Floxed refers to the devastating effects of a class of antibiotics called fluoroquinolones (FQs) and may include symptoms of extreme fatigue, tendon rupture, joint and muscle pains, nerve pains, and nervous system disturbances.
The symptoms may resolve after stopping the FQs, persist for years, or wax and wane as time goes by. I’ve witnessed the symptoms appear immediately when starting the FQs, or worse yet the symptoms can also appear long after the FQs are taken or only after multiple rounds of FQs, thus making the diagnoses of FQ side effects tricky.
The offending FQ medicines include ciprofloxacin (Cipro), gemifoxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin). There are subtle differences in the side effect profiles, but for sake of this article we’ll lump them together as FQs.
FQs kill bacteria by preventing bacterial DNA from unwinding and duplicating. Unfortunately, like most medications, there are a host of unwanted side effects in the host, that being the person taking the drug.
FQ Toxicity
In summary, FQs can cause:
- Tendon Rupture
- Nervous system disturbances
- Heart, kidney and liver damage
- Diabetes
- FQ Associated Disability (FQAD)
The main mechanisms of toxicity appear to involve:
- Oxidative stress
- Binding of metals (Magnesium, Calcium, Zinc, Copper, Manganese, Iron, and likely Selenium)
- Damage to mitochondria
- Disruption of cellular energy pathways
- Damage to DNA
FQ Associated Disability (FQAD)
In 2016 the term FQAD was coined to describe the long term symptoms observed in some patients after taking FQs. These symptoms can be severe and long-lasting, sometimes persisting for months or even years after discontinuing the medication. Some common symptoms associated with fluoroquinolone-associated disability include:
Musculoskeletal Symptoms:
- Tendon pain and inflammation (tendinitis or tendonitis), which can affect various tendons in the body, including the Achilles tendon, shoulder tendons, and others.
- Muscle weakness, stiffness, or spasms.
- Joint pain, stiffness, or swelling.
- Arthralgia (joint pain) or arthritis-like symptoms.
Neurological Symptoms:
- Peripheral neuropathy, which involves tingling, numbness, or burning sensations in the extremities (hands and feet).
- Nerve pain or neuropathic pain that may radiate along nerve pathways.
- Cognitive impairment, such as brain fog, memory problems, or difficulty concentrating.
- Neuropsychiatric symptoms, including anxiety, depression, or mood disturbances
Gastrointestinal Symptoms:
- Digestive issues such as nausea, vomiting, diarrhea, or abdominal pain.
- Changes in bowel habits or gastrointestinal motility.
Sensory Symptoms:
- Visual disturbances, such as blurred vision, double vision, or light sensitivity.
- Hearing loss, tinnitus (ringing in the ears), or other auditory symptoms.
Other Symptoms:
- Fatigue, weakness, or malaise.
- Skin reactions, including rash, itching, or photosensitivity (increased sensitivity to sunlight).
- Cardiovascular symptoms, such as palpitations or changes in heart rate.
It appears that FQs can bind to cellular components and linger in the body for years. This may be part of the ongoing symptoms associated with FQAD. We are able to test for residual FQ presence in the body using IGL Laboratory from Germany. This can help secure the diagnosis of FQAD.
There isn’t really a diagnostic test for this condition. It’s simply matching the temporal relation of taking FQ to symptoms. There isn’t a simple pill to fix it either. We see many patients who have seen many docs before finally getting the correct FQ toxicity diagnosis. Even then, they are usually left dangling as there isn’t a treatment to offer.
Treatment of FQAD
- Antioxidants
- Mineral replacement
- Mitochondria repair
- Restoring cellular energy
Our treatment protocol involves combinations of intravenous NAD, ozone, phosphatidylcholine (cell membrane support), nutrients (Myers, magnesium) and antioxidants (glutathione, ALA), along with numerous supplements aimed at targeting the 4 areas above.
The floxed symptoms and recoveries are extremely variable, but we can say most of our patients recover most of the way. Some people just come out for a day, others have stayed over a month. We realize, of course, the financial hurdle / barrier it presents, so we’re happy to accommodate whatever people can do. If you or someone you know has been floxed, have hope because we’ve helped numerous patients recover and reclaim their health.
Testimonials of Floxed Patients
“Although the FQ toxicity symptoms have disrupted my ability to study or work and taken an extremely large toll on my mental wellbeing, my very positive experience while being treated at your office has given me renewed hope that I can recover and resume my life. I am very grateful to you and your colleagues for being so caring, friendly, and hospitable. In terms of recovery at this point, I no longer appear to be having issues with insomnia and waking up every 2 – 3 hours. My mood has also drastically improved. Although I may still deal with the neuropathic itch after a hot shower or while trying to fall asleep, there have been multiple instances throughout treatment where I have not encountered the itch for the first time in 2 – 3 months. The degree of the tendon pain seems to be at least somewhat proportional to how clean my diet is, so I am hoping that addressing the leaky gut is a long-term solution.” – Tyler, Florida
“Dr. Rollins and the team are world class. From the moment I arrived, I was apart of the family. The office is calming and inviting and everyone is friendly. I have been struggling with extremely difficult side effects (joint pain, tendonopathy, fatigue, brain fog) from fluoroquinolone toxicity from cipro for over two years and hadn’t been able to find effective physicians who understand this complicated condition until Dr. Rollins. He has a unique and well thought-out treatment plan driven by biochemical rationale based on my particular symptoms. He has helped me feel better as I navigate this ambiguous and painful condition. Special shout out to nurse Deb who not only provided expert care but really made feel welcome and comfortable — couldn’t have done it without her. Thank you so much Dr. Rollins, Deb and team for helping me feel like me again.” – Wyatt, Texas
Resources
Some of these are difficult, highly scientific reads, but well worth at least an overview.
Treatment of FQAD: The Pathobiochemical Implications
Fluoroquinolone-induced serious, persistent, multisymptom adverse effects
Fluoride Toxicity Research Collaborative
Floxie Hope Links and Resources
