Athletes! Are You at Risk for Fluoroquinolone Toxicity?

If you look at the reports of those who have been damaged by Fluoroquinolone Toxicity, you’ll notice that a lot of reports of injury or damage are by athletes, despite common sense telling you that a high level athlete should be someone who is less likely to be injured by drug side effects. Unfortunately, this is not the case, and they may very well be MORE likely to be damaged by these drugs than the average person. In fact, I personally know both a former professional baseball and tennis player that were damaged by these drugs, despite remaining in a high level of athletic condition.

This is not just a ‘fluke’, there are good reasons why athletes might be at extra risk of being injured by the Fluoroquinolones. But first things first, if you are not familiar with the damage these drugs do, then please read our page on an Introduction to Fluoroquinolones to see the dangers these drugs pose and the injuries and disabilities that can occur from these drugs, even when only a few doses have been taken.

Even worse is that many are even injured completely unnecessarily since 50% of Antibiotic Prescriptions are Unnecessary! That’s a full ½ of all antibiotic prescriptions that should never have been written in the first place! When you realize that 10’s of million of antibiotic prescriptions are written every year, the sheer number of people wrongly treated quickly becomes staggering.

Why Athletes are at Risk of Fluoroquinolone Toxicity

The following 4 Problems are just a few reasons why athletes tend to be at extra risk when they take these antibiotics, and why being an athlete should be one of the official Risk Factors for Fluoroquinolone Toxicity.

  • Magnesium deficiency
  • Oxidative stress
  • Extra inflammation and tissue damage
  • Low iron levels

Magnesium Deficiency in Athletes

Few athletes take into consideration that they might be magnesium deficient, but magnesium deficiency is ‘epidemic’ in the western world due to various reasons, including the facts that you lose magnesium when you are stressed and when you sweat.  Since athletes tend to sweat more than others, they are going to be more at risk of magnesium deficiency 1.

Also, it is the nature of athletics that it produces stress on the body. So the higher cortisol levels increase the amount of magnesium used, leading to magnesium deficiency if those electrolytes are not replaced in adequate amounts. Since food today is much lower in nutrients than in generations past 2, 3,  and most municipal water has very little magnesium (magnesium is found naturally in many water sources), it’s extremely difficult to keep magnesium levels adequate without taking magnesium supplements.

“Similar biochemical changes in tendon samples from
dogs fed a magnesium-deficient diet for 6 weeks,
which strengthens the hypothesis that fluoroquinolone
toxicity could be related to chelation of magnesium.”
Musculoskeletal Complications of Fluoroquinolones:
A Guide for Athletes

Be aware that Blood Magnesium Levels are not reliable tests for magnesium deficiency since magnesium is predominantly in cells and not in blood. In other words, even if your magnesium blood test is normal, you can still be magnesium deficient.

What Kind of Stress?

You’ve obviously heard of stress, but most people have not heard of ‘oxidative stress’. Oxidative stress is the actual biochemical process that occurs in the body when stress occurs. Everyone, by now, has heard of ‘anti-oxidants’, and countering this oxidative stress is what ANTI-oxidants do!

All stress on the body creates actual damaging particles that lead to cellular and Mitochondrial Dysfunction, and even to DNA Damage. In low amounts, these particles cause us to produce mechanisms that ‘fight’ this oxidative stress, a process called hormesis that makes us stronger; that’s why exercise is good for us. It causes damage that we grow stronger by ‘learning’ to counter.

However, the Fluoroquinolone antibiotics ALSO produce oxidative stress, and when you add the oxidative stress of the Fluoroquinolones onto the oxidative stress of the athletic activity, for many it just proves to be too much and the free radical particles created by the two stressors cause too much cellular damage for the body to fight off, and the person becomes injured as a result.

Inflammation and Tissue Damage

It shouldn’t be surprising to find that exercise, particularly weight-bearing exercise, but also repetitive motion exercises such as tennis and rowing, induce both tissue damage and the subsequent inflammatory response. 4.

