[TMIC] Fw: [PCAdg] Possible solutions for Muscle Cramps while taking PC SPES or Lupron

Jan Burgess (datapro(AT)bconnex.net)
Tue, 8 Jun 1999 01:31:26 -0400

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Hi Everyone: The info below was posted on a Prostate Cancer list and =
discusses various methods of alieviating leg muscle cramps induced by =
some of the drugs the guys have to take. I thought that some of these =
suggestions could prove helpful for TM'ers who have this painful symptom =
- read what is worth reading & delete the rest and please don't try any =
of the stretching exercises beyond your capabilities/safety -=20

hugs,

JanB

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-------

Some guys who take Lupron, or Lupron/Caodex or Casodex/Proscar or PC =
SPES,=20
and probably other hormonal manipulation therapies as well, report =
muscle=20
cramps or charlie horses.

Here is an old post I wrote on possible solutions for PC SPES or Lupron=20
induced muscle cramps/charlie horses.=20

You may wish to run some of these ideas by your doctor. These ideas=20
were primarily taken from a book by Dr. Mary Eades, MD, She recommends =
first=20
that you make some important dietary modifications to make sure you are=20
getting adequate protein and then she said you should try to virtually=20
eliminate sugar (sugar, corn syrup, molasses, etc.) and starchy foods=20
(potatoes, white rice, white bread, corn, etc.) which will all increase =
your=20
insulin levels. Dr. Eades also recommends a number of different =
supplements=20
including: Riboflavin plus 50 mg. of B-complex, and/or supplement with=20
Vitamin B6 (pyridoxine), and/or increase the Vit. E to 1200 IU taken =
three=20
times daily, and/or supplement with 99 mg of potassium gluconate two to =
three=20
times daily. She says phosphorus increases cramping and recommends=20
elimination of carbonated beverage soft drinks (as these are a major =
source=20
of phosphorus), and she recommends that you drink either water, tea =
without=20
sugar, and non-carbonated sugar free drinks. She did not specifically=20
mention elimination of fruit juices that are loaded with sugar (carrot,=20
orange and many others), but I suspect she did not think to include =
those in=20
her list since she recommends elimination of sugar and fructose type =
drinks. =20
She does allow sugar in whole fruits, particularly the low glycemic =
fruits=20
such as apples, cherries, peaches but not many bananas or raisins which =
are=20
loaded with sugar.=20

Here is the entire muscle cramping post, with a few updated additions =
added=20
here and there. I am cross posting my response to various lists as many =
guys=20
have muscle cramps when they take various hormonal manipulation drugs, =
and=20
many of us are doing just that as we take various PCa therapies, either=20
mainline or alternative therapies.

Hello to All:

Today, I answered an Australian guy's request for muscle spasms =
information. =20
He got muscle spasms after he had started taking Zoladex. I recently=20
corresponded with Dr. Macintosh of the Univ. of Utah and his Dad was =
also=20
getting severe muscle pain and cramps after taking Lupron for a few =
months.

Muscle spasms and muscle pain can the result from various interactions =
with=20
hormonal manipulation or hormonal suppression drugs, your food intake,=20
absorption or lack of absorption of certain, vitamins, etc., and =
insufficient=20
liquids, and electrolytes. =20

1.0 General Background on What May Cause Muscle Cramps

Muscles in your body move by getting a signal to either tighten or =
relax. It=20
is believed that this tightening or relaxing force happens in the =
muscles=20
when your body causes various mineral ions to flow into or out of the =
many=20
thousands of muscle fibers that make up your various body muscles. =
Mineral=20
ions are charged chemical species that result when minerals such as =
sodium=20
chloride, potassium chloride, calcium citrate, etc., dissolve in water =
or in=20
other liquids.

