Leg cramps/twitching and HRT

[steph1964]

I have been on HRT for 4 weeks today and for the last 3 nights I have not been able to sleep because of leg cramps and twitching in my calves and thighs. They are not the normal type of cramp where the whole muscle cramps up, it is more like small sections all over and it feels like it is deep in my muscle. The twiching is more like leg jerking originating from deep in my thighs.

Has anyone else experienced this? I do have muscular legs so I was woundering if maybe it is just the muscles breaking down or maybe a result of one of the medications. I was also told to look for signs of blood clots in my legs but this doesn't appear to match the symptoms.

[Donna Joanne]

Steph,
Are you taking spirolactone? I had to stop taking it because of severe soreness in my thighs and leg cramps. I would check with your doctor.

[EnglishRose]

Water - drink TONS of it!

Spiro is a diuretic and you're dehydrated, most probably. Make sure you keep up salt intake too.

[steph1964]

Yes I am taking spiro...and getting up to pee several times a night...so that sounds like it may be the cause.

[LeaP]

Absolutely symptoms of dehydration. I experienced the same, stepped up the water, and it stabilized in time. I still have a slight tendency toward cramping more than before HRT, but controllable if I keep the hydration up.

[melissaK]

I get foot cramps. Nasty ones. Well I guess theres no good cramps. Anyway, I think we're supposed to watch potassium levels too, like eat a banana. [OK, just read Perspheone's comment below, then wiki'd up Spirolactone, and she's exactly right, Spiro can lead to high potassium, not low potassium. So probably skipping bananas is better advice, as is not getting medical advice from idiots like me in the forum! ]

While we're whining about Spiro side effects, I have an awful problem with split nails. I read to apply lotion and oils, and live with it. I also read try biotin, which hasn't made a lick of difference since I started it in Early January. Any tips?

[steph1964]

Thanks for all the advise. I am still at work and I have downed a couple of gatorades and a lot of water so hopefully this will fix the cramping problem. Off to the bathroom again.

[Persephone]

I do not pretend to be a medical doctor nor should this be taken as medical advice.

I do not know the cause nor the treatment for your cramps but I do understand and sympathize with how painful they can be. Perhaps the advice of others regarding hydration is appropriate, I don't know.

But Spiro is generally a "potassium sparing diuretic," which means it can remove sodium and chloride (common salt) while retaining potssium so I think you should be very careful about eating bananas, drinking Gatorade, or doing anything else that would up your potassium levels without a physician's advice. On the other hand, you might also ask your physician about increasing your hydration and/or your salt intake to balance your potssium levels.

Hugs,
Persephone.

[stefan37]

Make sure you are highly hydrated. Another tip I used was to drink 1 or 2 lightly salted glasses of water before bed. I modified this a bit and try to drink them an hour before I retire. Drinking them earlier relieves some trips in the middle of the night. Spiro is a potassium sparing diuretic and the sodium is lost during urination.

[LeaP]

But Spiro is generally a "potassium sparing diuretic," which means it can remove sodium and chloride (common salt) while retaining potssium so I think you should be very careful about eating bananas, drinking Gatorade, or doing anything else that would up your potassium levels without a physician's advice. On the other hand, you might also ask your physician about increasing your hydration and/or your salt intake to balance your potssium levels.

Persephone.

Yes, yes, yes!!!! Potassium intake on Spiro can be DANGEROUS! I'm very careful about not eating potassium-rich foods and still have elevated potassium levels. The relative levels of sodium and potassium in your body control electrial activity - as in your heart. It's one of the reasons that unmonitored, self-medicating is risky.

[StephanieC]

Yup! I echo the comment about bananas. My doc is always hollering at me about my potassium levels. I can't even smell a banana much less eat it. The problem is, potassium is in most things, especially as a preservative. I find it very hard to deal with this. For example, I can only find one brand of yogurt that does not list it (thought I do not know if that means it is not an ingredient but not listed). Same thing with potatoes, though I think it depends on how the potatoes are prepared.

