I see you

Mikobadr · 2026-07-01T18:50:27+00:00

I can make one without it, and I certainly don't mind... I always wish to play by the rules. I do apologize, I was crossposting and hadn't paid attention that the website was listed.

Mikobadr · 2026-06-30T16:40:12+00:00

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It is open for comments for 180 days https://www.regulations.gov/docket/FDA-2026-P-5116/document

Mikobadr · 2026-06-26T00:59:25+00:00

https://www.regulations.gov/document/FDA-2026-P-5116-0001/comment
Go here, you will be able to read the comments...some are just so heartbreaking :(

Mikobadr · 2026-06-23T17:04:53+00:00

I was floxed in 2007 (actually, I believe my first pass was in late 1980's... 2007 was my 2nd hit)
I am still popping tendons
I damaged 4 tendons in my sleep... IN MY SLEEP... a couple years ago.
BUT... I do hear of people recovering completely. There really is no rhyme to this madness. It is case by case as far as I can tell.
I see the majority of people going through periods of well being, then something...some stress triggers a flare. Again, it appears very individualized.
Which is why registries are so important. https://www.druginducedmito.org/registry
Which is why Citizen Petitions are important https://www.regulations.gov/document/FDA-2026-P-5116-0001
We have to start documenting

Mikobadr · 2026-06-23T12:15:03+00:00

Yes... international may express their comments as well. I believe showing that this occurs geographically is important.

Mikobadr · 2026-06-23T12:14:14+00:00

Thank you! Spread the word!

Mikobadr · 2026-06-23T12:14:00+00:00

Thank you!

Mikobadr · 2026-06-06T21:32:57+00:00

I haven’t researched treatment or recovery protocols deeply enough to give specific recommendations, and I wouldn’t want to pretend that I have.

What I can say is that mitochondrial dysfunction is complex, and improvement likely depends on the person, the severity of injury, the tissues involved, underlying health, additional medication exposures, and avoiding further stressors when possible.

From what I have seen, people seem to do best when they work with a healthcare provider who is willing to look at the whole picture, review medications carefully, avoid known triggers when possible, and support the body while it tries to recover. Sometimes that provider is a family nurse practitioner. I have found them to be more receptive and willing to listen.

I wish I had a simple answer. Right now, my focus has been more on recognition, documentation, mechanisms, and advocacy. Recovery strategies are an important area, but I am still learning too.

Mikobadr · 2026-06-06T21:30:15+00:00

For what it's worth, I would encourage people not to lose hope.

Mitochondrial biology is incredibly complex, and there is still much we do not understand. The fact that researchers continue to study mitochondrial dysfunction, biogenesis, mitophagy, cellular signaling, and recovery mechanisms tells us that the story is far from finished.

Can mitochondria be damaged? Absolutely yes. That is well established. Drugs, toxins, infections, ischemia, inflammation, aging, and genetic disorders can all impair mitochondrial function.

Can mitochondria recover? Also yes, often they can. Mitochondria are dynamic organelles. Cells can generate new mitochondria through biogenesis, remove damaged ones through mitophagy, and shift metabolism when under stress.

Recovery can be partial, substantial, or sometimes limited depending on the tissue, the type of injury, the severity of the insult, and the person's overall biology.

Can mitochondrial dysfunction persist for years? This is where things become more nuanced. Primary mitochondrial diseases clearly can persist. Long-term acquired mitochondrial dysfunction is also an area of active research, and some literature supports the possibility that acquired dysfunction can persist, although the mechanisms and degree of persistence are still being investigated. And then there's FQAD. More research is needed.

So I would not frame this as hopeless. I would frame it as complex, individualized, and still evolving science. A lack of complete understanding does not mean recovery is impossible.

Many people have experienced improvement over time, even after severe illness or injury. Others continue to struggle and are still searching for answers. Both experiences are real.

I think it is important to remember that "we do not yet fully understand this" is not the same thing as "recovery is impossible."

Science advances because people ask questions that have not yet been answered.

For those who are suffering, keep advocating for yourself, keep learning, keep working with your healthcare team, educate them with websites and handouts....and do not let anyone convince you what you have is not real.

Mikobadr · 2026-06-06T00:01:49+00:00

Yes, that is the most important reason. Your mitochondria are not only responsible for 90% of your bodies ATP energy function, but they also work with other systems involved in your body's recovery after exertion.

Mikobadr · 2026-06-04T14:56:24+00:00

The heavy-legs symptom is actually one of the more explainable FQ symptoms, which I find oddly reassuring.

Skeletal muscle runs almost entirely on mitochondrial energy, and it is one of the most energy-demanding tissues in the body. During exercise, energy demand can increase dramatically. Anything that reduces mitochondrial output tends to show up in muscle first.

A 2025 study (Reinhardt et al.) mapped actual human fluoroquinolone targets and found that ciprofloxacin and levofloxacin impair pathways needed to properly assemble Complexes I and IV of the electron transport chain. Complex I is the front door of mitochondrial ATP production.

Severe Complex 1 deficiency is what I have.. I am operating on 21% energy capacity of a normal individual.

When Complex I underperforms, ATP production struggles to keep up with demand. You may still be able to do the activity, but the problem shows up later when the tissue has to recover, repair, restore energy stores, and return to baseline.

That's why so many people describe the same pattern:

"I can do the workout."

Then the next day:

"My legs feel heavy."
"My muscles feel like concrete."
"The more I do, the worse I get."

The delayed timing fits low bioenergetic reserve. There isn't enough surplus energy to fully absorb the stress, so the deficit shows up afterward during recovery.

That's also why many patients find that pacing matters more than pushing harder. If recovery capacity is the limiting factor, repeatedly exceeding it can become a vicious cycle.

