antibiotic adverse reactions Archives

An Over Medicated and Chronically Ill Millennial

Published on March 11, 2020

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over medicated millennials benzodiazepine

Frequent Infections, Antibiotics, and Asthma

As I’ve reflected on my current health challenges, I’ve come to the realization that I need to head back in time to my earliest years. Like many kids born in the early 90s, I was the first to receive a slew of vaccinations that were previously never given to children. I suffered from frequent “earaches” that led to multiple courses of antibiotics before kindergarten, and by the time I reached middle school, I was taking yearly courses of antibiotics for all sorts of things: colds, sinus infections, acne. It was around this time that I was also diagnosed with exercise induced asthma. I remember almost passing out in a lacrosse practice in 7th grade, and before I knew it, I was put on Advair (daily inhaled steroid) and was hitting the albuterol 2 or 3 times before a workout. My allergies also raged during this time.

Anxiety and Doctor Prescribed Benzodiazepine

I started getting increasingly anxious in early high school. I remember getting what I now know are symptoms of a panic attack in late middle school. Though part of this was due to the fact that I was hiding my sexuality (and hiding it well), I also realize that I had been slamming my adolescent body with drugs, vaccinations and the standard high sugar American diet for 14 years at that point.

My anxiety caused sleeping issues and I was placed on Ambien when I was 16. When I was withdrawn from that, the anxiety got worse (I know now it was Ambien withdrawal), and I was finally sent over to a psychiatrist. After listening to my description of panic attacks, she placed me on Klonopin, one of the most potent benzodiazepines on the market that should never be used for more than a few weeks. She told me to take up to four a day (an insane dose) and that like a diabetic, I needed GABA enhancement, and I would have to take these for the rest of my life.

At 17, I was buzzing on a benzodiazepine every day. I remember that it actually felt quite good and erased all worry. But then I began to experience one of the most terrifying side effects of long-term benzodiazepine dependence: I was getting dementia! I couldn’t remember things for tests or quizzes no matter how hard I studied. When I brought this up to the psychiatrist, she assured me that a little amnesia was a common benzodiazepine side effect, but that the benefits outweighed this. Essentially, giving a teenager dementia outweighed him having anxiety.

Benzodiazepine Withdrawal and Repeat Concussions

When I decided I needed to come off the benzodiazepine after taking it for a year, her instructions were to taper over one week and then jump. Now, this was 2010, and the internet was alive and well at that point. Upon doing just a little bit of research, I knew this woman was insane. All recommendations were that benzodiazepines needed to be tapered over the course of many weeks if not many months. I found a benzo support group online that became my lifeline for the next 4 months as I gradually weaned myself off the drug with the support of my parents and a new primary care doctor. Throughout this time, the one drug that I actually credit with saving me is marijuana. Without it, I’m not sure I would have done as well as I did getting off the drugs and then staying off of them.

I went right off to college that fall, which in retrospect was a miracle. I struggled a lot that first year. I was experiencing post acute withdrawal syndrome (PAWS) from the benzodiazepine and almost flunked out. I gradually improved but was still dependent on nightly marijuana to go to bed. In 2014, I finally stopped smoking weed and was 100% drug free.

That summer, I ended up getting my first concussion, though I suspect I had many others growing up as I played soccer and lacrosse. As if one wasn’t bad enough, I somehow ended up getting another the next summer in 2015 when I was at the beach and hit my head on a car door. I was later told by a neurologist that once you have a concussion, it becomes significantly easier to get a second, and then a third, and so on.

I had long suffered minor symptoms from benzodiazepine withdrawal that never went away, like tinnitus in my ears, an inability to take GABA drugs without reactivating withdrawal symptoms, and other neurologic symptoms that always made me feel “different.” The concussions added to this complex situation and I would have what I can only describe as seizures during times of stress or intense workout. It felt like my brain had electric current running through it.

Around this time, I also received the first injection for the Gardasil vaccine. I never followed up with the rest of them because of how off I felt that the first few days after getting it. Only recently have I learned about the severe damage that Gardasil can cause.

By 2016, I had been doing a paleo/plant-based diet and felt generally well, but the symptoms from both benzo withdrawal and my concussions persisted. In 2017, I started using CBD oil, and I found that it relieved a lot of the symptoms. It calmed my brain down significantly. I also began using Truvada (HIV medication) during this time as PreP. The one issue that never went away throughout all of this was my anxiety and panic. I was prone to situational panic attacks that felt like my fight/flight system was in total chaos.

