The
first suspected cause is a mineral imbalance. Cramps can also be caused by strenuous
exercise, excess salt loss from sweating, vitamin deficiencies, or sitting or
standing too long. When you get a cramp, stretch and gently massage the muscle
immediately. This should relax the muscle and provide you with some much-needed
relief. If you find that youíre having muscle cramps every night, your doctor
is likely to prescribe quinine (approx. 260 mg at bedtime). This often-used
treatment for leg cramps can quickly build to toxic levels in the blood and can
cause nausea, vomiting, ringing in the ears (tinnitus), and deafness. It can
even damage your eyesight. Use it only as necessary. Another option is to take
"Tonic Water", which contains 27 mg of quinine. You can take 8 oz.
prior to going to bed. Stop taking when cramps go away. Do not take anything
with quinine, if you are allergic to sulfa. A way to eliminate that knot of
pain in your muscles is to try a combination of vitamin, mineral, and herbal
supplements. If youíre getting a nightly wake-up call from your leg muscles,
you probably need to get more magnesium and calcium. Both of these minerals are
involved in relaxing nerve impulses and regulating muscle activity. Calcium is
needed to contract the muscle, and magnesium is needed to relax it. An
imbalance in this relationship can irritate the muscle. Since the calcium in
bone provides a mineral supply to replenish the relatively tiny amount that you
need in your blood, youíre more likely to be low on magnesium. Most people get
only 75 percent of the Daily Value (DV) for magnesium, which is 400 milligrams
from food and supplements. Remember that some medical conditions may affect
your calcium availability. Start with a dose of 250 milligrams of magnesium glycinate or chelated magnesium
twice a day. These amino acidñbased mineral supplements are easier to absorb
than magnesium oxide. The more you absorb, the less likely it is that youíll
have diarrhea, a common problem with magnesium supplements. Magnesium oxide is
basically a rock. To help relieve cramps that interrupt your sleep, take your
second dose of magnesium right before you go to bed. If you donít get relief in
three to five days, increase the dose to 500 milligrams twice a day. Stay at
that level for another week to allow the tissue levels of the mineral to build
up. Magnesium may be obtained over-the-counter in "Doan's Pills", a
common muscle relaxer. If cramps are still a problem at that dosage, itís time
to add 500 milligrams of calcium to the regimen. The average adult absorbs only
about 30 percent of the calcium consumed. To maximize absorption, you can take calcium citrate instead of calcium
carbonate, the form commonly found in antacid tablets. It helps to take it with
a glass of milk since vitamin D is necessary for calcium absorption. If you are
unable to drink milk, you can take a calcium supplement that also contains
vitamin D. If youíre taking both calcium and magnesium, keep in mind that they
work best when they are taken in certain ratios. The two ratios recommended are
either equal doses of calcium and magnesium or twice as much
calcium as magnesium. Try the one-to-one ratio first, taking 500
milligrams of calcium and 500 milligrams of magnesium twice a day. If that
doesnít give you the results you want, shift the ratio to 2:1 by reducing the
magnesium to 250 milligrams. Some patients with nighttime cramping have success
with vitamin E. Although it has had mixed results in clinical trials, early
studies suggest that youíll improve arterial blood flow and reduce leg cramping
at night if you take vitamin E. In one of the largest studies, 123 of 125
people who suffered from nighttime leg and foot cramps reported complete relief
after taking vitamin E supplements. To see if it works for you, take 400 to 800
international units (IU) a day. Potassium is another mineral that helps
regulate muscle contraction. Deficiencies of this crucial electrolyte arenít
normally a problem if you eat a variety of fruits and vegetables. If you change
your diet drastically, however, you might become deficient. This is a potential
problem when using a high-protein weight-loss diet, which are
related to potassium deficiency. When protein makes up more than 30 percent
of your daily calories, potassium levels may fall far short of the DV of 3,500
milligrams. If youíre eating eight or nine servings of fruits and vegetables,
youíll get enough potassium to meet the DV, but the shift to a high-protein
diet makes this significantly more of a challenge. Cramps are more prevalent
when you first start a high-protein diet. After a few months, they normally disappear
on their own. To make them go away sooner, you can take one 99-milligram tablet
of potassium a day. This doesnít amount to much more than a bite or two of
banana, but it can make your legs feel better. A word of caution,
though: Donít take more than one tablet. Itís easy to get too much
potassium this way, which can upset the balance of other minerals in your body
and cause heart and kidney problems. Thatís why Food and Drug Administration
regulations donít allow more than 99 milligrams per tablet in over-the-counter
supplements.
