Muscle cramping

[kaysee]

Has anyone experienced muscle cramping with WG. I get cramps in my toes, my foot cramps inward at the ankle, my calves cramp as from low potassium (but my potassium runs normal to high), and I've had cramps in my fingers. I think it is from the prednisone as the only other drug I'm getting is rituxan infusions. I have strong cramps during the rituxan infusion but they give me high dose of steroid before those, so I am still thinking it is the steroid. I keep telling the doctors about it but no one seems to address it.

Karen

[Velma]

I think you are right about the Prednisone. I get cramps too especially when I am tapering the preddy. Try eating the bananas it will help the potassium and the cramps too and drink lots of water. Hope this helps

[renidrag]

Lots of water, and don't forget, lots of water.
Dale

[gilders]

Definitely due to Pred. Your cramps sound just like mine. I can usually feel a few twinges or my toes and fingers start twitching before the full blown cramping begins, but there's nothing I can do to stop it. The cramps are so severe that my feet and hands get twisted into positions that seem impossible. Personally the ones in the feet and toes seem worse.
I'm sure you know this already, but to try and treat the cramp you need to stretch the effected muscle. E.g. if it's your calf, straighten your leg and pull back on your toes and foot towards your knee. The only problem with this is that sometimes the muscle running down the front of your shin begins to cramp and you're now doing the exact opposite of what needs o be done with this muscle.
As for the feet. It's hard to know what to do with them. They bend and twist to such weird positions you don't know which way to push or pull on them.

My Dr has prescribed me Quinine Sulphate which is the usual treatment for persistent cramps, but I don't think it works on "steroidal cramps", at least not in my case. But it might be worth giving it a try.

I don't think I have ever mentioned my cramps on this forum as it "sounds" so insignificant compared to some of the other complications associated with WG, but it's one of the main things that effect day to day life when they are so severe.
When I'm on doses of Pred higher than 10mg/day I usually don't sleep for much more than an hour without been woken up with cramps.

You have my total sympathy with this.:crying: The good news is that I've found that about a month after dropping Pred to 10mg/day the cramps MUCH improve.:thumbsup:

As for the potassium. I have renal failure so my potassium levels are high. In fact I was fairly recently kept in hospital and had some IV drug to lower my potassium levels. I was still suffering from cramps, so I believe the Pred causing cramps can't be helped with Potassium.

[mrtmeo]

Hi Kaysee,
My mom had horrible muscle cramps in legs, hands and arms when every she dropped prednisone or dexamethasone.
It usually only lasts for 3 days.
Stretching the muscles and holding the tightened muscle for 30 seconds can help or hot rags.
My mom found some relief also, from Hylands Leg cramps cream.

The quinine never worked for my mom either, gilders.

Steroids mess with electrolytes for some reason.
Extra salt helped a tiny bit, but magnesium and or potassium didn't work.

[vdub]

Yeap, include me in, too -- toes and arch of foot. Not so much the calf. Starts cramping when I first lay down to go to bed. Cramps for a few minutes then eases up. Must be the pred....

[aewaustin]

I have done endurance events and for those we use the below salt tabs, they help with cramping, If I were having cramping issues I would take two of these a day. Keep in mind that drinking water is great, but you can screw with your electrolyte balance if you drink too much. When you hear of folks dying at marathons sometimes it is because they drink too much water and don't replenish their electrolytes. I try to drink tons of water each day and for every 3 32oz of water I will take two salt tabs, or you can balance with gatoraid or something like that.

Amazon.com: Saltstick Electrolyte Capsules (100/bottle): Sports & Outdoors (http://smile.amazon.com/Saltstick-Electrolyte-Capsules-100-bottle/dp/B002IY96B0/ref=sr_1_1?ie=UTF8&qid=1411997736&sr=8-1&keywords=salt+tablets+for+runners)

[RudiK]

I agree with everything everyone has said. I'd like to add that what helps me is to elevate my feet when I go to bed, at least is has stopped most of the cramps in my feet and lower legs.

[gilders]

Interesting that salt has been mentioned a couple of times. I have high blood pressure caused by renal failure so I'm on a low salt diet. I guess this could help explain why my cramps are so bad.