A Complete Crash with Tinidazole

Despite feeling okay in 2018 and most of 2019, my whole world was turned upside down again in the fall of 2019. I contracted some sort of stomach bug that wasn’t going away, and my doctor placed me on a drug called Tinidazole, the sister drug of Metronidazole (Flagyl). I haven’t felt the same since that day.

The symptoms came on almost immediately. Dizziness, depression, increased anxiety, neuropathy in my hands and arms. I became convinced that I had ALS because my hands weren’t working right. It was also unlike me to ever assume something as terrible as a fatal diagnosis, but my brain was in total disarray.

Two weeks after taking the Tinidazole, I had to go back on antibiotics for wisdom teeth removal. Immediately after the surgery, I went into one of the most horrendous panic attacks of my life, in part because I had been injected with novocaine about 20 times. I had to be wheeled out of the doctor’s office because the panic had been so bad. Looking back now, there is a similar case study in Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition.

Things only got worse. By the end of the penicillin, my body was in a total spiral. I began having daily panic attacks that I can’t even describe. My body temperature was low, my fight/flight system was in disarray, I was depressed, I couldn’t think clearly. There were nights when I wouldn’t sleep at all and be in total fight or flight mode. I now know that I was going through Tinidazole toxicity that had gradually gotten worse over a few weeks. Combined with the penicillin, it was a recipe for disaster.

The strangest symptom that has come out of this experience is hypoglycemia. My blood sugar is tanking to dangerously low levels during the day unless I am extremely diligent about eating. There have been a few times that I have almost blacked out. This isn’t a common symptom of Metronidazole/Tinidazole toxicity, but I don’t know where else it could have come from.

Where I Am Now

I’ve improved a bit, but I’m still having symptoms like dizziness, hypoglycemia, altered mental state, neuropathy and a total dysfunction of my fight/flight system.

Looking back at my long and complicated history, I’ve discovered a few things in my research:

Early and frequent antibiotic use is linked to anxiety and depression
I ate A LOT of sugar throughout my life and my thiamine stores were probably always being hit hard and my mitochondria have probably been fighting this battle my life
The benzodiazepine and Ambien have caused deep alterations to my nervous system/GABA receptors that became less noticeable with time but will never fully heal
Concussions cause a cascade of effects that damage mitochondria function and lead to other semi-permanent neurological issues
Truvada (PreP) also harms mitochondria
Tinidazole plummets your thiamine

Thiamine Deficiency and Problems With Paradox

I’d like to start Dr. Lonsdale’s protocol for high-dose thiamine, but I encounter painfully difficult paradox symptoms. I have tried to start with a low dose (less than 10 mg) twice now, and always end up having to stop because it gets so bad. The “heart attack” and “seizure” symptoms are simply too frightening and I’m not sure what’s actually going on in both my brain and heart. I’d like to find a functional doctor that could possibly work with me to measure what’s going on when I take thiamine.

I’m also in the process of working with doctors to run tests on my hypoglycemia issues.

The only other thing I’ve considered is a fecal transplant. Since I’ve been on so many antibiotics, I’m convinced that some of my issues may stem from altered gut microbiota.

Lots of people see improvement from Metronidazole/Tinidazole toxicity over the course of 6-12 months. But unless I can take action, I suspect my thiamine issue will remain.

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Repeated Use Doesn’t Make Fluoroquinolones Safe

by Lisa Bloomquist

Published on March 22, 2018

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“I’ve prescribed fluoroquinolone antibiotics to hundreds of patients and I’ve never seen problems like yours. It’s a good drug with an excellent safety record.”

