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Muscle Cramps/Neuropathy

Before reading this page please know that I am not a medical doctor nor medically trained in any way.  This information is here so that you have printable data that you can bring to your doctor for consultation.  None of this replaces a doctor or what instructions a doctor gives you. Your doctor will need to see these studies to decide whether or not you can take these supplements.

Kayla’s Neuropathy started early in her treatment, the first symptom showed up as severe muscle cramps in her legs.  These progressed into severe pain in her feet that became so bad she could not touch her feet to the floor.  It was another cancer survivor who told me about neuropathy and its effect on the patient, which eventually lead to the relief of this condition and why I wanted to share this with you.

WHAT IS PERIPHERAL NEUROPATHY?

“Peripheral Neuropathy is one of the most common diseases most people have never heard of…and yet, upwards of 20 million Americans have it. Peripheral neuropathy is caused by damage to your body’s peripheral nerves. This damage disrupts the body’s ability to communicate with its muscles, skin, joints, or internal organs. It is like the body’s wiring system breaking down. If ignored, neuropathy can lead to numbness, pain, weakness and incoordination. However, diagnosed and treated early, peripheral neuropathy can often be controlled, slowing the disease’s progression.” Definition taken from www.neuropathy.org Of course people think the only option is drugs. This is just not true!  I wrote this to promote safe non-drug answers.

Please note that Neuropathy is a temporary condition caused by chemotherapy and will go away after treatment is done. Two books I read about cancer patients described in detail the feeling that Neuropathy caused in their feet. Both described burning pain. One author said it felt like his socks were bunched up in his shoes, he would check and they were not. This feeling progressed until he was limping with pain. Kayla’s progressively worsened to the point of not being able to apply any pressure on her feet. Neuropathy can effect the hands, jaw, and other areas of the body.

Neurontin is a medication that alleviates the pain of Neuropathy and is prescribed by your physician.

There are specific nutrients that may help muscle cramps and/or neuropathy. Below are specific, quoted medical references, cited for your doctor to read.  Your doctor is more likely to approve of supplements if he/she is given medical information with references. Please print out the sections below for medical consultation.

Magnesium: What is it?

Magnesium is the fourth most abundant mineral in the body and is essential to good health. Approximately 50% of total body magnesium is found in bone. The other half is found predominantly inside cells of body tissues and organs. Only 1% of magnesium is found in blood, but the body works very hard to keep blood levels of magnesium constant [1].

Magnesium is needed for more than 300 biochemical reactions in the body. It helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and keeps bones strong. Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis [2-3]. There is an increased interest in the role of magnesium in preventing and managing disorders such as hypertension, cardiovascular disease, and diabetes. Dietary magnesium is absorbed in the small intestines. Magnesium is excreted through the kidneys [1-3,4].

When can a magnesium deficiency occur?

There is concern about the prevalence of sub-optimal magnesium stores in the body. For many people, dietary intake may not be high enough to promote an optimal magnesium status, which may be protective against disorders such as cardiovascular disease and immune dysfunction [7-8].

The health status of the digestive system and the kidneys significantly influence magnesium status. Magnesium is absorbed in the intestines and then transported through the blood to cells and tissues. Approximately one-third to one-half of dietary magnesium is absorbed into the body [9-10]. Gastrointestinal disorders that impair absorption such as Crohn’s disease can limit the body’s ability to absorb magnesium. These disorders can deplete the body’s stores of magnesium and in extreme cases may result in magnesium deficiency. Chronic or excessive vomiting and diarrhea may also result in magnesium depletion [1,10].

Healthy kidneys are able to limit urinary excretion of magnesium to compensate for low dietary intake. However, excessive loss of magnesium in urine can be a side effect of some medications and can also occur in cases of poorly controlled diabetes and alcohol abuse [11-18].

Signs of Magnesium Deficiency

Early signs of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, muscle contractions and cramps, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur [1,3-4]. Severe magnesium deficiency can result in low levels of calcium in the blood (hypocalcemia). Magnesium deficiency is also associated with low levels of potassium in the blood (hypokalemia) [1,19-20].

Many of these symptoms are general and can result from a variety of medical conditions other than magnesium deficiency. It is important to have a physician evaluate health complaints and problems so that appropriate care can be given.

Who May Need Extra Magnesium?

Magnesium supplementation may be indicated when a specific health problem or condition causes an excessive loss of magnesium or limits magnesium absorption [2,7,9-11].

Some medicines may result in magnesium deficiency, including certain diuretics, antibiotics, and medications used to treat

cancer (anti-neoplastic medication) [12,14,19]. Examples of these medications are: Diuretics: Lasix, Bumex, Edecrin, and

hydrochlorothiazide Antibiotics: Gentamicin, and Amphotericin Anti-neoplastic medication: Cisplatin


Individuals with poorly controlled diabetes may benefit from magnesium supplements because of increased magnesium loss in

urine associated with hyperglycemia [21].


