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The Center for Integrative Medicine

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Poisoned by an Antibiotic

Although he was only in his early thirties, he moved like an old man with widespread arthritis. At the stairs, he supported himself on the short banister to keep his full weight off his feet. It looked as if every one of his muscles were in pain.

Inside his chart, in the section where he’d written his reason for the appointment were the words, “Poisoned by Levaquin.” He was the fourth such patient I’d seen in the past year or so.

Levaquin (generic name: levofloxacin) is the best-seller among antibiotics in the fluoroquinolone class (“floxins,” for short). Others include Cipro and Avelox. Still others you’ve never heard of because they’ve been yanked by the FDA for excessively dangerous side effects including heart, brain, and nerve damage. Because of these potential side effects, the general recommendation to doctors has been to use floxins only when absolutely necessary, choosing milder antibiotics (like Z-Pak or Augmentin) whenever possible.

But both doctors and patients like the floxins. They’re fast, effective, conveniently dosed at one per day, and generally reliable for difficult infections like sinusitis. For most users, they are safe. The floxins are so widely used in their various forms–intravenous, oral, even eye and eardrops–that hospital residents refer to Levaquin as “Vitamin L.” An important aside: this overuse has led to more cases of hospital acquired MRSA (methicillin resistant staph infection) and C. Difficile (hard-to-treat diarrhea) than other antibiotics. At a recent WholeHealth Chicago staff meeting, half of us, including me, acknowledged having taken a floxin at least once in our lives, and we all generally avoid drugs.

Why it took so long to recognize that the floxins could destroy a person’s tendons is understandable. No one ever dreamed that tendonitis (inflammation of the rope-like tissue that attaches muscles to bones) could be caused by an antibiotic, or by any drug for that matter. Antibiotics routinely cause nausea, vomiting, diarrhea, skin rashes, and yeast infections, and every doctor knows this.

But when some people started suffering painful tendons during, or shortly after, taking a floxin drug, they didn’t connect the two and most didn’t mention it to their doctors. When it was mentioned, doctors didn’t make the connection either and often continued the antibiotic, adding an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen for the tendonitis, which we now know made matters worse.

The red flag on the floxins and tendonitis came up during “post marketing surveys” and letters to the FDA from doctors who did see the connection. Post marketing surveys are the bane of the pharmaceutical industry, which doesn’t really want to hear any bad news about its drugs. Historically, companies have minimized post-marketing data (just like Toyota is doing now), holding off as long as possible reporting their concerns to the FDA. After all, there’s serious money involved.

But more and more patients taking floxins began reporting tendonitis symptoms, especially when walking. Their pain usually started in the Achilles tendon at the back of the calf and then occasionally spread throughout the body, sometimes becoming indistinguishable from fibromyalgia, except that with fibro, the Achilles tendons are virtually never affected. Why the Achilles first? Probably because they’re the most heavily used–every step you take stretches and relaxes these tendons. Interestingly, the three people I’ve treated with this condition were all heavy users of their Achilles (hikers, cyclists, and basketball players).

In susceptible people, floxins can seriously damage the tendons. Several cases of spontaneous Achilles rupture (complete tear) have been reported, and during repair surgery the affected tendon tissue appears unhealthy and heals poorly. In some patients, tendon damage is permanent. Their lives are changed forever, and they suffer chronic daily pain after just a week on a floxin for something minor, like an annoying sinus infection. Fortunately, permanent tendon damage is uncommon. But full recovery can be very slow.

Treatment?
None known. Diagnostic tests? No tests comes up “positive” and therefore some patients are dismissed as neurotic. There is no cure. On the plus side, when the tendonitis is mild, it usually goes away by itself, often after a month or two. Severe cases are disabling and several class action lawsuits are currently underway. You can bet the defense attorneys for Big Pharma are delighted the floxins cause no positive tests and will play the neurotic card to the hilt. I suspect the plaintiffs would be happy to drop all charges if they could have their lives back.

At WholeHealth Chicago, we treat floxin toxicity using natural products to enhance the patient’s own detoxifying systems. Floxin-tendonitis victims have a history of sensitivities to a wide variety of chemicals and drugs, indicating sluggish detox mechanisms. We advise patients to start an anti-inflammatory eating program and take natural anti-inflammatory supplements, such as fish oil and boswellia. We also refer patients to our homeopath. Floxin patients are so drug-sensitive that I’m reluctant to prescribe any conventional drug, feeling comfortable only with the safe and gentle remedies of homeopathy.

Lessons?
• Essentially, all drugs are potentially poisonous chemicals. Please read that aloud, twice. As a small amount of chemical courses through your body, it has the potential to affect every single organ, for better or worse. The chemical’s single positive effect becomes its (heavily marketed) clinical use and can be worth billions in revenue. The chemical’s numerous bad effects (some obvious, others subtle, all euphemistically called side-effects) are diligently swept under the rug, mostly ignored by the pharmaceutical industry and the FDA, overlooked by the prescribing physician, and a source of endless but often well-founded concern to the patient.

• If you do need a drug, ask about the oldest rather than the latest. If you’re not allergic to sulfa drugs, for example, for sinus and urinary infections these have been around for more than 70 years and the side effects are known and familiar. If your doctor suggests a floxin drug, tell her you’ve read about them and would prefer a milder antibiotic.

• When you start on a drug, read the side-effect list. A rule of thumb I learned in medical school: if a patient arrives with a new and unexplained symptom and has started on a new drug, regardless the symptom investigate the drug first, not last.

• If you’re generally a chemically sensitive person (you know who you are), take all steps to avoid prescription drugs. If there’s no alternative, start with a pediatric dose. It will probably work fine for you.

• Most drugs are prescribed to cover you for years of unhealthful lifestyle choices (diabetes, heart disease, acid reflux, emphysema, etc). Others are for conditions you could treat in safer ways (neti pot for sinus infections, St. John’s wort and counseling for depression). Most drugs work much less well than anyone (doctors, patients, even Big Pharma) likes to consider. In their heart of hearts, doctors bank heavily on the placebo effect.

I’ll leave you with this unsettling fact: It’s estimated that correctly administered and correctly taken prescription drugs are the fourth leading cause of death in the US.

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