muscle cramps, Bun 26, bun/cre ratio 24, creatinine normal 1.1

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Hello all - I really need your help.  I have been having severe muscle cramps in all muscles after moderate or light use.  I have been getting very severe cramps after walking a few blocks when I normally can walk miles and miles.  I get cramps in jaw after chewing a steak.  I get cramps in my arms after taking out garbage.  Cramps in my hand after normal activity (thumb and index finger pulling together and locking).  Went to doctor and had full work-up at NYU.  They had few answers. A few things were a little abnormal.  My BUN was 26, my BUN/Creatinine ration was 24.  My creatinine was normal at 1.1.  My vit D was low at 17.  My RDW was slightly high at 17.1 (prev was 19.4).  Doctor says this cannot be causing severe symptoms I am having.  It is so bad I cannot lie down after walking, the cramps are so bad, I get up and walk around for a few minutes and they get a little better.  I am not dehydrated at all.  I take all necessary supplements and blood work shows it.  Cramps are worse in legs because they get the most use but it happens in every muscle.  Even when I am cleaning myself in shower, if I turn to left or right, pain in the "lats" of the side I turn.  Please help if you can.  I would really appreciate it.  Thank you.

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  • Posted

    joecus, did they check your magnesium levels?  If not, ask for a magnesium blood test.  A magnesium deficiency can cause cramps, in which case a magnesium supplement can help.  Also look up foods containing high magnesium levels - for instance, I eat a few dried apricots a day.

    I'm sorry I don't understand your blood test results as I'm in the UK and we have different readings.  For instance, a Vit D of 17 here would be considered as extremely low and would be supplemented with high dose Vit D3.

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  • Posted

    Hi Joecus,

    Sorry to hear about your cramps.  I might have missed it in your query, but do you suffer from CKD and if so, what stage are you at?  If your creatinine is "normal" it doesn't sound like it?

    Regardless, I can say that muscle cramping is typical of CKD and the lower your kidney function, generally speaking, the worse the cramps get.  I myself have suffered more than my fair share of cramps, particularly at night (fierce leg cramps).  Here is how I address them:

    1)  Stretching:  can't emphasize that enough, especially after a workout or even moderate physical activity.  In fact, I typically stretch several times a day, for sure right before going to bed.

    2)  Avoid sleeping on your back:  it has something to do with shortening your leg muscles overnight (perhaps others can explain that better than I).  Sleep on your side.

    3)  Quinine tablets:  my physician prescribed these for me and I take them only when I sense the cramps are starting to get bad (you don't want to take them every day).  Effective.

    4)  Physical exercise:  I think you're doing that already; just need to make sure you stretch.  A lot.

    Other than that, I'm not sure what to suggest.  Mrs O is probably right about getting your magnesium levels checked.  FWIW my cramps were not as bad as yours, although I certainly did get cramping in my abdominals and even my jaw once or twice, as you stated - however, this improved with dialysis in addition to my daily stretching routine.

    I hope that helps a little!  Good luck,

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  • Posted

    Sounds awful. I agree with the other comments. Check Magnesium as a supplement, remain on Vit D as that is vital and low D is often indicative of other issues. I also drink a specific electrolyte water approved by my physician. It replaces potassium.

    The massage really helps with heat. Sometimes elevating legs as directed by my doctor, helps.

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  • Posted

    Thank you all. My Magnesium levels checked out.  They did extensive testing, Lyme along with almost every blood test.  The doctor now ordered three MRI, head, cervical and lumbar.  He is doubtful this will show cause of craps but I do have the numbness in my feet, sometimes up my legs and in my hands.  All my cramps  and tingling happen after workouts.  No matter how minor or major.  Numbness in feet is pretty much constant. The cramps are worse based on the amount of muscle use.  If I use a cordless drill for 5 minutes, my hands cramp and my thumb and index finger lock.  My Jaw locks sometimes after chewing.  My calves have intense cramps after short walk.  My doctor put my on 30 mg of pregnisone a day as a "shot in the dark" but it is not helping.  I did have some old muscle relaxer that I took (zanaflex) and that did help a lot and allowed me to sleep without cramps the last few nights.  However, I think this is just covering the cause and am concerned at this.  I think I should also tell you a little more about my medical history.  Up until 2009, I was very active, triathlons including Ironman.  I got hurt and stopped extensive workouts.  Then in 2010, I developed Tachycardia for no known reason.  I've had extensive testing and the only thing they came up with is my autonomic nervous system,  parasympathetic nervous system, the sympathetic nervous system are not functioning properly.  I've also recently developed breathing problems.  I attributed this to my sister-in-law moving in my basement apartment with two dogs.  The breathing issues happened shortly after she moved in.  I have a dog and have never had breathing issues other than minor when I groomed her hair.  I assumed three dogs pushed me to this point.  I now, for the first time in my life, use and inhaler.  I am being treated with atenonol for the tachycardia.  All of this happened after I was injured and stopped working out.  My legs feel like they weigh a ton and all activities require a huge amount of effort.  Just going to the doctor wipes out my legs and causes much fatigue.  I am at a loss and have do so much research and came up with nothing other than more confusion.  A long shot I thought of was a side effect of the Zanaflex which I took for a long while after my injury.  There are rare side effects causing Tachycardia and (and other symptoms) which is my first abnormality.  If anyone would care to comment on this possibility I would really appreciate it.  Take a look at the side effects and let me know.  Also, is there a way to get notified if someone responds to me?  I did not know about the responses until I checked.  Thank you so much.

