Orange Juice Placebo?

[RSLancastr]

I have suffered from severe night leg cramps ever since I was around 12 years old. It wasn't until I was around 30 years old that someone (the choreographer for a production of Camelot I was in) told me that I probably needed more potassium in my diet. cramps are evidently caused (at times) by an imbalance of Potassium and Sodium in the body. I had over-salted my food since childhood, and never ate any of the common foods high in potassium (bananas, spinach, oranges), so this was probably the cause of my leg cramps.

I didn't particulary care for orange juice, but started a regimen of drinking a small bottle of it before going to bed each night. This, combined with cutting way back on my salt intake, greatly reduced the frequency and severity of the leg cramps! Why hadn't somebody (like a DOCTOR) told me about this DECADES earlier?

There were times I would occasionally wake up with a leg cramp, but these were usually after I had neglected to drink my nightly OJ. When this would happen, I would ask my wife (or yell for one of our kids) to go grab one of the small bottles of OJ from the fridge and bring it to me pronto. When the OJ arrived, I would guzzle the 8-10 oz. bottle, and - here's the thing - THE CRAMP WOULD STOP BEFORE I HAD EVEN FINISHED THE BOTTLE!

I assume that whatever process takes the Potassium out of the OJ in my stomach and puts it wherever (the muscles?) it helps with the cramp takes longer than that, which leads me to conclude that the OJ helping THAT quickly was, at least in part, due to The Placebo Effect.

Fortunately, that conclusion has not seemed to reduce the OJ's efficacy in this.

So, when I get a night cramp (again, usually only after neglecting to drink my bedtime OJ), My Susan brings me a bottle of what she calls my "Magic Elixer", and the cramp stops before I even finish downing the bottle.

I take Potassium supplements, and use less than half the table salt that I used to use, so the leg cramps are far less frequent and severe than they used to be, but they still happen (maybe once or twice a week, rather than every single night like in the old days).

My question to the forum is this: Could downing the OJ actually be having a (non-placebo) effect within seconds like that?

I'll ask my doc next time I see him.

 

[AdMan]

I'm thinking placebo (or some other effect of you sitting up to drink the juice) rather than the potassium--the OJ won't have reached your small intestine for the potassium to even start getting absorbed, let alone made its way to your muscles.

ETA: Dehydration can also cause cramping, but I also doubt that drinking something could help that quickly...

 

[casebro]

Co-Q10 (co-enzyme Q-10) sure fixed my night time leg cramps.

Cramps could be be caused by poor balance of potassium, sodium, magnesium or calcium. Calcium is a biggie, it seems the muscle cell needs energy to push the calcium ion back out of the membrane, no energy, the calcium triggers contraction. CoQ10 helps with the muscle energy metabolism, so helps with cramps. I take it daily, last five years, but had the cramp episode while using a different brand, smaller dose pill. I ran out of those, switched to the bigger pills again, cramps went away. I take it because of a bonafide muscle problem.

eta: COQ10 is recommended for people on statins. Seems the statins cut down the body's ability to make the CoQ10. So, statins + cramps = take COQ10 for sure.

I think the Wiki article on cramps was pretty good.

So far as the OJ, I'd go with the hydration idea, since water is absorbed faster than anything. Try a glass of water next time?

In addition to the potassium, OJ also has citric and ascorbic acids, either one of which could have an effect on muscle metabolism.

 

[Professor Yaffle]

Orange juice? Rip it up and start again.

 

[tesscaline]

When I'm having leg cramps, I find that sitting up, or standing up, relieves them temporarily. So, the mere act of sitting up to drink the OJ could have made them stop.

My best defense against leg cramps, hasn't been taking any supplement, or drinking water, or anything like that. It's been exercise. Walking around a bit before bed helps a great deal. Doing some basic stretches for them also helps preventatively. If I do end up with leg cramps, walking and stretching puts a stop to them. I know those aren't necessarily things you can do, those are just the things that have worked for me.

 

[RSLancastr]

I'm thinking placebo (or some other effect of you sitting up to drink the juice) rather than the potassium--the OJ won't have reached your small intestine for the potassium to even start getting absorbed, let alone made its way to your muscles.

