How These Five Strategies Help Your Tendons and Joints to Heal from Ciprofloxacin Damage

For people with Lyme disease who have sore, swollen tendons and joints after taking cipro
by Greg Lee

wooden table

Have you ever regretted leaving something outside in the rain? I took a wooden table outside to hold some snacks for guests. Towards evening, we took everything back inside except the table. That night, a passing shower soaked the table. Unfortunately, the table top was made out of pressed wood and warped into a roller coaster shape from the rain.

How is a warped table top similar to joint inflammation after taking ciprofloxacin?

Similar to rain that has warped a table, ciprofloxacin can warp joints out of shape
Ciprofloxacin, also known as cipro, is an antibiotic used to treat many infections including Lyme disease and co-infections. This drug has been effective against a broad range of pathogens including many gram negative bacteria. It belongs to a class of antibiotics called fluoroquinolones. Cipro has been used especially to treat infections in the respiratory, urinary, and digestion tracts. Unfortunately, cipro can produce painful conditions especially in joints, including tendon rupture[1]. The high risk of tendon damage has also been acknowledged by the US Food and Drug Administration placing a “Black Box” warning on the drug. Patients at greater risk are over 60 years old, corticosteroid users, nursing infants, and kidney, lung, and heart transplant recipients[2]. There are clears signs and symptoms associated with ciprofloxacin tendon damage.

Ciprofloxacin can produce redness and swelling around affected tendons and joints
After taking ciproflaxin for three days, Anton experienced redness, swelling, and severe pain in his left wrist. The redness and pain migrated to his left hip and left ankle. He was unable to use these joints due to severe pain. Other patients have reported similar symptoms that lasted for weeks after taking cipro. Cipro has been found to degrade type-I collagen found in tendons, joints, and skin by upregulating Matrix metallopeptidase 2 (MMP-2)[3]. This antibiotic has been cited repeatedly as the cause of Achilles tendon ruptures. If a tendon has been ruptured, then a joint will become immovable.

Cipro has also been associated with gastrointestinal upset, neurological symptoms, headache, dizziness, insomnia, skin eruptions, vision damage, gait problems[4], Clostridium dificile diarrhea[5], and irreversible peripheral neuropathy, weakness, burning pain, tingling, or numbness[6]. This antibiotic can deplete important compounds like magnesium[7] and glutathione[8] out of collagen. Higher doses have been found to lead to a greater severity of symptoms. Symptoms can occur hours to several months after taking the medication. Once tendon or joint symptoms occur, patients are recommended to discontinue taking the medication. What are the recommendations for reducing tendon inflammation and damage after taking cipro?

Rest and physical therapy are recommended for treating cipro pain and inflammation
Rest and physical therapy are the main recommendations for reducing cipro damage in symptomatic tendons and joints. Unfortunately, this approach relies solely upon the body’s ability to detoxify the cipro and repair the damage.

If tendon pain or rupture can occur months after taking cipro, what else can help patients to reduce pain and inflammation and protect against tendon rupture?

Here are five strategies for reducing pain, inflammation and repairing collagen damage in people who have taken cipro
There are five strategies that can help to reduce the symptoms of pain and inflammation in patients that have been taking ciprofloxacin. These strategies focus on reducing inflammation through treatment and natural remedies. Some of these strategies are also for promoting the repair of damaged collagen.

Strategy #1: Cupping and bloodletting to reduce inflammation in affected joints
Anton discontinued use of cipro when his first symptoms appeared. Despite stopping quickly, his symptoms continued to migrate along his left side. Fortunately, he received a treatment called wet cupping which applied suction cups to the symptomatic joints. During this procedure, the cups were removed and needles were used to make small holes where the cup had been. Next, the needles were removed and the cups were re-applied to pull out inflammation[9]. Within a few minutes, the redness and swelling disappeared. At the end of the treatment, Anton reported a 90% reduction in pain and discomfort, and a much greater flexibility in his joint mobility. A treatment called Frequency Specific Microcurrent was also used to reduce inflammation and promote healing.

Strategy #2: Frequency Specific Microcurrent for reducing inflammation, inorganic chemicals, and promoting healing
Frequency Specific Microcurrent uses very low electrical signals of a millionth of an amp to reduce inflammation, detoxify inorganic chemicals, and promote healing in ligament, tendons, and joints[10]. These frequencies can be directed into specific joints all over the body. Anton received multiple sessions of Frequency Specific Microcurrent aimed at clearing inflammation and repairing his damaged joints. Supplements can also help with reducing symptoms and promoting collagen healing.

Strategy #3: Supplements for reducing collagen damage
Anton added magnesium and vitamin E to his daily supplements. In one rat study, rats fed a diet supplemented with magnesium and vitamin E for ten days had a decreased amount of ciprofloxacin induced joint cartilage lesions[11]. He also received customized liposomal remedies to protect against cipro damage.

Strategy #4: Liposomal nutrients for reducing inflammation
Anton was given a liposomal remedy of glutathione and ascorbic acid (vitamin C), which provided substantial protection against ciprofloxacin in one lab study[12]. Glutathione is a compound produced in the body, that helps to reduce inflammation and toxicity[13]. In addition to supplements, herbs can also help to reduce inflammation in patients damaged by cipro.