When you get leg cramps, the first
suspects are naturally the big minerals that weíve already discussedó calcium,
magnesium, and potassium. But maybe those cramps are due to an imbalance of
trace minerals, especially if the pain is triggered by overexertion. Muscle and
nerve function are electrical, and we need the right mix of minerals for that
to happen. There are a lot of little players in there. You can deplete levels
of trace minerals as you perspire. Electrolyte
drinks work well to help restore these depleted minerals. You can also take
a trace mineral supplement that contains copper, manganese, zinc, selenium, and
chromium. Although trace mineral supplements vary in content, donít exceed the
dosage guidelines on the bottle. Trace minerals should be taken in small doses
because thatís how they are found in your body. More is not better. If you get
leg cramps when you walk, see your doctor to rule out other conditions such as
intermittent claudication, which is caused by poor blood flow to the legs. Always consult your physician, prior to starting any
type of nutritional supplements.
Definition
An electrolyte disorder is an imbalance of
certain ionized salts (i.e., bicarbonate, calcium, chloride, magnesium,
phosphate, potassium, and sodium) in the blood.
Electrolytes
Electrolytes are the elements necessary for
electrochemical activity in our body. Water (H20) ñ and the three minerals
sodium, potassium and chloride are all necessary for the transmission of
electrical impulses between cells. Sodium and potassium are cations (positively
charged atoms), and chloride is an anion (negatively charged atom) ñ all are
essential nutrients. These minerals are supplied by the typical diet in
thousands of milligrams per day. Sodium and chloride are overabundant in the
diet and are not generally added as a mineral supplement.
Essential Minerals
Minerals are
inorganic substances mined from the earth, meaning they are not of plant or
animal origin. They exist naturally on and in the earth and many are critical
parts of human tissue and are termed "essential" nutrients. Of the 92
naturally occurring elements, the 14 minerals that have been shown by research
to be essential to human health are: calcium, chromium, copper, fluorine,
iodine, iron, magnesium, manganese, molybdenum, phosphorus, potassium,
selenium, sodium and zinc. Essential macrominerals are those we need in
significant quantities (such as calcium) ñ usually measured in milligrams, and
essential trace minerals are those we need in minute quantities (such as
selenium) ñ usually measured in micrograms (one microgram [mcg] equals
1/1,000th of a milligram [mg]).
These 14 essential
minerals are crucial to the growth and production of bones, teeth, hair, blood,
nerves, skin, vitamins, enzymes and hormones; and the healthy functioning of
nerve transmission, blood circulation, fluid regulation, cellular integrity,
energy production and muscle contraction.*
Minerals work in
combination with each other and with other nutrients, so imbalances of any
mineral can cause health problems ñ too little of any essential mineral can
lead to deficiency diseases, and too much of any mineral can be toxic.
We get these
essential minerals primarily through the foods we eat. Good sources of
essential minerals include fruits, vegetables, meats, nuts, beans and dairy
products. Unfortunately, much of the soil in which food is grown has been
depleted of these nutritive minerals, therefore the
mineral content in food is reduced. We also obtain some minerals from the water
we drink, but the amounts vary widely.
Mineral availability
and absorption is also affected as foods are cooked, processed and refined, and
many naturally occurring minerals in food are removed. A daily mineral
supplement is not a substitute for a healthy diet, but can ensure we get the
minerals we need for optimal health.
Description
Electrolytes are ionized molecules found
throughout the blood, tissues, and cells of the body. These molecules, which
are either positive (cations) or negative (anions), conduct an electric current
and help to balance pH and acid-base levels in the body. Electrolytes also
facilitate the passage of fluid between and within cells through a process
known as osmosis and play a part in regulating the function of the
neuromuscular, endocrine, and excretory systems.
The serum electrolytes include:
… Sodium (Na). A
positively charged electrolyte that helps to balance fluid levels in the body
and facilitates neuromuscular functioning.
… Potassium (K). A main
component of cellular fluid, this positive electrolyte helps to regulate
neuromuscular function and osmotic pressure.
… Calcium (Ca). A
cation, or positive electrolyte, that affects neuromuscular performance and contributes
to skeletal growth and blood coagulation.
… Magnesium (Mg).
Influences muscle contractions and intracellular activity. A cation.
… Chloride (CI). An
anion, or negative electrolyte, that regulates blood pressure.
… Phosphate (HPO4).
Negative electrolyte that impacts metabolism and regulates acid-base balance
and calcium levels.
… Bicarbonate (HCO3).
A negatively charged electrolyte that assists in the regulation of blood pH
levels. Bicarbonate insufficiencies and elevations cause acid-base disorders (i.e.,
acidosis, alkalosis).
Medications, chronic diseases, and trauma
(i.e., burns, fractures etc.) may cause the concentration of
certain electrolytes in the body to become too high (hyper-) or too low
(hypo-). When this happens, an electrolyte imbalance, or disorder, results.