ETA: Dehydration can also cause cramping, but I also doubt that drinking something could help that quickly...

I also, at various times in my life, have urinated excessively, which can lead to dehydration.

In hospital following my stroke, I urinated far too much, leading them to check me for, and diagnose me with, Diabetes Insipidus. Not a problem now, though.

 

[RSLancastr]

Co-Q10 (co-enzyme Q-10) sure fixed my night time leg cramps.

Cramps could be be caused by poor balance of potassium, sodium, magnesium or calcium. Calcium is a biggie, it seems the muscle cell needs energy to push the calcium ion back out of the membrane, no energy, the calcium triggers contraction. CoQ10 helps with the muscle energy metabolism, so helps with cramps. I take it daily, last five years, but had the cramp episode while using a different brand, smaller dose pill. I ran out of those, switched to the bigger pills again, cramps went away. I take it because of a bonafide muscle problem.

eta: COQ10 is recommended for people on statins. Seems the statins cut down the body's ability to make the CoQ10. So, statins + cramps = take COQ10 for sure.

I think the Wiki article on cramps was pretty good.

So far as the OJ, I'd go with the hydration idea, since water is absorbed faster than anything. Try a glass of water next time?

Were your cramps a result of taking Statins?

I will try the water next time, as well as the sitting up, as per AdMan's post.

as to the potassium, OJ also has citric and ascorbic acids, either one of which could have an effect on muscle metabolism.

 

[RSLancastr]

Orange juice? Rip it up and start again.

If this was a joke, it went over my head.

If it wasn't a joke, it went even farther over my head.

 

[fuelair]

I have suffered from severe night leg cramps ever since I was around 12 years old. It wasn't until I was around 30 years old that someone (the choreographer for a production of Camelot I was in) told me that I probably needed more potassium in my diet. cramps are evidently caused (at times) by an imbalance of Potassium and Sodium in the body. I had over-salted my food since childhood, and never ate any of the common foods high in potassium (bananas, spinach, oranges), so this was probably the cause of my leg cramps.

I didn't particulary care for orange juice, but started a regimen of drinking a small bottle of it before going to bed each night. This, combined with cutting way back on my salt intake, greatly reduced the frequency and severity of the leg cramps! Why hadn't somebody (like a DOCTOR) told me about this DECADES earlier?

There were times I would occasionally wake up with a leg cramp, but these were usually after I had neglected to drink my nightly OJ. When this would happen, I would ask my wife (or yell for one of our kids) to go grab one of the small bottles of OJ from the fridge and bring it to me pronto. When the OJ arrived, I would guzzle the 8-10 oz. bottle, and - here's the thing - THE CRAMP WOULD STOP BEFORE I HAD EVEN FINISHED THE BOTTLE!

I assume that whatever process takes the Potassium out of the OJ in my stomach and puts it wherever (the muscles?) it helps with the cramp takes longer than that, which leads me to conclude that the OJ helping THAT quickly was, at least in part, due to The Placebo Effect.

Fortunately, that conclusion has not seemed to reduce the OJ's efficacy in this.

So, when I get a night cramp (again, usually only after neglecting to drink my bedtime OJ), My Susan brings me a bottle of what she calls my "Magic Elixer", and the cramp stops before I even finish downing the bottle.

I take Potassium supplements, and use less than half the table salt that I used to use, so the leg cramps are far less frequent and severe than they used to be, but they still happen (maybe once or twice a week, rather than every single night like in the old days).

My question to the forum is this: Could downing the OJ actually be having a (non-placebo) effect within seconds like that?

I'll ask my doc next time I see him.

This is pure anecdote, but, three or so years after I was told I had high blood presure and needed to reduce salt intake (among other things) (and had switched to a seasoned potassium salt (straight it tastes lousy)) I was walking through my living room when my right leg stopped functioning and I went down. I had been avoiding Potassium salt (and Sodium same ) for several days to see if that would help drop my BP a bit more. Took me about thirty seconds to run through reasons and hit "K is necessary for muscles to operate well". I pulled myself into the kitchen, reached up on the counter and knocked my container of fixed Potassium salt down, put some in my hand and then in my mouth. Swallowed it and about a minute later was able to get up. May be a placebo, but I now make sure I have some around at all times. Fortunately, A) no cramps and B) has never happened again. I suspect it is not just a placebo.....