Strategy #5: Liposomal herbs for reducing serum levels of cipro, lowering inflammation, and restoring collagen
Anton was also given a liposomal herbal combination to stop the spreading of his symptoms, reducing inflammation, and to promote healing of damaged collagen. His herbs included Chinese dandelion, sanguisorbia, red root, sophora root, scutellaria, angelica root, astragalus root, and rehmannia root.

In one rat study, Chinese dandelion, Chinese name: Pu Gong Ying lowered the maximum plasma concentration of cipro by 73%[14], and sanguisorbia, Chinese name: Di Yu lowered the maximum plasma concentration by 94%[15]. In a rat study, a compound called Tanshinone IIA found in red root, Salvia miltiorrhiza, Chinese name: Dan Shen reduced MMP-2 levels[16]. Matrine which is a compound found in sophora root, Chinese name: Ku Shen also reduced MMP-2 in another rat study[17]. Wogonin is found in scutellaria baicalensis, Chinese name: Huang Qin and was found in a lab study to reduce MMP-2[18]. A compound called SBD.4 found in angelica root increased Type-I collagen in a human dermal fibroblast study[19]. In another lab study, astragalus root, Chinese name: Huang Qi combined with rehmannia root, Chinese name: Sheng Di Huang upregulated the expression of Type I and Type III collagen[20]. A combination of treatment and remedies can be effective at overcoming the damage caused by ciprofloxacin.

Using a combination of remedies and treatments can help you to reduce inflammation and promote healing in cipro damaged joints
Just like sanding and refinishing a warped table top, the proper combination of treatments, anti-inflammatory, and collagen healing remedies can help to counteract the damage caused by cipro. Cupping and bloodletting, Frequency Specific Microcurrent, supplements, and liposomal remedies helped Anton to clear inflammation, reduce stiffness and pain, and rapidly promote healing of damaged collagen in his tendons and joints. In a few treatments, the redness, swelling, and pain was gone from his joints. Since some of these remedies and treatments require specialized training, work with a Lyme literate Chinese medicine practitioner to develop a proper, safe, and effective strategy for your condition.

– Greg

P.S. Do you have experiences where treatments or remedies helped to relieve damage from cipro treatment? Tell us about it.

[1] Menon A, Pettinari L, Martinelli C, Colombo G, Portinaro N, Dalle-Donne I, d’Agostino MC, Gagliano N. New insights in extracellular matrix remodeling and collagen turnover related pathways in cultured human tenocytes after ciprofloxacin administration. Muscles Ligaments Tendons J. 2013 Aug 11;3(3):122-31. eCollection 2013. http://www.ncbi.nlm.nih.gov/pubmed/24367771

[2] Kawtharani F, Masrouha KZ, Afeiche N. Bilateral Achilles Tendon Ruptures Associated with Ciprofloxacin Use in the Setting of Minimal Change Disease: Case Report and Review of the Literature. J Foot Ankle Surg. 2014 Sep 1. pii: S1067-2516(14)00323-8. doi: 10.1053/j.jfas.2014.07.005. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/25189336

[3] Tsai WC, Hsu CC, Chen CP, Chang HN, Wong AM, Lin MS, Pang JH. Ciprofloxacin up-regulates tendon cells to express matrix metalloproteinase-2 with degradation of type I collagen. J Orthop Res. 2011 Jan;29(1):67-73. doi: 10.1002/jor.21196. http://www.ncbi.nlm.nih.gov/pubmed/20602464

[4] G. K. Kim, The Risk of Fluoroquinolone-induced Tendinopathy and Tendon Rupture: What Does The Clinician Need To Know? J Clin Aesthet Dermatol. Apr 2010; 3(4): 49–54. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921747/

[5] Owens RC Jr, Donskey CJ, Gaynes RP, Loo VG, Muto CA. Antimicrobial-associated risk factors for Clostridium difficile infection. Clin Infect Dis. 2008 Jan 15;46 Suppl 1:S19-31. doi: 10.1086/521859. http://cid.oxfordjournals.org/content/46/Supplement_1/S19.full

[6] FDA Drug Safety Communication: FDA requires label changes to warn of risk for possibly permanent nerve damage from antibacterial fluoroquinolone drugs taken by mouth or by injection. http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/019537s082,020780s040lbl.pdf

[7] K. Pfister, D. Mazur, J. Vormann, and R. Stahlmann, Diminished Ciprofloxacin-Induced Chondrotoxicity by Supplementation with Magnesium and Vitamin E in Immature Rats. Antimicrob Agents Chemother. Mar 2007; 51(3): 1022–1027. Published online Jan 8, 2007. doi: 10.1128/AAC.01175-06. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1803142/

[8] V. Talla and P.R. Veerareddy. Oxidative Stress Induced by Fluoroquinolones on Treatment for Complicated Urinary Tract Infections in Indian Patients. J Young Pharm. 2011 Oct-Dec; 3(4): 304–309. doi: 10.4103/0975-1483.90242 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249743/

