What’s causing those annoying leg cramps?

What causes leg cramps?

All of us know by experience what a leg cramp is — and how much they can hurt. Especially a Charley horse in the middle of the night…

When these occur night after night, it can be a serious problem due to pain and the sleeplessness they cause. A recent study revealed that in the over-sixty age group, 31 percent reported being woken up by leg cramps and 15 percent had them more than three times a month on average. The main area of cramping (80 percent) was in the calf muscles.

What is thought to cause leg cramps?

The exact mechanism of leg cramps is unknown. However, we know that muscle fatigue and nerve dysfunction are at the heart of it, more so than electrolyte depletion.  There are medical conditions associated with an increased prevalence of leg cramps: cancer treatment, heart disease, liver disease, kidney dialysis, spinal stenosis, peripheral vascular disease, low thyroid function, and pregnancy. Also, there is a long list of medications that could be the trigger for leg cramps, most notably the antipsychotics, birth control pills, diuretics, statins, raloxifene, naproxen and corticosteroids (this reliably causes leg cramps for me).   Yet, it can still be puzzling as to why they occur.

Consider that muscles need blood flow that carries oxygen and nutrients (such as mineral electrolytes magnesium, potassium, and calcium) to function normally. Also, the muscles involved must generate enough ATP energy.  Some possible ways these nutrients could be depleted are by prolonged standing or sitting (with legs crossed); dehydration (from diuretics or not drinking enough); and sleep deprivation (seems to make it worse for many leg cramp sufferers).

Digging deeper, what else could be causing leg cramps?

There is more I’ve discovered that contributes to leg cramps. A 2017 report of 5,563 Americans aged 18-85 showed that “higher levels of urinary pesticides, heavy metals, phthalates, and polyaromatic hydrocarbons were associated with leg cramps while sleeping.”

Furthermore, some foods constituents that worsen leg cramps are:

  • aspartame (the artificial sweetener NutraSweet),
  • caffeine (in coffee and certain cola drinks),
  • gluten (wheat protein),
  • monosodium glutamate (MSG),
  • alcohol,
  • tobacco (nicotine), and
  • refined sugar (too much and for too long).

Research from Washington State University notes that patients with fibromyalgia, improved after completely removing aspartame and MSG (monosodium glutamate) from their diet. Aspartame and MSG are “excitotoxins” to nerve tissue and can result in muscle contraction and cramping.

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Moreover, aspartame directly and indirectly (through its metabolites) harms nerve cells. It is metabolized into phenylalanine (50 percent), aspartic acid (40 percent) and methanol (10 percent) after you eat it:

  • The excess phenylalanine blocks the transport of certain amino acids which contributes to lowered levels of dopamine and serotonin — your important feel good brain and gut neuro-hormones.
  • Aspartic acid at high concentrations is known to be toxic and causes hyperexcitability of neurons and leads to the degeneration of neurons.
  • More recent studies show that aspartame’s metabolite, diketopiperazine, indeed does contribute to the formation of the brain cancers known as gliomas, medulloblastomas and meningiomas.

Magnesium deficiency can contribute to leg cramps

7 of 10 adults have low magnesium but don’t realize it. Classic symptoms of low magnesium include tremor, muscle fasciculation, twitches, involuntary jerks and cramps.

How can you become deficient in magnesium if you have a built-in homeostasis mechanism to keep your blood magnesium in proper balance (intestinal absorption, kidney excretion, and bone deposition/exchange of minerals)?

Part of answer lies in the fact that magnesium deficiency in your muscles is difficult to measure and therefore, is not generally detected or reported. Blood tests for magnesium is a very inaccurate evaluation of magnesium in your muscles, because only 0.3 percent of your total body magnesium (and less than 1.0 percent of total body calcium) are measurable in your blood.  Peer reviewed scientific articles reveal that the diagnosis of low magnesium or low calcium is vastly underestimated.

To make things worse, our government’s RDI (recommended daily intake) of magnesium is too low for optimal health.  A government study shows that 68 percent of Americans do not consume the RDI of magnesium (420 mg a day for adult males) and 19 percent of Americans consume less than half of the RDI of magnesium.

Additional reasons for low magnesium body tissue levels include:

  • Magnesium soil depletion is increasing and is becoming less absorbable
  • Prescription medications and hormone imbalances also lower our magnesium.
  • Processed foods, refined sugars, alcohol, and miscellaneous conditions can deplete you magnesium.

Despite mainstream medicines claim that “No current treatments for leg cramps have been proven both safe and effective”  in my next article I’ll share with you what is working for many people, from highly absorbable magnesium supplements and D-Ribose, to Botox injections.


Maisonneuve H, Chambe J, Delacour C, Muller J, Rougerie F, Haller DM, Leveque M. Prevalence of cramps in patients over the age of 60 in primary care: a cross sectional study. BMC Fam Pract. 2016 Aug 12;17(1):111. PubMed PMID: 27520635. https://www.ncbi.nlm.nih.gov/pubmed/27520635

Shiue I. Urinary arsenic, pesticides, heavy metals, phthalates, polyaromatic hydrocarbons, and polyfluoroalkyl compounds are associated with sleep troubles in adults: USA NHANES, 2005-2006. Environ Sci Pollut Res Int. 2017 Jan;24(3):3108-3116. PubMed PMID: 27858272. https://www.ncbi.nlm.nih.gov/pubmed/27858272

Rycerz K, Jaworska-Adamu JE. Effects of aspartame metabolites on astrocytes and neurons. Folia Neuropathol. 2013;51(1):10-7. Review. PubMed PMID: 23553132. https://www.ncbi.nlm.nih.gov/pubmed/23553132

Rycerz K, Jaworska-Adamu JE. Effects of aspartame metabolites on astrocytes and neurons. Folia Neuropathol. 2013;51(1):10-7. Review. PubMed PMID: 23553132. https://www.ncbi.nlm.nih.gov/pubmed/23553132

Wilhelm Jahnen-Dechent, Markus Ketteler. Magnesium Basics. Clin Kidney J (2012) 5 (Suppl 1): i3-i14.


King D, Mainous A 3rd, Geesey M, Woolson R. Dietary magnesium and C-reactive protein levels. J Am Coll Nutr. 2005 Jun 24(3):166-71

Wilhelm Jahnen-Dechent, Markus Ketteler. Magnesium Basics. Clin Kidney J (2012) 5 (Suppl 1): i3-i14.

Dr. Michael Cutler

By Dr. Michael Cutler

Dr. Michael Cutler is a graduate of Tulane University School of Medicine and is a board-certified family physician with more than 20 years of experience. He serves as a medical liaison to alternative and traditional practicing physicians. His practice focuses on an integrative solution to health problems. Dr. Cutler is a sought-after speaker and lecturer on experiencing optimum health through natural medicines and founder of the original Easy Health Options™ newsletter — an advisory on natural healing therapies and nutrients. His current practice is San Diego Integrative Medicine, near San Diego, California.