2

votes

My trouble-shooting skills need hacking! Cramps, electrolytes, b-vits: deficiency or sensitivity?

Answered on September 12, 2014
Created May 18, 2012 at 6:17 PM

I'm teetering on the brink of either a deficiency of something, or a reaction to something.

The symptom is cramping (foot, calves, hands) and muscle discomfort.

Initially, when it was just a problem in my right foot, I saw a podiatrist who diagnosed it as tendinitis. However, it got worse, and then my calves and hands started cramping, so I don't think the tendinitis is the root problem. I sense it's more systemic.

I've been googling this to death and electrolytes seems like the most likely culprit.

To rule out magnesium deficiency, I upped my Calm fizzy and other magnesium supplements to bowel tolerance for months. Eventually, I got a magnesium RBC test which said it was normal, so it's not that.

I noted I wasn't eating much salt because I've been cooking from scratch since going paleo for the last 3 months, and I don't add salt when cooking. I've tried increasing sodium, and I don't think it's that.

Thinking maybe the calcium pills I take weren't being absorbed, I added milk (2 cups) to my daily routine a few days ago, along with a liquid calcium citrate / magnesium citrate supplement.

I just read that deficiency of b-vitamins could cause these types of problems. I just bought a Solgar b-complex 50 and will take two/day (started today).

One more piece of data: the symptoms were pretty bad on Wednesday. Wednesday night I cooked in the sauna at the gym (in case it was a reaction to food or something, I figured I might 'sweat it out of me'). Thursday morning, it was significantly worse. Unless getting worse after sauna was just a coincidence, and assuming it's a deficiency, maybe I sweated out too much of whatever it is, making it worse?

As to my trouble-shooting technique, since I don't know what it is, I'm trying to prove what it isn't by ruling things out one by one.

Questions:

  1. If it is a calcium deficiency, how long before it might respond to changing calcium formulas and adding milk?

  2. If it is b-vitamins, how long before it might respond?

  3. Is there a better of trouble-shooting this problem if it is a deficiency? Going on a strict elimination diet and taking no supplements would only make it worse.

  4. Any other thoughts or suggestions would be very much appreciated.

Thanks,

Mike

7fc82eebafd44badc73c520f44660150

(3275)

on July 09, 2013
at 05:39 PM

@jo60: it's a shame that potassium supplements are limited to like 1 or 2% RDA. So five would be 5%-10% (which is better than nothing). I wish there was just a magic pill for 100% !!

5b8cf203186c3cb7810f5046e0532be8

(166)

on September 18, 2012
at 03:59 PM

ZC eating should be possible without cramps. Look at the inuit and grok, they eat large periods of the year ZC / VLC. Wile ZC and VLC tend to dehydrate the body, enough minerals keep dehydrating from going to far. I suspect the low Magnesium body saturation values for about everyone. The body keeps the blood value in a strict range, at a cost of the rest of the body saturation. So a bloodvalue in range is not a good indicator.

7fc82eebafd44badc73c520f44660150

(3275)

on May 31, 2012
at 08:45 PM

but does topical magnesium work?

B525b3e4b1d6f1cdceec943cdec6eb7d

(1680)

on May 20, 2012
at 04:05 PM

I am fond of berries, but wasn't eating many of them after switching to paleo. I'm very interested to hear of the three changes you've made. Will look forward to your update!

7fc82eebafd44badc73c520f44660150

(3275)

on May 20, 2012
at 02:12 AM

In pursuit of me upping my sodium, I added about 1/2 tsp of real salt to a 17oz container of coconut water. That had a similar and disturbingly quick effect similar to taking about 1,000 of magnesium salt, which draws water into the intestine producing an unpleasant effect. I'll try and be less aggressive with it in the future.

