Fluoroquinolones and Peripheral Neuropathy
Peripheral neuropathy, this is an often devastatingconditionwhich people develop pain and numbnesstheir hands and feet. Basicallythey're told on the evening news that they should be taking this or that mediion 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 thatAmerica,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 amatically increases yourrisk for having peripheral neuropathy and
fact being devastated by it. This is adisease that effects 115 Americans. Let's take a look. So again this is 115 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,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 usedwalks. If you have a urinarytract infection, you may have received these mediations. Well, here's what the study showedus: So this is a study publishedSeptember2014 that looked at men between age 45 to 80 years of age followed for a 10 year periodandthis 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 fluoroquinolonesthe United States, ians must weigh the riskof PN against the benefits of prescribing FQ when prescribing these ugs 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 journals is nowtelling us that the use of these mediionsâ€”these fluoroquinolone antibiotics is associatedwith doubling of the risk of peripheral neuropathy. A disease which often is not treatable. Sokeep thatmind 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.
Epilepsy and Gluten Sensitivity
Epilepsy, it effects 3 million Americans and generally,we as treating physiciansâ€”as neurologistsâ€”don't know the cause. Certainlysome cases thecause is readily identifible, but most cases of epilepsy are what we call, quot;idopathic,quot;meaning we don't understand the cause. And again, that's 3 million Americans. Now, the goto treatment for epilepsy is obviouslyusing mediionâ€”what we call anticonvulsive mediions. But let's have al look at kindof another perspective on what we should be thinking aboutterms of this sometimesdevastating situation. This is a study publishedthe journalNeurology, a very well respected peer
journal that describes the case of an individual,a 30 year old man who has a headache history for 2 years, and also what are called refractoryseizures, meaning that despite giving this gentleman seizure mediion, his seizurescontinued. In addition he has other issues of chronic constipation, he has a rash onhis elbows and his knees, and interestingly the researches found that his antigliadinlevels, antibodies against gliadin, which is something foundgluten,wheat andbarley and rye, were elevated, meaning he was reacting to glutencontaining foods. Andwhat they did for this gentleman was really quite interesting. They went ahead and puthim on a glutenfree diet. And what they found
when they did that was that his seizures completelywent away. So not only did his seizures go away, but his blood work actually normalizedas well. Very interesting. Giving a gentleman witha seizure disorder a glutenfree diet and his seizures went away. And here's anothercase of a 23 year old woman who has seizures for 11 years, also called refractory seizures,meaning that nothing could help herterms of pharmaceuticals. They put her also on aglutenfree diet and her epilepsy went away. Well, the reason we're having this discussiontoday is because of this recent article that appearedthe journal Neurology callingfor us to look at treatment of epilepsy in
a different way. The study is called quot;Epilepsysurgery trendsthe United States 19902008,quot; again, publishedthe journal Neurology.Stating, and I quote, quot;Temporal lobectomy,quot;â€” and that means taking out the temporal lobeof the brainâ€”quot;continues to be heavily under utilized as a treatment for epilepsy. Patientswho are medically refractory after failing 2 anti epileptic mediions should be referredto a comprehensive epilepsy center for surgical evaluation.quot; And this is a picture of whatit looks like when you've had your temporal lobe of your brain removed. So what this studyis saying is that if you are refractory, meaning that you're still having seizures, after twomediions have been tried, then you should
be referred to a center to have your temporallobe of your brain removed. Now I opened this tutorial showing you casesof patients who had gluten sensitivity whose epilepsy resolved when they simply wentgluten free. Let's take a look at another study. This is a report called, quot;Gluten sensitivity:from gut to brain,quot; written by a British researcher named Marios Hadjivassiliou, publishedin the journal Lancet Neurology. And he tells us that quot;most patients who present with neurologicalmanifestations of gluten sensitivity may have no gastrointestinal symptoms.quot; And what thatmeans is basically that we should always have a high index of suspicion for gluten sensitivity,even if there are no gastrointestinal issues.
My point is this: that prior to taking outsomebody's temporal lobe, what would be the harm of trying that epilepsy patient on aglutenfree diet? At the very least you'll reduce inflammation, they'll feel better,they may lose a little weight, their headaches may improve, their cognitive function mayvery well improve as well, and as we've now learned, it may actually help their seizuredisorder. Why not give it a try? I'm David Perlmutter.