But yes, yes about water. I'm terrible with this as I really don't like the taste of water. I don't drink soda either but lots of coffee. I tell myself that coffee contains water so it is good but I'm not a doctor. In any case, water is good for you, especially for skin (and, I think, nails).

I too have trouble with splitting nails...I really hate that. They split, they peel, layers become exposed. I have tried pills (labelled for nails and hair) but that does not seem to work. Note on this....the amount of biotin in this bottle is much more than the dosage listed on the bottles of biotin in Target. So dosage of biotin may make a difference. But I always have trouble with dry skin and nails around Jan-Feb but it seems to correct itself later in the year. Again, I think water helps with this, but I'm not good with water.

So, bottom line, you probably can't go wrong by stepping up water consumption. The body is mostly water anyway, electrolyte balance is critical (for us), yadda yadda. I don't usually get leg cramps but I do get weird foot/toe cramps....but that I chalk up to age (ugg).

Good luck!

-stephani

[Inna]

Potassium myth is well, just that!
It is true, that because Spiro throws lots of water out, it may lead to salt-potassium imbalance. Spiro taken in larger doses, such as for HRT is even more taxing on your body. However, said all that, depending on your metabolism, you may be low or in fact hi on potassium, or the little cramps may be a result of Estrogen working its magic and reworking the whole dynamic of your cellular metabolism.
Hormones are a software for cell metabolism, you change the gender marker and voila, everything changes.

Do an experiment, NO it will not kill you, lol, eat a banana an evening before, go to sleep, if cramps persist, it probably isn't potassium.
In fact you had been only several weeks on HRT, that alone can not alter these levels in such short period of time, unless these levels had been off to begin with.

[Kaitlyn Michele]

I know i had cramps and some off and on "dizzy" feelings... i craved salt as if it was oxygen ... i took my spiro dose down a notch and drank tons of water... the salt craving stayed with a long time..

[TeresaL]

Dang, salty foods are tasty when on spironolactone. I love the occasional treat, having a pickle spear and few olives with my Bloody Mary. But I've had almost no cramps when hydrated with three or four glasses of water a day - sometimes more.

The VA fact sheets that are mailed with spironolactone do warn about potassium issues and Hyperkalemia - a life threatening condition causing palpitations and heart failure.

[My Lady Marsea]

I went through all this like in the beginning of my HRT (about 5 yrs now) and used to so totally get the most awful cramps in my toes and fingers as well as calves. Just stretch or contract the muscle until the pain like goes away. Might wanna prepare for the breast, esp the nipples to get super sensitive too, like just rubbing against your blouse is painful. The good news (was for me anyway) is it will all kinda stabilize at some point and life gets better lol. .

[steph1964]

I drank a lot of water yesterday evening, something that I am usually bad at doing especially since I live in Arizona. The twitching and cramps were still there but they were a lot less than the other days, so it didn’t affect my sleep as much…other than the trips to the bathroom. I am hopeful that a couple more days of hydration should fix the problem.

The pamphlet that came with the Spiro does say to limit foods high in potassium such as bananas, potatoes, tomatoes, and not to take supplements or salt substitutes containing potassium.

Thank you everyone for your comments.

[CharleneT]

Potassium myth is well, just that!
It is true, that because Spiro throws lots of water out, it may lead to salt-potassium imbalance. Spiro taken in larger doses, such as for HRT is even more taxing on your body. However, said all that, depending on your metabolism, you may be low or in fact hi on potassium, or the little cramps may be a result of Estrogen working its magic and reworking the whole dynamic of your cellular metabolism.
Hormones are a software for cell metabolism, you change the gender marker and voila, everything changes.

Do an experiment, NO it will not kill you, lol, eat a banana an evening before, go to sleep, if cramps persist, it probably isn't potassium.
In fact you had been only several weeks on HRT, that alone can not alter these levels in such short period of time, unless these levels had been off to begin with.

I would recommend against that experiment and the attitude that you do not need to watch potassium intake while on Spiro. It is a fact that Spironolactone is a potassium sparing diuretic. As such, it is possible to trigger hyperkalemia. You most certainly do not want to do that.

