostate, cipro was just given preventatively. And again, this directly violates FDA advisory. Both of your cases do, these drugs are NOT supposed to be given for sinus infections nor UTIs because they are too dangerous. You should also consider that there are hundreds of people in the groups reporting they took one, two, even ten courses with no problems, but the next course ruined their body and life. Taking these drugs without side effects once doesn't mean they're safe to take again.

These drugs definitely don't target just the elderly. No one knows why they hit some people hard and others not. Not a chance I'm willing to take again.

People in the groups talk about recovery time in months or years, or permanent. There aren't any studies that follow FQ toxicity for that long so I highly doubt all the side effects and recovery data are accurate in the scientific literature.

Anyone hear of low level light theraphy? LLLT? There's some science behind it, curious if people here have tried it or built one for post workout recovery.

 

[timtom]

As I suspected, and I was right, recent MRI showed multiple tears in my right shoulder, and joint ligament deterioration causing bone on bone. I haven't used my shoulder for exercise in 8 months. Pretty strange to have so much damage in there? These drugs are horrifying.

So what do I inject to rebuild a rotator cuff?