7fc82eebafd44badc73c520f44660150

(3275)

on May 20, 2012
at 01:15 AM

Interesting blueberry point @redberry (sounds like you're fond of berries). For whatever it's worth, the 3 changes I made seemed to improve things substantially: added calcium, added b-complex vitamin supplement, increased fluids AND sodium. As a side benefit, I feel substantially better than I have over the last week or so. None of this is conclusive, and could have nothing to do with my changes, but I did want to share. I'll report back in a week or so with an update.

279493cd0b85ed78595dec94b93d1d31

(155)

on May 19, 2012
at 07:59 PM

What type of magnesium were you taking? I tried the Natural Calm stuff, but it completely SCREWED with my GI system. The topical magnesium does not have the same effect for me.

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 11:51 AM

For the last few days, in a feeble effort to rule out LC issues, I upped my carb. Yesterday, I had 2300 calories, 45% from carb (about 270g carb). I think the great answers here suggesting I focus first on sodium are good, and I'll be rigorous for the new few weeks. Thanks again to everyone for the great suggestions.

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 11:49 AM

I just added almost a 1/2 tsp of himalayan salt to a 17oz container of coconut water with acai & pomogranate. Surprisingly, it wasn't too oppressively salty and I was ok drinking it. For me, it seems that unless it's sprinkled on food, I don't taste it nearly as much. If it's dissolved in soup or liquid, it sneaks by.

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 11:44 AM

Upon further reflection, I'm guessing I drink 2.5 Liters / day. I'll keep better track going forward.

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 10:41 AM

I was torturing myself taking magnesium despite the g.i. Consequences. I finally found requestatest.com and was able to get a magnesium rbc test to get an accurate level. Standard doc office mag serum test are NOT accurate.

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 19, 2012
at 02:50 AM

see above 1/2 tsp in 3 L of water. not including a little sprinkle here and there in broth, a burger, etc..I lightly" salt "some" food and barely taste the salt in the water. 3-4 grams per day for normal activity/weather. which is approx 1/2 tsp over the day-not at once. start with that or a tad more if you a big guy. I dont really care if I get a check or not :)but thank you.

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 19, 2012
at 02:45 AM

right on that..as well as exercise or just hot weather.

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 12:55 AM

How much total sodium do you take each day?

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 12:11 AM

Use of a sauna would make the problem worse, right?

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 12:07 AM

Upon further reflection, I don't think I increased sodium enough nor long enough before concluding that wasn't the problem and moving on to my next hypothesis. I'm increasing calcium and b vitamins as well in hopes of getting resolution. I rather get it fixed than know which variable was the solution.

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 12:05 AM

Thanks @jo60. That link is particularly helpful. Had it been a separate answer, I would have put a green checkmark on it !

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 18, 2012
at 10:50 PM

Mike I found the easiest way is to fill up xLitres/day and set it somewhere /or take x amount with you so that you can always visually see exactly where your consumption is. I find the 4 L milk/water jug great to fill up/salt and pour from there. I add my magnesium citrate powder to that as well. Saves having to measure extra times. I do not include tea/broth or other liquids in my water intake so some days I drink a bit more or less. I think just a couple of days will give you a good idea.

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 08:23 PM

The fact that I can't answer that question is probably an indication that I need to measure out salt and water for at least a week. Thank you for point. I will do that starting today.

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 08:20 PM

Thanks @Kelly. The 5 days reference is helpful. It's soo hard to tell how long you need to try a hypotheses before you conclude it's not that, and move onto the next test.

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 08:20 PM

i'm pretty good about no grains, occasional lapses during the month

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 18, 2012
at 08:14 PM

I actually take 1/2 tsp Himalayan salt in 3 L of water and my only exercise is moderate walking. Eades says it is dehydration. http://www.proteinpower.com/drmike/saturated-fat/tips-tricks-for-starting-or-restarting-low-carb-pt-ii/

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 18, 2012
at 08:11 PM

how much water are you actually consuming/day? on a normal day without heat/physical activity? how much sodium is in that water?

