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Hey, this is Dr. Ken Berry, family physician with over 20 years of clinical experience and author of "Lies My Doctor Told Me." For the next few minutes, I want to discuss leg cramps: seven causes and seven cures. Millions of people suffer from leg cramps. Some people have them just very rarely, and some people have them almost every day. You can help yourself, your friends, and your families by watching this video and by sharing it on your social media. So many people think that leg cramps are just part of life for them, and it doesn't have to be that way, because you can share this information and help them out.
Now let's jump into the seven causes of leg cramps. At the end of each cause, I'm going to talk about the cure right there on the spot so that you can figure this out for yourself. I've ranked these causes from the most common to the least common. The most common is not really that dangerous, while the least common causes can be very, very dangerous, so you probably want to watch the last one just to make sure you know the most serious, dangerous causes of leg cramps so you can get that checked out if you need to.
Number one is by far the most common cause of leg cramps, and that is not getting enough salt in your diet. We were taught starting about 50 or 60 years ago that salt is bad for us, that we should limit salt, and that we should cut back on salt. There's no research to support that. There's a great book that I'm going to put a link to in the show notes, where you can look at the meaningful research behind salt. Human beings are mammals, and all mammals love and need salt on a daily basis. So stop being afraid of salt and eat salt to taste. I have a favorite salt that I'll put down in the show notes below, but in your process of eating more salt, I want you to focus on eating real salt. A lot of salt that comes from the superstores contains dextrose, which is sugar, and multi-dextran, and has aluminum added to keep the salt from clumping. It's natural for real salt to clump, and that's okay. That's one of the ways you know it's actually real salt. Also, salt that comes from the modern oceans can be full of microplastics and nanoplastics, neither of which you need. So make sure you're eating a real salt that comes from an ancient ocean, not from the modern ocean.
Number two is electrolytes. Under electrolytes, I'm going to include magnesium, potassium, and calcium, and I'm going to talk about arachidonic acid, because it helps your muscle cells use the electrolytes. Almost everybody in modern society is depleted in magnesium and potassium, and many people are depleted in calcium. This doesn't mean you need to take a calcium supplement. It just means you need to eat more calcium-rich foods. Any fish that you eat with the bones in, like sardines and anchovies, are great sources of calcium. You can get some calcium from dark leafy green vegetables and other sources. I actually have a video on this channel about good calcium sources in your food. You can also get magnesium and potassium from your food, but keep in mind that regardless of your diet, whether you're eating the standard American diet or a low-carb keto or carnivore diet, almost all of us in modern society are depleted in magnesium and potassium, and you have to go out of your way to get these extra things. I try to eat lots of foods rich in magnesium and potassium, but I also use an electrolyte drop that I put in my coffee and other liquids, which really helps me stay on top of my magnesium and potassium. I eat lots of bony little fish, which gives me lots of calcium. Now, arachidonic acid is something your body makes, but you can also get it in your diet by eating lots of fatty meat, both red meat, white meat, and seafood. Arachidonic acid helps calcium go into your muscle cells, and your muscle cells can either contract or relax properly. If you're not getting enough calcium inside the cell, arachidonic acid helps with that. So make sure you're eating lots of fatty meat and seafood, which will help you have plenty of arachidonic acid to help the calcium do its job at the muscle.
Number three, the third most common cause, is temporary overexertion. Let's say you're living a sedentary life and your friend comes to visit and says, "Hey, let's go for a hike." I know I used to like hiking. If you go on a hike that's eight miles, all uphill, then that night or the next night, since you've overexerted your leg muscles, you may very well have some leg cramps. That's normal and very common. It's not a sign of anything medically wrong with you, and it's not even necessarily a sign that you have an electrolyte or salt deficiency. It just means you overexerted those muscles. In a few days, those cramps will go away. That doesn't mean you should never go hiking with your friend again. It means you should be more active more often, because the more you use your muscles, stretch them, and strengthen them, the less likely you are to have muscle cramps in your legs. So don't worry about that overexertion.
