This is a subject of intense debate. Before I give you the yes and no answer, let’s review one point:
It is not necessary for the drug to remain in the body to wreak long term havoc. Let me repeat, “It is not necessary for the drug to remain in the body to wreak long term havoc.”
Before some of you with preconceived notions get upset, let’s look at a few logical points to back up this assertion. If you have been consuming alcohol and/or smoking, the effects of either drinking or smoking permanently stop 2 to 3 days after you quit using them, right? Of course they don’t. There are many individuals who had to deal with the consequences of smoking or drinking years after stopping.
Now I am not trying to be sarcastic, uncaring or rude. I just want make a point that substances can have a strong, long lasting consequences. Because of this, there can be no expectation your side effects or adverse events will go away when discontinuing the medication.
Let’s look at another point regarding mitochondrial damage. The analogy is the snowball rolling down the hill. In some people, when you damage the mitochondria it is akin to starting a small snowball rolling down from the top of a large hill. Initially the snowball is almost unnoticeable. But as the snowball rolls downhill it gets larger and picks up speed, becoming more damaging as it proceeds. When drug toxicity damages mitochondria the damage is not immediately observed. Many times people believe the have recovered or never had an adverse event in the first place. Since mitochondria turn over slowly in many tissues, time is required for the amount of mitochondrial machinery and the ability to synthesize ATP fall below a pathogenic threshold value.
Because limited space I will not go into all the ways FQs can damage your body, but one more avenue they can damage your body and leave, and that is through epigenetic influence, or the turning ‘On’ or ‘Off’ of genes that control disease processes. In this scenario the FQ’s basically switch ‘On’ a process that becomes a problem ‘down the road’, then they leave.
So no, I personally, do not believe that the intact molecule remains in the body. I believe it does its damage and it leaves.
Additionally, I am not aware of any academic or private documented research that proves the intact molecule remains in the body.
But there’s more…
As you probably know by now, nothing is simple when it comes to the FQ’s. I believe that in some people the FQ molecule breaks apart and various metabolites remain. These metabolites can remain in adipose (fat) tissue. These metabolites have the ability to join with other metabolites from concomitant substances (other drugs such as NSAIDS) to form toxic metabolites. This theory is purely anecdotal but is pretty sound based on input from over a decade of interactions. The FQ molecule is complex and we know of some of the metabolites it can break down into but, again, there is no documented research that elucidates all the metabolites the FQ molecule can break down into. There are many variables so I do not know if that will ever bee accomplished. We do know from research that FQ metabolites can adduct to cellular micro and macro structures causing problems with various structures in the cell such a lysosomes or DNA.