Night Muscle Cramps – Magnesium or Potassium

by Eileen Schutte | Oct 4, 2021 | Functional Medicine Nutrition

Night muscle cramps, especially in the calf, are commonly referred to as a “charley horse” and are extremely painful and will wake you up out of peaceful sleep. These muscle cramps are referred to as nocturnal muscle cramps and can occur in the toes, ankle, and even the Achilles tendon.

Fortunately, nocturnal muscle cramps only last from seconds to a minute or two. If they last any longer than this, you should see your doctor as they could be a sign of something more serious.

There are many causes of nocturnal muscle cramps, and that is why it can be frustrating trying to find a solution to stop these types of cramps.

One of the most common causes of nocturnal muscle cramps is supposedly magnesium deficiency. Unfortunately, the research does not show magnesium deficiency as a leading cause of nocturnal cramps.

To avoid nocturnal muscle cramps, I have taken magnesium before bedtime and even during the night when I had a muscle cramp. Sometimes it helped, but in most cases it did not.

What does help with nighttime muscle cramps?

Many factors can into play with muscle cramps, including age, activity level, diet, medications, and simply not drinking enough water. Most of these causes impact our electrolyte status, and muscles depend on a balance of electrolytes.

Electrolytes play a critical role in our muscle function and include sodium, calcium, magnesium, potassium, and chloride. Our muscles depend on calcium for contraction and magnesium for relaxation or release. At the same time, potassium works by signaling blood flow to our muscles; a lack of blood flow can easily lead to a cramp even at night.

Looking at the research, the number one culprit of muscle cramps is dehydration. And, dehydration almost always leads to electrolyte imbalances. Maybe the factors that lead to dehydration might be the cause and not just a magnesium or potassium deficiency.

Who is More Likely to Experience Night Time Muscle Cramps?

Certain factors are going to put you at more risk for NC. Most of these factors affect our electrolyte balance, circulation, and in some cases, our nerve health.

- elderly – tight muscles, medications, dehydration
- health conditions – cardiovascular, kidney disease, cancer treatment, liver failure, osteoarthritis, peripheral neuropathy, vascular diseases, type-2 diabetes, hypothyroidism
- nerve diseases – multiple sclerosis, Parkinson’s
- alcoholics
- athletes – especially those that do not adequately hydrate
- salt and potassium avoidance
- vegans/vegetarians – low B12

The elderly are more at risk due to numerous reasons. First, as we age, we lose our thirst mechanism, and this can lead to dehydration. Our muscles also tighten and become stiff, especially with lower activity levels.

In addition, the average 70-year-old is on five medications to treat health conditions like hypertension (high blood pressure), cardiovascular disease, and diabetes. Salt avoidance is also common in the elderly, especially those with high blood pressure and cardiovascular disease.

Does a Lack of Sodium Cause Nighttime Cramps?

The number one food source of sodium is table salt which contains sodium and chloride. Sodium is the most abundant electrolyte playing a significant role in keeping our minerals, most notably magnesium and potassium, in balance, helping to prevent nighttime muscle cramps.

We don’t often think about deficiency in sodium as the typical American diet is so high in salt, especially from processed foods, preserved meats, and restaurant meals.

Sodium deficiency, however, can occur with:

- salt avoidance
- medications especially diuretics
- strict or restrictive food plans
- excessive sweating without replenishment of electrolytes

It is not uncommon to see clients going from a highly processed food diet to cooking at home experience symptoms of sodium deficiency, especially if they are not using salt in their cooking. Enjoy using moderate amounts of salt in your cooking if you are avoiding processed foods and restaurant meals.

Reduce Cramps with Magnesium Citrate Malate

Can Magnesium Help with Nighttime Cramps?

Our muscles get the signal to release from magnesium, so it would make sense that this mineral would help with muscle cramps. And that muscle cramps at the beginning of exercise when you are warming up is a sure sign that you are deficient in magnesium.

Magnesium deficiency is also very prevalent in America, with a projected 65% of Americans not getting enough magnesium in their diet, as noted in my blog, Magnesium – Diva of Nutrients. So it would make sense that magnesium deficiency might be the cause of nocturnal muscle cramps.

But does magnesium help with muscle cramps, especially at night? Unfortunately, the research does not show that magnesium can help with nocturnal or nighttime muscle cramps.

Maybe the studies did not consider what might be causing the magnesium deficiency. For instance, medications like Gabapentin are known to increase the need for magnesium.

Nonetheless, it would not hurt to supplement magnesium through an electrolyte beverage or low dosage supplementation at bedtime.