 

[RSLancastr]

When I'm having leg cramps, I find that sitting up, or standing up, relieves them temporarily. So, the mere act of sitting up to drink the OJ could have made them stop.

The same choreographer who told me about Potassium also taught me about stretching/walking a cramp out.

From the first time I got a nocturnal leg cramp at around age 11, I instinctively did the totally wrong thing: I bent the knee and pulled my foot up towards my butt. It gave a (very) short-term lessening of the pain, but also allowed the cramp to set in all the deeper, resulting in more long-term pain (I would limp for dats afterwards).

The right thing to do is to stretch the muscle, even walk on it if you can. But, short-term, it hurts, so I did not do it. Once that choreographer showed me the proper way to stretch a leg cramp (dancers tend to know a LOT about leg injuries/problems), I useed that to reduce the strength and duration of the cramp. Again, why didn't a doctor tell me this DECADES earlier??

My best defense against leg cramps, hasn't been taking any supplement, or drinking water, or anything like that. It's been exercise. Walking around a bit before bed helps a great deal. Doing some basic stretches for them also helps preventatively. If I do end up with leg cramps, walking and stretching puts a stop to them. I know those aren't necessarily things you can do, those are just the things that have worked for me.

As you say, these aren't things I can do at present. But thank you.

 

[tesscaline]

The same choreographer who told me about Potassium also taught me about stretching/walking a cramp out.

From the first time I got a nocturnal leg cramp at around age 11, I instinctively did the totally wrong thing: I bent the knee and pulled my foot up towards my butt. It gave a (very) short-term lessening of the pain, but also allowed the cramp to set in all the deeper, resulting in more long-term pain (I would limp for dats afterwards).

The right thing to do is to stretch the muscle, even walk on it if you can. But, short-term, it hurts, so I did not do it. Once that choreographer showed me the proper way to stretch a leg cramp (dancers tend to know a LOT about leg injuries/problems), I useed that to reduce the strength and duration of the cramp. Again, why didn't a doctor tell me this DECADES earlier??



As you say, these aren't things I can do at present. But thank you.

You know, I have no idea why doctors don't tell us these things. I learned to take care of my leg cramps through personal experimentation and online research. They've been a problem for me ever since I was a teenager, and pop up and bug the hell out of me whenever I'm having allergy problems (it's weird... systemic allergic reactions do strange things to a person).

Only once I got to see an actual pain management specialist for the allergen caused pain issues did I have a doctor give me the advice I'd already been following for over a decade.

I think... Generalists are generalists. They just don't know. I don't fault them for that. They're only human, brains only hold so much knowledge, and it doesn't materialize there on it's own -- Ya gotta go out and find it. *shrugs*

 

[RSLancastr]

This is pure anecdote, but, three or so years after I was told I had high blood presure and needed to reduce salt intake (among other things) (and had switched to a seasoned potassium salt (straight it tastes lousy)) I was walking through my living room when my right leg stopped functioning and I went down. I had been avoiding Potassium salt (and Sodium same ) for several days to see if that would help drop my BP a bit more. Took me about thirty seconds to run through reasons and hit "K is necessary for muscles to operate well". I pulled myself into the kitchen, reached up on the counter and knocked my container of fixed Potassium salt down, put some in my hand and then in my mouth. Swallowed it and about a minute later was able to get up. May be a placebo, but I now make sure I have some around at all times. Fortunately, A) no cramps and B) has never happened again. I suspect it is not just a placebo.....

Interesting, thanks for sharing that!

I tried tons of "salt substitutes" over the years, but they all tasted horrible. I recently found Norton's Lite Salt, which is 50% table salt and 50% Potassium, and not bad at all. It has enabled me to cut my Sodium intake (from salting at the table anyway) by more than 50%.

