Don’t Jump To Occlusions

legcrampPeripheral artery disease (PAD) is among the most underdiagnosed, untreated and potentially deadly conditions people can face, raising the risk of heart attack and stroke. An aging population and an increase in obesity and diabetes are causing a wave of non-cardiac vascular disease, affecting as many as eight million people. Canadian cardiologists learned that five percent of the adults over fifty who were screened for PAD had it, but an astounding 80% were unaware of it. Those pains and cramps you feel in your legs when you climb the stairs or simply walk down the driveway to get the mail might be more than you think.

Only about a fourth of the over-fifty group is aware of PAD. That’s the group most likely to be affected by it. PAD can be identified by comparing blood pressure in the arm to the blood pressure in the leg. Those who have already suffered a heart attack or stroke are at the highest risk, and need to be screened at least once a year. Dr. Ross Tsuyuki, of Canada’s U. of Alberta, adds that, “The second highest priority would be people middle-aged and beyond who are at risk for heart disease and stroke, such as people with high blood pressure, diabetes and high cholesterol.”  Besides leg pain, other PAD symptoms include leg sores that are slow to heal, toe pain in the evening, and a sensation of coldness or numbness in one or both legs. Dr. Peter Hibberd contributed that, “The secret to treatment is first-line prevention by avoiding…cigarettes and reducing risk factors for vascular disease (such as lipid disorders) as much as possible as early as possible.”  (Scaglione. Newsmax Health. 2011)  (Makowsky. 2011)

Rapidly evolving vascular technologies have introduced non-invasive, cutting-edge procedures for treating PAD. Interest in screening for non-cardiac vascular disease has also grown since preventive approaches to medicine are on the upswing. One of the latest treatments, although somewhat invasive, is the use of the patient’s own stem cells to make new blood vessels to replace or to augment those choked off by plaque buildup. (Society for Interventional Radiology. 2010)

A person at risk for PAD might consider dietary interventions to help manage contributing factors. Increasing fruits and vegetables, and decreasing empty calories can help to attenuate the accumulation of arterial fat deposits. Of course, drug treatments abound. Cholesterol drugs, blood pressure drugs, blood sugar drugs, anti-blood clot drugs, and symptom-relief drugs are at your doctor’s fingertips…or pen point. On the other hand, there is a body of research to support alternative measures to address PAD, as you’ll see in a minute.

Mortality in patients with recognized coronary artery disease (CAD) and PAD is unsurprisingly high, but therapy can mitigate that. Maintenance of normal weight is an important step, and keeping the body mass index lower than 25.0 is vital, even for those who have never smoked. (Ix. 2011)  Research has shown that a greater BMI will intensify PAD symptoms as evidenced by a decline in walking velocity and performance. (McDermott. 2006)  In cases such as this, supervised exercise training and education provide significant benefits in quality of life and reduced risk for cardiovascular episodes. (Casillas. 2011)

European medicine is supportive of complementary and alternative approaches to the healing arts, so it comes as no surprise that a considerable level of research starts there. German studies have used ginkgo biloba in PAD trials that date back to the late 90’s, finding that efficacy of the herb is dose-dependent, with 240 mg a day superior to the standard dose of half that. (Schweizer. 1999)  (Li. 1998) The British agree that ginkgo is better than placebo in treating the intermittent claudication that accompanies PAD. (Pittler. 2000)    Besides ginkgo, L-arginine, the amino acid that tells blood vessels to relax via the manufacture of nitric oxide, has shown benefits in handling intermittent claudication of PAD (Boger. 1998)  Nitric oxide inhibits contractions of vascular smooth muscle and keeps the blood flowing while helping to sustain blood pressure. There is some evidence that arginine improves the management of multiple CVD indications. (Cheng. 2001)

It might be comforting to know that alternatives to drugs for PAD exist, but it is prudent to look at diet, exercise, and lifestyle before heading to the supplement aisle.


Donna V. Scaglione
Peripheral Artery Disease: More Than Just an Ache
Thursday, September 15, 2011 1:08 PM

Makowsky M, McMurtry MS, Elton T, Rosenthal M, Gunther M, Percy M, Wong K, Fok J, Sebastianski M, Tsuyuki R.
Prevalence and treatment patterns of lower extremity peripheral arterial disease among patients at risk in ambulatory health settings.
Can J Cardiol. 2011 May-Jun;27(3):389.e11-8.

Society for Interventional Radiology. 16 March 2010
Stem cells build new blood vessels to treat peripheral arterial disease

Ix JH, Biggs ML, Kizer JR, Mukamal KJ, Djousse L, Zieman SJ, de Boer IH, Nelson TL, Newman AB, Criqui MH, Siscovick DS.
Association of Body Mass Index With Peripheral Arterial Disease in Older Adults: The Cardiovascular Health Study.
Am J Epidemiol. 2011 Sep 13. [Epub ahead of print]

McDermott MM, Criqui MH, Ferrucci L, Guralnik JM, Tian L, Liu K, Greenland P, Tan J, Schneider JR, Clark E, Pearce WH.
Obesity, weight change, and functional decline in peripheral arterial disease.
J Vasc Surg. 2006 Jun;43(6):1198-204.

Casillas JM, Troisgros O, Hannequin A, Gremeaux V, Ader P, Rapin A, Laurent Y.
Rehabilitation in patients with peripheral arterial disease.
Ann Phys Rehabil Med. 2011 Aug 5.