Some version of that statement is said to many patients who approach doctors with the many symptoms of fluoroquinolone toxicity syndrome. Fluoroquinolones (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin) have been shown to damage connective tissue (tendons, ligaments, cartilage, fascia, etc.) throughout the body, damage the nervous systems (central, peripheral and autonomic), and lead to multi-symptom, often chronic, illness. Most of the symptoms of fluoroquinolone toxicity are listed on the 43 page warning label for cipro/ciprofloxacin. However, disregard of patients with fluoroquinolone toxicity syndrome is, unfortunately, common. Statements like the one above are wrong-headed and foolish – here’s why:

The statement of, “I’ve prescribed fluoroquinolone antibiotics to hundreds of patients and I’ve never seen problems like yours” and implying that therefore fluoroquinolones are safe, is an illogical argument based in ego, not fact. Prescribing a drug hundreds of times does not make it a good, or safe, drug. The fact that something has been done millions times before does not mean that it’s the right way to do things. As an example, millions of people were given Vioxx before it was taken off the market because it causes heart attacks and strokes. If a physician never saw a heart attack result from Vioxx use, that doesn’t mean that they didn’t happen. They did. Thousands of people had heart attacks and died because of Vioxx. A history of doing something wrong does not make it right. Implied in the statement that a physician has never seen fluoroquinolone damage is the assumption that what a physician sees is factual and without bias. If a doctor regularly prescribes a drug, he or she is going to believe in its safety and efficacy based on a desire to see him or herself as one who helps patients, regardless of its actual safety and efficacy. Doctors have bias and ego just like the rest of us. Anecdotal evidence, even anecdotal evidence from a doctor, is not able to trump experimental evidence. Drugs need to hold up in scientific experiments and controlled trials – not in the opinion court of doctors. In multiple experiments, fluoroquinolones have been shown to damage cells (by depleting mitochondrial DNA, magnesium, lipids, enzymes, etc.). Science wins every time, and the scientific evidence comes down on the side of fluoroquinolones being dangerous drugs.
It shows an unwillingness/inability to connect pharmaceutical drugs to multi-symptom diseases. Fluoroquinolones deplete mitochondrial DNA and lead to mitochondrial dysfunction. When mitochondria aren’t functioning properly, cells aren’t functioning properly. Mitochondria are the energy centers of eukaryotic cells – the engines. If cellular engines are malfunctioning, many systems shut down. This shut-down can lead to a cascade of damage – much of it self-perpetuating and difficult to repair. The details of the biochemistry behind this are incredibly complex and difficult, but the basic concept of drugs that cause mitochondrial damage lead to multi-symptom, chronic illness, isn’t so difficult that someone who went through med school shouldn’t be able to grasp it. But many doctors are loathe to admit that the drugs that they prescribe cause mitochondrial damage. Many studies have shown that fluoroquinolones damage mitochondria (HERE and HERE). Even the FDA acknowledges that the mechanism through which fluoroquinolones do damage is through mitochondrial toxicity. Mitochondrial toxicity = multi-symptom, often chronic, illness. It’s not that hard. But if doctors admitted that fluoroquinolones cause multi-symptom, chronic illness, they may have to look at the relationship between all mitochondria damaging drugs (statins, SSRIs and even acetaminophen are on the list along with fluoroquinolones) and the rise in mysterious multi-symptom illnesses. If they did that, they may have to admit that the drugs they prescribed, ‘hundreds of times’ are hurting people – and who wants to do that? It’s much easier to repeat the lie of, “these drugs have an excellent record of safety and efficacy,” than it is to admit to inflicting harm (even inadvertently) on patients.
They’re not looking at delayed reactions or tolerance thresholds. Despite the fact that both delayed adverse reactions and tolerance thresholds for fluoroquinolones are documented (it all goes back to how mitochondria respond to damage – more HERE), reactions that occur after administration of the drug have stopped are not connected to the drug by many physicians. “It should be out of your system by now,” is repeated often. That may be the case, but the drug set off an intracellular bomb and now the damage is self-perpetuating. Delayed reactions and tolerance thresholds may make recognition of adverse drug reactions difficult, but it doesn’t make them go away. Unfortunately, cells don’t always act as they “should” – they act as they do – with messy things like non-linear reactions, negative feedback loops, etc.
The specialist model keeps many doctors from seeing the damage that fluoroquinolones cause. For example, ER doctors often prescribe fluoroquinolones because they’re powerful broad-spectrum antibiotics. But when people have an adverse reaction a week later that looks and feels a lot like an autoimmune disease, they’re not going to the ER for treatment because autoimmune-disease-like symptoms are for a rheumatologist or general practitioner to treat, not an ER doctor. This disconnect keeps many doctors from seeing the harm done by fluoroquinolones.
Statements like, “I’ve prescribed fluoroquinolone antibiotics to hundreds of patients and I’ve never seen problems like yours. It’s a good drug with an excellent safety record.” communicate to patients that a physician’s anecdotal evidence is more important than a patient’s pain. It communicates that it’s okay for side-effects of a drug to be devastating as long as the doctor perceives the adverse reactions as rare. It’s not okay for a doctor to disobey his or her Hippocratic Oath and hurt patients – even inadvertently. And I would argue that adverse reactions to fluoroquinolones are far less rare than anyone would like to believe (arguments HERE and HERE).
It shows that doctors don’t believe the warning labels on drugs. The warning label for Cipro/ ciprofloxacin is 43 PAGES long and lists many musculoskeletal and nervous system adverse effects of cipro and other fluoroquinolones. Do doctors think that the FDA is just kidding when they put all those adverse effects on the warning label?
The mantra of, “fluoroquinolones have an excellent safety record” has been repeated so many times that it is assumed to be true. It is not true. There are hundreds of studies showing that fluoroquinolones profoundly damage cells and there are zero studies that show that people are immune to the damage caused by fluoroquinolones. The perception of safety is based on an unwillingness to recognize tolerance thresholds for fluoroquinolones, delayed adverse reactions to fluoroquinolones and the connection between fluoroquinolones and multi-symptom diseases.
It shows that they’re afraid. Some of the fear is legitimate. Antibiotic resistance is on the rise. If fluoroquinolones are restricted to only being used appropriately – i.e. in life-or-death situations after all other antibiotics have failed – doctors will have fewer tools at their disposal and they may not be able to fight a nasty infection without inflicting cellular damage that results in chronic illness. No one wants to have to choose between an infection and multi-symptom, chronic illness. It would be better to have neither. But if there aren’t any options of antibiotics that don’t cause the cellular damage that leads to oxidative stress and multi-symptom illness… well, that’s a possibility that is too frightening and daunting to think about.
Too many doctors are attached to lazy medicine – throwing strong, broad-spectrum antibiotics at everyone who comes in the door with an infection (or just a high white blood cell count). If the adverse effects of fluoroquinolones were acknowledged, the pros and cons would have to be careful weighed before administering them. A long discussion with patients about tendon ruptures, peripheral neuropathy, increased chance of diabetes, central nervous system damage, etc., would have to be had along with every prescription for Cipro, Levaquin or Avelox in order for an obligation of informed consent to be met. If broad-spectrum fluoroquinolones couldn’t be thrown at every infection, bacterial cultures would need to be done to figure out exactly what antibiotics would work best. That takes time and money and it’s easier to do things as they have been done – even if it involves denying the damage that fluoroquinolones do. Those pesky tests to make sure that the Hippocratic Oath is upheld may get in the way of business.