Muscle cramps (spasms) are believed to be caused by a deficiency of =
various=20
mineral ions thus interfering with the normal flow of these electrolytes =

(ions). This confuses the muscle and or the brain. According to Dr. =
Mary=20
Eades, MD, in the book, "The Complete Doctors Guide to Vitamins and=20
Minerals," (see page 395), any deficiency, such as a calcium, sodium, or =

potassium ion deficiency disrupts the flow of these mineral ions and can =

cause muscle tightening which we call cramps or spasms. Over use and =
muscle=20
fatigue can also cause cramping but so can a lack of the proper =
electrolytes,=20
vitamins and foods.=20

2.0 Recommendations For Reducing Muscle Cramps:

Here are some recommendations from Dr. Eades taken from the book cited =
above.

2.1. Many people with chronic muscle cramps get relief by eating a diet=20
sufficient in protein but free of sugar. She recommends you eat =
one-half=20
gram of a complete protein per pound of your lean body mass (LBM). If =
your=20
read my 'good eicosinoids" post of last week, you can learn how to =
calculate=20
your LBM. Eat a Zone type diet with 40% of calories coming from =
non-starch=20
low glycemic index type vegetables and fruits, 30% from good fats and =
oils,=20
and 30% from complete proteins. Try to eliminate table sugar, corn =
syrup,=20
high-fructose corn syrup

2.2 Take 20 mg of Riboflavin plus 50 mg. of B-complex (because the =
B-complex=20
likes to work together. This reduces many muscle spasms.

2.3 Take 400 IU of Vitamin E two to three times per day for a minimum =
of six=20
weeks
Then reduce your dose to 400 IU as symptoms improve. She warns that =
Vit. E=20
can cause elevation of blood pressure in some people and that you should =

monitor your blood pressure on these high doses.

2.4 Vitamin B6 (pyridoxine) helps relieve night time leg cramping and =
carpal=20
tunnel syndrome. She recommends 50 mg. of B6 daily for 4 to 6 weeks and =
if=20
improvements result continue on a 25 to 50 mg. dose thereafter. She =
cautions=20
against a dose in excess of 150 mg. per day as permanent nerve injury =
may=20
result.

2.5 Deficiencies of calcium and magnesium can cause cramps. When you =
take=20
Ca and Mg, the ratio of these two is very important to their proper=20
absorption. You should take 2 milligrams of Calcium for every 1 =
milligram of=20
Magnesium. She says typical adults take 1,000 mg Calcium and 500 mg=20
Magnesium daily. (Note: this Ca/Mg ratio precaution of 2/1 should also =
be=20
observed by all, including those who do not have muscle cramps).

2.6. A deficiency of potassium can cause muscle cramping particularly =
if you=20
are taking diuretics (fluid pills). Sometimes dieting, exercising on =
hot=20
days, illness, etc., can lead to potassium deficiency. She recommends =
99 mg=20
of potassium gluconate two to three times daily.=20

2.8 Sodium deficiency can occur (but in my opinion this is not as =
likely in=20
the American diet) and for that she recommends a glass of Gatorade =
Light, or=20
a glass or two of bouillon soup just prior to bedtime, or some salt =
tablets.=20
(I also drink one or two glasses of V-8 juice daily when I have leg or =
back=20
cramps, and at least one per day when I don't get any cramping)

3.0 What makes muscle cramping Worse. Dr. Eades says:

3.1 Increased intake of phosphorus can deplete your body fluids of =
calcium=20
and may contribute to muscle cramping. She recommends elimination of=20
carbonated beverage soft drinks as these are a major source of =
phosphorus.=20
She recommends you drink water, tea without sugar, and non-carbonated =
sugar=20
free drinks.

4.0 Some Physical Manipulations That May Help Ease the Pain
4.1 Try this accupressure technique says editors of the Prevention =
Magazine,=20
to get instant pain relief:

"Grab Your upper lip between your thumb and index finger and squeeze for =

about 30 seconds." They say its hard to believe but it works. This=20
technique is used by Pat Morency, a sports injury specialist who works =
with=20
Olympic hopefuls.

