Recently sleeved - with leg cramps

[Janina__sleevingitallbehind 4]

Happy Friday! I am recently sleeved - about 3 weeks ago. All my life I've had leg-shin-ankle-foot cramps off and on and usually remedied them by upping my hydration, drinking Gatorade, eating bananas or avocados, and taking magnesium supplements. After the surgery I've had them EVERY NIGHT/EARLY MORNING. I'm hoping to stick it out till my next appt to bug my doc about it, but I wondered if any of you take supplements (like magnesium or potassium) that help with this? If so, do you have a recommendation of a brand that worked well for you? I can't just eat half an avocado anymore - I'm only up to 4 tbs per meal....so while I can certainly have a Gatorade, I'm not really sure how to handle this effectively. I know I should consult my doc and plan to - but any tips are greatly appreciated.

[WendyJane 54]

Contact your team right now. You don't know if you have a DVT (leg clot) that developed. Obviously you can't eat or take what supplements that you normally have/do, so call and find out what to do.

[SpartanMaker 1,305]

2 hours ago, WendyJane said:

Contact your team right now. You don't know if you have a DVT (leg clot) that developed. Obviously you can't eat or take what supplements that you normally have/do, so call and find out what to do.

Agreed.

It's always best to talk to a health professional whenever your health is involved. It's never a good idea to self-diagnose issues, even if it's something you've had going on before.

Deep Vein Thrombosis (DVT) is potentially life threatening, so not worth taking a risk. While the risk for DVT is highest in the first few days after surgery, it can happen even weeks or months later.

If it's not DVT, I do find it odd that you seem to struggle so much with dehydration and think you really need to double-down on drinking more Water and not so much on supplements. Hopefully you're taking a bariatric Multivitamin as recommended by your doctor? These typically already have potassium and magnesium, so it seems unlikely to me that you'd need additional supplementation of these particular electrolytes. (I assume that was the rationale for eating bananas and avocados).

Sometimes people that sweat a lot exercising can actually lose too much sodium and cause an electrolyte imbalance since sodium is the primary electrolyte in your sweat. I suspect if you're only 3 weeks out, this is also unlikely.

[Arabesque 7,589]

Totally agree with @WendyJane & @SpartanMaker. Rule out a possible DVT first.Though I would also start taking your magnesium supplements again. Won’t hurt if you take the recommended dose. Are you on Calcium tablets too? Remember they used to help with leg cramps when I was younger. Those muscle knots are so painful.

Nothing wrong with adding an electrolyte drink as part of your Fluid intake. Many of us added one to help with the energy drops in the first months. I used to take one to work and if I was going to have a busy day out & about for a boost. Check with your dietician for a recommendation. I would add a hydralyte sachet or tablet to 500mls of Water - doubled the water as it tasted too sweet in 250 ml.

[Janina__sleevingitallbehind 4]

5 hours ago, WendyJane said:

Contact your team right now. You don't know if you have a DVT (leg clot) that developed. Obviously you can't eat or take what supplements that you normally have/do, so call and find out what to do.

Idid this before I posted. Surgeon referred me to PCP, PCP responded after I posted and suggested magnesium lotion.

[Janina__sleevingitallbehind 4]

3 hours ago, SpartanMaker said:

Agreed.

It's always best to talk to a health professional whenever your health is involved. It's never a good idea to self-diagnose issues, even if it's something you've had going on before.

Deep Vein Thrombosis (DVT) is potentially life threatening, so not worth taking a risk. While the risk for DVT is highest in the first few days after surgery, it can happen even weeks or months later.

If it's not DVT, I do find it odd that you seem to struggle so much with dehydration and think you really need to double-down on drinking more Water and not so much on supplements. Hopefully you're taking a bariatric Multivitamin as recommended by your doctor? These typically already have potassium and magnesium, so it seems unlikely to me that you'd need additional supplementation of these particular electrolytes. (I assume that was the rationale for eating bananas and avocados).