Adverse drug reactions don’t stop happening just because they’re inconvenient; or because they’re unrecognized or misdiagnosed. They don’t become rare or insignificant just because they are complicated and difficult to recognize.

Fluoroquinolones are dangerous drugs that damage cells on multiple levels. This has been shown in laboratories many times. The cellular damage caused by fluoroquinolones (along with the destruction of the microbiome) leads to multi-symptom, often chronic, illness. This has been shown by multiple patient reports.

Many doctors haven’t read the memo about how dangerous fluoroquinolones are though. Shouldn’t they know the dangers of the drugs that they prescribe? Shouldn’t they have learned about adverse drug reactions in school? It doesn’t seem like too much to ask for. There are hundreds of studies showing that fluoroquinolones damage eukaryotic cells. Shouldn’t they have read them, or at least been told about them by the FDA?

You’d think so. But the mantra of, “Fluoroquinolones have an excellent record of safety and efficacy” has been repeated so many times that it’s thought to be true just because it’s been heard over and over again. Let’s change the mantra. How about, “fluoroquinolones are dangerous drugs that should only be used in life-or-death situations?” That mantra sounds much better. It’s more appropriate, and it’s closer to the truth. If we keep on repeating it, maybe doctors will start to listen.

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This post was first published on October 1, 2014.

Information about Fluoroquinolone Toxicity

Information about the author, and adverse reactions to fluoroquinolone antibiotics (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin) can be found on Lisa Bloomquist’s site, www.floxiehope.com.

Photo by karatara: https://www.pexels.com/photo/male-statue-decor-931317/