GIST Support Wiki

 
Muscle Cramps

Several strategies help with cramps. Leg cramps are the most frequent, but some people report cramping of the hands and other body areas.


Contents

Prescription Medications

Chlordiazepoxide, 10 mg taken at bedtime, was reported in one case study to relieve cramps in a patient who had obtained no relief from calcium plus magnesium. (Medeiros and Lipton, 2006: European Journal of Haematology 77: page 538). The authors say "Chlordiazepoxide possesses sedative, anxiolytic, and muscle relaxant properties. It does not interfere with CYP3A4 enzyme activity..."


Calcium and Magnesium

Low magnesium can cause cramps as well as more serious side effects such as irregular heartbeat. Proton pump inhibitors (drugs taken to reduce acid reflux) can cause magnesium depletion according to FDA MedWatch warning


a Nurse Practitioner had suggested that I get Magnesium capsules with liquid inside and when these HORRIBLE cramps start to break one open and rub it into the cramping muscle .... Shin cramp.... Felt like the bone would break...Had to mix in an oil free lotion to get it all to disappear into the skin but the relief was IMMEDIATE... Remarkable and wonderful....


I take a tablespoon or two of blue bonnet liquid calcium mag with vit D at night and it takes cramps away. If I dont take it, I have quite a lot of them so this has been a good remedy for me. Sold at whole foods. Not cheap but worth it.


I was told by both Duke and UNC-(Dr Stinchcombe) that the problem was a calcium depletion so when I get the first HINT of cramping begining- used to be in the legs now I can get a cramp ANYWHERE ... don't ask... I take three tums or other chewable antacid and within fifteen minutes the cramping passes or does not get fully developed. The cheaper the brand of antacid the faster they work becasue they break apart faster ... this really works.

I am not exactly sure what Gleevec is doing to cause muscle cramps. I read that Gleevec might "stick" to a particular calcium channel protein in a membrane...and thus "gums it up." The swelling and low potassium levels in general indicate that Gleevec is disrupting normal ion balances.

Try the Calcium supplements with vitamin D. A study showed that Gleevec causes excess loss of vitamin D in the urine.


If serum calcium, magnesium, and potassium levels are in the normal range, the culprit might be a relative calcium deficiency of free calcium. (Calcium is both free and also protein-bound in plasma.)

Try taking calcium citrate with water each evening (Citracal-D, Cosco). Using a calcium supplement without vitamin D3 works just as well.

The calcium in oyster shells is still calcium, of course, and once ionized and absorbed should have the same effect. The difference is that oyster shells are comprised of calcium carbonate rather than citrate and so is a bit less soluble - and less so if you are decreasing gastric acid with an H2 blocker such as Prilosec. So, try a calcium CITRATE supplement rather than a calcium CARBONATE one.


Calcium and magnesium supplements help with muscle cramps (look for ones that also contain vitamin D). Here is great link detailing the synergistic balance required between calcium and magnesium: [1] Many dietary factors reduce calcium uptake, such as foods high in oxalic acid (spinach, rhubarb, chocolate) which can interfere with calcium absorption by forming insoluble salts in the gut. Phytic acid, or phytates found in whole grain products, foods rich in fiber, excess caffeine from coffee, colas, tea, as well as certain medications may all reduce the absorption of calcium and other minerals, or leach calcium from bone."

Either supplementing calcium, magnesium and potassium or possibly reducing some of these foods and drinks mentioned above temporarily to see if it lessened muscle cramps.

Drinking Gatorade in the evening or when a cramp is coming on, just in case electrolytes are low.

If you don't like the taste of Gatorade you can buy Smart Water instead. It contains the same Electrolytes without the flavoring and just tastes like water. I drink it while I play tennis and prefer it to Gatorade.

