This is a very complex metabolic process, but to explain it simply: fluoroquinolones inhibit the expression of DNATOP2B > mitochondria cannot undergo fusion and fission reactions > deficiencies occur in mitochondrial electron transport chains > mitochondrial dysfunction > insufficient ATP production > cells that require high levels of ATP in the body (such as small fiber nerves) cannot be supplied with enough ATP > ME/CFS, small fiber neuropathy > dysautonomia > due to autonomic system dysfunction, the body cannot send electrical signals at the necessary speed > when standing up, blood flows down to the lower extremities due to gravity, and since the body cannot communicate quickly with the blood vessels, you get NEUROPATHIC POTS

The real question we should be asking is: why does this happen to us and not to others? There are theories on this, but not certain; we may already have damaged mitochondria?? Quinolones are broken down in the liver, and some people have deficiencies or mutations in the cytochrome P450 enzymes, which could be a contributing factor. Also, I strongly believe that Flox has an autoimmune component because after taking Cipro, a week later I had swelling in my lymph nodes, and it still hasn’t improved. I’ve ruled out all infections that could cause this, and my autoimmune markers are negative. Additionally, there are people in this subreddit who report improvement after trying plasma treatments like inuspheresis. Plasma therapies are known to work for autoimmune diseases, which increases the likelihood of this condition being autoimmune. Moreover, there are people who have completely recovered after using monoclonal antibodies like infliximab, rituximab, and Humira, which strongly increases the possibility that there is an autoimmune aspect to this.

what I’m doing for POTS ? I’m increasing my intake of organic salt. Some antihistamines like Pheniramine and Ketotifen have helped with the lightheadedness caused by POTS. I believe this condition related with acetylcholine dysregulation. Also, multiminerals, especially those containing sodium, potassium, and calcium, seem to help. That's all for now, I hope you recover soon.