Levaquin for throat infection now pain in ankles and wrist

by Wendy
(Los Angeles)

Hi Joshua,

I am so glad to have found your website and hope that you can help me!

I had a really bad throat infection for almost a month. My ENT prescribed Clindomycin for 10 days which did not help so he said that I needed a stronger antibiotic b/c I now had an ulcer on my tonsil.

He prescribed Levaquin 500 mg for 7 days. I'd taken Levaquin two years ago (prior to the black box warning) and had no side effects so I thought it would be okay this time, too.

My ENT told me about the Black Box warning and not to do any exercise during the 7 days that I'd be on Levaquin. I had been working out w/a personal trainer 2x/wk for six mos and had lost 15 lbs. I put the trainer on hold while on Levaquin and did no exercise of any kind (and even took the elevator instead of the stairs.)

For the first six days I had no side effects except nausea but I knew that was temporary.

BUT, on the 7th and final day of Levaquin, my ankles started to hurt and it felt like I had shin splints.

It seemed strange b/c everything I'd read re: achilles tendon problems described having pain in the calf and thigh (not the ankle and shin) so I did not know what to make of it.

The day after I stopped Levaquin, my ankle pain continued and I started to have pain in my right wrist. The wrist pain was mild, but what was worse is that my wrist felt weak and it was hard to hold up a coffee cup or grasp anything w/a firm grip and I have NEVER had this problem in my life (and if anything, I have gained strength from working w/a personal trainer all these months.)

It is now three days after stopping Levaquin and I have been taking Advil and doing your "ice massage" several times per day. My ankles feel a little better today but my wrist is the same. I know my case is mild compared to what I have read on your site.

I would love to hear your expert opinion re: how you think I should proceed to avoid any further injury.

I will never take Levaquin (or any drug in it's class) ever again. I will be putting my trainer & gym on hold until my ankles and wrist are back to normal. Do you think I should take Magnesium or CoQ10? Will that speed up the healing process? From your experience, does my case sound reversible?

What really upsets me is that my ENT (and the makers of Levaquin) made it sound like tendon damage is a rare side effect that can occur only while taking the med.

No one told me that it can occur long after you stop taking the med or that your tendon structure/DNA
can change.

Thank you, Joshua, for sharing this information.

I now think Levaquin should be taken off the market and I suspect that some day it will.


Joshua Answers:

Hi Wendy.

Sorry you're having pain and problem. That's never fun.

1. Yes, I think you should take CoQ10 and Magnesium. Those two nutrients are the only thing I've seen a small minority of doctors (that are committed to trying to treat Levaquin Tendonitis) using that can(has a chance of)help.

2. I want to fine tune your thinking on this a little bit.

Tendonitis is one thing. In a simple case, damage happens, then you heal the damage.

But with Levaquin and Cipro (and all the other fluoroquinolones on and off the market) the cytotoxic damage happens when you are intaking Levaquin, and possibly for weeks afterward. This doesn't necessarily mean you feel any pain/problem at the time.

A lot of people affected by Levaquin feel it immediately. The rest feel it some time later.

But the damage has already been done. Tissue, and DNA, are degraded. So when new tissue is made to heal the problem, it too is degraded.

That's why Levaquin tendon damage has such a tough time healing. It's not like stepping on a nail. That heals. But degraded tendon, whether Achilles or wrist or shoulder, heals 'bad'. The bad tissue is not replaced with good tissue.

That's the thing about 'healing' fluoroquinolone induced Tendonitis: There's a problem with the healing process.

CoQ10 and Magnesium, among a host of other things one would be wise to do to give your body an optimal chance to overcome the damage, help.

CoQ10 by getting cell energy production back on track, and Magnesium does a whole host of things, including being a critical compononent of tendon tissue, being a detoxifier, and decreases oxidative stress.

And, the actual percentage of Levaquin users that get obvious damage is pretty low. The actual number is debated. And for instance, my Kerri in a decade of ER work never saw a (recognized) case of Levaquin or Cipro poisoning. And those two antibiotics are given out a lot.

So in doctor's defense, the numbers are statistically low. Again, there's debate about the extent of damage: it's obvious like in your case, and it can be subtle and the cause of a lot of 'disease' out there.

Still, even if actual percentage is low, A. there are A LOT of prescriptions given out and B. The game changes instantly if you're one of 'the few'.

There are a number of doctors with Levaquin damage, which, surprisingly enough, has changed their viewpoint on it.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.
And, comments have a 3,000 character limit so you may have to comment twice.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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Apr 10, 2010
PART 2 - More questions! - Levaquin for throat infection now pain in ankles and wrist
by: Wendy

Hi Joshua,

Thank you for posting my story. I have a few more questions and want to update you. My ankles have significantly improved but the rest of my problems have gotten worse. It is no longer just my right wrist, it is now both wrists and both arms. Both my triceps are very painful and I can no longer grasp a pen to write (and it's hard to even type.)