Sometimes people that sweat a lot exercising can actually lose too much sodium and cause an electrolyte imbalance since sodium is the primary electrolyte in your sweat. I suspect if you're only 3 weeks out, this is also unlikely.

I have spoken with both my surgical team and contacted my PCP. Surgical team referred me to the PCP. This was all before I posted. My PCP responded a couple hours ago and recommended magnesium lotion and electrolyte powders. There is no alarm from either group - potentially because I do have a history of this?

I don't struggle with dehydration. Due to the fact that I've had frequent leg cramps for the last decade and a half, I'm very intentional about drinking as much Water as I can (without overdoing it). My dad dealt with this too, we also live in high altitude - so water has always been my go-to. I am drinking at least 70 oz of water a day. My mention of dehydration, avocados and Gatorade were all in pursuit of soothing leg cramps since about my 30s - when I started having them more frequently. But obviously not recently.

I'm taking the bariatric Multivitamin recommended by my surgeon, it has 25% magnesium and zero potassium. I've looked up a few different kinds and find varying amounts of magnesium but haven't seen any with potassium.

I haven't found myself sweating a lot either.

So I'll give the lotion and electrolytes a try and see what happens.

[Janina__sleevingitallbehind 4]

42 minutes ago, Arabesque said:

Totally agree with @WendyJane & @SpartanMaker. Rule out a possible DVT first.Though I would also start taking your magnesium supplements again. Won’t hurt if you take the recommended dose. Are you on Calcium tablets too? Remember they used to help with leg cramps when I was younger. Those muscle knots are so painful.

Nothing wrong with adding an electrolyte drink as part of your Fluid intake. Many of us added one to help with the energy drops in the first months. I used to take one to work and if I was going to have a busy day out & about for a boost. Check with your dietician for a recommendation. I would add a hydralyte sachet or tablet to 500mls of Water - doubled the Water as it tasted too sweet in 250 ml.

I do take Calcium supplements - as directed by my surgeon. My PCP and surgical team do not seem alarmed. I contacted both prior to posting, but the heard back from my PCP a couple of hours ago and they recommended magnesium lotion and electrolyte powders. So we will see what kind of magic those do! I was just curious if others had experienced similar and what worked for them.

[SpartanMaker 1,305]

7 hours ago, Janina__sleevingitallbehind said:

I have spoken with both my surgical team and contacted my PCP. Surgical team referred me to the PCP. This was all before I posted. My PCP responded a couple hours ago and recommended magnesium lotion and electrolyte powders. There is no alarm from either group - potentially because I do have a history of this?

I don't struggle with dehydration. Due to the fact that I've had frequent leg cramps for the last decade and a half, I'm very intentional about drinking as much Water as I can (without overdoing it). My dad dealt with this too, we also live in high altitude - so Water has always been my go-to. I am drinking at least 70 oz of water a day. My mention of dehydration, avocados and Gatorade were all in pursuit of soothing leg cramps since about my 30s - when I started having them more frequently. But obviously not recently.

I'm taking the bariatric Multivitamin recommended by my surgeon, it has 25% magnesium and zero potassium. I've looked up a few different kinds and find varying amounts of magnesium but haven't seen any with potassium.

I haven't found myself sweating a lot either.

So I'll give the lotion and electrolytes a try and see what happens.

So glad to know you did talk to your surgeon! One of the reasons people responded to your post the way we did is because we see way too many people on this board who ask people here for advise when they have a medical issue after surgery. The reality is even if someone here had a similar issue, that does not mean you are having the same issue. While most people here are really grateful they had bariatric surgery, the risks of complications can be high. We're not doctor's here and we just want people to be safe.

As to your Multivitamin, It's likely there is potassium in it, since almost all of them I've seen have potassium iodide as an ingredient. If yours does not, then it might be a good idea to switch to one that does have that in it. Just because it's combined with iodide, does not mean that the potassium is not bioavailable.

