Thursday, January 23, 2014

Prednisone side effects: Leg muscle cramps and spasms

Sometimes the 'cure' for a disease can have side effects that are almost as bad as the disease itself. Such is the case for many patients that are being treated with Prednisone. While the list of Prednisone side effects are many, one that might sneak up on you (and your doctor) is leg muscle cramps and spasms (charlie horses). And if you're also taking Mestinon (pyridostigmine), as most MG patients are, you might suspect it rather than the predsnidone. A logical assumption for sure. But overlooking the prednisone side effect of erratic muscle activity in the legs - especially in the calf and
toes  - could cause you unnecessary pain.

How Does Prednisone Cause Muscle Cramps and Spasms?
With or without having myasthenia gravis, your doctor might suggest that you drink more water, stretch your calf muscles and add a calcium supplement to your diet to ease leg muscle cramps. All good advice. Your neurologist will also recommend that you start taking a calcium supplement when you begin prednisone, primarily to help prevent osteoporosis. But adding calcium and prednisone in the body can upset the electrolyte system because both act as potassium depleting agents. Potassium is an essential electrolyte element and as such regulates the electrical signals of cells. Since nerves and muscles use high levels of electricity, they will be particularly affected if potassium levels drop too low. That's when painful leg cramps, can develop.

Prednisone alone can deplete the body of potassium fairly rapidly - upsetting the balance of chemicals in the electrolyte system. Low potassium levels can cause the heart muscle to beat erratically and other muscles, especially the large muscles in the legs, to twitch and to develop severe muscle spasms.

More about potassium from
          "Potassium is important for muscle function, both in the muscles you control, such as your biceps and hamstrings, and those you don’t, such as the muscles that enable your heart to beat and your digestive system to push waste through your intestines for excretion. Potassium is also important for maintaining the balance of water in your body, which has an effect on blood pressure. The transmission of impulses between nerves also relies on adequate potassium."

Foods That Are High In Potassium
Those with MG are usually encouraged to eat foods that are high in potassium. That's because there's a tendency for people with myasthenia gravis to have low potassium levels to begin with. And if they are taking prednisone and calcium, the risk of a severe drop in potassium levels increases. Fortunately, there are lots of foods that are high in potassium. Before you look to a potassium supplement (which may be necessary) make sure that you are eating a diet that is rich with this essential mineral.

Top 10 Potassium-rich foods (by portion size)

#1: White Beans
Potassium in 100g 1 cup cooked (179g)
561mg (16% DV) 1004mg (29% DV)

Other Beans High in Potassium (%DV per cup): Adzuki (35%), Soy (28%), Lima (28%), Kidney (20%), Great Northern (20%), Pinto (18%) and others at an average of 15% DV per cup cooked.

#2: Dark Leafy Greens (Spinach)
Potassium 100g (Raw) 1 Cup (Raw - 30g) 1 Cup (Cooked - 180g)
558mg (16% DV) 167mg (5% DV) 839mg (24% DV)

Other Greens High in Potassium (%DV per cup cooked): Swiss Chard (27% DV), Kale (8% DV), and Collards (6% DV).

#3: Baked Potatoes (With Skin)
Potassium 100g Average Potato (173g)
535mg (15% DV) 926mg (26% DV)

Warning: Potatoes are high in simple carbohydrates and not recommended for people with diabetes. Sweet potatoes are actually better for regulation blood sugar, an average baked sweet potato with skin (114g) provides 542mg (15% DV) of potassium.

#4: Dried Apricots
Potassium 100g 1/2 cup (65g)
1162mg (33% DV) 755mg (22% DV)
Other Dried Fruits High in Potassium (%DV per 1/2 cup): Peaches (22% DV), Prunes (20% DV), Raisins (18% DV).
Warning: Dried fruits are high in sugar.

#5: Baked Acorn Squash
Potassium 100g 1 cup cubed (205g)
437mg (12% DV) 899mg (26% DV)
Other Squash High in Potassium (%DV per cup baked): Hubbard (21%), Butternut (17% DV), Zucchini (14% DV), Average Winter Squash (10% DV).

#6: Yogurt (Plain, Skim/Non-Fat)
Potassium 100g 1 cup (245g)
255mg (7% DV) 625mg (18% DV)
Other Yogurt High in Potassium (%DV per cup): Whole-Fat (11% DV), Chocolate Yogurt (24% DV).

#7: Fish (Salmon)
Potassium 100g 1 3oz fillet (85g)
628mg (18% DV) 534mg (15% DV)
Other Fish High in Potassium (%DV per 3oz fillet (85g)): Pompano (15% DV), Lingcod (14% DV), Halibut (13% DV), Yellowfin Tuna (13% DV), Anchovies (12% DV), Mackerel (10% DV), Herring (10% DV) and most other fish at an average of 10% DV. .

#8: Avocados
Potassium 100g Average Avocado (201g) 1/2 Cup Pureed (115)
485mg (14% DV) 975mg (28% DV) 558mg (16% DV)
An average avocado provides 322 calories, half a cup purred contains 184 calories.

#9: Mushrooms (White)
Potassium 100g 1 cup sliced (108g)
396mg (11% DV) 428mg (12% DV)
1 cup cooked sliced white mushrooms contain 28 calories.
Other mushrooms high in potassium (%DV per cup sliced): Portabella (9% DV), Brown or Crimini (9% DV), Enoki (7% DV), Shiitake (5% DV), Maitake (4% DV).

#10: Bananas
Potassium 100g Average Banana(118g) 1 Cup Mashed (225)
358mg (10% DV) 422mg (12% DV) 806mg (23% DV)
An average banana provides 105 calories, 1 cup mashed contains 200 calories.

In most cases, a diet that includes foods that are high in potassium will be sufficient. In other cases, such as those taking high doses of presnidone or taking it for long periods of time, a Potassium Supplement may be called for. One that many prefer is amino acid complex Potassium. It can be found at at Vitabase Health Supplements. Of course you should check with your doctor before adding any supplement.

Severe leg cramps can make life miserable. Especially when they occur at night and interfere with sleep. Taking prednisone can increase the possibility of developing muscle spasms but there are other causes - known and unknown. You can download an interesting (and inexpensive) digital book that covers the subject,'Stop Leg Cramps at Night'. Read it on your Kindle Fire, iPad or your computer.

Further Research: Drugs that deplete Calcium
                            Drugs that deplete Potassium

George Barron

Disclosure: This article is provided for informational purposes only and is not intended to provide medical advice. The administrator of this website may receive a commission for products or services purchased as a result of being reviewed or recommended here.

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