Troubled by a series of health problems that included an excruciating, wake-you-up-out-of-a-sound-sleep case of leg cramps, Geraldine Young got some interesting advice from, of all people, her surgeon: “Take 400 international units of vitamin E a day, and let’s see what happens.” You can probably guess the rest. As her nightly cramps loosened their grip, the Lebanon, Ohio, resident fell in love with vitamin E. “It’s fabulous,” she says. “My mother takes it now, and she doesn’t have leg cramps anymore, either.”
Though a hit with many, vitamin E is by no means the only treatment for leg cramps, mainly because there are all kinds of causes of this not-so-serious yet painful condition.
The Cause of the Cramp
Defining a cramp is simple enough: It’s nothing more than the short, involuntary contraction of a muscle. One of your muscles literally decides to flex, and to briefly stay that way, without your permission.
Exactly what provokes this display of belligerence is a little more difficult to get a handle on. For one thing, researchers can’t seem to get muscles to cramp on cue. “To have a cramp actually happen in a laboratory situation, when you’re in a position to study it, can only be described as fortuitous,” says Lorraine Brilla, Ph.D., associate professor of exercise physiology at Western Washington University in Bellingham.
Doctors do know that those who are more muscular seem to have more leg cramps. They also know that pointing your toes a certain way while swimming can cause cramps. Getting your feet trapped in tight bedsheets can elicit a similar response. But bodybuilding, swimming and playing footsie with your bedspread are among the least innocuous causes of leg cramps.
Low levels of certain minerals known as electrolytes—magnesium, potassium, calcium and sodium—have long been linked to leg cramps. (Marathon runners sweating out the miles are particularly prone to this variety.) Certain drugs, such as diuretics (water pills) for the heart and for high blood pressure, have also been cited as a cause of leg cramps. Dialysis patients, who have their blood filtered by a machine because their kidneys don’t work properly, often complain of leg cramps. And pregnancy, it seems, is also a factor.
What do these last four causes have in common? Studies have found that each sometimes responds to vitamin and mineral therapy.
| Food Factors These dietary tips can help you keep magnesium and vitamin E, the nutrients that help ward off leg cramps, where you need them: in your body. Cut the cocktails. Even a single drink containing alcohol may decrease the supply of magnesium in your body, says Lorraine Brilla, Ph.D., associate professor of exercise physiology at Western Washington University in Bellingham. Trim the fat. Dietary fat makes magnesium harder to absorb, increasing the chances that it will be wasted, Dr. Brilla says. Cap your sweet tooth. Eating sugary foods forces your body to use magnesium just to metabolize the sweet stuff, adds Dr. Brilla. Can the cola. Soft drinks contain phosphates, which experts say also deplete your body of magnesium and calcium. |
Victory with Vitamin E
Fred Whittier, M.D., professor of internal medicine at Northeastern Ohio Universities College of Medicine in Canton, owes his foray into the world of vitamin E to a rash. As part of his regular medical practice, he prescribed quinine for one woman’s leg cramps. Quinine normally is an effective treatment for leg cramps, but this particular woman experienced an unpleasant side effect: It made her skin break out.
While researching other possible treatments, Dr. Whittier and his staff spotted a letter in a medical journal that reported good results using vitamin E for leg cramps. He decided to give it a try. Sure enough, a short time after the woman began taking vitamin E, her cramps disappeared.
Encouraged by his success in that case, Dr. Whittier and his associate began studying the effects of vitamin E on leg cramps. In one study, they gave 40 people who were on dialysis and who regularly suffered from leg cramps either 400 international units of vitamin E or quinine at bedtime.
A month after starting treatment, both groups went from an average of 10 leg cramps a month to 3.5 a month. If anything, the vitamin E group performed a little better.
Although he’s still not sure why vitamin E seemed to help these people, Dr. Whittier does have a theory. Dialysis treatment may clean the blood, but it doesn’t work as well as your own kidneys. As a result, toxins, including renegade molecules known as free radicals, which damage healthy molecules by stealing electrons to balance themselves, are left behind to irritate the muscles. Just as vitamin E soaks up free radicals linked to heart disease and cancer, it may also attack those causing leg cramps, Dr. Whittier suggests. “We know vitamin E is a scavenger. It may be picking up those irritable agents,” he says. These same irritating agents may also be roaming the muscles of some people who are not undergoing dialysis, he adds.
While Dr. Whittier’s research looked just at people undergoing dialysis, several older studies showed the benefits of vitamin E for people without kidney problems.
In one of the largest studies, 103 of 125 people who had been experiencing leg and foot cramps at night reported relief after taking vitamin E. A daily dose of 300 international units was effective for half of the participants, while the others required 400 international units or more for relief.
While not all studies have demonstrated that vitamin E is effective treatment for leg cramps, Dr. Whittier stands behind this remedy. “I don’t think it’s unusual in medicine to have two studies reporting opposite results,” he says. “Vitamin E is just as good a remedy as quinine and probably safer, too.”