Certainly follow your doctor's advice regarding your hydration and magnesium supplementation needs. I did want to point out that 70 oz of water per day sounds a bit low to me, especially since you live at altitude. All patients at my bariatric clinic are told to try to hit 100 oz and we're down on the plains at roughly 1000 ft. I also wanted to mention that magnesium is a common sleep aid, so while the effects of a lotion may be different for you, higher doses of magnesium might make you sleepy, so are typically best taken later in the evening.

I agree with @Arabesque that an electrolyte drink might not be a bad idea. I started taking one pretty early after surgery and still use them quite a bit now that my exercise routine is quite strenuous. Just keep in mind, the point in your case is to help you retain water, not really replace lost electrolytes. This means your sodium levels will rise above normal and if you're not used to them, they can cause some weight retention. (It's just water, which is what you want.) If it freaks you out because the scale stops moving for a while, keep this in mind. I should also caution you that if you have edema, upping your sodium intake might not be a good idea, so it would be best to check with your doctor first.

Best of luck! I hope you get it figured out.

[FifiLux 564]

I used to regularly get similar cramps but since my sleeve surgery, doing more exercise and losing weight they are thankfully less frequent though when I do still get one they can still be so bad I almost vomit. Something I am using most nights is a massage roller on my feet and legs and I find it can help. When I do get a cramp, if I can manage it (sometimes is too bad to do more than walk and stretch it out) I will roll on the area and massage it out.

I also take electrolyte powder a few nights a week if needed.

[learn2cook 626]

I got/get the cramps too. I did talk with docs and dietitian and they suggested magnesium supplements and electrolytes. It solved most issues, but sometimes I still get cramps right after having a simple carb. It will happen even after taking Protein in first. Apparently the sugars need more Water to process so my body floods the simple carbs out and throws off the electrolytes. So I plan my occasional intake and have a prune and bottle of Fairlife protein milk ready on hand for when the cramping starts. I do also take 400 mg Magnesium Nature Made supplement in the evening regularly . I lived high altitude for a decade and it did happen more often then. My WLS doctor said I have avoided sweets so long now due to wanting to avoid dumping, that I’m super sensitive. I usually use Gatorade Zero powder in my water too.

Side note, anyone else interested in researching whether cramping from carbs is more prevalent with diabetes or pre-diabetes? I had an elderly friend who inadvertently died from a cramp. She tried to walk off the cramp, broke her leg, gangrene and blood clots did her in,…it does make me wonder about the simple carb and blood sugar relationship and electrolytes relationship to muscle cramping.

[Janina__sleevingitallbehind 4]

16 hours ago, SpartanMaker said:

So glad to know you did talk to your surgeon! One of the reasons people responded to your post the way we did is because we see way too many people on this board who ask people here for advise when they have a medical issue after surgery. The reality is even if someone here had a similar issue, that does not mean you are having the same issue. While most people here are really grateful they had bariatric surgery, the risks of complications can be high. We're not doctor's here and we just want people to be safe.

As to your Multivitamin, It's likely there is potassium in it, since almost all of them I've seen have potassium iodide as an ingredient. If yours does not, then it might be a good idea to switch to one that does have that in it. Just because it's combined with iodide, does not mean that the potassium is not bioavailable.

Certainly follow your doctor's advice regarding your hydration and magnesium supplementation needs. I did want to point out that 70 oz of Water per day sounds a bit low to me, especially since you live at altitude. All patients at my bariatric clinic are told to try to hit 100 oz and we're down on the plains at roughly 1000 ft. I also wanted to mention that magnesium is a common sleep aid, so while the effects of a lotion may be different for you, higher doses of magnesium might make you sleepy, so are typically best taken later in the evening.

I agree with @Arabesque that an electrolyte drink might not be a bad idea. I started taking one pretty early after surgery and still use them quite a bit now that my exercise routine is quite strenuous. Just keep in mind, the point in your case is to help you retain water, not really replace lost electrolytes. This means your sodium levels will rise above normal and if you're not used to them, they can cause some weight retention. (It's just water, which is what you want.) If it freaks you out because the scale stops moving for a while, keep this in mind. I should also caution you that if you have edema, upping your sodium intake might not be a good idea, so it would be best to check with your doctor first.