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 18, 2012
at 08:00 PM

From Dr. Eades Protein Power "Potassium is linked to sodium. If you lose a lot of sodium through the diuretic effect of the low-carb diet, you’ll ultimately lose a lot of potassium as well. Keeping your sodium intake up as mentioned above will help preserve your potassium as well. And keeping your potassium levels up helps to ensure that you don’t lose a lot of lean muscle mass during your weight loss. Plus, just as with sodium, adequate potassium prevents cramping and fatigue.You can replace your potassium by taking potassium supplements. >taking 4-5 99 mg supplement

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 07:58 PM

Thanks @Briana!

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 18, 2012
at 07:34 PM

Try upping potassium. do you consume "any" grain items at all at all?? I had no idea that my aches/cramps were caused by that until I gave it up and then at some and it all came back.

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 07:21 PM

good points. That was on my radar, and appears not to be the issue in my case. I just edited my question to reflect that in a PS

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 06:51 PM

I haven't been taking my d3 much lately, but last time it was at 45 (pretty good level). I just started taking it again yesterday (5,000 iu). According to cronometer.com, I'm getting about 50% potassium. I was on lowish carb 75g-100g but about a week ago increased the carbs since I wasn't feeling great (not sure if it's related to this issue or not0.

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6 Answers

best answer

3
279493cd0b85ed78595dec94b93d1d31

(155)

on May 18, 2012
at 07:51 PM

I have been experiencing similar symptoms with my calves. I went to an ND after my self-treating failed. I recommend that you do the same because sometimes tests have to be done to find out underlying issues. I have Adrenal Fatigue and I'm Hypothyroid. From what I understand, having an out of whack thyroid can cause mineral deficiencies (don't quote me on that ;D). In general, stress can deplete the body. Stress comes in all kinds of forms. Perhaps you have some inflammation? That can be taxing on the body. I say keep up with the Concentrace. My ND recommended that I do nightly footbaths with Epsom Salts. She also recommended drinking 8oz of Coconut Water daily. I use topical Magnesium to ensure maximum absorption. I also use Concentrace. Google Tahoma Clinic online. They have an online supplement store. Dr. Wrights Salt is another thing that she wants me taking for my low sodium and potassium levels. If you order some, 1/4 teaspoon spread throughout the day. My BP is low and I'm supposed to use it to increase that. You could try Bone Broth daily too. That's all I got! Health issues suck. =X Good luck to you on your journey!

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 18, 2012
at 08:14 PM

I actually take 1/2 tsp Himalayan salt in 3 L of water and my only exercise is moderate walking. Eades says it is dehydration. http://www.proteinpower.com/drmike/saturated-fat/tips-tricks-for-starting-or-restarting-low-carb-pt-ii/

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 12:05 AM

Thanks @jo60. That link is particularly helpful. Had it been a separate answer, I would have put a green checkmark on it !

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 19, 2012
at 02:50 AM

see above 1/2 tsp in 3 L of water. not including a little sprinkle here and there in broth, a burger, etc..I lightly" salt "some" food and barely taste the salt in the water. 3-4 grams per day for normal activity/weather. which is approx 1/2 tsp over the day-not at once. start with that or a tad more if you a big guy. I dont really care if I get a check or not :)but thank you.

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 07:58 PM

Thanks @Briana!

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 12:55 AM

How much total sodium do you take each day?

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 11:49 AM

I just added almost a 1/2 tsp of himalayan salt to a 17oz container of coconut water with acai & pomogranate. Surprisingly, it wasn't too oppressively salty and I was ok drinking it. For me, it seems that unless it's sprinkled on food, I don't taste it nearly as much. If it's dissolved in soup or liquid, it sneaks by.

6
345c1755efe005edd162b770dc6fb821

(8767)

on May 18, 2012
at 07:59 PM

definitely start with the dehydration theory first, its the easiest to resolve; coconut water will help, or get rehydration salts from the pharmacy and mix with water, or just buy it mixed already with or without flavoring. I had the same issue and its a achy crampy feeling thoughout your lower body and arms. Within drinking a liter or rehydration salts I was better in a day; but had to drink it for about 5 days to snap out of it.