I've had leg and foot cramping as well since going to 800 mg. Gleevec. They've disappeared over the past week. I credit one of two things. -- 800 mg. has increase acid reflux and I eat several Tums or Tums Ultra during the day and at night. Perhaps the calcium is reducing cramps. -- I thought heat might keep the muscles loose, so I wear my socks to bed and put my sweatshirt atop the foot of my bed for extra covers. Tooties are overly warm, but no cramps.

Potassium

V-8 juice and tomato juice both have a lot of potassium (about a third of your daily recommended intake in 12 ounces).


There is another old-fashioned way to get more potassium. It sounds weird, but it makes sense and works.

1. Buy a box of plain Quaker Oats. 2. Pour some oats into the bottom of a drinking glass. Cover with water and store in the refrigerator for 24 hours. 3. After 24 hours, drink the "oat" water. Discard the oats in the glass and start again.

Oats are known to be rich in potassium. I think the potassium is extracted into the water. Don't ask me why you don't just eat the oats, but the "oat" water is pretty bland and easy to drink.

Homeopathic Magnesium

I have had much experience with hand cramps while on Gleevec but not on Sutent. What I found works extremely well on those cramps is a homeopathic remedy available at health food stores. Most will tell you that if you experience cramps you should take potassium. I found that with the hand and leg cramps the best thing for me was sublingual magnesium. This product goes by many different brand names. You start by putting little tablets as directed under your tongue AT THE VERY START OF SYMPTOMS and let them dissolve. It is amazing how quickly it works.

Exercise

Exercising muscles several times a week helps to eliminate cramps. Even little stretching helps. If I do not do it for a few weeks my nightly leg cramps return.

A hatha yoga routine, which is gentle stretching, can be done before bedtime or at anytime to help relax muscles and mind. This website does a wonderful job of animating simple asanas called stress postures: http://www.hathayogalesson.com/ No special training or equipment is needed to start... and drink lots of water.


Soap Under the Sheets

Leg cramps resulting from Gleevec? Try soap under your sheets, it really helps!

I have used the bar of soap for muscle cramps and it did work for me. The only soap that seems to work is Ivory. It seems that it contains a unique kind of potassium salt not found in other brands.

Here is why it works. The soles of the feet are one of the most absorbing parts of the body. You unwrap the bar of soap and place near the foot of the bed between the sheets. Rub the soles of your feet over the soap when you go to bed or when you feel a cramp coming on. Many people smear Vicks Vapor Rub on the soles of their feet and put on a light pair of socks when they have a stuffy head cold. This works well and those who do it report sleeping very well even with very bad colds. The bar of soap does not stain the bed or anything.


BenGay sports cream

Using BenGay at night before bed helps prevent muscle/leg cramps.


Avoid Pectin and Raspberries

This was discovered after a determined period of trial and error efforts to find solutions to alleviate those blasted cramps. Keeping well hydrated and getting some form of regular exercise helped somewhat but it wasn't until i cut out pectin that the cramps really resided. Cutting out raspberries was the other key. I haven't had any cramps since.

Pectin is found in jam, jelly, preserves, some fruit flavored yogurt, etc.

Tonic water w/lemon or lime

I was at my oncologist yesterday and she advised to take tonic water with a squirt of lemon/lime for muscle cramps.....

Mustard

Some have had success with eating mustard or applying to leg in area of cramp. Mustard contains selenium and magnesium which, when deficient, can cause muscular cramps.

V8 and pickle juice

I remember reading a post about the V8 juice. It has a lot of Potassium and that's supposed to help the leg cramps. Drink some pickle juice from a jar of dill pickles. It sounds silly and I'm not sure why it works.

Marijuana

I have found marijuana particularly helpful for night time leg cramps. These were extremely severe and horribly painful until I started prescription quinine, which helped a lot. But the FDA pulled it. The ivory soap in the sheets helped, but not enough. Now I routinely ingest a baked marijuana cookie or muffin, which I bake myself with marijuana I buy legally, in the evening, and I generally sleep well through the night with only minimal, not terribly painful, leg cramps.