Number four is medications. A lot of people aren't aware that medications can really increase your risk of leg cramps. By far the most common medications for this are the statin drugs, which lower your total cholesterol and your LDL cholesterol. People take these drugs thinking they lower their risk of heart attack and stroke. The research on this is equivocal at best and ridiculous at worst. I have other videos on this channel about whether you should take a statin to lower your total cholesterol. But one of the most common side effects of statin drugs, which include Zocor, Lipitor, Crestor, and Lovastatin, is muscle aches, joint aches, and muscle cramps in your legs. The next most common I hear about in clinical practice is Forteo or Evenity. These are both medications to improve bone density if you've been diagnosed with osteoporosis. If you'd like to get off that kind of medication and you're having leg cramps from it, talk to your doctor, and also watch my video on this channel about osteoporosis. You can actually strengthen your bones naturally without taking a lot of prescription medications. Any of the synthetic estrogens, like estradiol, Premarin, Prempro, and any estrogen you take in pill form, can increase not only your risk of leg cramps but also your risk of blood clots in your legs, which is another cause of leg cramps I'm about to talk about. If you're going to optimize your hormones, please use bioidentical, real hormones, not the synthetic estrogen pills. Another medication that can increase your risk of leg cramps is naproxen or Celebrex, and any non-steroidal anti-inflammatory drugs like ibuprofen. Calcium channel blockers like Procardia and Norvasc interfere with calcium channels, and they affect all calcium channels, not just the ones in your heart and arterial tree, but also the ones in your skeletal muscle. So if you're taking a calcium channel blocker and you've already addressed the other most common causes of leg cramps, you might talk to your doctor about another medication choice. Some patients I see talk about leg cramps when they take diuretics too often. It's fine to take them occasionally, but don't take them every day for years and years. Cipro, which is the antibiotic ciprofloxacin, can cause problems with muscles and tendons, and leg cramps are a symptom that often appears. Celexa, which is a serotonin reuptake inhibitor, can increase your risk of leg cramps. So if you take Celexa or any of the SSRIs, you might talk to your doctor about decreasing the dose, changing to something else, or weaning down and stopping. Now, let me ask you this: if you've ever been on a medication that you think caused leg cramps, put the name of that medicine in the comments below, and let me know whether the leg cramps stopped after you stopped taking it. A lot of people taking these medicines think they're completely harmless. They think an antibiotic just works on bacteria and has no other effect in the body, or that a calcium channel blocker just lowers blood pressure and does nothing else. Seeing your comment may help somebody else understand that these things have multiple potential effects and side effects, and maybe they should think about not taking that every single day of their life.
Number five is a blood clot in your leg, called a DVT. This usually presents as a cramp that comes on in one leg, not both. The more you walk, the more the muscle seems to cramp, and then it goes away, and then all of a sudden it comes back. It might stay the same or get worse. If you have a cramp in just one leg while walking, you need to see your doctor and get a venous Doppler, which is an ultrasound that looks not at the surface veins in your leg but at the deep veins you can't see. If there's a clot in one of these deep veins, it needs to be medically addressed, because it can increase your risk of a pulmonary embolism and all of its potentially devastating effects. So if you have a cramp in one calf or one foot that started over the last few weeks and isn't getting better, or is getting worse, go see your doctor as soon as possible.
Number six is a blockage in the arteries in your legs. You can have this in one leg or both legs. The more you walk, the more your leg muscles seem to cramp. You can also have leg cramps at night if you have blocked arteries that are supposed to supply blood to the muscles in your legs, feet, and toes. This comes up for people who have been diabetic for years, have smoked or used tobacco products for years and years, or have had high blood pressure for years. If you suspect this, and you've addressed causes one through four and you know you don't have five, then it could be peripheral artery disease, which can potentially lead to losing toes, feet, and legs. If you have this and you've taken care of the salt and magnesium, and you know you haven't overexerted, you need to see your doctor and tell them you're worried about the arteries in your legs. Your doctor will probably order a test called an ankle-brachial index, or ABI, which shows whether the arterial circulation in your arms is about the same as in your legs, which it should be to a certain degree. If that's abnormal, you'll probably get an ultrasound, a special kind of ultrasound of your leg arteries, and you may even get angiography or a CTA to look at it in more detail. Some people with lots of blockages in the leg arteries have to have a stent or even a bypass. It doesn't get better quickly unless you see your doctor and get these tests ordered.
Number seven, the final cause, is by far the rarest cause of leg cramps, but in many cases it's the most concerning and dangerous, and the biggest reason to see your doctor if you're having leg cramps. If you've addressed steps one through six and you know it's not those, then you need to go back to your doctor, because number seven is that some forms of cancer can cause leg cramps. They can mess with your electrolyte metabolism even when you're getting enough electrolytes in your diet, and lead to muscle cramps. Some autoimmune diseases can cause muscle aches and muscle cramps in the legs. Cirrhosis of the liver and other liver diseases can cause muscle cramps in your legs. On the initial lab work at your annual visit, there may be no indication that you have cirrhosis or liver disease, and your doctor will have to dig to the next level and look deeper to uncover it. Another very common cause of leg cramps is lumbar stenosis. Usually you'll have lower back pain with this as well, but not always. So have a conversation with your doctor about whether this could be coming from your lumbar spine even if you're not having low back pain.
These are by far the most common seven causes of leg cramps, and the seven cures, or at least the seven interventions that go along with them. I've put links to my favorites below, including the electrolyte drops I use and the salt book you probably need to read so you can tell your doctor to stop worrying about your salt intake. If you enjoyed this video, where I take the ancestral history of the human species, add some common sense, and look at the meaningful research behind it, please consider subscribing to this channel. There's a link here you can click to subscribe, and a bell down there, which you can click to get a notification every time I have a bright idea. This is Dr. Berry, and I'll see you next time.