Dealing with cramps – Part I
Leg cramps are a common complaint for those starting out on a low carb or ketogenic diet. I was a bit worried, if I’m honest, because I have a grizzly history with cramps. I was afflicted from an early age (long before keto) and my mother was the same. My pregnancies were just nine long months of painful cramps and endless peeing. They are benign, nocturnal or exercise induced cramps and I also often get some less troublesome post-exercise fasciculations (twitching as opposed to big muscle contractions).
My blood levels of Potassium, Sodium and Magnesium have never been anything other than normal (when being tested of course). I went to my GP once, when I was 19, I was playing rugby, drinking beer, partying a lot and waking at night with vicious cramps. His suggestion – stop eating tomatoes. He meant well and was genuinely looking for up-to-date answers but I was sceptical and never took his advice.
My cramps were noticeable when I started a proper ketogenic diet this time round. I’ve played about with low carb/ketogenic diets previously but don’t remember thinking about cramps in depth. The cramps occur most often in my calves but also in the front of my legs (so so painful), throughout my feet and also my hands (that’s actually quite funny when it happens, as long as it doesn’t last). I get cramps in my abdominal muscles and in my big back/neck muscles. You name them, lots of my muscles like to cramp. It can from time to time be distressing and can leave me sore for many days. You can see why I went to the GP. My cramps may have increased on the ketogenic diet but at the same time I increased the amount of exercise I was doing. I am rugby training as well as martial arts training, I recently ran a 10km and have been in competition for steps with my fitbit friends. I have also been very self-aware since ditching carbs, clocking every feeling and twitch, so it may not have been an increase, just an increased awareness.
Of course I have seen the advice to drink more water, take more salt, check my potassium and magnesium intake, drink bone broth, drink pickle juice. I take supplements. I haven’t noticed any change. I see a lot of people advising potassium or magnesium supplementation but I never saw any of them quote any evidence.
I wanted some answers and so I started researching. There is some interesting physiology research out there, there are some brain tickling N=1 thoughts and there is lots of very general advice around keto-flu and supplementation of various electrolytes. It will be difficult though to find out what helps for me if I don’t actually quantify the cramps. I already diligently record what I eat, so I have started to record cramps, including the details of muscle groups, extent and timing. Then when I have some idea of the extent of the problem, I can start to look for correlations and can start to change up the diet and supplements to look for any changes. Again, I’m sceptical that I can find an answer after so many years, but I’m looking.
So, watch this space and I will publish some results – one way or another. I have more questions than answers just now. Here are some links…
Central nervous system or peripheral generation? I always assumed that the mechanism was a peripheral one (local to the muscle and local motor neurons/terminal nerve branches) but it looks like there could be a central mechanism that is important. This has interesting bearing on prevention.
Then there’s what Diet Doctor says. They mention Volek and Phinney’s book – I haven’t read that yet (gasp, what an admission!).
I will get back to you.