Over the last three months I counted the amount of times I was asked, via email, or contact form about Fluoroquinolones at DNA adductions. The answer was 18. Eighteen times, I received a unique question pertaining to my opinion on the validity of DNA adductions. What was disconcerting about each contact was the overtly negative or depressed tone of each person. Here are snippets from those correspondences, “From what I have been reading, we all have DNA damage so why bother to seek treatment options.”, “ needless to say, if your DNA is damaged….” , “is there really any hope?”, and the coup de grâce, so to speak, was that in at least five of the emails that authors forwarded me a line directly from the author of the fluoroquinolone adduct theory which is “The bottom line is this, we are not going to recover from the FQ adducts.” So for those individuals who want my opinion regarding this theory I will elaborate in this article, entitled, “Hopeless or hopeful, Fluoroquinolones and DNA Adductions, Part Deux”
There are several camps of thought that constantly float around the fluoroquinolone community and, just like those who believe in different modes of medical practice such as allopathic or naturopathic, the personalities can be strong, the arguments intense, and the lines of demarcation often blurred. I have a tendency to stay away from camps of thought that migrate toward one extreme or the other. I am starting to see, however, a greater wave of despair and hopelessness that is rising to a level above the normal despair that is associated with becoming a victim of FQ toxicity. Being in the unique position of getting frequent emails from new sufferers that are still reeling from the realization of what has happened to them, many are buying into a fallacious theory that can be a further detriment to their already weakened state. Unfortunately, I do not have the time or the emotional where-with-all to respond to everyone, but I occasionally and regretfully get drawn into this often unproductive argument when I am asked to correct, what I believe, are egregious scientific beliefs surrounding FQ toxicity.
Loss of Objectivity
Objectivity by researchers, professional or amateur, has not, and probably never will be attained. 
People will always have biases; some will be created by cultural values and others by personal views. A lack of objectivity could clearly be seen recently on Facebook when a group of people began to promote what they thought was good science. They, being enamored by the perceived science and the pleasant demeanor of the person who allegedly authored it, lost all objectivity in their hope and desire for some real advancement in FQ research. So when people attacked (critiqued) the argument, the defenders could not separate the argument from the man. All critiques were assumed to be attacks. The group had chosen their popular theory, not the objectively best theory. As a result, the community is divided more now than ever. If the people involved had attempted to set aside their biases and pursue the goal of objectivity, it is less likely that all this confusion would reign.
As a case in point as to how many people have lost their objectivity when they put their whole belief system into the ever changing realm of scientific discovery, recently I tried to inject some common sense into a heated debate that surrounded this very subject on a Facebook group (a mistake I know), after doing so, I received several vitriolic private messages, and the worse was “Hubris kills! You, people like you that run ‘expose’ blogs, and all your progeny, who claim to have superior knowledge should be obliterated off of this planet as it would be a much better place!” This examples how heated this debate has become and how high the emotions run, although I have never before been accused of displaying hubris before, I will admit to ignorance on many levels!
Faulty Assumptions
Many newly affected individuals are coming into the community and while still reeling from the shock and horror of the initial onslaught are greeted with a new strong dose of fatalism. How? They search through older Facebook posts or come across supporters of certain camps of thought, and are told unequivocally that based on scientific data, they are not going to recover. The biggest misconception, which is circulating the community and has caused great division and consternation among community members is, that it has been proven that DNA adductions do occur from FQ’s and the result is an unrecoverable state of decline. This poorly understood science can be destructive when misinterpreted in the light of personal filters that bias ones opinion in a certain direction. Those who push this theory on the ill-informed have done more damage to some newly affected individuals then they will ever realize. I, unfortunately still get many questions regarding this theory, or misconception as I call it, so I am going to elaborate on what I know. As a primer, I suggest that you read the article that I wrote entitled “Fluoroquinolones and DNA Adduction”.