There are many different forms of magnesium, and it is important to take the form of magnesium that will be most effective for you and is less likely to cause digestive disturbances. Thorne Magnesium CitraMate combines two different forms of magnesium that relaxes the muscles while reducing the chance of digestive disturbances.

Magnesium malate is very effective at relaxing muscles especially tight and sore muscles. On the other hand, some forms of supplemental magnesium may lead to diarrhea.

What Role Does Potassium Play in Nighttime Cramps?

Since potassium plays a role in muscle contraction and signaling blood flow to muscles, potassium deficiency may lead to muscle cramps. A diet rich in fruits, vegetables, and nuts should provide sufficient potassium; however, some conditions and medications can lead to a deficiency.

Muscle cramping at the end of exercise or after prolonged endurance activity is mainly the cause of lack of potassium and not magnesium. Lack of potassium has not been directly linked to nighttime muscle cramps.

However, with kidney failure, dialysis, and certain medications, potassium may play a role in nocturnal night cramps. A very low potassium diet could be the underlying cause of muscle cramps with these conditions as this dietary protocol is mandatory with kidney failure and dialysis.

Supplementing with potassium other than small amounts in multiple vitamins and electrolyte beverages should only be done with professional medical supervision.

Excessive potassium can lead to gastrointestinal symptoms, including nausea, vomiting, and abdominal discomfort. Other signs for excessive potassium or hyperkalemia include tingling of the hands and feet, muscular weakness, and temporary paralysis.

To assure that potassium is not the cause of your nighttime cramps, drinking an electrolyte beverage even without working out would be sufficient. Make sure that the electrolyte beverage does not contain artificial colors or sweeteners and is balanced with all electrolytes, including magnesium.

Catalyte by Thorne is an excellent electrolyte beverage that contains a balance of electrolytes with key nutrients that helps with hydration and recovery.

Is Your Medication Causing Your Night Cramps?

Many medications can cause imbalances in your electrolytes, lead to dehydration, affect circulation and nerve health. All of these can increase the risk for nocturnal muscle cramps. The top five medications that have been linked to nocturnal muscle cramps are:

Intravenous Iron Sucrose (used for iron anemia)
Conjugated Estrogens – hormone replacement therapy for postmenopausal
Raloxifene – estrogen modulator and bone health
Naproxen – OTC pain killer
Albuterol & Levalbuterol – bronchodilators

Other medications that might play a role in muscle cramps are:

Statin Drugs – cholesterol-lowering
Ciprofloxacin, Levaquin – fluoroquinolone antibiotics
Gabapentin – restless leg syndrome
Prevacid – stomach ulcer
Ambien – sleep

Always check with your doctor before going off of any medications. If you feel that your medications might be causing your night time muscle cramps, ask your doctor if there is another medication without this side effect.

What Are Other Causes of Night Cramps?

In addition to medications and health conditions, other causes of night cramps are readily resolved. Most have to do with lifestyle habits, lack of exercise, poor sleeping, or drinking alcohol.

Lack of movement can lead to muscle cramps because the muscles have been contracted for too long. They need to relax, recover and move again. If your job requires long periods of sitting or standing – try taking breaks throughout the day and get moving.

Alcohol consumption comes with a double whammy. First, it is very dehydrating, leading to electrolyte imbalances.

Secondly, during the metabolism of alcohol, lactic acid is produced. Lactic acid build-up can cause muscle spasms and soreness. If you drink alcohol, make sure to limit it to 1-2 drinks, drink plenty of water, and avoid drinking within 2 -3 hours before bedtime.

Not getting enough sleep can cause nighttime cramps; this is ironic because nighttime cramps lead to poor sleep. A lack of sleep leads to muscle fatigue, one of the leading causes of muscle cramps. Make sure to practice healthy sleep hygiene and get 7.5 – to 8 hours of sleep per night.

What Can You Do to Reduce Nighttime Cramps?

For me, it was an aha moment when I discovered that my nighttime cramps were a result of many different things, not just a magnesium deficiency as I thought. Start with these steps to begin resolving your nighttime cramps.

- Make sure you are properly hydrated and drink filtered water throughout the day. By drinking water every 20 to 30 minutes, your body will absorb it more readily. My favorite filtered water pitcher.
- Want to make you are hydrated? Purchase a scale that measures your hydration level and focus of getting that number up and less on how much you weigh. Did you know that as your hydration level increases; your fat percentage will drop.
- Try an electrolyte beverage like JigSaw Electrolyte Supreme or NutriDyn – Dynamic Hydrate, even if you are not working out. This will quickly replenish those key electrolytes and nutrients.
- Always drink an electrolyte beverage after a workout or even a long walk.
- Thorne Recovery Bundle is an excellent way to provide electrolytes and reduces inflammation speeding up your recovery and reducing muscle cramps.
- Make sure to get adequate magnesium and potassium from fruits, vegetables, and nuts. Are you getting 5-6 servings of fruits and vegetables?
- Are you taking medications? Do they have muscle cramps as a side effect? Check with your doctor to see if you might be able to do another medication without this side effect.