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 12:11 AM

Use of a sauna would make the problem worse, right?

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 08:20 PM

Thanks @Kelly. The 5 days reference is helpful. It's soo hard to tell how long you need to try a hypotheses before you conclude it's not that, and move onto the next test.

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 19, 2012
at 02:45 AM

right on that..as well as exercise or just hot weather.

5
3351f6c8ec1ea64435e419f380ca6468

(1255)

on May 18, 2012
at 07:08 PM

One possibility - on fairly low carb and below, you excrete a lot of water, since it isn't needed to process the carbs. You may just be dehydrated. Peter Attia talks a lot about balancing electrolytes in ketosis on his blog (I cannot find the right entry, but he drinks a cup of commercial bouillon daily to ensure his salt intake is adequate). And Dr. Michael Eades has an entry on his blog discussing cramping and dehydration that you might find useful.

Having provided that information, I have to admit that I spent about 9 months doing VLCish Paleo for weight loss and was jumping out of bed with intense calf cramps nightly the whole time (this was before finding either of those references). It got so that I felt the weight loss was stalling if I didn't. I have reintroduced some carbs since then, randomly, and the cramps hardly ever occur anymore.

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 07:21 PM

good points. That was on my radar, and appears not to be the issue in my case. I just edited my question to reflect that in a PS

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 18, 2012
at 08:00 PM

From Dr. Eades Protein Power "Potassium is linked to sodium. If you lose a lot of sodium through the diuretic effect of the low-carb diet, you’ll ultimately lose a lot of potassium as well. Keeping your sodium intake up as mentioned above will help preserve your potassium as well. And keeping your potassium levels up helps to ensure that you don’t lose a lot of lean muscle mass during your weight loss. Plus, just as with sodium, adequate potassium prevents cramping and fatigue.You can replace your potassium by taking potassium supplements. >taking 4-5 99 mg supplement

5b8cf203186c3cb7810f5046e0532be8

(166)

on September 18, 2012
at 03:59 PM

ZC eating should be possible without cramps. Look at the inuit and grok, they eat large periods of the year ZC / VLC. Wile ZC and VLC tend to dehydrate the body, enough minerals keep dehydrating from going to far. I suspect the low Magnesium body saturation values for about everyone. The body keeps the blood value in a strict range, at a cost of the rest of the body saturation. So a bloodvalue in range is not a good indicator.

7fc82eebafd44badc73c520f44660150

(3275)

on July 09, 2013
at 05:39 PM

@jo60: it's a shame that potassium supplements are limited to like 1 or 2% RDA. So five would be 5%-10% (which is better than nothing). I wish there was just a magic pill for 100% !!

1
B525b3e4b1d6f1cdceec943cdec6eb7d

(1680)

on May 19, 2012
at 04:05 PM

Leg cramping at night is the only problem I've had since switching to a paleo diet. Tried a bunch of things (potassium supplements, etc) and nothing worked. Ow.

Now, before paleo I always used to have porridge with blueberries for breakfast. In a try-anything spirit, I decided to add the blueberries back into my diet, minus the porridge. No leg cramps since. I try to have a handful of blueberries or other berries each day now.

I suppose it could be a coincidence, or the placebo effect; I've no idea. But now I can stretch in bed without having leg muscles go into painful spasms, so I'm happy.

B525b3e4b1d6f1cdceec943cdec6eb7d

(1680)

on May 20, 2012
at 04:05 PM

I am fond of berries, but wasn't eating many of them after switching to paleo. I'm very interested to hear of the three changes you've made. Will look forward to your update!