I have had the wonderful opportunity to work with a handful of FQ researchers over the last 8 years. DNA adductions have been discussed, starting several years ago, as a matter of fact, and basic adduction research was initiated before at the university level. Most of it has dead ended with the researchers unable to deliver consistent proof of FQ DNA adductions (a point that I will elaborate on shortly). Only recently has it risen to the forefront of the community again, when certain individuals made astounding claims, asserting that all those who have had a reaction to FQ’s are plagued with DNA adductions. Following that, certain community leaders picked up on the idea and it became a trending wave. Unbeknownst to many, this theory had been looked at before, not only in the U.S. but abroad as well and mostly tabled by researchers due to inconsistent results. There are few exceptions which I will point out shortly. Unfortunately, like many memes that gain momentum, this one arose again with supposed new technical proof. After all, to the laymen it looked viable and with some community leaders pushing it, it had credibility. Unfortunately, some who tried to shed light on the reality of the flaws in this theory were often marginalized or shouted down, since so many were/are desperate to find that “one” root cause of FQ toxicity. Because of this, emotions run high and inevitably the ability to think critically, as I mentioned earlier, was and is tossed out.
Before I proceed any further, there are those that may misconstrue what I am trying to say. Like I have said before, it is quite probable that under certain circumstances metabolites of the FQ molecule could adduct onto DNA. I am not arguing that fact. What I take exception with is the assumption that DNA adduction is the ‘root problem’ or the ‘mother of all causes’ in the laborious search for reasons why people have reactions to FQ’s in the first place. And, following this initial faulty assumption is then the faulty conclusion that the DNA adducts lead to an inevitable and progressive state of decline with no hope of recovery. This lose-lose scenario is both tragic and not founded in really good science. There are those who do have terrible reactions followed by a state of declining health, and for those individuals adducts could play a role in their health issues (although I would put my money on out of control oxidative stress, which has been documented scientifically and linked to the FQ’s over and over again), BUT there are equally as many or more individuals who recover and move on with life, some more worse for the wear than others.
Let’s get to the crux of the matter. I am going to attempt to describe a technical matter in laymen’s terms so I run the risk of being too simple for some and too complex for others, but please bear with me. Many newly floxed folks will tell me that they have seen mass-spec scans of FQ victims showing adducts caused by FQ’s. This is unequivocal proof of the FQ adduct theory, right? Well not necessarily. The word mass-spec has been bantered about in the community in conjunction with this theory and some folks do not understand it. For those who do not know, mass-spec is short for mass spectrometry (MS) or in our particular case HPLC-MS which stands for high performance liquid chromatography–mass spectrometry. This long mouthful of words is used to describe the equipment and technique used to separate a sample into its individual parts and then assist in identifying those parts, if significant. HPLC has been a breakthrough for biochemists seeking to identify individual compounds present in bio-material samples quickly. It has advantages and disadvantages.
What they look for on a MS is peaks. The position on the X axis identifies its molecular weight, which translates into identity. The Y axis is the mass or abundance (how much) of the mo
lecule. If they already know the weight of a particular molecule, let’s say 379.3, and we look at the X axis and see a spike at 379.3, we can be pretty sure that we have what we are looking for. This is what happens when the use MS for, let’s say, athlete drug testing. I already know ahead of time what very specific molecules performance enhancing drugs will break down into and then we can look for them since I will have their molecular weight. Very low spikes on the X axis are clutter and usually considered unimportant.
Not Clear Cut
It is not that easy with FQ’s. Why? Because the FQ’s are very complex molecules and although we know
that they metabolize more than what the drug companies have told us, we do not know all the main partially metabolized compounds they can break in to. And, since we do not know what to look for we have to look for spikes that have significant mass and try to identify them. Scientists try to piece together identity of elements using computer programs or using tables available in several textbooks. Of the known molecules the accuracy rate is pretty good at about +/- 0.005. If the compound is not known it can takes months of painstaking work and the accuracy rate goes down, sometimes way down to the point that the results are questionable.
Also, since our physiology is not static and things such as enzyme levels and trace mineral are in a constant state of flux, not to mention genetic variances, all which affect metabolization, combined with the fact that the FQ molecule is very complex, there is no way of determining if the same decomposed and identifiable compound will form an adduct in each person. In theory a person would have a better chance of having an adduct with one large dose of FQ’s, as opposed to multiple doses, since a person’s physiology would change between exposures to the drug. Some people have said or theorized that an adducted molecule will grow in abundance with each exposure. This is pure speculation, since theoretically a new metabolized compound could be created and adducted during the next exposure, if at all.
I have seen a handful of MS test results performed on serum samples from some FQ sufferers. Of the ones that I have seen there was a common result. They all lacked consistently identifiable and quantifiable spikes that showed compounds that were from the metabolization of the FQ molecule.
