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Comment by Zenst | Hacker News Reader

An experience I had relating to medications and the stomach: I had salmonella food poisoning, week later I'm better and then I get a call from doctor who had got tests back saying I had salmonella and was insistent I take this medication ciproxin. I questioned it as was feeling better. Anyhow took the medication that turned out to be broad-spectrum and it killed all the bacteria et all in my stomach. Week of shitting like a baby (green) and was worst that second week and had gone back to work, yet ended up off ill again. Since then had issues with stomach, mood, even tendons and few other aspects and went from sporty type to not being able to do any sports.

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Ciprofloxacin? It has a black box warning from the FDA. Specifically for tendon issues.

“ Fluoroquinolones, including CIPRO®, are associated with an increased risk of tendinitis and tendon rupture in all ages. This risk is further increased in older patients usually over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants (see WARNINGS). Fluoroquinolones, including CIPRO, may exacerbate muscle weakness in persons with myasthenia gravis. Avoid CIPRO in patients with known history of myasthenia gravis (see WARNINGS).”

https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/01...

All the quinolones also associated with lots of internet reports of ill health in a variety of respects, but tendinitis is the official warning.

Actually I see there is an updated warning about central nervous system damage now too. FDA recommends they only be used as a last resort.

Sorry you had that experience. I had Cipro about ten years ago, wasn’t really necessary. Can’t say for sure it did anything but my reaction was intense while on it, and I had much worsened general digestion and overall health after that point.

https://www.fda.gov/news-events/press-announcements/fda-upda...

I also had the pleasure of taking cipro about 10 years ago. Since, then I have met hundreds of people. Symptoms of adverse reaction include depression/anxiety, tendon/muscle pain, tendon ruptures, vision issues, such as visual snow and floaters. These issues are widely underreported as negative symptoms may show up even up to 12 months after medication was stopped.

I have seen 40+ physicians at Mayo, Rush and other popular hospital networks, only one doctor said it's a possibility. Others outright dismiss it and look for alternative diagnosis.

However, there are some recent discoveries and theories. There was a study which found DNA adducts from cipro, others are looking at mtDNA and collagen issues.

For anyone reading please research any flouroquinolone antibiotic before taking them. It is A SERIOUS medication and not like other antibiotics.

The worst part of FQAD (Flouroquinolone Associated Disability) as it is a thing now, there is ZERO tests to confirm it. If it happens to you, you will be dismissed and ignored by the medical community. I know doctors, pharmacists who had a negative reaction and were outright called crazy by their colleagues. An optometrist who was quite outspoken was dropped by some insurance companies as this view is "controversial". Many older flouroquinolone antibiotics have been taken off the market completely due to severe adverse reactions.

> However, there are some recent discoveries and theories. There was a study which found DNA adducts from cipro, others are looking at mtDNA and collagen issues.

Have any links? And find anything that helped?

I’m doing much better than I was before. But not knowing whether the issues are due to Cipro I also can’t be sure that anything I tried addressed it.

A decent place to get information is a subreddit r/floxies. There isn't any treatments yet, however, magnesium seems to be a supplement that helps a lot of people. Check out the subreddit.

I was prescribed Ciprofloxacin for traveler's diarrhea when I was traveling internationally for an extended period of time. I knew it was some hardcore stuff, so I didn't use it until it was a last resort. A single dose, and within 40 minutes I was experiencing neurological effects. I called a nurse-on-call and was told to discontinue. No permanent effects I know of, but it basically gave me temporary dementia. Definitely a medication that should come with stronger warnings. I know it's the only valid treatment for anthrax infections, but for general use it should not be prescribed.

I saw an emergency doctor for a bad upper-respiratory infection (coughing blood) and was prescribed Augmentin for 10 days. It abolished the lung issue but wiped out my gut bacteria and gave me severe IBS-D.

That was seven years ago. I was forced to quit my job. I couldn't travel at all, even across town. I became dreadfully sick with even light physical exertion. After five years of every test, diet, medication, and therapy available to me I was prescribed medication (eluxadoline) which is effective, but costs me $24,000/year and is not covered by insurance. I still have flare-ups once a month but at least I can ride my bicycle again.

I wish I could sue the doctor who stole my twenties from me. But I stand no chance in court.

I don't know why precisely this story but it left a bit of an impact. I'm sorry for your lost twenties. I hope you can make the best of it.

If your hunch that the antibiotics' effects on your gut bacteria was the cause is correct, have you considered a fecal microbiota transplant to restore a healthier mix?

https://en.wikipedia.org/wiki/Fecal_microbiota_transplant

Yes! In 2019, the experimental medicine department at my local university hospital started scheduling FMT procedures. They're suspended now because of COVID-19 restrictions (much like dentists and optometrists). But I'm in the queue. Somewhat awkwardly, I am responsible to nominate a suitable donor.

What about diy?

For what it's worth, I asked this question sincerely. There are people who do it themselves, and I was curious about the tradeoff he saw between risk / reward of doing it this when there was a long wait.

You should get a family member from what research I did into IBS and fecal transplants as a possible cure.

I don't know where you are, but with so many medical workers now vaxxed in US, my impression is hospitals/etc are mostly eager to catch up on delayed non-pandemic procedures.

If your own nearest option is still slow or requires a personally-nominated donor, other providers offering the freeze-dried pills, perhaps even via telemedicine, might be an option. Good luck!

I wonder whether its possible to transplant the bacteria out before such a treatment and introduce them again later..

