Fluoroquinolones and Peripheral Neuropathy
Peripheral neuropathy, this is an often devastatingcondition in which people develop pain and numbness in their hands and feet. Basicallythey're told on the evening news that they should be taking this or that medication sothat they can get through life. That's treating the smoke and ignoring thefire. Those medicines that you're seeing advertised don't treat the neuropathy, they only treatthe symptoms. But what's causing peripheral neuropathy? Well we know that in America,one of the biggest causes of peripheral neuropathy is being diabetic, which is clearly relatedto the foods that you eat by and large. Becoming a type 2 diabetic dramatically increases yourrisk for having peripheral neuropathy and
in fact being devastated by it. This is adisease that effects 1 in 15 Americans. Let's take a look. So again this is 1 in 15 Americansâ€”thisis 20 million Americans afflicted by this disease, that aside from diabetes, we're toldthe cause is unknown. Well maybe that's not exactly true. Last month, in the journal Neurology,an incredible study was published describing a relationship between what are called fluoroquinolones,and the risk of developing a peripheral neuropathy. You may not know what fluoroquinolones are,but chances are you may have actually been exposed to fluoroquinolone. These are antibioticsused for treating things like upper respiratory
infections and even urinary tract infections.Things like Levaquin and Cipro are commonly used in walk in s. If you have a urinarytract infection, you may have received these mediations. Well, here's what the study showedus: So this is a study published in September2014 that looked at men between age 45 to 80 years of age followed for a 10 year periodand in this group there were over 6,000 cases of peripheral neuropathy. And they comparedthese individuals to about 25,000 aged match controls, and what they found was that riskfor developing this devastating condition called peripheral neuropathy was doubled inthose individuals exposed to this class of
antibiotics called fluoroquinolones. And whatthe researchers also told us is that, and I quote, quot;Fluoroquinolones have been shownto neurotoxic. Oral fluoroquinolones have also been associated with reported cases ofpsychosis and seizures, which similar to peripheral neuropathy have been shown to be acute eventsoccurring within days of fluoroquinolone use. In light of strong evidence of unnecessaryprescribing of oral fluoroquinolones in the United States, ians must weigh the riskof PN against the benefits of prescribing FQ when prescribing these drugs to their patients.quot; We've got to practice medicine under the dictumof quot;above all do no harm.quot; One of our most
well respected peer review journals is nowtelling us that the use of these medicationsâ€”these fluoroquinolone antibiotics is associatedwith doubling of the risk of peripheral neuropathy. A disease which often is not treatable. Sokeep that in mind the next time you think you need an antibiotic for this or that problem,discuss this study with your treating physician. I'm David Perlmutter.
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Autoimmune Inflammatory Infectious Diseases Part 3 Mimic Lower Back Pain CO Spine Surgeon
reiter's syndrome is associated with asexually transmitted disease with clamydia and occasionally with enterocolicinfections such as dysentery the infection ceases and the syndrome begins as an autoimmunedisease the hallmarks are urethritisconjunctivitis and arthritis there's also significant heel pain inseventy percent from achilles tendonosis
and there's also SI painassociated forty percent of patients will developconjunctivitis as noted in this eye exam seen on theright myalgias are common sausage digits orlarge swollen fingers are very rare and circinate balanitis is a painless sore on the glanspenis which is quite common with reiter's
psoriatic arthritis is a typical disease estimated atthree percent of the population has psoriasis and it's a skin disease normally seenwith silvery erythematous patches over extensor surfaces patients with the nail bed changes asseen on the right have a higher correlation with the arthritic components of psoriasis
twenty three percent of patients withnail bed changes will develop arthritis and five percent will have spondyloarthropathy enteropathic arthritis as crohn's and ulcerative colitis andpossibly even irritable bowel ten to twenty percent will develop sacroilitis and ten percent
will develop spondylitis here we see a CT scan of a normal right SI jointand a fused left SI joint rheumatoid arthritis is noted for the destruction of synovialjoints throughout the body you develop enthesopathyas we note on the right picture of an inflamed joint
with worn cartilage versus thenormal joint the rheumatoid arthritis problem istypically symmetrical there's painful subcutaneous nodules and spinal involvement is almost alwaysexclusively cervical very uncommon to have a lumbar spine involved patients with rheumatoid arthritis candevelop mononeuritis multiplex and even vasculitis rheumatoid arthritis of course