Fluoroquinolone Toxicity: What Works

Yesterday I talked about fluoroquinolone toxicity and what causes it. I see a lot of patients with this condition and with the right approach, they recover. Here are some of my favourite tried & tested strategies for floxed patients:


Urinary organic acids testing is probably our most useful test for assessing mitochondrial function, histamine and oxalate activity, as well as assessing nutrient status. We can look at overall health picture by looking at standard bloodwork & a fatty acid panel and serum metals.

Address mitochondrial dysfunction

This is crucial. Fluoroquinolone antibiotics as disrupt mitochondrial function. Key nutrients & phytonutrients include

  • B vitamins
  • Co-enzyme Q10
  • Magnesium
  • Omega 3 fatty acids
  • Vitamin C
  • Alpha-lipoic acid
  • Carnitine, creatine, citrulline
  • Vitamin E
  • D-Ribose
  • Reveratrol (from Japanese knotweed, grape skin, peanut, cocoa, blueberry)
  • Curcumin (from turmeric)
  • Gingerol (from ginger)
  • ECGC (from green tea)
  • Allicin (from garlic)
  • Ginsenoside (from ginseng)
  • Withaferin (from ashwagandha)

Work on stress perception, resilience & sleep

Working on sleep & stress regulates cortisol & immune response, and reduces oxidative stress. I recommend breathing exercises, Heartmath, meditation, and white noise. I caution against going back to exercise too quickly, so we start with walking and gradually increase.

Nutrition & fasting strategies

Replete nutrient status (macronutrients, vitamins, minerals, omega 3 fats, amino acids), correct deficiencies, optimise diet, support assimilation with digestive enzymes. Insufficient iron levels can cause oxidants to leak from mitochondria (damaging mitochondrial function & DNA further).

Some examples: Iron is also crucial for liver detox pathways. Most people are getting adequate iron in the diet, they just aren’t assimilating it. Zinc is crucial for both stomach acid production and along with protein and other minerals, is broken down by stomach acid. Inadequate zinc causes DNA damage.

Calorie restriction activates SIRT genes to stimulate mitochondrial production in muscle & liver cells, promoting metabolic repair & energy production. This reduces free radical activity & turns off NFk-B induced inflammation.

I promote a diet high in phytonutrients and taurine foods, avoiding sugar and alcohol. I don’t necessarily suggest all patients go gluten or dairy-free but if gut health needs work, these restrictions often speed up the process.

Restore microbiome health, address pathogens, die off & mast-cell activation

With pre, pro & postbiotics, binders, herbal antimicrobials, anti-histamine foods & herbs. A significant proportion of my floxed patients do have significant fungal overgrowth as well as high levels of sulfidogenic and histamine-releasing bacteria, and often parasites.

Support detox pathways reduce toxic burden

Optimise glutathione levels, support liver detox pathways with liver-supporting foods & look at addressing environmental factors like air & water quality, chemical exposures in the home & in food which can further damage mitochondria.

Useful therapies

Some of my favourite adjunct therapies to support this approach are:


Du, J., Zhu, M., Bao, H., Li, B., Dong, Y., Xiao, C., Zhang, G. Y., Henter, I., Rudorfer, M., & Vitiello, B. (2016). The Role of Nutrients in Protecting Mitochondrial Function and Neurotransmitter Signaling: Implications for the Treatment of Depression, PTSD, and Suicidal Behaviors. Critical reviews in food science and nutrition56(15), 2560–2578. https://doi.org/10.1080/10408398.2013.876960

Mahoney, D. E., Hiebert, J. B., Thimmesch, A., Pierce, J. T., Vacek, J. L., Clancy, R. L., Sauer, A. J., & Pierce, J. D. (2018). Understanding D-Ribose and Mitochondrial Function. Advances in bioscience and clinical medicine6(1), 1–5. https://doi.org/10.7575/aiac.abcmed.v.6n.1p.1

Tao, F., Zhang, Y., & Zhang, Z. (2019). The Role of Herbal Bioactive Components in Mitochondria Function and Cancer Therapy. Evidence-based complementary and alternative medicine : eCAM2019, 3868354. https://doi.org/10.1155/2019/3868354

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