Normally, this is not necessarily a ‘bad’ thing. In fact, this breaking down of tissue causes the tissues, as well as the whole body, to become stronger when it has to rebuild these damaged areas. That’s why they tell women who want to prevent osteoporosis to do weight-bearing exercises; it makes the bones stronger by putting stress and tension on them. However, in the case of the Fluoroquinolone drugs, adding the serious insult of cellular damaging drugs on top of the low-level injury and damage that has not yet healed can cause serious damage.

outsmart the Fluoroquinolones with the Fluoroquinolone Toxicity Solution

It’s no secret that one of the most notorious damaging actions of these drugs are Tendonitis, Tendon Damage, and Even Tendon Rupture. Athletes should consider themselves particularly susceptible to tendon injuring effects since most athletes will already have some level of tendon or connective tissue damage existing before they take these drugs. Athletes who have had any connective tissue injury or damage in the past, and athletes such as gymnasts or dancers who are ‘hypermobile’ may have a genetic predisposition for a connective tissue disorder, and thus be at exceptionally high risk for injury.

“On histologic examination, findings in fluoroquinolone-
associated tendon disorders are similar to those
seen in overuse injuries in athletes…”
Musculoskeletal Complications of Fluoroquinolones: Guidelines for Athletes

Not only does engaging in athletic endeavors cause an increase in inflammation and tissue damage from the repetitive motion and pounding of the tissues involved, but the decrease in magnesium, by itself, also causes inflammation 5, leading to a double whammy of risk factors when athletes take the Fluoroquinolone drugs.

Low Iron Levels

The Fluoroquinolone drugs are well-known to remove iron from the body, in a chemical process called ‘chelation’ where the drugs attach to the iron molecules and eliminate the iron from the body. In fact, they are so good at removing iron from the body that they are equivalent in effect to drugs that are used to remove iron from the body in people who absorb too much 6!

Now, in the vast majority of people, this is not going to be an issue, and considering that many people actually have too much iron, particularly most men, this might even be BENEFICIAL in certain cases. In those who already have low iron levels, however, this could ‘push them over the cliff’ and reduce low iron levels even lower, leading to serious symptoms, even when there were none before the antibiotics.

Unfortunately, athletes tend to be one of the groups that are at risk since they tend to have lower iron levels than average people 7, at least during the training season 8.

“Both male and female Canadian Olympic athletes
had significantly lower (P < 0.01) values than the
other three groups. The suboptimal hemoglobin
concentrations may be related to inadequate
dietary intake of protein and iron.”
Hemoglobin values in olympic athletes: a comparative survey

In one study, elite athletes were in the LOWEST 25% of the population for hemoglobin levels 9. Since women tend to have lower iron levels anyway, women athletes are at particular risk of excess iron chelation from these drugs. But why is this a problem?

Well, iron performs a huge number of tasks in the body, the most well-known is its role as an integral part of hemoglobin, the oxygen carrying portion of the blood. If that were not important enough, iron is integral to mitochondrial function, and the mitochondria are the ‘energy centers’ or ‘power plants’ of cells. Disrupting iron metabolism is a big deal, diminishing both energy production and oxygen carrying capacity.

These are just a few of the more obvious reasons why seemingly ‘healthy’ athletes tend to be inordinately at risk for damage by the fluoroquinolone antibiotics leading researchers in one study to declare, “Athletes should avoid all use of fluoroquinolone antibiotics unless no alternative is available.” 10. While doctors should know this information and be the advocate for ‘best practices’ for patients at risk, unfortunately they are not. The vast majority of doctors are unaware of the incredibly damaging actions of the Fluoroquinolone drugs; many do not even BELIEVE that these drugs could damage those who are susceptible, particularly young and healthy athletes!

As a result, people have to be their own best advocates and weigh the pros and cons of any drug they receive before taking it. We cannot blindly trust that doctors have researched the best course of action and have chosen drugs with the best risk/benefit profile for us. So, please share this page with all of the athletes in your life and save them from a future of disability by getting them this knowledge BEFORE they walk into a doctor’s office to get an antibiotic prescription.

 

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