Iatrogenic tendonitis and peripheral neuropathy: Beware of Cipro, Levaquin, and other Fluoroquinolones

I mentioned in an earlier post that my diabetic blood sugars caused my peripheral neuropathy and tendonitis.  Now I have learned that Cipro may be a contributor.  My travel clinic prescribed Cipro as a remedy for travelers diarrhea, and from about the year 2000 or so I started taking at the end of my trips to Africa.  The antibiotics in the Fluoroquinolone category, including Cipro and Levaquin, by depleting the body of magnesium and destroying cellular mitochondria, have been implicated in tendonitis and peripheral neuropathy.  The “Tendonitis Expert” calls  it “Levaquin Tendonitis”, when Fluoroquinolones have contributed to the the problem, and urges dietary supplements (especially CoQ10) to heal persistent cases.  I am working on this, by increasing the consumption of the magnesium and dietary sources of CoQ10 and by implementing a program of intermittent fasting (to reduce inflammation and to promote the production of human growth hormone).

Global News also did a scathing report on the dangers of Fluoroquinolones:

As mentioned in this report, my physician provided no warning whatsoever about the dangers of Cipro and casually said that he takes it every time he suffers from traveler’s diarrhea (he is himself a frequent traveler to developing countries).  It is so good at killing bacterial flora in the gut, the good with the bad, that some websites recommend reconstituting one’s probiotics after a Cipro treatment (I didn’t know this either).

Recently, since late August, I’ve had recurring quadriceps tendonitis in my left knee, caused in the first instance by merely rising up from a supine position.  This has aggravated my Achilles tendonitis in my left foot.  Also, I seem not to be able to shake the rotator cuff tendonitis, which continues to trouble me somewhat.  My first problems with tendonitis coincide with when I started taking Cipro.  It may have weakened my tendons and made me susceptible to injury.  Uncontrolled blood sugars and improper diet would also have been a factor but I now realize that they are not solely to blame for this debilitating and recurring condition.

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Exercise to lose weight to avoid or treat diabetes? Give me a break

A few years ago, a missionary friend of mine visited us here in Ontario.  He was keen to go fishing, and so one early afternoon, we rented a canoe at Lake Opeongo and headed towards North Opeongo beyond which was located our campsite.  But the winds were against us and soon they had driven us to the far shore of East Opeongo; and so we had no choice but to make camp there despite not having a permit for that area.  My friend was in pain, especially in his shoulders and he slept badly.  I thought it odd that a few hours of paddling had put him in such agony.  The next day, he called canoeing an “extreme sport”.  A few years later, this same friend had to leave the mission field for a medical furlough.  His vision had clouded over and the diagnosis was Type II Diabetes; his hbA1C was 14%. He had undoubtedly been suffering from hyperglycemia and experienced a bout of severe tendonitis from our little excursion.

I remembered this story recently, as I was thinking back about the many sports injuries I myself had suffered trying to stay active to lose weight.  Peripheral neuropathy destroyed my ability to canoe–the tingling in my hands was too severe; it also hindered weight training.  Later, weight training became impossible when I experienced debilitating rotatory cuff tendonitis.  Often, after playing basketball, I couldn’t even walk for three to four days, and I frequently suffered from Achilles tendonitis, a couple times so bad that I needed crutches.  I had lost most of my flexibility, but if I stretched, I could cause severe injury to my tendons.

It is commonly thought that an effective treatment for diabetes is exercise.  That’s fine and may help, but if the patient has tendonitis, peripheral neuropathy, or loss of proprioception (loss of coordination–I often fell inexplicably when working around the house, walking up steps or when doing sports), then the devastating effects of high blood sugars would make exercise at best difficult at worst impossible.  Diabetics and prediabetics who like me suffer from tendonitis must first control their blood sugars before they can expect to exercise.  In his book, Why we get fat and what to do about it, Gary Taubes makes an important point:  We don’t get fat because we don’t exercise.  We don’t exercise because we are getting fat.  In other words, therapists (e.g., physicians and nutritionsts) who recommend losing weight and exercise to treat obesity and diabetes–i.e., the vast majority of the imbeciles who practice medicine and nutrition–have a buggy-driven horse.

As soon as I gained control of my blood sugars I began to notice major improvements.  After a couple weeks, though I had the energy to walk, I still suffered injury to my knees and Achilles tendons, but now these problems are much less severe after exercise.  Before I started to low-carb, I tried to do my rotator cuff exercises after a hiatus of many moons; I suffered an immediate relapse of the tendonitis which took a couple weeks to lessen.  It is clear to me that I couldn’t exercise to lose weight that way.  But now that my blood sugars have normalized after four months of low carbs, I can pretty much exercise every day as necessary.

I am exercising in the evening to achieve perfectly normal over-night blood sugars and I am having considerable success with it.   This is about fine tuning the blood sugars. That is impossible on a high carbohydrate diet, and it is often cruel to recommend to diabetics that they must exercise to control blood sugars.

I become angry when I read that diabetics and prediabetics must exercise and lose weight to control their diabetes.  Rather, those of us who suffer from hyperglycemia must first achieve normal blood sugars via low carbohydrate diet, and then the weight loss will take place naturally and exercise will become possible.  I look forward to going canoeing again now that my peripheral neuropathy is gone.