Best of luck! I hope you get it figured out.

If you're aware of a bariatric Multivitamin with potassium iodide in it - can you point me to that direction? This is the one they started me on and I don't see it anywhere on the nutrition facts or other ingredients: https://store.bariatricpal.com/products/bariatricpal-multivitamin-one-day-bariatric-capsule-45mg-iron?variant=13156335845453. I've found similar results with others I've looked into.

Prior to surgery I easily drank 150 oz a day. The directions I've received from my surgeon has been at least 64 oz a day which really didn't seem like much. Surprisingly, though I love drinking water, I've had trouble drinking more than 70 oz since surgery. Today I hit 80 and was pleasantly surprised! It's been something to adjust to.

My PCP also recommended an electrolyte drink so I started that today and am awaiting the lotion (had to order from Amazon). I found an electrolyte mix that includes magnesium and potassium - so I sent it to my dietitian to see if she's ok with it. Also a few years ago I took magnesium every night for quite awhile - I never knew if it really helps, so we will see what the lotion does.

TBH this is something I've dealt with since I was about 15 (I'm 44), but it was pretty mellow in the last year or two - so I was really bummed when it started up again.

Thanks for all the info!

[Janina__sleevingitallbehind 4]

12 hours ago, FifiLux said:

I used to regularly get similar cramps but since my sleeve surgery, doing more exercise and losing weight they are thankfully less frequent though when I do still get one they can still be so bad I almost vomit. Something I am using most nights is a massage roller on my feet and legs and I find it can help. When I do get a cramp, if I can manage it (sometimes is too bad to do more than walk and stretch it out) I will roll on the area and massage it out.

I also take electrolyte powder a few nights a week if needed.

That is pretty cool - I might have to get one! Thanks for the tip!

[Janina__sleevingitallbehind 4]

7 hours ago, learn2cook said:

I got/get the cramps too. I did talk with docs and dietitian and they suggested magnesium supplements and electrolytes. It solved most issues, but sometimes I still get cramps right after having a simple carb. It will happen even after taking Protein in first. Apparently the sugars need more Water to process so my body floods the simple carbs out and throws off the electrolytes. So I plan my occasional intake and have a prune and bottle of Fairlife Protein milk ready on hand for when the cramping starts. I do also take 400 mg Magnesium Nature Made supplement in the evening regularly . I lived high altitude for a decade and it did happen more often then. My WLS doctor said I have avoided sweets so long now due to wanting to avoid dumping, that I’m super sensitive. I usually use Gatorade Zero powder in my Water too.

Side note, anyone else interested in researching whether cramping from carbs is more prevalent with diabetes or pre-diabetes? I had an elderly friend who inadvertently died from a cramp. She tried to walk off the cramp, broke her leg, gangrene and blood clots did her in,…it does make me wonder about the simple carb and blood sugar relationship and electrolytes relationship to muscle cramping.

That is something I hadn't thought about yet - the relationship of sugar with cramps. At this point I don't think that is causing them - I am taking in so little sugar...but I do wonder about the timing and what I eat/drink at night. Last night, for a variety of reasons, the last thing I had before going to bed was a Protein Shake and I woke up around 5:30 with milk cramps in my shins/ankles...nothing major and easily walked off. So maybe there's something to that last food being protein.

Thanks for the info! Sorry you deal with this too :(

[SpartanMaker 1,305]

6 hours ago, Janina__sleevingitallbehind said:

If you're aware of a bariatric Multivitamin with potassium iodide in it - can you point me to that direction? This is the one they started me on and I don't see it anywhere on the nutrition facts or other ingredients: https://store.bariatricpal.com/products/bariatricpal-multivitamin-one-day-bariatric-capsule-45mg-iron?variant=13156335845453. I've found similar results with others I've looked into.