Still, struggling with nighttime cramps? Then it might be time for a Functional Nutrition Assessment to see what the underlying cause might be. Book a Discovery Chat to learn more.

Book Your FREE 15 min. Discovery Chat to Learn More!

References:

Top 5 Foods to Repair Nerves and Reduce Nerve Pain

by Eileen Schutte | Sep 1, 2021 | Floxed, Functional Medicine Nutrition

Top 5 Foods to Repair Nerves and Reduce Nerve Pain

I became painfully aware of nerve pain when my seventh nerve (facial nerve) was damaged due to a severe infection that partially paralyzed my face. Psychologically it was devasting and painful taking years for the pain to subside and begin the healing process.

Years later, I was quickly reminded how painful and devasting nerve damage can be when my husband suffered nerve damage from taking Levaquin, a fluoroquinonal antibiotic known to cause peripheral neuropathy. His chronic pain, tingling, and numbness in his hands and legs took months to heal after taking just eight pills of Levaquin.

When I experienced nerve damage, also known as peripheral neuropathy, little was known about neuropathy or a connection between nutrition and healing the nerves. Sure, we knew about thiamine (vitamin B1) deficiency which leads to a condition known as beriberi with neuropathy symptoms. But what other nutrients could help the nerves and prevent neuropathy?

Food Can Impact the Health of Your Nerves and Help to Heal Damaged Nerves

After a doctor recommended B-complex supplements to speed up the healing process, I realized that certain foods might help repair nerve damage and reduce the pain.

Considering the leading cause of peripheral neuropathy is Type 2 Diabetes in the U.S., a condition very much related to diet, what we eat or don’t eat surely plays a role in nerve damage and healing.

Other conditions can lead to nerve damage. For example, other causes of nerve damage are cancer therapy, exposure to toxins, and even certain medications.

Interestingly enough, all of these conditions can impact our nutritional status. Especially those nutrients that are involved in maintaining healthy and responsive nerves.

How Do You Know if You are Suffering from Neuropathy?

Symptoms from nerve damage can start slowly or come on very quickly. Initially, you might feel pain or tingling in your hands or your feet. Or, you might feel numbness similar to when your limbs “fall asleep” due to lack of blood flow. With peripheral neuropathy, the numbness doesn’t go away when you stand up or stretch to improve blood flow.

Other Symptoms Are:

Pin & Needles
Pain in Extremities
Numbness
Muscle Weakness & Atrophy
Tinnitus (Ringing in the Ears)

What are Causes for Nerve Damage?

According to the U.S. National Library of Medicine, the number cause of nerve damage or neuropathy is diabetes. Even high blood sugar without being a diabetic can put you at risk for nerve damage as it constricts the blood flow to the nerves. Along with Type 2 Diabetes, some other causes of nerve damage are:

Nutrient Deficiencies – B1, B6, B12, Folate, Copper, Vitamin E
Lyme Disease
Mold Infection
Medications
Toxins – Industrial, Heavy Metals
Viruses – Shingles, Hepatitis C
HIV/AIDS
Kidney Disease
Autoimmune Disorders, i.e., Multiple Sclerosis

Can Medications Cause Nerve Damage?

One of the most overlooked causes of nerve pain are medications, and, in most cases, it is the long-term uses of certain drugs that can damage nerves.

Or deplete the nutrients that help maintain healthy nerves, as seen with Hydralazine (blood pressure medication) that depletes vitamin B6.

Other medications can cause nerve damage with short-term use, as seen in some antibiotics like Metronidazole and Levaquin.

Whereas it is still controversial whether Fluoroquinolones (Cipro, Levaquin), my husband knows first hand that this class of antibiotics can cause nerve damage even with short-term use.

Key Nutrients for Healing Nerves

Ironically, my doctor in the 1980s was right about taking a B-complex supplement to help heal my facial nerve.

And reduce my tinnitus (ringing in the ears due to nerve damage) started with the same severe infection in 1982. Later I found out that I had an increased need genetically for those B vitamins – B12, B2, B1, B3, Folate, and B6.