BTW, for possible migraine headache pain relief, grab your nostril in =
the=20
lower nose, where it attaches to skin above your lips and pinch the =
nostril=20
hard for a minute or so. Sometimes this will work. If not call your =
doctor.

4.2 For Severe Leg Cramps contract and relax opposing muscles.

Prevention Magazine editor's recommend for calf cramps that you flex =
your=20
shin muscle by pulling your toes toward your knee. Better yet have a =
friend=20
push the top of your foot the other way as you pull your toes toward =
your=20
knee which maxes out the tension on your shin muscle which causes the =
calf=20
cramp to be released.

4.3 After cramps stretch the muscle, begin slowly and do not bounce.=20

Try this stretch: sit on the floor with leg extended and pull your toes =
back=20
toward your knees for a minute or so.=20

Also Prevention says some have good luck with this technique: grab the=20
cramped muscle, digging your fingers into the cramped muscle as far as=20
possible holding the position for 10 to 20 seconds, and then release the =

hold. Repeat this several times as long as the pain continues. If you =
rub a=20
muscle rub up or down the muscle and not across it. For example rub you =
calf=20
muscle toward your heel.

Another good way to stretch your calf muscle, which I learned from my=20
physical therapist, is to stand on some stairs with only the front half =
of=20
your foot, and then holding on to the bannister slowly lower your heels =
and=20
hold them in a stretched position for 30 seconds to a minute. Don't =
bounce up=20
and down.

Also you can lean forward against a wall, and move your feet far away =
from=20
the wall until you are standing on your toes; then slowly lower your =
heels=20
while still keeping your hands on the wall. Hold this position on the =
down=20
stroke for 30 seconds or more and this will stretch your calf and =
Achilles=20
tendon. Sometimes thorough stretching prevents or reduces the pain =
severity=20
of cramping.

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charset="iso-8859-1"
Content-Transfer-Encoding: quoted-printable

<!DOCTYPE HTML PUBLIC "-//W3C//DTD W3 HTML//EN">

Hi Everyone: The info below was posted on a Prostate Cancer list = and=20 discusses various methods of alieviating leg muscle cramps induced by = some of=20 the drugs the guys have to take.  I thought that some of these = suggestions=20 could prove helpful for TM'ers who have this painful symptom - read what = is=20 worth reading & delete the rest and please don't try any of the = stretching=20 exercises beyond your capabilities/safety -
 
hugs,
 
JanB
 


Some guys who take Lupron, or Lupron/Caodex or Casodex/Proscar = or PC=20 SPES,
and probably other hormonal manipulation therapies as well, = report=20 muscle
cramps or charlie horses.

Here is an old post I wrote = on=20 possible solutions for PC SPES or Lupron
induced muscle = cramps/charlie=20 horses.

You may wish to run some of = these=20 ideas by your doctor.  These ideas
were primarily taken from a = book by=20 Dr. Mary Eades, MD,  She recommends first
that you make some = important=20 dietary modifications to make sure you are
getting adequate protein = and then=20 she said you should try to  virtually
eliminate sugar (sugar, = corn=20 syrup, molasses, etc.)  and starchy foods
(potatoes, white = rice, white=20 bread, corn, etc.) which will all increase your
insulin = levels.  Dr.=20 Eades also recommends a number of different supplements
including:=20 Riboflavin plus 50 mg. of B-complex, and/or supplement with
Vitamin = B6=20 (pyridoxine), and/or increase the Vit. E to 1200 IU taken three =
times daily,=20 and/or supplement with 99 mg of potassium gluconate two to three =
times=20 daily. She says phosphorus increases cramping and recommends =
elimination of=20 carbonated beverage soft drinks (as these are a major source
of = phosphorus),=20 and she recommends that you drink either water, tea without
sugar, = and=20 non-carbonated sugar free drinks.  She did not specifically =
mention=20 elimination of fruit juices that are loaded with sugar (carrot, =
orange and=20 many others), but I suspect she did not think to include those in =
her list=20 since she recommends elimination of sugar and fructose type = drinks. =20
She does allow sugar in whole fruits, particularly the low glycemic = fruits=20
such as apples, cherries, peaches but not many bananas or raisins = which are=20
loaded with sugar.

