Leg cramps, no matter the cause, are painful, annoying and sleep-disturbing.
You can decrease your chances of experiencing leg cramps by modifying physical activity — like avoiding prolonged sitting or standing — or by avoiding the not-so-obvious triggers I previously discussed.
But if you find yourself writhing in “Charley horse agony” often, you might need to dig deeper…
Where to begin
First consider whether you can treat any medical illnesses or eliminate any prescription medicine known to promote cramps. If the medicines are prescribed by your doctor, talk with him first. Medicines that contribute to leg cramps include diuretics which can promote the loss of potassium, calcium and magnesium.
Then consider if you can eliminate any of the known food constituents likely to contribute to cramps.
Next, try stretching, massage, heat, ice, and drinking plenty of fluids with electrolytes. Unfortunately most people turn next to a doctor’s prescription, but even these don’t heal the problem. Quinine has been my favorite, but in 2006 the FDA ordered it to be removed from use due to too many adverse effects. Tylenol and stronger medications (there are many, such as Tramadol) could be used just to block the pain caused by cramps, but they don’t reverse the cause.
Other medications are used but there are only small studies done which have only shown marginal benefit: Diltiazem, Gabapentin, and Carisoprodol (Soma) which metabolizes into diazepam (Valium). However, Botox injections ($$$) right into the affected muscles have shown some benefit in small studies.
Magnesium supplements for leg cramps?
We know that mineral electrolytes are a vital part of nerve and muscle function. But 7 out of 10 adults are low in a primary one — magnesium. Therefore, you might think the first treatment would be to take a magnesium supplement, which many people do. Yet clinical studies don’t show such great results with magnesium supplementation.
However, it may depend on what type of magnesium supplement is being used. Some supplements are poorly absorbed, and to reap any benefit your body needs a type that is bioavailable — meaning more easily absorbed.
The better choices are magnesium compounds that dissolve well in liquid and are more completely absorbed in the gut. According to studies these are not magnesium oxide or magnesium sulfate, but rather magnesium aspartate, magnesium citrate, magnesium lactate and magnesium chloride.
Also, magnesium is absorbed easily through your skin and you can supplement with magnesium oil or Epsom salt baths. Even if you feel you eat enough magnesium from nuts, fish, meat, dark green vegetables, legumes, whole grains and fruits, you can still supplement and be the better for it.
Nutrients to heal muscle and nerve function
We know that chronic disease begins with an unhealthy gut. Refined sugar, excessive bread, and other processed foods must be replaced by mostly raw, whole foods: fruits, vegetables and other whole foods which contain minerals, vitamins, anti-oxidants, fiber, healthy oils, and phytochemicals.
Once digestive health and a clean diet are established, look to certain nutrient supplements to repair the underlying metabolic malfunction:
- D-Riboseis one of the necessary nutrients to stimulate the formation of ATP, the “universal” energy molecule we all need to move every cell. D-ribose is especially great for over-worked muscles. Exercise physiologists have shown that D-ribose supplementation increased total ATP production by up to four-fold. Other researchers demonstrated as up to a six-fold rise in ATP recycling with D-Ribose supplementation.
- Omega-3 oil (Krill oil, fish oil, flaxseed oil, etc.) are building blocks of nerve tissue and are useful at high doses (6 grams daily) to reduce nerve inflammation.
- Gamma-linolenic acid (GLA) is an omega-6 oil that has been studied and found to protect nerves from diabetes-induced injury, also found to be high in evening primrose, borage and black currant oils.
- α-Lipoic acid is used in Germany given intravenously (IV). Oral doses of 300 mg twice daily or more are recommended for nerve healing.
- Acetyl-L-carnitine is an amino acid that clearly improves diabetic neuropathy at 500 mg or 1,000 mg three times daily.
- Vinpocetine opens up peripheral blood flow affecting nerves; one could begin with 20 mg twice daily with meals and increase as needed.
- Inositol 500-1,000 mg daily was effective in certain studies.
- Tumeric (curcumin) is an Ayurvedic herb used to calm nerve pain.
- B6 and B12 Vitamin injections build healthy muscle and nerve tissue.
- CoEnzymeQ10 as an anti-oxidant and ATP-generator to cells (200-300 mg/day)
- Sphingomyelin, Phosphatidyl Choline, or Phosphatidyl Serine are all known to be healing specifically to nerve tissue disorders
- Ginkgo biloba extract 40-80 mg twice daily to help improve nerve cell function and anti-oxidation
- Valerian root, Passion flower, and Kava Kava are slightly sedative to help with a good night’s sleep
Roffe C, Sills S, Crome P, Jones P. Randomised, cross-over, placebo controlled trial of magnesium citrate in the treatment of chronic persistent leg cramps. Med Sci Monit. 2002 May;8(5):CR326-30. PubMed PMID: 12011773. https://www.ncbi.nlm.nih.gov/pubmed/12011773
Sebo P, Cerutti B, Haller DM. Effect of magnesium therapy on nocturnal leg cramps: a systematic review of randomized controlled trials with meta-analysis using simulations. Fam Pract 2014;31:7–19. https://www.ncbi.nlm.nih.gov/pubmed/24280947.
Garrison SR, Allan GM, Sekhon RK, et al. Magnesium for skeletal muscle cramps. Cochrane Database Syst Rev 2012;9:CD009402. https://www.ncbi.nlm.nih.gov/pubmed/22972143
Tullson PC, Terjung RL. Adenine nucleotide synthesis in exercising and endurance-trained skeletal muscle. Am.J Physiol. 1991 Aug;261(2 Pt 1):C342-7.
Zarzeczny R, Brault JJ, Abraham KA, Hancock CR, Terjung RL. Influence of ribose on adenine salvage after intense muscle contractions. J Appl Physiol. 2001 Oct;91(4):1775-81.
Brault JJ, Terjung RL. Purine salvage to adenine nucleotides in different skeletal muscle fiber types. J Appl Physiol. 2001 Jul;91(1):231-8.
Jamal GA, Carmichael H. The effect of gamma-linolenic acid on human diabetic peripheral neuropathy: a double-blind placebo-controlled trial. Diabet Med. 1990;7:319-323.
Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. The gamma-Linolenic Acid Multicenter Trial Group. Diabetes Care. 1993;16:8-15.
Sima AA, Calvani M, Mehra M, Amato A; Acetyl-L-Carnitine Study Group. Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy: an analysis of two randomized placebo-controlled trials. Diabetes Care. 2005 Jan;28(1):89-94.
Salway JG, Finnegan JA, Barnett D, et al. Effect of myo-inositol on peripheral-nerve function in diabetes. Lancet. 1978;2:1282-1284. Also: Gregersen G, Bertelsen B, Harbo H, et al. Oral supplementation of myoinositol: effects on peripheral nerve function in human diabetics and on the concentration in plasma, erythrocytes, urine and muscle tissue in human diabetics and normals. Acta Neurol Scand. 1983;67:164-172.