Alka Seltzer

A friend from the LMS list, Alison, has discovered that Alka Seltzer helps her leg cramps. Not sure why, but give it a try.

Guaiphenesin

I have found Guaifenesin to be very effective with cramps. The most well known name for this product is Mucinex. It is available in most large chains sometimes for plain old "allergy relief", and is far less expensive. I discovered purely by accident when I was taking Guaifenesin for upper respiratory problems that I no longer experienced cramps. I spoke to my pharmacist about it and he told me that product is extremely effective against hand cramps. We have a pharmacy in my area that makes what is called Guaifenesin Speed Gel. It is a gel substance that you rub on the site of the cramp and it disappears almost immediately.

I suffered from cramps both in my legs and my feet and sometimes in my hands. At first I used a homeopathic remedy of sublingual magnesium I got at the local health foods store. That worked but I found something else by accident. There is a product on the market called Guaifenesin. It is commonly sold as "Mucinex" but For some reason it stops the cramps.

If you can find a pharmacy that compounds it own things you may be able to get what is called Guaifenesin SpeedGel. It is a gel that is rubbed onto the affected area as soon as the cramp starts and gives almost instant relief.

Quinine

I thought I had seen an article about not using quinine for leg cramps so I looked it up. Let me give you the body of it. There are also a couple of links where you can go to web sites to get more information.

DEPARTMENT OF VETERANS AFFAIRS VETERANS HEALTH ADMINISTRATION PHARMACY BENEFITS MANAGEMENT STRATEGIC HEALTHCARE GROUP AND MEDICAL ADVISORY PANEL Dear VA Clinician: In December of 2006, the United States Food and Drug Administration (FDA) released a statement reinforcing their earlier recommendations that quinine should NOT be used for the prevention or treatment of nocturnal leg cramps because of the risk for serious adverse effects. Quinine associated adverse events, although rare, may include thrombocytopenia, arrhythmias, severe hypersensitivity reactions and even death. The adverse effects are unpredictable and may occur at any time even in an individual who has been taking quinine on a chronic basis without problems. As a result, the Department of Veterans Affairs will no longer provide quinine for leg cramps because of concern for patient safety. Quinine will continue to be available on a non formulary basis for the treatment of malaria. Please refer to the following links for additional information. http://www.fda.gov/bbs/topics/NEWS/2006/NEW01521.html and http://www.fda.gov/cder/drug/unapproved_drugs/quinineQA.pdf At this time, other pharmacologic treatments have not been found to be helpful or have been inadequately studied. A letter of explanation for patients, available on the PBM website http://vaww.pbm.va.gov/tig/Quinine%20for%20Leg%20Cramps%20Patient%20Letter.p df , makes the following non-pharmacologic self care suggestions: 1. Loosen up the covers/blankets over the feet at night to reduce the likelihood of your calf muscles contracting. 2. Try stretching your calf muscles several times a day. (Stand about two to three feet in front of a wall. Put your hands on the wall and lean forward without taking your heels off the ground. Hold for 10-30 seconds). 3. If a cramp does occur while lying in bed, try to stretch the muscle by first straightening your legs and flexing your feet towards your knees. It may be helpful to sit up and grab your toes and pull them towards your knees while keeping your legs straight or bending your knees if needed. You can also try massaging the muscle during the cramp to help it relax.

Here's my 2 cents on Quinine: I drink Quinine in Tonic Water, not by Rx. I buy the Wal-Mart store brand Tonic Water with Quinine. Yes, it tastes funky but you get used to it. It really helped my cramps at first. I would drink about an 8oz glass a day and the cramps were noticably reduced. I've been drinking Tonic Water for about 9 months and I've noticed the cramps are starting to come back quite often. So perhaps it only works temporarily. You can try it for a few months and see if it works for you. Try adding lemon juice and salt to help with the taste or if you drink alcohol, make a Gin & Tonic!