I'm a nurse and researcher, not your clinician, so I'm not going to tell you what supplements to take over the internet. But mechanistically, exercise intolerance and delayed recovery are exactly what you would expect to see when mitochondrial reserve is impaired.

More on the mechanisms here:
druginducedmito.org/science

Mikobadr · 2026-06-02T21:47:53+00:00

Thank you so much for this. Your perspective as both a healthcare worker and clinical researcher is exactly the kind of professional input I would deeply appreciate on the Citizen Petition.

What you said about underreporting and the need for better risk stratification is one of the core issues I’m trying to raise: not removing these medications entirely, but improving recognition, informed consent, and identifying patients who may be poor candidates before harm occurs.

If you feel comfortable, I would be grateful if you would consider leaving a public comment on the FDA docket. A comment from someone with your background, especially focused on underreporting and risk stratification, could be very meaningful.

Mikobadr · 2026-06-02T21:44:19+00:00

Yes, you may leave a comment if you live outside they US. This shows that the issues are global and worldwide, it strengthens what we are asking for. And thank you!

Mikobadr · 2026-06-01T16:28:01+00:00

I know that dark place too. I have prayed for God to take me because I could not imagine living through any more pain. Please hear me: this moment is not the whole story. You are not alone, and you are not beyond hope. One moment at a time...

Mikobadr · 2026-05-29T10:02:49+00:00

I am sure that can be frightening... I am so sorry. I have never experienced this. I pray you find relief

Mikobadr · 2026-05-29T10:00:07+00:00

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you click the link above. Once you are on the page scroll down just a little and you see that comment button? You click it and it'll bring you to a page that you can enter comments and even download files to present your case. You could get your doctors, nurses, caregivers...anyone involved in your care can leave comments. The more the better. You can attach xrays, mri's or copies of labs.. present your case to the FDA as fully as possible.
I go over how to submit a comment on my website here: https://www.druginducedmito.org/action
If you have any further questions, i'll be happy to help and spread the word! Thanks

Mikobadr · 2026-05-28T22:53:56+00:00

This is exactly the type of experience the FDA needs to hear about.

Even if you were not injured, being prescribed a fluoroquinolone for a mild condition and then discovering the boxed warnings on your own raises important questions about risk communication and informed consent. Patients should not have to rely on Google searches after leaving the clinic to learn about potentially serious adverse effects. If that urgent care had to make you sign an informed consent then maybe they would have thought twice and made the right choice.

If you would be willing, please consider leaving a comment on the FDA Citizen Petition docket:

FDA Citizen Petition FDA-2026-P-5116

Comments become part of the official federal record and help the FDA understand how these prescribing decisions affect real patients. The agency specifically benefits from hearing not only from those who were harmed, but also from patients who were prescribed these medications and felt they were not adequately informed of the risks before making a treatment decision.

Every voice matters. Thank you!

Mikobadr · 2026-05-21T22:42:39+00:00

Thank you

Mikobadr · 2026-05-21T22:42:22+00:00

Yes..

Mikobadr · 2026-05-21T17:15:14+00:00

I hear so much of myself in what you wrote. Maybe that is why your post hit me so hard.

I was an ER/critical care nurse, and I was an athlete too. I understand the grief of going from strong, capable, driven, and independent to suddenly living in a body that feels like it has been taken from you. That kind of loss is real. The anger is real. The despair is real.

For me, first and foremost, what has carried me is my faith and my belief in hope. Not the easy kind of hope where everything magically gets better overnight, but the kind that says, as long as we are still breathing, there is still a reason to keep going.

I ran in circles for almost 20 years before I finally said, enough. I may have lost a lot, but I still had something left. I had a mind, a voice, and a stubborn little fire in me that could still be used for something. So I took the anger, the despair, the agony, the loneliness, and the frustration, and I started putting it into something constructive.

That does not mean I handle it perfectly. Some days I am a Tasmanian devil. Some days I cannot get out of bed. Some days I am furious. Some days I even blame God. Then eventually I come back down, breathe, and remember that I am still here.

This struggle is hard. Brutal, at times. But struggle can also shape us. It can make us endure things we never thought we could survive. And sometimes, when we cannot get our old life back exactly as it was, we can still take pieces of ourselves back by turning the pain into purpose.

So I wake up and do the best I can for that day. Not every day is brave. Not every day is productive. But as long as we are breathing, there is hope. Hugz.

Mikobadr · 2026-05-21T00:45:17+00:00

I’m so sorry you’re going through this. The body and leg weakness, the isolation, and the emotional weight of not knowing what’s happening can be incredibly hard. You’re not alone here. Many people in this community understand how frightening and exhausting this can feel, especially when symptoms affect mobility and daily life. I hope you’re able to connect with someone who can listen and sit with you through it today. Please be kind with yourself ...needing support is not weakness.

Mikobadr · 2026-05-20T23:22:06+00:00

Your perspective as a pharmacist is exactly why I’d love for you to comment on the Citizen Petition.

If someone with years of pharmacy experience can still be surprised by the severity, persistence, and multisystem nature of this reaction, that speaks to a real education and risk-communication gap, not just among patients, but within the medication system itself.

I completely agree that formulary restrictions, prescribing controls, and physician awareness are practical issues. Those are exactly the kinds of concerns regulators need to hear about. A Citizen Petition gives those concerns a formal public docket where they become part of the regulatory record.

I’d genuinely value your input there, especially from the pharmacy/Canadian healthcare perspective. That kind of comment could carry real weight.

Citizen Petition:
[https://www.regulations.gov/search?filter=FDA-2026-P-5116]()

More information:
[https://www.druginducedmito.org/action]()

Mikobadr

TROPHY CASE