 

[RSLancastr]

You know, I have no idea why doctors don't tell us these things. I learned to take care of my leg cramps through personal experimentation and online research.

Well, I had no access to online researching back in 1969, but a few years after I learned about Potassium's possible role in the cramps, I got access to the Internet and followed up on that.

I think... Generalists are generalists. They just don't know. I don't fault them for that. They're only human, brains only hold so much knowledge, and it doesn't materialize there on it's own -- Ya gotta go out and find it. *shrugs*

Nowadays, I do just that with any medical questions I have. And I start threads about them.

 

[Scott the Grey]

If this was a joke, it went over my head.

If it wasn't a joke, it went even farther over my head.

It was a band and song. It made me chuckle anyway

 

[saraban]

If this was a joke, it went over my head.

If it wasn't a joke, it went even farther over my head.

It's a line from a song called Rip It Up by Orange Juice

 

[littleroundman]

Why hadn't somebody (like a DOCTOR) told me about this DECADES earlier?

Most probably because the exact cause of cramps, in particular, night cramps, remains a mystery.

Most research contains a large number of disclaimers such as "may" and "appears to" and "in some cases"

Athletes (and dancers) certainly lose potassium from the muscles during times of high exercise and a smaller amount is lost in sweat.

However, this does not necessarily translate into "the general populace should take additional potassium to prevent night cramps" especially since potassium supplements have been linked to increased hypertension.

IANAD, but at first glance, the reduction of sodium and increase in total potassium intake would appear to be a more likely to lead to a decrease in night cramps, rather than OJ being the instant "fixer"

 

[Emet]

I think... Generalists are generalists. They just don't know. I don't fault them for that. They're only human, brains only hold so much knowledge, and it doesn't materialize there on it's own -- Ya gotta go out and find it. *shrugs*

While I'm not speaking about you or Robert, I think it's also an issue of patients failing to communicate to their doctors, or asking the right questions. Or not hearing the answers.

I have a pseudomedical background (I'm a vet), and I'm tenacious. I have friends who know nothing about medicine, but know how to speak to doctors, and get the information they need. I know others who see a white coat and clam up.

 

[RSLancastr]

Emet, do your patients fail to communicate with you? Sometimes it is a matter of expertise which one doctor has and another lacks. And sometimes it can be a matter of a patient using just the right word in describing their condition - a word which "turns the lightbulb on" for the doctor. the patient may have described the condition to a dozen doctors, but never used that magic word.

 

[tesscaline]

While I'm not speaking about you or Robert, I think it's also an issue of patients failing to communicate to their doctors, or asking the right questions. Or not hearing the answers.

I have a pseudomedical background (I'm a vet), and I'm tenacious. I have friends who know nothing about medicine, but know how to speak to doctors, and get the information they need. I know others who see a white coat and clam up.

As much as I'm phobic of white coats, I have never had a problem asking questions or making issues known to doctors. The problem is, of all the times I have brought up issues like muscle cramps, the issue gets shrugged off by the doctor with "well, if it gets worse, let me know" or "well, there's not much to be done about that" or "oh, they should go away on their own". And while those may be legitimate responses for some things, they don't actually provide any benefit in treating an ongoing issue.

Not to mention that I've had more than my fair share of doctors who automatically dismiss patients who complain of pain with no specific obvious cause as "wanting attention" or "drug seeking" and just outright refuse to take their complaints seriously.

I'm not saying all doctors do this, but I've run across way too many of ones who do act this way to think that it's a minority.

 

[littleroundman]

Emet, do your patients fail to communicate with you? Sometimes it is a matter of expertise which one doctor has and another lacks. And sometimes it can be a matter of a patient using just the right word in describing their condition - a word which "turns the lightbulb on" for the doctor. the patient may have described the condition to a dozen doctors, but never used that magic word.

And, sometimes it's a matter of who is going to pay, financially and time wise, to find out ??

For example, night cramps are not uncommon, and there ARE some recognizable causes.

But, who is going to invest the time and money to undergo the range of tests required to identify THE cause.

ESPECIALLY when there's a fairly good chance no single cause will be identified and there's not going to be a silver bullet fixall.