[aewaustin]

Interesting article on Paleo and blood pressure... 6 Ways To Lower Blood Pressure By Changing Your Diet (http://chriskresser.com/6-ways-to-lower-blood-pressure-by-changing-your-diet)

[JeanMarie]

Kaysee, be cautious about stuff like salt or excessive water. I think you said you had kidney involvement & you should probably check with your kidney doc before making changes. We are all so different. When first diagnosed I was on cytoxin & told to drink lots of water--I did, and my sodium levels tanked. I got phone calls from all my docs saying "back off on some of that water, & replace some of it with Gatorade, etc. Best to run it by your docs!

About your doctors not addressing it. Sometimes I really have to get in their face before they respond. They are looking at things they think are important, & we have to make sure they know what is important to us.

[mrtmeo]

Interesting that salt has been mentioned a couple of times. I have high blood pressure caused by renal failure so I'm on a low salt diet. I guess this could help explain why my cramps are so bad.

Hi gilders,
Salt keeps water in and potassium takes water out.
I drink lots of coffee, so I get too much potassium and have to take salt to get rid of cramps, but I am not on prednisone.
Prednisone seems to really mess with sodium/potassium levels.
I wish I knew the mechanism that causes potassium to rise with kidney disease versus sodium.

[kaysee]

Glad to hear I'm not the only one with these cramps. None of my doctors have given me any insight into what I can do to help them. I did stop having the cramps for the two weeks I was off pred and now that I'm on it again they have not been as bad. Like you, Gliders, I can feel them coming on and I have learned to position my legs in certain ways that help avoid them. I can't do salt as my kidney function is compromised considerably and I'm also not supposed to drink great quantities of water. I am having water retention problems as well. I need to learn how to work on balancing the salt, potassium and water intake. This is all new to me so I have a lot to work out. Thanks all of you for your information and support. I am so glad I found this group.

Karen, diagnosed April 2014

[gilders]

I am having water retention problems as well.


Another similarity between us. My Dr has prescribed Furosemide (water tablet/diuretic) for water retention. He warned me that one of the side effects can be cramps. My cramps have not worsened on these tablets, which reaffirms that it's the Pred causing the cramps.

[Psyborg]

I'm pretty sure it's Prednisone. WHen I'm on lower doses I never have cramps. At 15+ I get weird cramps in my feet and lower legs. Like on the front of my shin, and weird cramps were my feet starting pulling downward into a curve. As soon as I get below 15 those all seem to subside. Eating bananas does seem to help a little.

[mrtmeo]

I remember reading that steroids, including inhalers, push out potassium and keep the sodium too high.
I asked a dr if the sodium levels measured in serum can tell if our sodium is high or low and he said no.
They can't really tell our true sodium levels with blood work.
So, if our blood serum says our potassium is high, but doesn't know how high our sodium is, it could just be a huge imbalance in the sodium/potassium levels.

If you have high potassium levels from the kidneys, there was a study using glycyrrhizic acid (from licorice) can reduce potassium levels.
Effect of glycyrrhizine on hyperkalemia due to hypo... [Life Sci. 1993] - PubMed - NCBI (http://www.ncbi.nlm.nih.gov/pubmed/8336514)

Also, with kidney disease phosphorus can go too high which is due to protein and can be reduced using Niacinamide.
A Randomized, Double-Blind, Placebo-Controlled Trial of Niacinamide for Reduction of Phosphorus in Hemodialysis Patients (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440276/)

[Pete]

I'm pretty sure it's Prednisone. WHen I'm on lower doses I never have cramps. At 15+ I get weird cramps in my feet and lower legs. Like on the front of my shin, and weird cramps were my feet starting pulling downward into a curve. As soon as I get below 15 those all seem to subside. Eating bananas does seem to help a little.

My experience is pretty much the same as Bob's. Except my worst cramps were in my hands. My fingers and thumbs would go in directions that I can't normally make them go.

[annekat]

I get weird cramps in my feet and hands. Funny thing, I was getting them in my hands right before dx and before treatment. So if it is the pred, maybe it is the tapering of pred rather than the pred itself? I have been on 20mg. or less during the last 2.5 years, up and down a couple of times between 20 and 10 due to minor flares. It does seem the cramping flares up when I'm tapering, along with some joint pain in my hands, some red dots on my forearms, and a bit of blood in my nasal discharge. Right now I'm at 12mg, down from 15, and am having the hand and foot cramping now and then but not the other things. Heck, I don't know.... as soon as I think there's a rhyme or reason I start to doubt it.

[drz]

I have had lots of cramps in legs and hands for years for various reasons. Dupytrens contractures caused many hand cramps. Surgery seemed to help decrease these. My leg cramps came from other causes. Dehydration was only thing I could try to avoid to reduce leg cramps plus taking enough calcium. Mild exercise also seems to help. Mild stretching seems to help me the most. Too much exercise seems to bring on more cramps for me.

