The functional medicine world carries ill feelings towards a class of medications called the fluoroquinolones. These antibiotics include ciprofloxacin and levofloxacin among several others. They are known for their mitochondrial harm and many people say that these medications “floxed” them or call themselves “floxies” after the damage is done. I have seen a number with whom I agree that a fluoroquinolone was the probable cause of their chronic illness.
In this study, researchers from the University of British Columbia worked with the provincial Health services Authority’s Therapeutic Evaluation Unit to find that current or recent use of these medications increased one’s risk of developing aortic and mitral regurgitation. These are conditions in which the aortic or mitral valves of the heart allow blood to flow backwards instead of preventing backflow. If severe enough, heart failure can result from these valve disorders.
While use in the present or past 60 days increased risk, use of these medicine more than 60 days prior was not associated with increase risk of these heart condition. They compared the rates to those taking amoxicillin or azithromycin, neither of which showed increased risk.
The authors are not advocating wholesale withdrawal of these medications, but judicious use of them only where necessary. While some of them have convenient once a day dosing and can be effective against some antibiotic resistant bacteria, we should only use them when other less risky options are not available. If someone has a life-threatening infection for which other antibiotics are not effective, then a fluoroquinolone may be a reasonable option. Otherwise, consider saying no.
My quick soapbox rant concerns the unwillingness of conventional medicine to admit that some therapies are hurting patients until a study “proves” it. While evidence-based medicine provides a decent foundation from which to start our “practice” of medicine, it does not mean we can shut our brains off. Good medicine requires good thinking and keeping one’s mind open to unexpected occurrences. In our contemporary world of medicine where genomics has uncovered why some small groups of patients respond very unusually to some therapies, we should not automatically doubt our patients who happen to be the “unusual” case in terms of medication side effects.
By combining the best of evidence with the best of clinical wisdom, a functional medicine doctor like myself can help patients find healthier more abundant lives.
Mahyar Etminan, Mohit Sodhi, Saeed Ganjizadeh-Zavareh, Bruce Carleton, Abbas Kezouh, James M. Brophy. Oral Fluoroquinolones and Risk of Mitral and Aortic Regurgitation. Journal of the American College of Cardiology, 2019; 74 (11): 1444 DOI: 10.1016/j.jacc.2019.07.035
Thanks to Science Daily:
University of British Columbia. “Commonly used antibiotics may lead to heart problems.” ScienceDaily. ScienceDaily, 10 September 2019. <www.sciencedaily.com/releases/2019/09/190910154710.htm>.