Causes and symptoms
HYPERNATREMIA
Sodium helps the kidneys to regulate the
amount of water the body retains or excretes. Consequently, individuals with
elevated serum sodium levels also suffer from a loss of fluids, or dehydration.
Hypernatremia can be caused by inadequate water intake, excessive fluid
loss (i.e., diabetes insipidus, kidney disease, severe burns, and
prolonged vomiting or diarrhea), or sodium retention (caused by
excessive sodium intake or aldosteronism). In addition, certain drugs,
including loop diuretics, corticosteroids, and antihypertensive
medications may cause elevated sodium levels.
Symptoms of hypernatremia include:
… thirst
… orthostatic
hypotension
… dry mouth and mucous
membranes
… dark, concentrated
urine
… loss of elasticity
in the skin
… irregular heartbeat
(tachycardia)
… irritability
… fatigue
… lethargy
… heavy, labored
breathing
… muscle twitching and/or seizures
HYPONATREMIA
Up to 1% of all hospitalized patients
develop hyponatremia, making it one of the most common electrolyte
disorders. Diuretics, certain psychoactive drugs (i.e., fluoxetine, sertraline,
haloperidol), specific antipsychotics (lithium), vasopressin, chlorpropamide,
the illicit drug "ecstasy," and other pharmaceuticals can cause
decreased sodium levels, or hyponatremia. Low sodium levels may also be
triggered by inadequate dietary intake of sodium, excessive perspiration, water
intoxication, and impairment of adrenal gland or kidney function.
Symptoms of hyponatremia include:
… nausea, abdominal
cramping, and/or vomiting
… headache
… edema (swelling)
… muscle weakness and/or tremor
… paralysis
… disorientation
… slowed breathing
… seizures
… coma
POTASSIUM
Potassium
is the major mineral in, and primary regulator of, fluids inside cells ñ along
with sodium. Potassium is critical to the transmission of nerve impulses,
muscle contractions and maintenance of normal blood pressure. The kidneys
control potassium levels, if adequate water is consumed. Potassium deficiency
is rare in healthy people ñ but is a very common side effect of two widely
abused modern drugs ñ chemical laxatives and diuretics. Potassium deficiency
can also be caused by excessive vomiting, chronic diarrhea or kidney failure.
Signs of deficiency may include muscle weakness, intestinal problems, heart
abnormalities and respiratory weakness.
Potassium is widely available in foods, but
mostly in unprocessed fresh foods ñ especially fruits and vegetables. The
estimated average adult intake of potassium varies widely between 1,000 and
10,000 mg daily, depending on diet (vegetarians get
the most). Potassium is toxic for healthy adults if daily intakes exceed 18,000
mg. Pills with more than 100 mg, if taken on an empty stomach and without
sufficient water, may cause ulcerations in the stomach or esophagus.
HYPERKALEMIA
Hyperkalemia may be caused by
ketoacidosis (diabetic coma), myocardial infarction (heart attack),
severe burns, kidney failure, fasting, bulimia nervosa,
gastrointestinal bleeding, adrenal insufficiency, or Addison's disease.
Diuretic drugs, cyclosporin, lithium, heparin, ACE inhibitors, beta blockers,
and trimethoprim can increase serum potassium levels, as can heavy exercise.
The condition may also be secondary to hyponatremia (low serum concentrations
of sodium). Symptoms may include:
… weakness
… nausea and/or
abdominal pain
… irregular heartbeat
(arrhythmia)
… diarrhea
… muscle pain
HYPOKALEMIA
Severe dehydration, aldosteronism, Cushing's
syndrome, kidney disease, long-term diuretic therapy, certain penicillins,
laxative abuse, congestive heart failure, and adrenal gland impairments
can all cause depletion of potassium levels in the bloodstream. A substance
known as glycyrrhetinic acid, which is found in licorice and chewing tobacco,
can also deplete potassium serum levels. Symptoms of hypokalemia
include:
… weakness
… paralysis
… increased urination
… irregular heartbeat
(arrhythmia)
… orthostatic
hypotension
… muscle pain
… tetany
Calcium is the most important, and most common,
mineral we need. Eating a diet rich in nutrients that help your bones stay
strong should be the first step in stopping or slowing the process of
osteoporosis. Calcium, magnesium, vitamin D, phosphorus, soy-based foods and
fluoride compose the major nutrients that strengthen bone. At this moment, 98
percent of your body's calcium resides in your bones,
the rest circulates in the blood, taking part in metabolic functions. Because
the body cannot manufacture calcium, you must eat calcium in your daily diet to
replace the amounts that are constantly lost. When the diet lacks sufficient
calcium to replace the amount that is excreted, the body begins to break down
bone for the calcium necessary for life-preserving metabolic processes. Calcium
in the diet can generally slow calcium loss from bones, but it usually doesn't
seem to replace calcium already gone. The National Institutes of Health
recommend 1000-1200 milligrams of dietary calcium per day for premenopausal
women and 1200-1500 milligrams for menopausal and postmenopausal women Good
sources of calcium include milk and milk products, yogurt, ricotta, cheese,
oysters, salmon, collard greens, spinach, ice cream, cottage cheese, kale,
broccoli and oranges. If you cannot tolerate dairy products, calcium supplements
are an easy way to consume calcium. Take supplements with a meal to aid
absorption of calcium from the stomach.