Vitamin B12

Vitamin B12 is an important supplement for nerve health.  Even now, 1 year after treatment Kayla is taking a mega dose of vitamin B12 on a daily basis as the neuropathy continued to linger long after completion of chemotherapy.

What is vitamin B12? Vitamin B12 helps maintain healthy nerve cells and red blood cells [1-4]. It is also needed to help make DNA, the genetic material in all cells. Vitamin B12 is bound to the protein in food. Hydrochloric acid (digestive acid)  in the stomach releases vitamin B12 from proteins in foods during digestion.

What foods provide vitamin B12?

Vitamin B12 is naturally found in foods that come from animals, including fish, meat, poultry, eggs, milk, and milk products. Fortified breakfast cereals are a particularly valuable source of vitamin B12 for vegetarians. [5-7]

When is a deficiency of vitamin B12 likely to occur?

Results of two national surveys, the National Health and Nutrition Examination Survey (NHANES III-1988-94) [8] and the Continuing Survey of Food Intakes by Individuals (CSFII 1994-96) found that most children and adults in the United States (US) consume recommended amounts of vitamin B12 [6-8]. A deficiency may still occur as a result of an inability to absorb vitamin B12 from food and in strict vegetarians who do not consume any foods that come from animals [9]. As a general rule, most individuals who develop a vitamin B12 deficiency have an underlying stomach or intestinal disorder that limits the absorption of vitamin B12 [10]. Sometimes the only symptom of these intestinal disorders is subtly reduced cognitive function resulting from early vitamin B12 deficiency. Anemia and dementia follow later [1,11]. (Emphasis mine.)

Signs, symptoms, and health problems associated with vitamin B12 deficiency: include anemia, fatigue, weakness, constipation, loss of appetite, and weight loss [1,3,12].

Deficiency also can lead to neurological changes such as numbness and tingling in the hands and feet [7,13]. (Emphasis mine.) Additional symptoms of vitamin B12 deficiency are difficulty in maintaining balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue [14].

Signs of vitamin B12 deficiency in infancy include failure to thrive, movement disorders, delayed development, and megaloblastic anemia [15]. Many of these symptoms are very general and can result from a variety of medical conditions other than vitamin B12 deficiency.

I added the highlighted emphasis above (bolded words) because the symptoms highlighted are particular to patients receiving chemotherapy, which may cause deficiencies.

Workable Tips

Our physical Therapist is married to a Chinese doctor. He gave us the following tip and it helped immensely. We had to find a large dry sponge. Then we were instructed to take this sponge and run the dry sponge over the area of pain. In Kayla’s case this was the bottom of her foot and up the calf. We were told to do this several times and hour. This remedy is thousands of years old from AncientP2070002 Chinese Medicine and is a means of trying to train the nerves to follow the correct path and function. Since our medication was not working we decided to try it. The sponge produced results in the first week, with less pain and the ability to apply small amounts of pressure. Kayla did this for a couple of minutes many times a day.

Our program for Neuropathy is as follows;

PSST – This information is not here to replace the advice of your doctor!  This is not a prescription and just because this worked for Kayla does not mean that this is safe for you.  Print off these pages and consult with your healthcare practitioner.  All of this information is here for educational purposes only.

Neurontin as prescribed by your doctor

Sponge massage many, many, times a day

B12 lozenge 500 mcg in the morning

Peter Gillham’s CALM magnesium powder every night,

1 tsp, before bed.

(Start with a low dose like 1/4 teaspoon, to ensure this does not upset your stomach!)

There has been no sign of Neuropathy in Kayla for two months. She is now walking and we have been able to reduce the Neurontin from three doses a day, to two doses a day. This makes us both very happy. I think we see a light at the end of the tunnel : ) I hope you do too.

Update: Kayla has been off Neurontin for 8 months now.   While getting off the Neurontin and for a while afterwards, Kayla was taking a high dose of B12.  This has worked to stop the pain and the only time the pain comes back is if I try to get her off of the B12.  We slowly lowered the dose of B12 and now she only takes it the day before chemo and a couple of days after.  Here feet are now returning to normal with no pain at all!

