Cipro Concerns/Questions

I got test results back from the Fry Labs Stool test, and it was a bit of a surprise as I have two shigella variants, shigella sonnei and shigella flexneri. Likely had it for a while, it could possibly explain some bowel issues I've had over the years, but I think the main culprit causing my issues is still likely lyme. I probably caught this in Europe and am likely a carrier, and I think there is a good chance that I am asymptomatic from the shigella. Doesn't mean I shouldn't treat it though.

Dr F wanted me to do one week cipro, I dropped off the results at my other dr.'s office, Dr M, thinking we'd hold off and discuss at my next appointment. He got back to me a little later saying he wants me to treat right away with the cipro, but for two weeks.

I've started reading up on the drug, and it makes me a little nervous. I'm partially assuaged that I have two doctors saying I should take it. Dr M recommended I increase intake of vitamin c and magnesium while I'm on it as that can help with tendon issues (which don't worry me as much as the offer possible side effects).

Cipro is in a class of drugs, fluoroquinolones that can have very serious side effects, including permanent nerve damage and cause permanent neuropathy. Given my health history, and neuropathy herxes I've had from biaxin, I'm very hesitant to take this medicine. I know every drug has a risk profile, but I'm not sure I'm comfortable with this class of drugs. Plus horror stories like these, including times where people took one dose and had permanent damage:

http://www.consumeraffairs.com/rx/cipro.html

http://well.blogs.nytimes.com/2012/09/10/popular-antibiotics-may-carry-serious-side-effects/?_r=0

I did email Dr M explaining my concerns, I'm hoping to see if there are any alternatives to the fluoroquinolones for shigella.

What do you guys think, should I be concerned about this drug? have you guys taken it and been ok? I'm a bit confused and stressed about what to do.

After i read your post, I looked up shigella on the internet.

It is sometimes treated with zithro or bactrim....maybe do some research of your own before agreeing to take the flouroquinolones.
The flouroquinolones black box warning is for the risk of tendon rupture.

I also read that it often clears up on it's own....and if you're not symptomatic...

If it were me, I'd start taking magnesium and maybe even low dose manganese now before I started on the Cipro. It's unlikely to cause a bad herx IMO, especially if you are just dealing with Lyme. What it can do is cause tendon issues if you are deficient of polyvalent cations in your tendons. If you have been sick for quite a long time, you may be deficient in these. Too much oxidative stress can cause neuro side effects as well.

Cipro's main metabolite also has a lot of antibacterial activity. Taking polyvalent cations while on Cipro can decrease the action of the metabolite or even Cipro if taken in close proximity to each other. So you need the cations, but they inhibit the action of the medication. Staying hydrated with Cipro helps a lot as side effects can mount with dehydration. Caffeine also can cause issues while on Cipro. I'd go as far to say that any high nitrogen containing food (like meat) may increase side effects. If worried about side effects, drink a lot of water and eat little meat or beans. Your pharmacist dispenses Cipro so much that it doesn't phase him. If you're on the 500mg twice a day, taking the precautions mentioned should help tremendously. For the short period of time you are on it, you should be fine.

Thank you so much Georgia and Tickbite!

My head has been spinning from this shigella thing, really thrown me for a loop. And whenever I get stressed, especially in regards to my health, my symptoms get worse and I just feel trapped by my body and my situation and have a hard time making decisions. I'm going to wait till I mentally calm down and I can then decide what to do. I'll wait to see what my doc says and maybe he can offer guidance or reassure me on my concerns.

It's just a weird thing, having two shigella strains. My best guess is that the two shigella strains are chronic due to a weakened immune system. And it is a tantalizing thought that if I treat them effectively, maybe it will give my body a boost and allow the rest of my treatments to work more effectively and be one less thing for my immune system to have to handle.

Thanks for mentioning the caffeine intake and liquid intake Georgia, that is very helpful. And thank you for your reassurances and guidance. I really appreciate it. It will be hard to give up caffeine (which I should be avoiding anyways!) for two weeks but if it can help me handle the meds better then it is a no brainer.

Tickbite, thank you as well for sharing your experience. That is also reassuring, I'm glad my doc mentioned magnesium and vit c. I am just trying to exercise due diligence on cipro, and I obviously came across horror stories about minimal amount of doses causing permanent damage and that struck a nerve. I think if I hadn't read that I would've been fine, gimme the cipro and let's knock out this shigella and then I can move on with the rest of my treatments.

The only thing the doc mentioned was to take the cipro about two hours away from probiotics. Should I also space it further out from my multivitamin supplements? I feel I read somewhere that certain vitamins can interfere with this drug so you need to take them pretty far apart, something like 6 hrs before cipro dose or two hours after?

I'm hoping two weeks of Cipro isn't going to hurt me. Everyone in my family has taken it before and been ok. But honestly I don't think I could mentally recover if I took this medicine and ended up with permanent damage of the type described in the horror stories. Obviously there are risks with any medication, and I tend to be pretty gung-ho when it comes to taking meds, whatever it takes kind of mentality, but I also want to take meds with minimal risk profiles (which is pretty standard I think!).

I have just fought so dang hard to get to where I'm at, as some of you know, I'm making my way out from a very deep hole, and while I feel so much closer to regaining my health, there is still a bit of road ahead of me. It would just be devastating to get a wrench thrown into my recovery from a negative drug reaction that caused permanent damage. Maybe I'm making a mountain out of a mole hill with cipro, but I know I can recover my health and don't want to jeopardize things.

Post Edited (sebreg) : 8/25/2015 5:39:38 AM (GMT-6)

thank you rowingmoom. I went ahead and ordered his book. If I can I'd rather avoid cipro, but everyone around me seems to be saying I should take it. I'm waiting to hear back from my llnd to hear what he thinks about my concerns and if there are other options. I imagine he is familiar with the natural options, or at least he can research them and let me know if he thinks they will be strong enough for a chronic shigella infection.

I'm just stressed and scared right now. I like having straight forward options and courses of action. I know I'm playing with fire every time I take a new med, and usually I'm fine with that, but cipro gives me pause. I know a lot of people take it and are fine, but still.

I took 2 doses of levaquin and all heck broke out. Cns and pns issues that wished you were dead. EXTREME anxiety with multiple panic attacks a day. I had over 90 symptoms. Search flouroquinolone forums, please.

Thanks again for all the info and suggestions guys! I was pretty run down with my treatments, sometimes I get too aggressive without realizing it and the herx builds up slowly and kind of sneaks up on me. I think this is why the shigella/cipro thing was harder to handle stress-wise. My tolerance and sensitivity to new stress and changes when I'm pushing along with my treatments is always exacerbated.

Shigella is probably just another layer in the onion that we are going to have to peel in my treatment. My llnd admitted he isn't too familiar with treating shigella, but he did some cursory research and suggested samento. He is going to do more research. I think we will explore options at my next appointment.

As rowingmom's buhner link suggested, CSA can be used to treat shigella. CSA is something I am supposed to be working into my treatment regimen anyways. Samento is also something I'm supposed to work in down the line. GSE, which is also something I'm taking, seems to have some effect on shigella as well. The shigella test I had took place before I started all these new treatments, so maybe with all these new meds I have started I might be treating shigella without realizing it.

It is tempting to wonder if taking cipro and blasting the shigella could be a key to speeding up my recovery and making the underlying issues easier to treat. My intuition is that it is going to be a long process either way and there are no quick fixes. And if I can avoid cipro I will.