HYPERCALCEMIA
Blood calcium levels may be elevated in
cases of thyroid disorder, multiple myeloma, metastatic cancer,
multiple bone fractures, milk-alkali syndrome, and Paget's disease. Excessive
use of calcium-containing supplements and certain over-the-counter medications
(i.e., antacids) may also cause hypercalcemia. Symptoms include:
… fatigue
… constipation
… depression
… confusion
… muscle pain
… nausea and vomiting
… dehydration
… increased urination
… irregular heartbeat
(arrhythmia)
HYPOCALCEMIA
Thyroid disorders, kidney failure, severe
burns, sepsis, vitamin D deficiency, and medications such as
heparin and glucogan can deplete blood calcium levels. Lowered levels cause:
… muscle cramps and spasms
… tetany and/or
convulsions
… mood changes
(depression, irritability)
… dry skin
… brittle nails
… facial twitching
Magnesium is essential to maintain
both the acid-alkaline balance in the body and healthy functioning of nerves
and muscles (including the heart), as well as to activate enzymes to metabolize
blood sugars, proteins and carbohydrates. Magnesium is vital for proper bone
growth and is indirectly related to adequate calcium absorption. A 2:1 ratio of
calcium to magnesium is essential to maintain strong bones. Indications of a
magnesium deficiency may be muscle twitches, nervousness, abnormal heart beat
and disorientation. Good food sources of magnesium include seeds, unrefined
grains, beans and other vegetables.
HYPERMAGNESEMIA
Excessive magnesium levels may occur with
end-stage renal disease, Addison's disease, or an overdose of magnesium salts.
Hypermagnesemia is characterized by:
… lethargy
… hypotension
… decreased heart and
respiratory rate
… muscle weakness
… diminished tendon
reflexes
HYPOMAGNESEMIA
Inadequate dietary intake of magnesium,
often caused by chronic alcoholism or malnutrition, is a common
cause of hypomagnesemia. Other causes include malabsorption syndromes, pancreatitis,
aldosteronism, burns, hyperparathyroidism, digestive system disorders,
and diuretic use. Symptoms of low serum magnesium levels include:
… leg and foot cramps
… weight loss
… vomiting
… muscle spasms,
twitching, and tremors
… seizures
… muscle weakness
… arrthymia
HYPERCHLOREMIA
Severe dehydration, kidney failure,
hemodialysis, traumatic brain injury, and aldosteronism can also cause
hyperchloremia. Drugs such as boric acid and ammonium chloride and the intravenous
(IV) infusion of sodium chloride can also boost chloride levels, resulting in
hyperchloremic metabolic acidosis. Symptoms include:
… weakness
… headache
… nausea
… cardiac arrest
HYPOCHLOREMIA
Hypochloremia usually occurs as a result of
sodium and potassium depletion (i.e., hyponatremia, hypokalemia). Severe
depletion of serum chloride levels causes metabolic alkalosis. This
alkalization of the bloodstream is characterized by:
… mental confusion
… slowed breathing
… paralysis
… muscle tension or spasm
Most phosphorus in the body is found
in bone, usually at a 1:2 ratio to calcium. In soft
tissue and cells, phosphorus contributes to many
natural chemical body processes. For example, phosphate bonds of ATP (adenosine
triphosphate) provide the energy necessary for metabolism. Food sources of
phosphorus include protein-rich foods such as meats and dairy products,
although some is present in almost all foods. Due to the abundance available in
the average diet, as well as its high absorption rate, most supplements do not
contain phosphorus. People taking aluminum hydroxide as an antacid for extended
periods of time may develop a phosphorus deficiency since the aluminum prevents
phosphorus absorption.
HYPERPHOSPHATEMIA
Skeletal fractures or disease, kidney
failure, hypoparathyroidism, hemodialysis, diabetic ketoacidosis,
acromegaly, systemic infection, and intestinal obstruction can all cause
phosphate retention and build-up in the blood. The disorder occurs concurrently
with hypocalcemia. Individuals with mild hyperphosphatemia are typically
asymptomatic, but signs of severe hyperphosphatemia include:
… tingling in hands and
fingers
… muscle spasms and cramps
… convulsions
… cardiac arrest
HYPOPHOSPHATEMIA
S