Schweizer J, Hautmann C.
Comparison of two dosages of ginkgo biloba extract EGb 761 in patients with peripheral arterial occlusive disease Fontaine’s stage IIb. A randomised, double-blind, multicentric clinical trial.
Arzneimittelforschung. 1999 Nov;49(11):900-4.

Li AL, Shi YD, Landsmann B, Schanowski-Bouvier P, Dikta G, Bauer U, Artmann GM.
Hemorheology and walking of peripheral arterial occlusive diseases patients during treatment with Ginkgo biloba extract.
Zhongguo Yao Li Xue Bao. 1998 Sep;19(5):417-21.

Pittler MH, Ernst E.
Ginkgo biloba extract for the treatment of intermittent claudication: a meta-analysis of randomized trials.
Am J Med. 2000 Mar;108(4):276-81.

Böger RH, Bode-Böger SM, Thiele W, Creutzig A, Alexander K, Frölich JC.
Restoring vascular nitric oxide formation by L-arginine improves the symptoms of intermittent claudication in patients with peripheral arterial occlusive disease.
J Am Coll Cardiol. 1998 Nov;32(5):1336-44.

Cheng JW, Baldwin SN.
L-arginine in the management of cardiovascular diseases
Ann Pharmacother. 2001 Jun;35(6):755-64.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Leg Cramps (Night Cramps)

elyte-bannerLeg cramps can be very painful and are fairly common. A leg cramp is a spasm that comes from a muscle in the leg. It usually occurs in one of the calf muscles below and behind the knee. Sometimes, the small muscles of the feet can be affected, as wells as the hands.

night-crampsTypically, a cramp lasts a few minutes. In some cases, it lasts only seconds, but it can last for up to ten minutes. The muscle may remain tender after a severe leg cramp for as long as 24 hours. Leg cramps usually occur when you are resting – most commonly at night when in bed (night cramps). They may awaken you from your sleep and can become a distressing condition if your sleep is regularly disturbed.

Many people experience an occasional leg cramp but they do appear to be more common in older people. Approximately, one out of three people, over the age of 60, have regular leg cramps. This figure increases to around 50% for people over the age of 80.

There has been considerable uncertainty in the literature regarding the classification and nomenclature of muscle cramps. The term “cramp” is used to indicate a variety of clinical features of muscles, leading to its use as an imprecise “catch-all” term that includes stiffness, contractures and local pain. The cause is not known in most cases. However, working with high performing athletes has provided us with some insights into muscle function and the electrolytes that drive all muscle function.

Sodium Closes (constricts) and Potassium Opens (relaxes)

In essence, the closing and relaxing of a muscle is dependent on the four mineral horseman of function, calcium (Ca), sodium (Na), magnesium (Mg), and potassium (K). Sodium constricts and potassium relaxes, with Ca and Mg initiating each phase of the action. If an individual is low in potassium, it appears that that singular event of low potassium can be sufficient to permit a cramp to occur. Without enough potassium available to complete the relaxing cycle, a random signal (or even a conscious one) to close by an out of balanced condition can leave almost any muscle in a locked position.

To understand sodium’s influence on the closing of a muscle and potassium’s role in engineering the reverse (the opening), it could be helpful, though somewhat macabre, to examine the procedure for executions. Generally, the act of hanging was replaced by electrocution, which was in turn abandoned by the painless, yet highly efficient act, of an injection of a high concentrated solution of potassium. Flooding the body with potassium forces all muscles to relax. Eventually the concentration of potassium becomes so high that it dwarfs the normal balance with sodium, thereby restricting any ability to affect a normal muscle function. The net result is to block the beating of the heart. In effect the prisoner relaxes to death.

Essentially an execution by injection is the reverse of a cramp. The execution is clearly an excess of potassium and the cramp appears to be the reverse. The injection of potassium overwhelms the normal balance of sodium and robs it of its ability to initiate muscle function; the body cannot begin any function, you couldn’t even blink your eye. The reverse of high sodium (or to be more precise, the absence of sufficient potassium) is an imbalance that sets up a condition for a cramp to occur. The poor individual with insufficient potassium on hand may not be able to relax that muscle and must message or stretch the knotted jumble of muscle to force some potassium into the cells to turn off the tight cramping condition.

The potential cure for a cramp would logically be to have available sufficient stores of potassium. However, magnesium also plays an important role in muscle function, so it is necessary to insure an adequate supply of magnesium. Calcium is also important, but there is a ready supply from our storehouse of bone which appears to be sufficient for muscle function. However, the supply of sufficient Ca and Mg as we age, is often insufficient, even though normal blood test results suggest there is enough. But, that is a subject beyond this current discussion of cramps.

The true details concerning when and why a cramp may occur is still a mystery. However, our work with a large number of athletes and our success with a concentrated electrolyte drink is worthy of investigation. Check out the ElyteSport’s testimonials where you will find a large number of former “ crampers” from many walks of life. Their comments in their own words searching to find an answer to stop those pesky cramps could hold your answer as well.

The E-Lyte Story: Why You Need Electrolytes!
Sugar Free Electrolytes
Compare E-Lyte Sport with other “Sports” drinks
Pickle Juice
Taking A Peek Inside a Muscle Cramp
Night Cramps
ElyteSport Preloading

Other References:
References depicting the difficulty within the Medical Community to Resolve “Cramping”

The information contained in this web site is for educational purposes only and is not intended or implied to be a substitute for professional medical advice. Inclusion here does not imply any endorsement or recommendation. Always seek the advice of your physician or other qualified medical provider for all medical problems prior to starting any new regiment.

These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.