Along with B-vitamins, other crucial nutrients need for nerve health are vitamin E, choline, and copper. Omega-3 fatty acids also play a significant role in nerve health, with the richest source being cold-water fish like salmon and sardines.

Whereas just supplementing sounds like a great idea, it doesn’t have the other benefits that whole food can provide.

For instance, one of the causes of copper deficiency is excessive zinc supplementation. Another example is that vitamin B6 is needed for healthy nerves, but excess supplementation in the form of pyridoxine (200 mg. or more daily) can lead to nerve damage.

The 5 Superfoods for Nerve Repair and Health

Beef Liver/Organ Meats

A powerhouse of nutrition for nerve health can be found in beef liver and other organ meats. Beef liver is one the richest sources of vitamin B12 that plays a significant role in nerve development and maintaining healthy nerves. Liver can be prepared in many different ways to be palatable including preparing as pate or purchasing liver pate.

Beef liver is also rich in folate, vitamin B2, choline, vitamin B6, thiamine (vitamin B1), copper, and alpha-lipoic acid. All essential nutrients help to heal damaged nerves and maintain healthy nerves.

Vitamin B12 plays two significant roles in our body, one of which is forming the myelin sheath that protects our nerves. One of the signs of deficiency in B12 has been linked to neuropathy, beginning with sensory symptoms (burning, tingling, numbness, tightness) in the feet.

If you really can't stand the taste of liver, try supplementing with Perfect Desiccated Liver.

Perfect Desiccated Liver Bottle (120 Caps) title=

Salmon/Sardines – Cold Water Fish

Rich in omega-3 fatty acids, cold-water fish offers the best source of the essential fatty acid that is very anti-inflammatory. Research shows that a pro-inflammatory diet low in omega-3 fatty acids can put you at a higher risk of suffering from neuropathy.

Essential fatty acids are also an integral component of the cell membrane and myelin sheath that helps protect the nerves. And have been shown to reduce demyelination of nerves and neuropathic pain.

To get the full benefit of salmon and other cold-water fish, make sure to look for wild-caught fish and not farm-raised.

Farm-raised salmon has lower amounts of omega-3 fatty acids and higher omega-6 fatty acids, reducing anti-inflammatory properties.

Another plant-based source of essential fatty acids can also be found in chia seeds, hemp seeds, and flaxseeds.

These nutrition powerhouse seeds are not as high in omega-3 fatty acids as cold-water fish. However, they offer the same anti-inflammatory quality of omega-3 fatty acids, helping heal nerve damage and reduce pain.

Cruciferous Vegetables

Broccoli, cauliflower, Brussels sprouts, Bok Choy, radishes, and cabbage are in this class of vegetables.

These vegetables contain some of the building blocks for glutathione – our body’s most potent antioxidant that helps to reduce inflammation and oxidative stress.

Glutathione has also been shown to prevent neurotoxicity, preserving healthy nerves.

Cruciferous vegetables are also high in sulforaphane, a compound that triggers glutathione production by activating a gene known as NrF2. A double win.

Nuts & Seeds

Not only are nuts and seeds a rich source of omega-3 fatty acids, but they also have key nutrients that help to heal the nerves and reduce nerve pain.

Along with omega-3 fatty acids, nuts and seeds are a good source of vitamin E, copper, and omega-6 fatty acids needed for a healthy immune response.

Sunflower Seeds: Sunflower seeds are one the richest sources of vitamin E, a powerful antioxidant, and have been shown to reduce numbness, tingling, burning, and nerve pain.

Look for organic unroasted sunflower seeds or sunflower butter. Sunflower seed lecithin is also a plant-based rich source of choline in the form of phosphatidylcholine. I like this organic form of sunflower seed lecithin that can easily be blended into smoothies.

Almonds: Almonds are a great source of magnesium and vitamin E that has been shown to improve neurotoxicity, reduce pain, and heal nerves.

Flaxseeds: A great plant-based source of thiamine, an essential nutrient needed to help to maintain myelin protecting the nerves.

Not only are flaxseeds a good source of plant-based omega-3 fatty acids, but they are also high in fiber, helping to maintain a healthy gut. Look for organic whole flaxseeds or ground flaxseeds. Remember to store in the fridge or freezer after purchasing.

Eggs

Whether it is chicken or duck eggs, eggs are a rich source of choline and helps to produce acetylcholine, a neurotransmitter needed for a healthy nervous system, muscle movement, and memory.

Not only are eggs are rich source of choline, they are also high in other key nutrients for nerve health like vitamin B12, B2, folate, and vitamin E. In addition, some eggs are rich in omega-3 fatty acids depending on what the laying chicken were fed.