Here is the entire muscle cramping post, = with a=20 few updated additions added
here and there.  I am cross posting = my=20 response to various lists as many guys
have muscle cramps when they = take=20 various hormonal manipulation drugs, and
many of us are doing just = that as=20 we take various PCa therapies, either
mainline or alternative=20 therapies.

Hello to All:

Today, I answered an Australian = guy's=20 request for muscle spasms information. 
He got muscle spasms = after he=20 had started taking Zoladex.  I recently
corresponded with Dr. = Macintosh=20 of the Univ. of Utah and his Dad was also
getting severe muscle pain = and=20 cramps after taking Lupron for a few months.

Muscle spasms and = muscle=20 pain can the result from various interactions with
hormonal = manipulation or=20 hormonal suppression drugs, your food intake,
absorption or lack of=20 absorption of certain, vitamins, etc., and insufficient
liquids, and = electrolytes. 

1.0  General Background on What May = Cause=20 Muscle Cramps

Muscles in your body move by getting a signal to = either=20 tighten or relax. It
is believed that this tightening or relaxing = force=20 happens in the muscles
when your body causes various mineral ions to = flow=20 into or out of the many
thousands of muscle fibers that make up your = various=20 body muscles. Mineral
ions are charged chemical species that result = when=20 minerals such as sodium
chloride, potassium chloride, calcium = citrate, etc.,=20 dissolve in water or in
other liquids.

Muscle cramps (spasms) = are=20 believed to be caused by a deficiency of various
mineral ions thus=20 interfering with the normal flow of these electrolytes
(ions).  = This=20 confuses the muscle and or the brain.  According to Dr. Mary =
Eades, MD,=20 in the book, "The Complete Doctors Guide to Vitamins and=20
Minerals," (see page 395), any deficiency, such as a calcium, = sodium,=20 or
potassium ion deficiency disrupts the flow of these mineral ions = and can=20
cause muscle tightening which we call cramps or spasms.  Over = use and=20 muscle
fatigue can also cause cramping but so can a lack of the = proper=20 electrolytes,
vitamins and foods.

2.0 Recommendations For = Reducing=20 Muscle Cramps:

 Here are some recommendations from Dr. Eades = taken=20 from the book cited above.

2.1. Many people with chronic muscle = cramps=20 get relief by eating a diet
sufficient in protein but free of = sugar. =20 She recommends you eat one-half
gram of a complete protein per pound = of your=20 lean body mass (LBM).  If your
read my 'good eicosinoids" = post of=20 last week, you can learn how to calculate
your LBM.  Eat a Zone = type=20 diet with 40% of calories coming from non-starch
low glycemic index = type=20 vegetables and fruits, 30% from good fats and oils,
and 30% from = complete=20 proteins.  Try to eliminate table sugar, corn syrup, =
high-fructose corn=20 syrup

2.2  Take 20 mg of Riboflavin plus 50 mg. of B-complex = (because the B-complex
likes to work together.  This reduces = many=20 muscle spasms.

2.3  Take 400 IU of Vitamin E two to three = times per=20 day for a minimum of six
weeks
Then reduce your dose to 400 IU as = symptoms improve.  She warns that Vit. E
can cause elevation of = blood=20 pressure in some people and that you should
monitor your blood = pressure on=20 these high doses.

2.4  Vitamin B6 (pyridoxine) helps relieve = night=20 time leg cramping and carpal
tunnel syndrome. She recommends 50 mg. = of B6=20 daily for 4 to 6 weeks and if
improvements result continue on a 25 = to 50 mg.=20 dose thereafter.  She cautions
against a dose in excess of 150 = mg. per=20 day as permanent nerve injury may
result.