Carbs are poison: carpal tunnel or peripheral neuropathy?

Carbs are poison (for those with elevated glucose levels)

I’m going to start a new tag/category called “Carbs are Poison”. This is my new motivational motto as I have entered a major lifestyle change that took place two months ago.

About sixty days ago, I learned that the tingling I feel in my hands was related to elevated glucose levels in my blood stream. I’ve had this tingling in my hands for about ten years now, and it affects my comfort when driving, playing a guitar or ukelele, typing on a keyboard, and even holding a cell phone to my ear. I would have to lower my hands below my waist and shake them out to get rid of the tingling.

For years I thought that it was carpal tunnel, and generally speaking, my investigations into the question showed that carpal tunnel was work related, i.e., caused by repetitive use of, e.g., a keyboard or a jack hammer. But the more accurate term for my condition is peripheral neuropathy, a condition whose most common cause is diabetes. Once I learned this about two months ago, I was certain that I was diabetic.

Well, I also have four risk factors: I am (1) Asian, (2) obese, (3) over 40, and (4) I have a family history in that my brother, my mother, my grandmother and my grandfather all have/had type II diabetes. So I immediately went into get tested for diabetes and the hbA1c test came back 6.0, which means that I am prediabetic (between 5.6-6.9; 7.0 is considered diabetic).

But later, through reading Nikolaos Papanas, Aaron I. Vinik, and Dan Ziegler, “Neuropathy in prediabetes: does the clock start ticking early?” (Nat. Rev. Endocrinol. 7 [2011] 682-690), I confirmed that my symptoms were related to prediabetes–this is one that my physician couldn’t answer, “If I’m not diabetic, then why do my hands tingle?” The article shows that prediabetics with impaired glucose tolerance are more likely to have peripheral neuropathy and non-diabetics with peripheral neuropathy are likely to be prediabetic. The elevated glucose levels in the those with impaired glucose tolerance, i.e., those whose glucose levels don’t immediately come down from a high carb meal, can have the nerve damage that is related to peripheral neuropathy. The damage was so severe that I had for about one year started to experience severe arthritis in my finger joints.

It stands to reason that a low carb diet would have the benefit of helping me to control my glucose levels. I was especially informed by Dr. Richard Bernstein, who has made numerous appearances on Youtube. But I’ve also had some experience with low carb dieting in the past. So on November 28, 2012, I used the occasion of the twelve hour fast for my blood test, to begin a new low carb regimen. This is day 60, and here are the results so far:

  1. My blood glucose levels went down immediately from HbA1C 6.0% (=3 month average of about 7.7) in my blood test to about 5.4 (when testing with personal glucose tester).
  2. Within two weeks my blood pressure has come down from high (140/90) to normal levels (127/82).
  3. The tingling in my hands largely subsided immediately after beginning the low carb diet. At day 60, I’ve been typing at this keyboard for several minutes now, without any tingling.
  4. My arthritis is almost completely gone with some mild problems in only a few of the joints, particularly my right middle finger. Nevertheless, I can snap my fingers in both hands with no severe pain as before.
  5. I’ve lost about twenty-five pounds.
  6. I’ve come down two pants sizes, as my waist has shrunk from 43 to 39 inches.
  7. I feel less sleepy after eating.
  8. I have greater energy levels and enjoy exercising and long walks (except when my knees give me problems).

My low carb diet does require fat: it is not a low fat diet! However, I am consciously trying to eat only to satiety. I snack on low carb foods when I feel cravings or hunger between meals, but after the first few days, the intrusive thoughts of food and the cravings subsided. I now avoid all sugars and starches to the degree practical. Here are the main foods I avoid:

  • any thing with flour
  • bread
  • desserts with flour and sugar
  • potatos
  • carrots
  • lentils, beans, peas
  • sweet potatoes
  • milk
  • rice
  • candy
  • fruit

Here are some typical foods that I eat:

  • meat, fish, poultry (including the skin and organs)
  • spam, corned beef, sausages (kosher salami, summer sausage. pepperoni)
  • eggs
  • hard cheese (brie, gorganzola, blue, cheddar, gruyere, etc.), low carb/high fat yogurt
  • 18% table cream; whip cream (in home-made non-sugar, low-carb ice cream)
  • coconut milk or cream
  • tofu
  • pumpkin
  • onions and garlic
  • avocados (ca. 1 per day)
  • tomatoes
  • green vegetables: cabbage, lettuce, cauliflower, broccoli, eggplant, zucchini
  • olives
  • non-sweet pickled cucumbers and asparagus
  • mushrooms
  • turnips (small amounts in soup)

I am drinking no sweetened beverages. I have lowered my caffeine intake because I find that it stimulates the cravings for carbs. I drink a lot of water flavored with lemon or lime juice (e.g., Real Lemon), and now copious amounts of cold, weak green tea (1 tsp loose tea or 1 tea bag makes three litres). Since one is in a state of ketosis (using one’s own fat for energy), the low carb diet requires drinking a lot.

Finally, I am abstaining from alcoholic beverages for until I’ve reached my weight loss goal (at least 65 lbs–or down to about 180 lbs).