Leg cramps are common and are seen by doctors across different specialties. The diagnosis approach to the patient with leg cramps can be confusing because most cases of nocturnal leg cramps are idiopathic. Cramps may commonly occur because of decreased amounts of minerals, such as Ca and Mg in general notably in the later months of pregnancy. Nocturnal leg cramps usually involving the calf muscles or the small muscles of the foot are a common and distressing problem. Muscle cramps may also be brought on many conditions or activities, such as exercising, injury, or overuse of muscles, dehydration, blood flow problems, medication, etc.
Prevalence of Leg cramps:
Nocturnal leg cramps are reported by 50 to 60 percent of adults and by approximately 7% of children. They are slightly more common in women, and the prevalence increases with age. Nearly 25% to 50% of all pregnant women suffer from night time muscles spasms in their legs. In a study of 365 patients in a general practice register, the overall prevalence of cramps at rest was 37% . 40% of respondents had cramp symptoms more than 3 times per week, and 21% of participants described their symptoms as very distressing .In the same study patients with a mean age of 78.5 years, the prevalence of leg cramps was 50%. Women were more likely to report cramps compared with men (56% vs 44%) most prevalent at night.
Role of TocoTrienol:
Use of Vitamin E in muscles cramps and nocturnal cramps is gaining momentum in the present scenario. Tocotrienol is a potent antioxidant acting as scavenger of superoxide and other reactive species. A possible positive effect of plasma Vit.E on brachial reactivity could be postulated. Increased oxygen free radical production lowers the intracellular mg concentration, and this condition leads to altered intracellular calcium content, resulting in vasoconstriction. In light of such evidence, Vit.E administration might also regulate the intracellular magnesium concentration .In one study of 125 patients with nocturnal leg and foot cramps, all but 2 had complete or nearly complete relief from their symptoms when they took vitamin E supplements. In a double blind, randomized vs placebo trial ,40 type 2 diabetic patients were randomly assigned to Vit.E treatment at dose of 600mg/day (n=20) or placebo (n=20) for 8 weeks each, a significant increase in the percent change in brachial diameter was found in the vitamin E grp. In contrast, placebo treatment was ineffective on brachial reactivity indexes. In one another study total of 24 patients with leg cramps and two with restless legs syndrome were given vitamin E 100 I.U. three times a day before meals. Excellent results were obtained in 22 patients and moderate improvement in four. Relief was prompt, usually occurring within the first week or two suggesting therapeutic specificity.
The fact that the leg muscles are undergoing cramps or spasms even while at rest suggests a lack of some essential factor and the relief afforded by vitamin E may indicate an inadequate supply, inadequate absorption or defective utilization of vitamin E. Vitamin E is recognized as having alleviating effects in nocturnal leg cramps syndrome due to its support of blood circulation. The fact that chronic administration of vitamin Mediates reduction in oxidative stress, regulation of intracellular calcium and magnesium contents and improve brachial artery reactivity ,physiologically underlines the prompt and gratifying relief from leg cramps .
Tocotrienol,New generation Vitamin E: Tocotrienol is one of two major subgroups of Vitamin E family,other being tocopherol. Tocotrienol are safe and human studies show no adverse effects with consumption of 240 mg/day for 48 months. Tocotrienol differs from tocopherol by having and unsaturated side tail that results in significantly higher biological activity.Owing to this side tail,tocotrienol has more free and faster mobility within cell membrane than Tocopherol.Tocotrienol display up to 50 times greater antioxidant potential than tocopherol. Tocotrienol are also much ligher molecule compared to tocopherol and the 3 double bonds in the tail region results in benefits other than protection from oxidation.