2.5  = Deficiencies of=20 calcium and magnesium can cause cramps.  When you take
Ca and = Mg, the=20 ratio of these two is very important to their proper =
absorption.  You=20 should take 2 milligrams of Calcium for every 1 milligram of=20
Magnesium.  She says typical adults take 1,000 mg Calcium and = 500 mg=20
Magnesium daily. (Note: this Ca/Mg ratio precaution of 2/1 should = also be=20
observed by all, including those who do not have muscle=20 cramps).

2.6.  A deficiency of potassium can cause muscle = cramping=20 particularly if you
are taking diuretics (fluid pills).  = Sometimes=20 dieting, exercising on hot
days, illness, etc., can lead to = potassium=20 deficiency.  She recommends 99 mg
of potassium gluconate two to = three=20 times daily.

2.8  Sodium deficiency can occur (but in my = opinion=20 this is not as likely in
the American diet) and for that she = recommends a=20 glass of Gatorade Light, or
a glass or two of bouillon soup just = prior to=20 bedtime, or some salt tablets.
(I also drink one or two glasses of = V-8 juice=20 daily when I have leg or back
cramps, and at least one per day when = I don't=20 get any cramping)

3.0 What makes muscle cramping Worse.  Dr. = Eades=20 says:

3.1 Increased intake of phosphorus can deplete your body = fluids of=20 calcium
and may contribute to muscle cramping.  She recommends=20 elimination of
carbonated beverage soft drinks as these are a major = source=20 of phosphorus.
She recommends you drink water, tea without sugar, = and=20 non-carbonated sugar
free drinks.

4.0 Some Physical = Manipulations=20 That May Help Ease the Pain
4.1  Try this accupressure technique = says=20 editors of the Prevention Magazine,
to get instant pain=20 relief:

"Grab Your upper lip between your thumb and index = finger and=20 squeeze for
about 30 seconds."  They say its hard to = believe but=20 it works.  This
technique is used by Pat Morency, a sports = injury=20 specialist who works with
Olympic hopefuls.

BTW, for possible = migraine headache pain relief, grab your nostril in the
lower nose, = where it=20 attaches to skin above your lips and pinch the nostril
hard for a = minute or=20 so.  Sometimes this will work.  If not call your=20 doctor.

4.2  For Severe Leg Cramps contract and relax = opposing=20 muscles.

Prevention Magazine editor's recommend for calf cramps = that you=20 flex your
shin muscle by pulling your toes toward your knee.  = Better=20 yet have a friend
push the top of your foot the other way as you = pull your=20 toes toward your
knee which maxes out the tension on your shin = muscle which=20 causes the calf
cramp to be released.

4.3  After cramps = stretch=20 the muscle, begin slowly and do not bounce.

Try this stretch: = sit on the=20 floor with leg extended and pull your toes back
toward your knees = for a=20 minute or so.

Also Prevention says some have good luck with this = technique: grab the
cramped muscle, digging your fingers into the = cramped=20 muscle as far as
possible holding the position for 10 to 20 seconds, = and=20 then release the
hold.  Repeat this several times as long as = the pain=20 continues.  If you rub a
muscle rub up or down the muscle and = not=20 across it.  For example rub you calf
muscle toward your=20 heel.

Another good way to stretch your calf muscle, which I = learned from=20 my
physical therapist, is to stand on some stairs with only the = front half=20 of
your foot, and then holding on to the bannister slowly lower your = heels=20 and
hold them in a stretched position for 30 seconds to a minute. = Don't=20 bounce up
and down.

Also you can lean forward against a wall, = and=20 move your feet far away from
the wall until you are standing on your = toes;=20 then slowly lower your heels
while still keeping your hands on the=20 wall.  Hold this position on the down
stroke for 30 seconds or = more and=20 this will stretch your calf and Achilles
tendon.  Sometimes = thorough=20 stretching prevents or reduces the pain severity
of =20 cramping.


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