If you eat a banana or any other source of a lot of potassium and you get cramps it most certainly does not disprove a potassium prob. Quite the opposite, it about proves it - assuming you are taking a potassium sparing diuretic. Spiro can alter the salt balance in a person within a day or so of starting it. You could easily get your self in trouble in a week. I would in fact mention these symptoms to your doc ... not because of the cramps, they are given with Spiro, but because of the restless leg issue. I don't think you have anything to worry about, most likely it is small cramps.

Here is a handy list of foods high in potassium. You need to avoid eating a lot of them. You will probably need to increase your salt intake.

http://www.vaughns-1-pagers.com/food/potassium-foods.htm

Charlene (CPhT)

[StephanieC]

Until this thread, I never thought about a taste for salt. I've never really been much for potato chips, more for sweets. But I seem to be really pounding chips similar lately. I attributed this to stress, not to medication. But now I wonder...

btw. I don't eat any chips that list potassium on the ingredient list. Is this accurate, or do they sometimes exclude it from the label but still use it? Most packages have it, though some do not. I thought it was the way they were prepared.

-stephani

[Angela Campbell]

I was told in survival training that the way to tell if you need salt is to lick some salt...if it does not taste salty you need it and if you taste the salt you do not need it.

[Krististeph]

No experience with the meds you are taking, but i'd consider a gatorade and a walk or a bike ride. If your legs are muscular- serious working out? Pay attention to them- they are used to getting used hard- if they are twitching something may be up. Are you taking in a lot of calcium, magnesium or other electrolyte related mineral as well? If you are dieting- this tends to amplify the effects of mineral imbalance- this might be the time to eat balanced and do a little more exercise. A good leg massage can do wonders as well.

Just remember- more salt and water means higher BP, so be a little careful there too. When riding hard (60 miles in 3.5 hrs, mountain bike) i alternate G2 and water, and energy bars or gels every 45-60 minutes. G2 are great- low calories, but taste great, good electrolyte- and keeps you from overdoing the minerals as well.

Definately run this or any other suggestions by your physician, they should know what is happening with you and will give you a safe direction to follow.

[FurPus63]

Who are we Doctors? I think it's wrong to give medical/nutrition advice on a forum like this. I've been on HRT including Sparo for almost a year. The cramping was awful the first two months. So I sympathize. Definately ask your doctor. We're all individuals and these meds are powerful things to mess with. My doc told me to eat more bananas to increase my potasium, not decrease it...but I'm not going to tell you to do that. Seek professional guidance.

It sounds like you're doing better. So keep up the good work and call your doc. That's my advice. HRT can be very exciting! I know I've had a wonderful experience thus far. I love what the increase in estrogeon has done to my breasts! Other changes too! My skin all over my body is softer, softer look to my face, much more feminine, much more "passable," I feel and look great! Hope you have the same/simmular results. Good luck and enjoy the changes!

Paulette

[Jennifer Marie P.]

Yes I encountered leg cramps from time to time.

[LeaP]

Who are we Doctors? I think it's wrong to give medical/nutrition advice on a forum like this.

Yes and no. It IS individual, of course, and anyone on HRT should be monitored, with levels taken regularly. Thing is, a lot of doctors aren't familiar with the drug combinations, dosages, and expected results when it comes to trans people. It may be iffy at time, it may be occasionally contradictory, but there is more expertise within the trans community on this topic than most places. This is an area where you really are well-advised to self-educate (often to educate your doctor) ... and this is where and how some of the education happens.

[gonegirl]

Here is a handy list of foods high in potassium. You need to avoid eating a lot of them.

http://www.vaughns-1-pagers.com/food/potassium-foods.htm

Charlene (CPhT)

Thanks for posting that link, Charlene. It's extremely useful info.

It's also somewhat saddening to read because there are so many awesome foods listed that are rich in potassium :-(

Mac

[StephanieC]

...including many that are very healthy for you!

-s