> I wonder whether its possible to transplant the bacteria out before such a treatment and introduce them again later..

In theory yes, but there is the challenge of avoiding re-infection with the one species you're being treated to eliminate.

Is the gut usually the main target or just as byproduct getting wiped? If not then its not necessarily an issue.

The target species may not be thriving in your gut, if the location of the infection you're treating is elsewhere, but it is probably present.

Perhaps if a sample could be collected when healthy and frozen for long-term storage.

In my experience antibiotics were prescribed for acute symptoms that quickly worsened. I don't think they would have delayed my treatment for the hours or days needed to collect a pre-treatment sample.

Or find a way to trigger creating the positive bacteria.

Kevin rose did a podcast with https://pendulumlife.com/ that made that seem like a great path

So sad to hear this.

I took a lot of anti biotics as a kid. I'm pretty sure it killed off whatever gut microbiome I had multiple times over.

Never really had an issue except for becoming fat. Except for headaches. Which I never really thought about for many many years. You know, just take a pill. Probably took 20 years for me to figure it out somewhat.

This may or may not work at all for you and even for myself I can't really scientifically say anything about it. But what helped me was probiotics. I had to try a lot of them. And it got worse first before it got better while the bacteria were fighting with each other and I'm not sure what would happen if I stopped them.

However the best explanation I have found so far is that these probiotics that have Bacillus Subtilis in them made the difference. I don't want to advertise a specific product but since I've been asked before, what I take is Garden of Life Primal Defense Ultra. I tried others before and the one difference is Bacillus Subtilis. YMMV but worth a try if you ask me. I did combine it with a Keto diet too but I'm no longer on it and still fine.

Also in case you drink beer for example, I get worse when I have beer. Hard liquor? Absolutely fine now with the probiotics but beer still screws me up if I have it for a longer period of time.

This is really helpful info, thanks for writing the comment!

A coworker of mine had long term health issues from taking a powerful antibiotic. He changed his diet to only include "non gut fermenting food" (not sure what that includes) and his issues went away.

His issues were different than yours, but I think it was the same antibiotic. In any case, worth considering a dietary change.

Your coworker was probably referring to the low-FODMAP diet. People say it works and some doctors recommend it, but the data isn't quite there yet. Either way, yeah it's worth a try for people with GI issues. For anyone considering it, the highest quality information will come from your health provider.

IMO it's a workaround and doesn't address whatever core issue someone might have, but often with GI stuff we don't have a "cure" so workarounds are all people have.

>For anyone considering it, the highest quality information will come from your health provider.

That seems like a dubious assertion in a thread about peoples intestinal flora being destroyed by recommendations from their "health provider"s.

I personally got the low fodmap recommendation from my health provider.

What you're describing is called a low FODMAP diet. A family member has tried this diet for about a month to great success. They were fine for the last 1-2 years and then ate a coconut yogurt and the symptoms came back. They are back on the low FODMAP diet again and things have gotten better but they have like two to three more weeks before they are on their normal diet again.

You’re actually not supposed to do it permanently. The idea is eliminate, then work back in each of the six different sugars in small quantities to see what is tolerated.

If you’re zero fodmap for years you lose all the bacteria that digest them and are left even more susceptible.

This sounds like specific carbohydrate diet, IBD-AID diet, low-FODMAP, or similar. There are a bunch of options with different things prohibited - doing some sort of individual elimination and reintroduction seems like the only option to figure out one that works for you.

Have you researched fecal transplants? I've seen some evidence to suggest they can restore a microbiome after e.g. chemotherapy or broad-spec antibiotics.

I became aware of them watching a documentary upon Hitler many years ago - he was a fan of them apparently. Though wasn't aware at the time and quick dig shows it's not something the health service in the UK offer even today. Alas I can't afford private health care and not had great experiences with doctors, indeed any dealing been disaster on some level that I won't go thru them as it will just depress the hell out of me though the one when the a doctor said the stitches I'd had done was the worst job he'd seen in his entire life and he was a field medic during WW2, kinda gives an idea.

But certainly as a treatment - it has merit and wished was explored more. Just wished known about it at the time.

There were some studies going on in the US for various IBD issues but they ended them after several people got life-threatening infections.

1 point by zabzonk 1 minute ago | edit | delete [–]

You could probably sue him. Antibiotics should only be prescribed for salmonella food poisoning (and almost all similar gut problems) in severe cases - normally all you have to do is keep hydrated and you will get over it. Otherwise you run the risk of introducing antibiotic resistance, so such treatments may become ineffective in severe cases.

Not a medic. Used to be a microbiologist.

> keep hydrated

And I should have said, keep your electrolytes up.

I live in the tropics. I've had at least 30 courses of antibiotics over the course of my life.

Mostly for boils and related skin infections when I was a child growing up on a farm.

Have a family member who has had to take antibiotics in various occasions, including cipro. She takes probiotics (pills and probiotic yogurt) after each antibiotic. Don’t know if it works but seems to keep diarrhea at bay, and help with ‘brain fog’

Consider a raw milk diet for a while. Maybe probiotics and prebiotics. CRON-o-meter. There's such a thing as stool transplant.

Yeah cipro kills everything. I used to carry a script for it while traveling in case of emergencies.

>went from sporty type to not being able to do any sports

Can you elaborate on this? I'm curious as to the general details.

Sure, used to do kendo and professional swimming and was doing paint-ball tournament level. That all ended due to tendon issues, and also much lowered energy levels.

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