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References:

  1. Rude RK. Magnesium deficiency: A cause of heterogeneous disease in humans. J Bone Miner Res 1998;13:749-58. [PubMed abstract]
  2. Wester PO. Magnesium. Am J Clin Nutr 1987;45:1305-12. [PubMed abstract]
  3. Saris NE, Mervaala E, Karppanen H, Khawaja JA, Lewenstam A. Magnesium: an update on physiological, clinical, and analytical aspects. Clinica Chimica Acta 2000;294:1-26.
  4. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy Press. Washington, DC, 1999.
  5. Vormann J. Magnesium: nutrition and metabolism. Molecular Aspects of Medicine 2003:24:27-37.
  6. Ladefoged K, Hessov I, Jarnum S. Nutrition in short-bowel syndrome. Scand J Gastroenterol Suppl 1996;216:122-31. [PubMed abstract]
  7. Kelepouris E and Agus ZS. Hypomagnesemia: Renal magnesium handling. Semin Nephrol 1998;18:58-73. [PubMed abstract]
  8. Ramsay LE, Yeo WW, Jackson PR. Metabolic effects of diuretics. Cardiology 1994;84 Suppl 2:48-56. [PubMed abstract]
  9. Lajer H and Daugaard G. Cisplatin and hypomagnesemia. Ca Treat Rev 1999;25:47-58. [PubMed abstract]
  10. Elisaf M, Bairaktari E, Kalaitzidis R, Siamopoulos K. Hypomagnesemia in alcoholic patients. Alcohol Clin Exp Res 1998;22:244-6. [PubMed abstract]
  11. Shils ME. Magnesium. In Modern Nutrition in Health and Disease, 9th Edition. (edited by Shils, ME, Olson, JA, Shike, M, and Ross, AC.) New York: Lippincott Williams and Wilkins, 1999, p. 169-92.
  12. American Diabetes Association. Nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care 1999;22:542-5. [PubMed abstract]
  13. Rude RK and Olerich M. Magnesium deficiency: Possible role in osteoporosis associated with gluten-sensitive enteropathy. Osteoporos Int 1996;6:453-61. [PubMed abstract]
  14. Bialostosky K, Wright JD, Kennedy-Stephenson J, McDowell M, Johnson CL. Dietary intake of macronutrients, micronutrients and other dietary constituents: United States 1988-94. Vital Heath Stat. 11(245) ed: National Center for Health Statistics, 2002:168. Copied from the National Institute of Health, Office of Dietary Supplements. August 2008

B12

  1. Herbert V. Vitamin B12 in Present Knowledge in Nutrition. 17th ed. Washington, D.C.: International Life Sciences Institute Press, 1996.
  2. Herbert V and Das K. Vitamin B12 in Modern Nutrition in health and disease. 8th ed. Baltimore: Williams & Wilkins, 1994.
  3. Combs G. Vitamin B12 in The Vitamins. New York: Academic Press, Inc, 1992.
  4. Zittoun J and Zittoun R. Modern clinical testing strategies in cobalamin and folate deficiency. Sem Hematol 1999;36:35-46. [PubMed abstract]
  5. U.S. Department of Agriculture, Agricultural Research Service. 2003. USDA Nutrient Database for Standard Reference, Release 16. Nutrient Data Laboratory Home Page, http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl.
  6. Subar AF, Krebs-Smith SM, Cook A, Kahle LL. Dietary sources of nutrients among US adults, 1989 to 1991. J Am Diet Assoc 1998;98:537-47. [PubMed abstract]
  7. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academy Press. Washington, DC, 1998.
  8. Bialostosky K, Wright JD, Kennedy-Stephenson J, McDowell M, Johnson CL. Dietary intake of macronutrients, micronutrients and other dietary constituents: United States 1988-94. Vital Heath Stat. 11(245) ed: National Center for Health Statistics , 2002.
  9. Markle HV. Cobalamin. Crit Rev Clin Lab Sci 1996;33:247-356. [PubMed abstract]
  10. Carmel R. Cobalamin, the stomach, and aging. Am J Clin Nutr 1997;66:750-9. [PubMed abstract]
  11. Nourhashemi F, Gillette-Guyonnet S, Andrieu S, Shisolfi A, Ousset PJ, Grandjean H, Grand A, Pous J, Vellas B, Albarede JL. Alzheimer disease: protective factors. Am J of Clinical Nutrition 2000; 71: 643S-9S.
  12. Bernard MA, Nakonezny PA, Kashner TM. The effect of vitamin B12 deficiency on older veterans and its relationship to health. J Am Geriatr Soc 1998;46:1199-206. [PubMed abstract]
  13. Healton EB, Savage DG, Brust JC, Garrett TF, Lindenbaum J. Neurological aspects of cobalamin deficiency. Medicine 1991;70:229-244. [PubMed abstract]
  14. Bottiglieri T. Folate, vitamin B12, and neuropsychiatric disorders. Nutr Rev 1996;54:382-90. [PubMed abstract]
  15. Monsen ALB and Ueland PM. Homocysteine and methylmalonic acid in diagnosis and risk assessment from infancy to adolescent. American Journal of Clinical Nutrition 2003; 78:7-21.