For the sake of the argument let’s say that everyone DOES get a partially metabolized compound from the FQ’s adducted onto our DNA, what next? Our bodies have a tremendous capability to repair genetic onslaughts. It is estimated by research scientists, that our DNA can be exposed to anywhere from 1000 up to a whopping million individual attacks (lesions) per cell per day! Whoa! Obviously if some speedy repair was not taking place we would all melt down just by venturing outside and being bombarded by subatomic particles.
But again, the rate for you to be able to repair DNA damage is itself coded in your DNA and is extremely variable per person. As it was mentioned in another article, all kinds of things in our environment can cleave onto DNA, even certain fats that we consume. You can look at it this way, just like smoking, some people can smoke their entire lives and never get cancer and others can smoke for one year and get lung cancer. The difference? A lot. First, the ability to repair mutations, and then environmental factors, nutrition, and on and on… the variables are virtually endless.
Many individuals point to certain papers such as “Quinolone binding to DNA is mediated by magnesium ions” and others, which may lead us to believe that adductions are possible. If most of the papers are read in detail you will find that the researchers are, at best, tentative about their in vitro observations. What it does tell us, is that FQ’s are toxic to our genetic mechanisms and under certain circumstances genetic damage can occur. However, to apply this universally to all cases of toxicity is foolhardy. Although these papers give us clues as to what directions to follow, the leaps that have been made by those desperate to find an answer have been outlandish.
No Experts
Believe me, there are NO experts in this area (FQ’s and adductions), no matter what is being said elsewhere, and those who claim to be are blowing smoke up your skirt. As a matter of fact holding on to this theory as the cause, while excluding others, will lead to more obfuscation and delay of legitimate research that is already taking place. In addition, in my opinion it will also hurt advocacy greatly, a subject I will cover at a later date.
For those who are entering this fray as a newcomer please take some comfort from these words that I 
wrote in the previous DNA adductions article….”Everyone can make this judgment for themselves. Whether you are new to the FQ community or have been involved for a long time, take a moment, step back and view with your mind’s eye the community as a whole. What do you see? Does everyone have the same reaction? Does everyone that develops adverse events die? What about the fact that the community has a greater than 50% turnover rate yearly? If you are looking with an unbiased filter you will see a highly heterogeneous mix of results. There may end up being one cause, but there definitely is not one destination.”
No one asks for this tragedy. The truth is that some do heal while others do not heal well at all. However, do not let the gloom and doom of some folks that are so eager to push an agenda derail your emotional well-being. There are many self-proclaimed FQ experts. They may be experts in their own personal cases, but not in yours (this applies to self-proclaimed medical professionals as well). If you already know that what works for one person does not necessarily work for another, then the converse is true as well: What causes destruction in one person (aka DNA adductions or anything else you want to plug in here) is not necessarily true for the other. Never give up and always have hope.
To read more about how FQ’s create a disease process please read:
Pulling The Trigger: How the Fluoroquinolones Can Cause Mutations and Disease
This is a fabulous post, David. Thank you for taking the time and energy to intelligently discuss the issue of DNA adduction and fear mongering in the FQ toxicity community. There is just not enough evidence or research to conclude exactly what has taken place. Obviously, fluoroquinolones appear to be extremely dangerous and destructive compounds for long term sufferers like myself, but it is irresponsible and dangerous to say that knowledge of “permanent DNA” adduction exists when this is not the case.
I may be a genomic layman but it seems rather obvious there is signficant dna adduction behind extensive collagen degeneration. Tendon’s don’t heal begin dissolving with intrasubstance tears, new tears develop in other tendons years after the acute chemical injury…. ligaments tearing, healing and re-tearing.. What else could possibly explain it? ( besides dna damage perhaps all the way to the stem cell) And Perhaps if you’re young enough you can recover. But for high dose/duration of levafloxacin and with a steroid in a middle-aged or elderly person. Maybe not so much. Take this damned one off the market with ofloxacin. It is the worst.
What IntheShadows said. I am not a genomics expert either but do have clinical credentials He/She is rihg about levofloxacin as well. Multiple studies show it to be the worst offender of the fluroquinolones with respect to permanet adverse affects. There is also a recent retrospective on Medicare claims reviewing tendon damage and fluroquinolone administration and the only strongly correlated fluroquinolone is Levofloxacin. Anecdotally that’s the one that damaged at least 7 tendons as well as cartilege throughout my system. Providers have proven they are either blissfully unaware of updated black box warnings or are disregarding them. Levofloxacin belongs off the market.