[9] Zhang CQ, Liang TJ, Zhang W. Effects of drug cupping therapy on immune function in chronic asthmatic bronchitis patients during protracted period. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006 Nov; 26(11) pp. 984-7. http://www.ncbi.nlm.nih.gov/pubmed/17186726

[10] Dong P, Zhang Y, Gu J, Wu W, Li M, Yang J, Zhang L, Lu J, Mu J, Chen L, Li S, Wang J, Liu Y.. Wogonin, an active ingredient of Chinese herb medicine Scutellaria baicalensis, inhibits the mobility and invasion of human gallbladder carcinoma GBC-SD cells by inducing the expression of maspin. J Ethnopharmacol. 2011 Oct 11;137(3):1373-80. doi: 10.1016/j.jep.2011.08.005. Epub 2011 Aug 6. http://www.ncbi.nlm.nih.gov/pubmed/21855619

[11] K. Pfister, D. Mazur, J. Vormann, and R. Stahlmann, Diminished Ciprofloxacin-Induced Chondrotoxicity by Supplementation with Magnesium and Vitamin E in Immature Rats. Antimicrob Agents Chemother. Mar 2007; 51(3): 1022–1027. Published online Jan 8, 2007. doi: 10.1128/AAC.01175-06. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1803142/

[12] M. Goswami, S. H. Mangoli, and N. Jawali. Involvement of Reactive Oxygen Species in the Action of Ciprofloxacin against Escherichia coli. Antimicrob Agents Chemother. Mar 2006; 50(3): 949–954. doi: 10.1128/AAC.50.3.949-954.2006. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1426460/

[13] Rahman I. Inflammation and the regulation of glutathione level in lung epithelial cells. Antioxid Redox Signal. 1999 Winter;1(4):425-47. http://www.ncbi.nlm.nih.gov/pubmed/11233143

[14] Chen, John K., and Tina T. Chen. 2004. Chinese Medical Herbology and Pharmacology. City of Industry CA: Art of Medicine Press, Inc., p. 179. http://www.amazon.com/Chinese-Medical-Herbology-Pharmacology-John/dp/0974063509

[15] Chen, John K., and Tina T. Chen. 2004. Chinese Medical Herbology and Pharmacology. City of Industry CA: Art of Medicine Press, Inc., p. 569. http://www.amazon.com/Chinese-Medical-Herbology-Pharmacology-John/dp/0974063509

[16] Jiang P, Li C, Xiang Z, Jiao B. Tanshinone IIA reduces the risk of Alzheimer’s disease by inhibiting iNOS, MMP‑2 and NF‑κBp65 transcription and translation in the temporal lobes of rat models of Alzheimer’s disease. Mol Med Rep. 2014 Aug;10(2):689-94. doi: 10.3892/mmr.2014.2254. Epub 2014 May 20. http://www.ncbi.nlm.nih.gov/pubmed/24859152

[17] Zhang S, Kan QC, Xu Y, Zhang GX, Zhu L. Inhibitory effect of matrine on blood-brain barrier disruption for the treatment of experimental autoimmune encephalomyelitis. Mediators Inflamm. 2013;2013:736085. doi: 10.1155/2013/736085. Epub 2013 Sep 8. http://www.ncbi.nlm.nih.gov/pubmed/24194630

[18] Dong P, Zhang Y, Gu J, Wu W, Li M, Yang J, Zhang L, Lu J, Mu J, Chen L, Li S, Wang J, Liu Y. Wogonin, an active ingredient of Chinese herb medicine Scutellaria baicalensis, inhibits the mobility and invasion of human gallbladder carcinoma GBC-SD cells by inducing the expression of maspin. J Ethnopharmacol. 2011 Oct 11;137(3):1373-80. doi: 10.1016/j.jep.2011.08.005. Epub 2011 Aug 6. http://www.ncbi.nlm.nih.gov/pubmed/21855619

[19] Zhao H, Deneau J, Che GO, Li S, Vagnini F, Azadi P, Sonon R, Ramjit R, Lee SM, Bojanowski K. Angelica sinensis isolate SBD.4: composition, gene expression profiling, mechanism of action and effect on wounds, in rats and humans. Eur J Dermatol. 2012 Jan-Feb;22(1):58-67. doi: 10.1684/ejd.2011.1599. http://www.ncbi.nlm.nih.gov/pubmed/22146555

[20] Zhang Q, Fong CC, Yu WK, Chen Y, Wei F, Koon CM, Lau KM, Leung PC, Lau CB, Fung KP, Yang M. Herbal formula Astragali Radix and Rehmanniae Radix exerted wound healing effect on human skin fibroblast cell line Hs27 via the activation of transformation growth factor (TGF-β) pathway and promoting extracellular matrix (ECM) deposition. Phytomedicine. 2012 Dec 15;20(1):9-16. doi: 10.1016/j.phymed.2012.09.006. Epub 2012 Oct 17. http://www.ncbi.nlm.nih.gov/pubmed/23083814

Image courtesy of David40226543 on Wikimedia Commons

 

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