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    • Posted

      Have you seen a neurologist yet? I think I would put that on the list. I have autonomic dysregulation and some of your symptoms, especially the cramps, could be neurological. Worth a try and sooner rather than later. So sorry you are going through this.
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    • Posted

      Not yet but I am going to.  Then NYU doc ordered three MRI's brain, lumbar and neck.  I am having 2 Thursday and 1 Friday.  I will hopefully see Neurologist next week.  Cramps are still so bad, I'm going crazy.  Thanks for your input, I am going asap.  Thanks so much.  Not sure if I mentioned it but muscle relaxers help a lot but I don't really want to mask what is going on.  I have a call into doctor to see what he thinks, your thoughts?  I don't want to live on them without knowing the cause of cramps.

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  • Posted

    I  have had very similar symptoms: very severe cramps in my legs and feet that was not easy to get rid of and bent my toes into grotesque shapes and cramps in other muscles, too. I was prescribed Quinine sulphate too and my consultant recommnded I take it at night every night.  It has virtually fixed the cramp. I rarely get it now.  I found that heat helped, too and bought an electrically heated duvet.  I hope you find some relief soon.
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  • Posted

    It is always a relief to know there are others out there with the same problems.  The best relief I have had has been Magnesium 250mgs x 2 at night alternating every couple of weeks with quinine  ( quinine has bad side effects taken long term). A contributary factor has been claudication of arteries - which causes extreme pain after just a little excercise. I do not yet know if this can be treated. 
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  • Posted

    My husband makes sure to drink plenty of water everyday. He makes sure to drink throughout the day otherwise he'll get itchy legs or cramps. He does cardio exercise 5 out of 7 days a week to keep heart strong since ckd can effect heart later. He also does stretches every morning, after working out and before bed. This has help him.

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  • Posted

    Thank you all.  Did anyone get a diagnosis?  Can someone explain pros and cons of quinine?  I'm already doing the other things mentioned.  I had MRI of brain today.  Tomorrow is neck and lumbar.  My feet are totally numb and my legs are cramping like crazy as I write this.  I am at a loss along with doctors so far.  Not giving up yet.

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    • Posted

      Hi Joecus,

      So sorry to hear of your continued difficulties.  In terms of quinine:  it helps reduce cramping for a period of time (~8 hours?).  Pre-dialysis I would take them typically a few times per week right before bed to avoid overnight cramping - but only if I felt the cramps "coming on", otherwise I avoided it.

      The potential side effects of quinine are many and varied, I would copy & paste them all but it would literally read like a dictionary (it's a loooong list).  I don't think I can paste URLs in my answer so if you type "quinine side effects" into Google you'll find information easily.

      That said, for perspective, I will put it like this:  I have discussed quinine several times over the years with a variety of doctors and every time I've mentioned it, they always got a certain look of apprehension on their face and their advice was always the same:  "it's not something you want to be taking forever".  So I took that to heart, and I only take a quinine pill if I feel like I need it.  These days, that amounts to maybe once per month.  Pre-dialysis I was taking them 2 or even 3 nights in a row before sometimes, but always with a "break" of a few days in between.

      So, the bottom line is, take it if you need it but take it as sparingly as you can.  It will be up to you to decide, I have great sympathy for your ongoing leg cramps and I know how painful those can be.  If you're cramping all the time, it could very well be that the benefit outweighs any risk?  Best to try it and see how it works for you.

      I hope that helps a little.  Best wishes,

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    • Posted

      Oh, one more thing:  I have heard people comment on drinking Tonic water as this contains small levels of quinine.  You could try that as a first step?

      That said, my nephrologist said the amount of quinine in tonic water is teensy and he seemed doubtful anyone could drink enough Tonic water to consume quinine in any significant amount.  For comparison - if this helps - my prescription is labelled "quinine-odan" and they are 300MG tablets.

      Still, nothing to lose by trying!

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