When using vitamin E as a therapy, doctors frequently prescribe many times the Daily Value of 30 international units. Good food sources of vitamin E include wheat germ (one-quarter cup provides 39 percent of the Daily Value), safflower oil, corn oil, oatmeal and pastas. But even these fine sources provide relatively small amounts of the vitamin.
Studies have shown that some people can tolerate up to 1,600 international units of vitamin E a day without experiencing side effects, but some experts caution against taking more than 600 international units a day.
Making a Case for Magnesium
You’ve seen those sports drink ads on television, the ones featuring weary, sweat-soaked weekend warriors gulping bottles of fluid filled with electrolytes. Electrolytes—magnesium, potassium, calcium and sodium—are some of the most important and most well known nutrients in the fight against cramping. What most folks don’t know, however, is that you’re likely to run out of magnesium before any other electrolyte.
“The truth is, most people in this country just don’t eat enough foods containing magnesium,” says Robert McLean, M.D., clinical assistant professor of medicine at Yale University School of Medicine and an internist in New Haven, Connecticut. And even if you do eat plenty of green, leafy vegetables and other foods rich in magnesium (such as nuts, figs and pumpkin seeds), there are many things that rob your body of this important nutrient. Certain medications used to treat heart disease and high blood pressure, for example, flush magnesium from the body.
So what’s the connection between magnesium and muscle cramps? Think of a key and a lock. Normally stored in muscle and bone, magnesium acts like a key that unlocks muscle cells, allowing potassium and calcium to move in and out when needed as a muscle does its job.
Without adequate levels of any of these three nutrients, the muscle becomes irritable, says Dr. McLean. “It’s a crude analogy, but to keep the muscle cell adequately healthy and alive, you need to get potassium into the cell, and you need to have magnesium to open up the door to let the potassium in,” he explains.
Make no mistake: Both potassium and calcium are also vital to this process. It’s just that the body generally has adequate amounts of these two electrolytes on hand, says Dr. Brilla. If the body is going to get low on any electrolyte, it is most likely to be magnesium, she says.
Doctors have long marveled at magnesium’s powerful relaxant effect on muscles. In massive intravenous doses, this mineral is the preferred treatment for stopping premature labor contractions and a dangerous condition called preeclampsia, which causes extreme swelling and high blood pressure in pregnant women. (Note: Pregnant women should not take any supplement without first discussing it with their doctors.)
Before recommending magnesium supplements to ease muscle cramps, Dr. McLean does a blood test to determine an individual’s blood magnesium level, to make sure that it is not unexpectedly high. If the blood level is low or even normal, then body magnesium stores may be low. Unfortunately, a normal blood level does not ensure that body magnesium stores are adequate.
Based on the results of the tests as well as the person’s muscle cramp symptoms, Dr. McLean usually recommends taking one 400-milligram magnesium capsule two or three times a day. “I wouldn’t go higher than that, because too much magnesium can cause you to develop diarrhea,” he says. (Magnesium salt is the ingredient that makes Phillips’ Milk of Magnesia, a popular bowel cleanser, do its job.)
But be careful: If you have kidney problems, taking magnesium supplements may make you accumulate the mineral too quickly, which could be toxic, says Dr. McLean. If you have kidney or heart problems, you should check with your doctor before taking magnesium supplements.
Some people taking magnesium may get relief from leg cramps right away, but a long-standing deficiency can take weeks to overcome with supplements, says Dr. Brilla. “We like to recommend supplementing for four weeks,” she says. “That’s how long we feel it takes before we have some kind of measurable outcome.”
| Prescriptions for Healing Doctors recommend these nutrients to help end leg cramps. Nutrient Daily Amount
Calcium 800-1,200 milligrams Magnesium 800-1,200 milligrams, taken as 2 or 3 divided doses Vitamin E 400 international units
MEDICAL ALERT: Pregnant women should not take any supplement without first discussing it with their doctors. If you have kidney or heart problems, don't take magnesium supplements without medical supervision. Excess magnesium can also cause diarrhea in some people. If you are taking anticoagulant drugs, you should not take vitamin E supplements. |
Calcium Can Help
By now nearly everyone on the planet knows that calcium can help ward off osteoporosis. But here’s another reason to make sure you have at least one cup of skim milk or low-fat yogurt every day: Calcium can help your body absorb the magnesium you’re taking to fight your leg cramps, says Dr. Brilla.
“Calcium by itself may not have much benefit for leg cramps, but calcium helps magnesium absorption. You’re going to absorb more if they are both taken together,” says Dr. Brilla.
Getting enough calcium may be as simple as taking your magnesium supplement with skim milk. A single glass of skim milk provides 350 milligrams of calcium, which is 35 percent of the Daily Value, says Dr. Brilla. (The Daily Value for calcium is 1,000 milligrams.) If you’d rather take a calcium supplement, shoot for one that contains between 800 and 1,200 milligrams. You might also consider a supplement that combines calcium and magnesium in one tablet, she says.
