Hacker News Reader

Comment by mafuyu | Hacker News Reader

I had horrible fatigue a couple years ago; I wonder if it's related to CFS at all. It was utterly bizarre: I had just come off some antibiotics, when I suddenly had no energy to do anything at all. All I could do was lay in bed. I also got walking pneumonia about a month after the symptoms began, and my roommate had the exact same symptoms. A test for mono came back negative.

The worst part was that the recovery was slow and gradual. After 6 months, I felt like I could operate as a human being again, and only just this year did I feel like I'm back to normal.

I'm chalking it up to it being the first time I was on antibiotics for an extended period of time, plus a run-in with some unfortunate mysterious disease. I honestly have no idea, though.

View on HN

It seems to me that antibiotics are sort of reset-button-gamble - they wipe out large populations of bacteria, some strains die immediatelly, some slower, some are immune etc.

Humans have thousands of strains (types) of bacteria (100 trillion in human body) - some beneficial, some contributing to and causing ilness.

They settle on some equilibrium in each of us - a balance where the population ratios stay relatively constant (guess).

When you wipe out in one go (with antibiotics) a big chunk of this population they will not necessrily come back to the same balance. And this may be the problem because this new equilibrium may be with some illness-contributing bacteria winning too much of the space.

It's not impossible that the best cure for that is to take antibiotics again followed by probiotics to help recover the ones we know are good. This is also tiny part because you can buy couple of dozens of different strains but your body has thousands - so not sure if this alone is enough. Ideally you'd drink your healthy mom's breast milk - but that may not be an option for all of us :)

I wonder why there are no more big-data-like studies on strain population ratios. I'm guessing because the numbers are counted in trillions, small sample (saliva/urine/bowel?) should give quite good picture? Is it expensive to map it? How is it done to detect presence of bacteria? Is each test focusing only on single strain or you can do it in bulk to map it to some kind of histogram?

>why there are no more big-data-like studies on strain population ratios

Not an expert but there are studies going on. The current process seems to be roughly:

>There are two labs, O'Toole explains, that processed my sample. The first was the wet lab, where, through various molecular assaults, DNA was extracted, 95% of which was bacterial. This was then sent to an external company to be sequenced – there were over 30,000 sequences – and then a huge file of data was crunched by what O'Toole called "a bunch of computer nerds who sit around all day generating stats" in the institute's data lab. (https://www.theguardian.com/science/2014/feb/11/gut-biology-...)

so you get a lot of genetic data mixed up from a lot of strains and it's probably hard to make sense of.

There are some commercial services that will check your bacteria out from $90 https://ubiome.com/consumer/explorer/ https://atlasbiomed.com/uk/microbiome

Also those kind of symptoms sound similar to parasitic infections, I wonder if they tried this angle.

Check out monolaurin. It's a natural substance made from coconut milk. It's the ingredient in breast milk that supports a baby's immune system. I used it to kick Epstein Barr Virus. I highly recommend it.

Which antibiotics? I had a horrific experience with fluoroquinolones, and it put me out of commission for months

I was on topical mupirocin and then oral sulfamethoxazole for a couple months, both of which seem relatively pedestrian when it comes to antibiotics. It was my first time taking an oral antibiotic, and it probably nuked my entire gut flora.

You probably got 'floxed'. Fluoroquinolones are dangerous and should be reserved for life and death situations.

https://www.nature.com/articles/d41586-018-03267-5

Last year the European Medicine Agency put out a warning that the use of fluoroquinolone and quinolone antibiotics should be restricted. I also believe the FDA has slapped a black box warning on this class of antibiotics.

https://www.ema.europa.eu/en/medicines/human/referrals/quino...

I got 'floxed'. I was prescribed Ciproflaxin from a doctor for a fairly normal infection, who only said it was an antibiotic, with no mention of side effects, and said to take it daily for 30 days. I did look at the box when I picked up the prescription and thought it was really strange that it said "DO NOT EXERCISE WHILE TAKING THIS PRODUCT" and had a looooong list of side effects. I took a single pill and I was feeling neuropathy in my legs for the first time in my life. I kept taking it for eight more days, feeling more and more scared, as the neuropathy got more and more intense and widespread, and eventually called the doctor after I started feeling tingling all over my body and especially my face and felt there's no way that could be normal. They seemed very surprised but said to stop and gave me a different non-quinolone antibiotic instead.

I then found the stories, lots of them, online, about people who experienced horrible side effects. A lot of snapped tendons, neuropathy, etc that went on for years after they stopped taking the medicine. And I saw a lot of mentions of deaths from the drug as well, which didn't help matters at all.

And I got to join them in that also. I didn't exercise for at least a year afterwards out of paranoia that my achilles tendon would snap like the rest (it already felt sore all the time after that), and thankfully it hasn't so far.

But I felt neuropathy often. At first pretty much all the time, but eventually it would go away for a couple of weeks and then come back for a couple of weeks, off and on, off and on. Mostly in my legs and arms, but sometimes I'd feel it in my face again.

I went to urgent care to get it checked out a few times over the years and they would always have to rule out diabetes first because that's their assumption whenever they hear neuropathy apparently. I had several tests but they never pinned it down to anything they expected it to be, and didn't bother investigating my repeated mentioning that "Hey, I took Cipro, and this happened right afterwards. I read stories that it does this to people, maybe that could be checked somehow?"

I now just tell people I'm allergic to Cipro and I doctors look at me funny and ask how that could be sometimes, surprised that anyone would have bad side effects to it.

The neuropathy is mostly gone away now, but I had it off and on for at least 6 years. My right foot has always felt a little screwed up since as well, often sore, it's a lot harder to walk on it for long periods of time now (but I can do it).

Considering there were other antibiotics I could have been prescribed and no one seems to be aware that it could have serious side effects, I'm glad the FDA finally started mandating warnings on it, but I still don't think they've raised awareness enough, as no doctor I've talked to seems to be aware of the side effects.

Also I am now much, much more skeptical of anything a doctor tells me and make sure I read all side effects of drugs and I don't wait anywhere near as long when I have side effects anymore, even if they're somewhat mild.

After reading that article, I'm wondering if maybe I should try to find a doctor who has experience with this and verify that I don't have lingering damage from it that could possibly be addressed.

I feel like this is something that a good pharmacist could have helped call out. Still, they're kind of the last resort in these things, and you won't always hear the "real" side effects unless you ask them (and they may know better than the doctor. Glad to hear you're getting closer to okay.

Sounds like maybe Candidiasis.

> I had just come off some antibiotics

There's your answer. It was the depletion of your gut microbes that contributed to your fatigue.

Reply on news.ycombinator.com