Prior to surgery I easily drank 150 oz a day. The directions I've received from my surgeon has been at least 64 oz a day which really didn't seem like much. Surprisingly, though I love drinking Water, I've had trouble drinking more than 70 oz since surgery. Today I hit 80 and was pleasantly surprised! It's been something to adjust to.

My PCP also recommended an electrolyte drink so I started that today and am awaiting the lotion (had to order from Amazon). I found an electrolyte mix that includes magnesium and potassium - so I sent it to my dietitian to see if she's ok with it. Also a few years ago I took magnesium every night for quite awhile - I never knew if it really helps, so we will see what the lotion does.

TBH this is something I've dealt with since I was about 15 (I'm 44), but it was pretty mellow in the last year or two - so I was really bummed when it started up again.

Thanks for all the info!

So sorry you have struggled with this for so long!

It does sound like the increase in frequency was brought on by the reduced water intake and a reduction in the electrolytes.

I get that it's hard right after surgery to drink much since the amount you can drink at a time is so limited. This will get better over time, so I'd definitely try to eventually get back to at least 100-120 oz a day. FYI, you might not need to go all the way back to 150 oz in the long term. This is because your overall water needs, just like caloric needs will drop as your body becomes smaller.

That Multivitamin you linked has 150 mcg of Iodide (as Potassium Iodide). It's honestly not very much potassium, but it's in there. It sounds like your doctor is more worried about magnesium anyway, so I wouldn't sweat (lol), the potassium content unless they tell you it's an issue, especially since you're going to be adding an electrolyte powder.

Speaking of electrolytes, I'm glad you found a decent electrolyte mix. The better ones should absolutely have sodium, potassium & magnesium, and typically will have at least some glucose as well. This is because glucose will also help your body absorb the electrolytes (primarily the sodium). I get it that as close to surgery as you are, you may want to skip the glucose, so a sugar free brand like LMNT is a good choice. The important thing is to look for one that's free of artificial stuff like flavors or sweeteners because a lot of these ingredients can bother sensitive post-surgery tummies. Another tip, don't start using these full strength. That may bother your stomach as well. I'd say half strength is probably a good place to start. You can up that over time if it doesn't cause any stomach upset and you feel you need more electrolytes. Just keep in mind that really high doses of electrolytes may cause other issues like edema or heart palpitations, and can even cause a lot of the same symptoms as low electrolyte levels like muscle spasms. Look up Hypernatremia vs. Hyponatremia if you want to know more.

If anyone cares, my favorites (caution, they have glucose in them), are Tailwind Endurance Fuel and Scratch Labs Hydration Sport Drink Mix. Nothing artificial in them and they have worked well for me for quite awhile. I do occasionally use other brands for various reasons, thus I have an entire cabinet full of electrolyte drink mixes right now.

[SpartanMaker 1,305]

14 hours ago, learn2cook said:

Side note, anyone else interested in researching whether cramping from carbs is more prevalent with diabetes or pre-diabetes? I had an elderly friend who inadvertently died from a cramp. She tried to walk off the cramp, broke her leg, gangrene and blood clots did her in,…it does make me wonder about the simple carb and blood sugar relationship and electrolytes relationship to muscle cramping.

Interesting thought. I'm diabetic and have never had this happen, though I know it's a big issue for some people.

In diabetics, both low blood sugar and high blood sugar can cause muscle cramps. As I understand it, in the case of high blood sugar, you body reacts by excreting excess blood glucose into your urine in an attempt to get blood glucose levels down. Nasty things happen if blood sugar levels stay elevated. For a number of reasons, this process of excreting excess glucose can also carry away too much Water and electrolytes, leading to dehydration. In the case of low blood sugar, it's actually your muscles being starved for glucose (the primary fuel our muscles use), that causes the cramping, not dehydration.

My point is that technically I don't think it's consumption of carbs per se that's causing this. It's the impact of those carbs on blood glucose. Thus if someone is diabetic and having this issue, it would be a good idea to check their blood sugar levels when this happens. If they see either high or low blood sugar, then dietary modification is likely needed and talking to a dietitian would be a good idea.