I have no strength in my arms and am fearful it will stay this way or get worse. I don't think I will ever be able to exercise again.

I saw an orthopedist who agreed that Levaquin caused the problem. He said it should be reversible in two weeks and I am praying that he is right. He prescribed an anti-inflammatory called Relafen. Are you familiar w/this? I'm scared that it will upset my stomach.

I've been doing the ice massage and rolling my triceps on the frozen water bottle like your site suggests and it is the only thing that brings any relief. The orthopedist said not to try physical therapy and that it could make it worse.

Can you recommend how much Magnesium or CoQ10 to take and what brand? I would love to hear any other suggestions that you have for me?

Apr 10, 2010
PART 3 - Levaquin for throat infection now pain in ankles and wrist
by: The Tendonitis Expert

Joshua Comments:

Hi Wendy.

1. It's likely that whole muscle weakness thing is due to the disruption of mitochondria/energy production cycle. Thus CoQ10, and magnesium.

2. What clinical evidence is your doctor working off of to prescribe Relafin? I can't find a research/study on it, and it's a non-FDA approved, off-label prescribing. Meaning, as far as I can tell, your doctor can legally prescribe it despite a lack of 'weight of evidence' for that particular use.

Most researchers believe that Levaquin Tendonitis issues aren't primarily inflammatory based.

So, you can certainly experiment with the Relafin. But be clear that it's an experiment. Who knows if it will help or not.

3. Your doctor said it should heal in two weeks. Let's hope so. Many people have symptoms temporarily, that go away sooner or later. The rest....seemingly permanent.

4. I agree, no physical therapy right now. Gentle, easy movement is good. Do keep things moving, as that's good for the body and circulation and such.

5. The icing helps because it is creating circulation...old stuff out, new stuff in. Plus a certain amount of countering whatever inflammation process is in place.

6. Check out my Kerri's Magnesium Dosage page. You want to find and take your tolerance level, and I would get some Transdermal Magnesium Gel and slather it on liberally and often.

re: CoQ10. Research recommends 100-600mg/day, depending on how bad you have it. (Up to 1200mg/day is used in some Alzheimers research, and it's safe/harmless at that level. It's expensive, but the more the merrier.

Vitamin E. I don't know amounts, so do your own research here. But Vit E "may reduce joint cartilage lesions".

Vitamin E is an anti-oxidant, and Levaquin causes huge oxidative stress (BAD).

Kerri right now is working on a Levaquin Tendonitis protocol ebook right now, check back in later and see if it's out.

Apr 14, 2010
by: Wendy

Joshua, thank you for the new answers and I have started taking magnesium and CoQ10. My arms continue to get worse and it is almost impossible for me to write with a pen or type. I have no muscle strength to grip anything with my right hand. It's been two weeks since I've stopped taking Levaquin but the symptoms are not resolving.

I never took the Relafen and was too afraid it would make me nauseous.

I am going to make an appt with a rheumatologist and am trying to pursue all options.

Thanks again for all your help.


Joshua Comments:

Great. Good Luck!

And keep us updated on what happens, good/bad.

(and definitely get as much magnesium in you as possible. For many reasons, but specifically I say it here because -IF- the active agents are still active in you [theoretically shouldn't be], magnesium counters it).

Dec 28, 2010
Similar Symptoms
by: Anonymous

Hi Wendi,
My symptoms resemble yours. Ho are you doing now? I hope your problems resolved?

Dec 31, 2010
Response for George -- Levaquin for throat infection now pain in ankles and wrist
by: Wendy

Hi George,

Thanks for your comment and sorry that you are in the same situation w/Levaquin. It's now almost 10 mos since I took Levaquin and unfortunately I am not that much better.

I wish I could re-title my original post b/c my ankles & wrists improved rather quickly. What ended up happening is that my right arm (tendon & muscles in the upper arm- mostly triceps area) had a neurotoxic reaction to Levaquin and became very heavy, weak & painful.

If I tried to grip anything (even the most basic task like brushing my teeth or writing) my arm became incredibly fatigued and the upper muscles (shoulder, neck, jaw) overcompensated so I had pain & fatigue in my entire upper right side of my body.

I have seen about 10 different doctors and tried chiropractor, physical therapy, acupuncture, massage, etc, besides having every test under the sun to rule out other causes (MRI's, x-rays, blood tests, etc) and no other cause was found. I did a consult w/an expert on adverse drug reactions to fluoroquinolone antibiotics and he was 100% certain that my reaction was due to Levaquin.

I tried to pursue legal action but do not qualify for the class action suit b/c I did not have an actual tendon rupture.

I was on medical leave from work for 10 wks earlier this year b/c I could not write or type and have lost & spent a lot of money trying to get answers.

The answer is that Levaquin is a neurotoxic poison and should be taken off the market.

Please watch the documentary "Certain Adverse Events" if you have not already done so. You can find it on YouTube in six parts or purchase from the website.

Best of luck to you and I wish I had something more positive to report!

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