Naturally pastured chicken will fed on insects that are high in omega-3 fatty acids as well as some chickens are fed flaxseeds increasing the omega-3 fatty acid content. Look for omega-3 fortified eggs, organic, and pastured raised.

Eggs are also one of the richest sources of palmitoylethanolamide or PEA; some consider this compound a natural painkiller that helps protect the nerves. In addition to increasing PEA in your diet, our bodies naturally produce PEA as a way for our bodies to manage inflammation and pain. Supplementing with PEA has been shown to decrease neuropathy and nerve pain. Designs for Health Cannab-PEA 300 has added phytocannabinoids for reducing pain.

What is the Best Diet for Overcoming Nerve Damage & Chronic Nerve Pain?

Interesting enough, at the time of my severe illness and nerve damage, I was a Lacto-Ovo (dairy, eggs) vegetarian. I was in college at the time, and my diet was very high in processed foods, most of which was were very pro-inflammatory.

In addition, my diet was low in those essential nutrients like B-vitamins and omega-3 fatty acids because I was a vegetarian. On top of eating a diet of processed foods, I missed those essential nutrients that would have sped up my recovery. Lesson learned.

The one thing that these superfoods have in common is that they are a part of the Mediterranean diet that is primarily plant-based with healthy sources of animal products to provide critical nutrients like vitamin B12, B1, B2, and B6. Research does show that an anti-inflammatory diet can help heal the nerves and prevent neuropathy. Check out my guide to the Mediterranean diet.

References:

Nutritional Neuropathies, Hammond, et al May, 2013
Peripheral Neuropathy Due to Vitamin Deficiency, Toxins, and Medications, Nathan P. Staff, et al, 2014
Severe Acute Axonal Neuropathy Induced by Ciprofloxacin: A Case Report
PEA is for Pain – FX Medicine

Magnesium – Diva of Nutrients

by Eileen Schutte | May 17, 2017 | Functional Medicine Nutrition

Magnesium, Key Nutrient

Magnesium is one of the most important electrolytes as well as it plays a major role in our muscles. It works in the opposite of calcium allowing the muscles to relax while calcium signals contraction. This is why one of the symptoms of magnesium deficiency is muscle cramps especially in our toes and sometimes our calf. It is one of the major causes of night time cramps.

Along with this major function, magnesium is also involved in over 300 biochemical reactions in our bodies. Even though this mineral is plentiful in our diet, deficiencies are becoming more common as the conditions for absorption and retention needs to be just right for magnesium to perform.

Perhaps this is why this nutrient is often referred to as the consummate Diva of Nutrients – just like an opera singer, when the conditions are just right, she performs beautifully.

If the host of conditions for absorption or retention are not met, magnesium from the diet will not be absorbed or magnesium will quickly “leave the stage” and be eliminated from the body.
The absorption of magnesium is greatly affected by other nutrients as well as the parathyroid hormone.

How to Entice the Diva

In order to entice the diva, magnesium needs both the parathyroid hormone and vitamin D to be absorbed and with widespread deficiencies in vitamin D, it is no wonder magnesium deficiencies are showing up. In addition a diet high in saturated fats or unhealthy fats, low in vitamin B6 can also hinder its absorption along with long term use of stomach acid-lowering medications like Prilosec will also greatly hinder absorption. It is now recommended by the FDA that if you take a proton pump inhibitor like Prilosec or Nexium for over 1 year to have your magnesium levels tested.

Keeping the diva on stage can also be challenging as some dietary, as well as lifestyle habits, can lead to increased elimination of magnesium. Excessive supplementation of calcium which is often seen with postmenopausal women, excessive vitamin K, and D as well as certain medications can increase elimination. Most high blood pressure medication can reduce absorption.

Dietary and lifestyle habits including lack of water or chronic dehydration, excessive sugar, alcohol, coffee, tea, salt, sodas as well as chronic stress can also greatly increase elimination.

What Foods Are High in Magnesium?

Dietary sources of magnesium are widely available and are found in dark leafy vegetables (cooked), nuts especially almonds, Edamame (cooked), avocado, potatoes, chicken, fish especially halibut and in beef. So a diet high in cooked green leafy vegetables and raw nuts would provide most of your needs however, it is our lifestyle habits as well as most of don’t get our 5-6 servings of vegetables per day that can lead to deficiencies.

Therefore supplementation with magnesium would not be out of line and in some cases recommended.
If you choose to supplement with magnesium, check with a nutritionist to determine the correct dosage as too much magnesium can have adverse effects. And, too little will not adequately correct an imbalance. As with all minerals, the form used in a supplement can have a large difference in bioavailability or absorption.