True contractures are rare. They are brought on when adenosine triphosphate-the muscle's 'fuel'-is depleted, resulting in calcium accumulation that inhibits muscle relaxation. In contrast to cramps, contrac-tures are electrically 'silent' and occur during exercise, and are more likely to be caused by some systemic disorder.
It has been noted that a number of nutrients can influence neuromuscular irritability and, in clinical practice, a host of nutritional interventions have proved successful. One theory maintains that muscle cramps are part of the syndrome of reactive hypoglycaemia (low blood sugar, with epi-sodes of weakness, perspiration and intense hunger a few hours after a meal that are relieved by food or glucose). Roughly
one-third of patients with spontaneous leg cramps at night also suffer from restless-legs syndrome, where strange or unpleasant feelings in the legs (such as pulling, crawling or burning) are relieved by moving them.
The diagnosis of hypoglycaemia with muscle cramps can be confirmed by glucose tolerance testing. The testing procedure itself can cause hypoglycaemia and, occasionally, the onset of muscle cramp will also be triggered. Of 350 patients so tested, those whose glucose tolerance test confirmed the diagnosis were placed on a diet designed to stabilize their blood sugar levels-in other words, a sugar-free, high-protein diet, with frequent snacking encouraged and one obligatory night-time meal. In the great majority of patients, symptoms went into remission immediately and remained so, unless they failed to follow the prescribed diet duing the preceding 12 hours (J Fla Med Assoc, 1973; 60: 29-31).
Calcium and calciferol (vitamin D2) supplementation should also be considered when muscle cramps manifest during pregnancy, as such a state is associated with increased urinary calcium loss (N Engl J Med, 1991; 325: 1439-40).
Hypokalaemia (low blood potassium) may equally be responsible for muscle cramps (Nouvelle Presse Medicale, 1973; 2: 1717). But before correcting the hypokalaemia, the patient's magnesium status should be evaluated, as around 50 per cent of hypokalaemic patients are also magnesium-depleted (Arch Intern Med, 1984; 144: 1794-6; Am J Cardiol, 1989; 63: 31-4G).
In athletes, supplementation with 10 mg of riboflavin (vitamin B2) has been shown to reduce (though not abolish fully) neuro-muscular irritability (Nutr Metab, 1976; 20: 1-8). It is likely that this effect is responsible for the reputed success of riboflavin in treating the leg cramps of pregnancy (J R Soc Med, 1983; 76: 712).
Riboflavin is also credited with bringing about the longstanding, well-known successes in treating the muscle cramps associated with a number of disorders, including diabetes, intoxications, infections and circulatory disturbances (Paris Medicale, 1946; 36: 549-54), for which the suggested dosage is 20 mg/day.
Quinine is sometimes recommended by orthodox medicine against leg cramps. However, the adverse effects that are known to follow its administration include ringing in the ears, impaired hearing, vertigo, blurred vision, fever, nausea, vomiting, diarrhoea, abdominal pain, flushing or itching of the skin and headache. Also, avoid taking it if you have optic neuritis, tinnitus aureum or atrial fibrillation (see also www.medicinenet.com/ script/main/art.asp?articlekey=7532).
Not surprisingly, Samuel Hahnemann indicated quinine as the medicine to be used against malaria (called 'ague' in his day). The symptoms produced by this remedy in normal healthy people were homeopathic to-that is to say, they mirrored-the typical symptoms of malaria, including abdominal cramps.
As usual, it should be borne in mind that the nutritional treatment outlined here is best undertaken with the supervision of practi-tioners whose training has prepared them to recognize serious illnesses and to integrate nutritional interventions safely into the treatment plan.
Harald Gaier, a registered naturopath, osteopath, homeopath and herbalist, practises at The Allergy and Nutrition Clinic, 22 Harley Street, London, and the Irish Centre of Integrated Medicine, Co. Kildare (www.drgaier.com).
WDDTY Volume 20 Issue 10