7fc82eebafd44badc73c520f44660150

(3275)

on May 20, 2012
at 01:15 AM

Interesting blueberry point @redberry (sounds like you're fond of berries). For whatever it's worth, the 3 changes I made seemed to improve things substantially: added calcium, added b-complex vitamin supplement, increased fluids AND sodium. As a side benefit, I feel substantially better than I have over the last week or so. None of this is conclusive, and could have nothing to do with my changes, but I did want to share. I'll report back in a week or so with an update.

0
E28862b6c91551a974b2906e5c9e31d7

on May 19, 2012
at 06:50 AM

I had bad night cramps in the legs, almost nightly, till I figured out a protocol that works for me. First some background for context: I'm male, 63, palaeo since 2000 (people describe me as "hard core" and "strict"). Cramps began in 2003 and I attributed this to excessive carb intake on "carb load days" while I used Faigin's "Natural Hormonal Enhancement" diet for about 6m, but I have no evidence of this other than coincidence. Since then my carb intake is 40-100g/d. I exercise Brooks Kubik style 3 days a week and am active other days. Retired, so no stress. I sleep very still, often in the same position for hours. My protocol: ••• Final meal of the day 2:00-4:00pm ••• No snacks ••• Stay hydrated over the afternoon and evening by drinking 1 - 1.5 litres of water above apparent need (i.e., more than I would drink if driven only by feelings of thirst) ••• Drink 350 - 500ml full cream milk at about 7:00 - 9:00 pm (mine is organic/raw, but I don't think that's critical) ••• Drink about 500ml water before going to bed. Whenever I still get cramps, I can trace it back to either (a) drinking only to perceived feelings of thirst in the afternoon, or (b) neglecting my pre-sleep 500ml. There may be other background factors that are relevant, but I don't want this answer to read like a bio. I'd be happy to enlarge on the above. BTW, note that conventional medicine has nothing definitive to say about the causes or prevention of night cramps, other than a stab in the dark to keep hydrated and take additional magnesium. I used magnesium supplements for a year, but did not experience any significant effects from them.

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 10:41 AM

I was torturing myself taking magnesium despite the g.i. Consequences. I finally found requestatest.com and was able to get a magnesium rbc test to get an accurate level. Standard doc office mag serum test are NOT accurate.

279493cd0b85ed78595dec94b93d1d31

(155)

on May 19, 2012
at 07:59 PM

What type of magnesium were you taking? I tried the Natural Calm stuff, but it completely SCREWED with my GI system. The topical magnesium does not have the same effect for me.

7fc82eebafd44badc73c520f44660150

(3275)

on May 31, 2012
at 08:45 PM

but does topical magnesium work?

0
E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 18, 2012
at 06:41 PM

vit d3? taking any? how about potassium? I suspect it is that.

you don't really say what kind of "Paleo" diet you are on? low carb? dairy? etc..

What are your fat/protein/carb %

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 08:20 PM

i'm pretty good about no grains, occasional lapses during the month

7fc82eebafd44badc73c520f44660150

(3275)

on May 19, 2012
at 11:51 AM

For the last few days, in a feeble effort to rule out LC issues, I upped my carb. Yesterday, I had 2300 calories, 45% from carb (about 270g carb). I think the great answers here suggesting I focus first on sodium are good, and I'll be rigorous for the new few weeks. Thanks again to everyone for the great suggestions.

7fc82eebafd44badc73c520f44660150

(3275)

on May 18, 2012
at 06:51 PM

I haven't been taking my d3 much lately, but last time it was at 45 (pretty good level). I just started taking it again yesterday (5,000 iu). According to cronometer.com, I'm getting about 50% potassium. I was on lowish carb 75g-100g but about a week ago increased the carbs since I wasn't feeling great (not sure if it's related to this issue or not0.

E7e7e1c856d4494d4a1b700b6869df90

(982)

on May 18, 2012
at 07:34 PM

Try upping potassium. do you consume "any" grain items at all at all?? I had no idea that my aches/cramps were caused by that until I gave it up and then at some and it all came back.

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