[Thinker]

I also get muscle cramps in my calves and feet. I thought they were related to my anemia or neuropathy but this gives me new insight in that prednisone may be to blame. I take calcium supplements so I don't think that is to blame. Mine seem to be most bothersome at night, as if I didn't need something else besides prednisone and getting up to use the bathroom to interfere with what little good sleep I get! :sad: Stretching also seems to help me when they strike.

[drz]

I also get muscle cramps in my calves and feet. I thought they were related to my anemia or neuropathy but this gives me new insight in that prednisone may be to blame. I take calcium supplements so I don't think that is to blame. Mine seem to be most bothersome at night, as if I didn't need something else besides prednisone and getting up to use the bathroom to interfere with what little good sleep I get! :sad: Stretching also seems to help me when they strike.

If you have osteoporosis from the pred you need a bit more calcium. I take two kinds every day and still have some bone loss and fragile teeth.

[Thinker]

If you have osteoporosis from the pred you need a bit more calcium. I take two kinds every day and still have some bone loss and fragile teeth.
That is good advice. I had a bone density test last month and have osteopenia. I currently take 1000 mg calcium citrate with vitamin D and magnesium but I may need to I increase it.

[aewaustin]

Just ran across this article, interesting.

Cramps: A few months into my sugar-free life I realized that I hadn't had any leg or foot cramps since the diet began. Serious cramping had been a constant problem for years, mostly happening suddenly -- and painfully -- at night. I had no idea how sugar and leg cramps were related, so I began to talk about it to the doctors with whom I work. About half of them said my cramp-less nights were unrelated to sugar intake. The other half believe that it is directly related, having to do with well regulated glucose levels in the cells of my leg muscles.
A month after realizing the cramps had disappeared, I was confronted by a dessert I couldn't easily refuse. Not wanting to seem picky or demanding in front of Greg's relatives, whom he hadn't seen in 40 years, I knocked back cousin Theresa's mound of whipped cream and berry-filled meringue. Frankly, it was delicious and I was enjoying myself thoroughly -- until an epic and extremely painful charley horse in my thigh levitated me off my chair. It took 25 minutes of limping around in front of the house to ease the cramp. It was the last time I knowingly ate sugar. If I had previously doubted the impact of sugar, all doubts now disappeared. The sweetness was simply not worth the pain.

My Year off Sugar | Rick Foster (http://www.huffingtonpost.com/rick-foster/no-sugar-diet_b_1397439.html)

[mrtmeo]

Just ran across this article, interesting.

Cramps: A few months into my sugar-free life I realized that I hadn't had any leg or foot cramps since the diet began. Serious cramping had been a constant problem for years, mostly happening suddenly -- and painfully -- at night. I had no idea how sugar and leg cramps were related, so I began to talk about it to the doctors with whom I work. About half of them said my cramp-less nights were unrelated to sugar intake. The other half believe that it is directly related, having to do with well regulated glucose levels in the cells of my leg muscles.
A month after realizing the cramps had disappeared, I was confronted by a dessert I couldn't easily refuse. Not wanting to seem picky or demanding in front of Greg's relatives, whom he hadn't seen in 40 years, I knocked back cousin Theresa's mound of whipped cream and berry-filled meringue. Frankly, it was delicious and I was enjoying myself thoroughly -- until an epic and extremely painful charley horse in my thigh levitated me off my chair. It took 25 minutes of limping around in front of the house to ease the cramp. It was the last time I knowingly ate sugar. If I had previously doubted the impact of sugar, all doubts now disappeared. The sweetness was simply not worth the pain.

My Year off Sugar*|*Rick Foster (http://www.huffingtonpost.com/rick-foster/no-sugar-diet_b_1397439.html)

If you have bad kidneys, the sugar maybe the problem.
I took the sugar out of my mom's diet and trying a more ketogenic type diet and she has had no swelling in her feet since.
She only seemed to have cramps when she reduced the prednisone, so will have to see what happens when she cuts the prednisone again and is off sugar and grains.

[MaxD]

Cramps are common with prednisone. I was told to try tonic water (quinine) twice a day. But make sure it's the sugar-free kind!

[gilders]

Cramps are common with prednisone. I was told to try tonic water (quinine) twice a day. But make sure it's the sugar-free kind!
And don't forget the gin. Put enough gin in it and you won't even care about the cramps!:wink1: