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So, about that weird medical issue that has me wondering if I ought to eat more salt, and other electrolytes.
I get these painful calf cramps once in a while. The frequency is generally in the neighborhood of every 6 months to a year or so, probably sometimes longer intervals. It's hard to be completely sure, since I only started noting down the dates of them for the last couple of times. I'm not even sure how long ago it really started, though it's definitely years. I'm pretty sure it started at some point after I started eating Keto 8-10ish years ago, though not soon enough after to be an obvious correlation.
So far, it's only happened when I'm lying down, and have been for a while. When it happens, it hits with no particular signs or warning, one of my calf muscles instantly cramps up pretty hard. It's pretty painful, and if I grab the muscle, it feels like a brick under my skin. I think it lasts around 10 seconds or so, but it's hard to be sure, since I've never timed it. Afterward, the muscle feels sore, as if I just did a tough workout, which usually lasts for hours, but no other lingering pain or damage. It only hits one leg, and I think it's random which one. If it were to happen while I was standing, I think I'd probably fall down, though it never has yet.
At first, it seemed to happen most commonly after a night of moderate to heavy drinking. After some searching around, I got the idea that it might be related to an electrolyte deficiency of some kind. I started preparing and drinking a glass of electrolyte water (sodium, potassium, magnesium) every time I came home after drinking before going to bed. This seems to have more or less worked, and it didn't happen for quite a while. Then it started happening again, but not after drinking at all, infact no particular correlation to anything I can tell so far. I'm wondering if maybe it is still related to electrolyte issues, and would be helped by consuming more electrolytes in general regardless of activity, or even just more salt possibly.
I'm generally in good health, don't have any other health issues, and aren't on any prescription medications. I pretty consistently do 5k-10k+ steps every day based on my phone's step counter. Eating moderately keto has helped keep my weight in check.
I haven't tried to ask any proper doctors about this. I don't really go to any much anyways. I don't have much confidence that I'd get any kind of useful answer from them on this issue. If there was some way take a blood test immediately after, or even before, one happened, that might give some useful hard information, but it seems rather impractical due to how infrequent it is. Possibly a urine sample from right after would be reasonably practical and useful. Or maybe my attempts to consume more electrolytes will mean it goes away entirely anyways. Just thought I'd post it here in case anyone is curious or might have some kind of insight.
I've had a journey on this issue. I was getting charlie horses in both fucking legs while hiking. Turned out it was caused by creatine.
https://www.themotte.org/post/3412/smallscale-question-sunday-for-december-14/391978?context=8#context
My doctor was pretty stumped by this but some meathead suggested I'm not hydrating enough and the creatine worsens it because it pulls so much water into muscles.
Anyway I stopped taking creatine but had other signals I wasn't hydrating enough: I would run with a group and be the only one feeling like shit on the longer runs even though we were training the same.
I figured out I have a very hard time staying hydrated (I'm in my 40s). I just never feel thirsty at all. I basically have to force myself to remember to drink any water, and need to go out of my way to strap bottles of water with an eighth of a teaspoon of salt in them to a vest when I go for runs.
Much better overall now that I'm deliberately hydrating, but damn is it tedious.
btw if you feel one coming on in your leg sit down and grab your toes with your hand and try to extend your leg completely, essentially pulling your toes back and stretching your calf out. It often provides immediate relief without lingering soreness.
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Where do you get your cramps? I have gotten cramps in my legs and feet, and occasionally elsewhere, for my entire life. If I eat a banana every few days I don't have cramps. I am sure it is tied entirely to potassium intake for me. I never get the cramps within a day or two after eating a banana, every time I get a cramp it has been several days since I've had a banana. I've looked up alternate sources of potassium- avocado is supposed to be one, but I find that avocados don't work as well as bananas for me.
What did people do to prevent cramps before they had access to exotic fruit?
Plenty of meats and fishes are good sources of potassium if you eat them with their cooking juices
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Other great sources of potassium: Potatoes with skin, spinach, beans/lentils, salmon and clams. I happen to dislike spinach, beans and lentils, so I don't get my potassium there. I'm not a huge potato person and didn't eat much seafood until a few years ago. Other people probably get plenty of potassium from those foods but I don't, so the bananas it is for me.
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More vegetables probably. As in 90% of the diet.
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I've had the same problem for several years, let me know if you figure out a solution.
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I run, and I've dealt with calf cramps before, and while the literature is still inconclusive on exact causes, electrolyte issues and muscle fatigue are most commonly blamed. Neither alone will fix everything: pounding pickle juice won't get you through a marathon untrained without cramps. It might help to do some minor strength work on the calves (and their antagonists) regularly, especially if you aren't exercising regularly. A dozen calf raises and toe raises a couple times a week seems a modest time commitment, if you're willing to try.
The other thought I have is that it could be related to positioning: I've had trouble with calf cramps while swimming before, which is funny because you don't really use your calves for that at all. But you do point your toes for extended periods, which isn't a very common posture otherwise. When I've had similar calf cramps while sleeping, I've noticed that I sometimes sleep with my toes pointed. If you're doing that, perhaps a change in posture could avoid the issue. There are also products that might help for sleeping (compression socks, ankle braces), but I haven't tried any myself.
I do do that 5-10k steps a day, which is walking at a brisk pace back and forth to my current job in the heart of NYC. It may not sound like that much to some, but when Covid WFH limited my walking for a couple years and I started up again, it was pretty tiring and left me a little sore for the first couple of weeks. I don't do any strength training right now, but I do train Muai Thai roughly once a week.
I don't think I point my toes while sleeping. Once in a while, I do that deliberately to crack my ankle, which I don't think has ever triggered one of these types of cramps.
Speaking of kind of exercise related and weird muscle issues, I also occasionally get a restless or antsy feeling in my quads and I think also calves. It doesn't seem to be related to the cramps, I think. It's basically a physical need to stand, walk, or even run. Once in a while, it feels intense enough that I just need to go outside and run a few blocks. Pretty weird I guess.
Anyways, hopefully consuming substantially more electrolytes daily will help some.
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How is your calcium intake?
No clue, I mostly eat meats and vegetables in forms that don't have nutrition labels, so I don't even have much idea of how to get an accurate estimate of that.
Do you eat like four servings of dairy and/or [spinach/bok choy/kale/ broccoli] a day?
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Sounds like what I know as a "charley horse". No idea how to solve them, though. Potassium and hydration was what I was always taught, but that doesn't mean it ever did anything.
Hmm, I'd always thought of Charley Horses as mild cramps that happened while exercising. This is severe pain while resting. Some searches claim that is a variant of the same thing, so maybe it is, and the treatment seems similar. At least that gives it a probable actual name.
I also have heard what you’ve described above (abrupt and major calf cramp while sleeping/resting) called a Charlie horse. The mild cramp while exercising (presumably in your side/abs), I’ve always called a stitch.
I used to get Charlie horses (as in, exactly what you’ve described, to a T) pretty often (like, once every couple months) during a period when I was taking much worse care of myself. The last time I got one was a few months ago after a, let’s say, rather significant night of drinking. Before that I hadn’t had one in years. As far as I know, dehydration is the main cause, as well as a lack of potassium, which is why they correlate with excessive drinking and being hungover. Being overtired can also bring them on, I think, although that’s probably a more indirect causation via tiredness fucking up your body in general. I’d honestly suggest just drinking more water during the day and adding a few bananas to your weekly diet, and stretching won’t hurt either.
If you don’t notice any change after doing that for a while it may be worth asking a doctor to do some tests/screening in case you have some other, less common sort of deficiency going on. But I’d bet it helps.
I already drink a lot of water pretty much every day. In fact, I had the idea that might be contributing to the problem, from washing away electrolytes. I did start adding a packet of this Liquid IV electrolyte supplement that we have available at work to the water I drink with my workday lunch, which has a pretty comparable amount of potassium to a banana reportedly. It may take the better part of a year to see if it really does the trick though, due to the low frequency.
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