If you’re taking both calcium and magnesium, keep in mind that they work best when they are taken in certain ratios. The two ratios recommended by naturopathic doctors are either equal doses of calcium and magnesium or twice as much calcium as magnesium. "A lot of it is a guessing game, particularly with something like leg cramps," says Dr. Jacques. "You have to find out what ratio works best for you." Try the one-to-one ratio first, taking 500 milligrams of calcium and 500 milligrams of magnesium twice a day, Dr. Jacques says. If that doesn’t give you the results you want, shift the ratio to 2:1 by reducing the magnesium to 250 milligrams.

Some patients with nighttime cramping have success with vitamin E, says Dr. Stengler. Although it has had mixed results in clinical trials, early studies suggest that you’ll improve arterial blood flow and reduce leg cramping at night if you take vitamin E. In one of the largest studies, 123 of 125 people who suffered from nighttime leg and foot cramps reported complete relief after taking vita min E supplements. To see if it works for you, take 400 to 800 international units (IU) a day, says Dr. Jacques.

 

Potassium is another mineral that helps regulate muscle contraction, says Dr. Stengler. Deficiencies of this crucial electrolyte aren’t normally a problem if you eat a variety of fruits and vegetables. If you change your diet drastically, however, you might become deficient. This is a potential problem, if you go on one of the high-protein weight-loss diets that some experts advocate. "When people go on high-protein diets, they begin to develop leg cramps. I see it repeatedly," says Dr. Jacques. She believes that such diets are related to potassium deficiency.

When protein makes up more than 30 percent of your daily calories, potassium levels may fall far short of the DV of 3,500 milligrams, according to Dr. Jacques. If you’re eating eight or nine servings of fruits and vegetables, you’ll get enough potassium to meet the DV, but the shift to a high-protein diet makes this significantly more of a challenge. Cramps are more prevalent when you first start a high-protein diet, Dr. Jacques has observed. After a few months, they normally disappear on their own. To make them go away sooner, you can take one 99-milligram tablet of potassium a day, she suggests. This doesn’t amount to much more than a bite or two of banana, but it can make your legs feel better, she says.

A word of caution, though: Don’t take more than one tablet. It’s easy to get too much potassium this way, which can upset the balance of other minerals in your body and cause heart and kidney problems. That’s why Food and Drug Administration regulations don’t allow more than 99 milligrams per tablet in over-the-counter supplements.

When you get leg cramps, the first suspects are naturally the big minerals that we’ve already discussed— calcium, magnesium, and potassium. But maybe those cramps are due to an imbalance of trace minerals, especially if the pain is triggered by overexertion, says Dr. Jacques. "Muscle and nerve function are electrical, and we need the right mix of minerals for that to happen. There are a lot of little players in there."

You can deplete levels of trace minerals as you perspire. Electrolyte drinks work well to help restore these depleted minerals. You can also take a trace mineral supplement that contains copper, manganese, zinc, selenium, and chromium, says Dr. Jacques. Although trace mineral supplements vary in content, don’t exceed the dosage guidelines on the bottle, she says. "Trace minerals should be taken in small doses because that’s how they are found in your body. More is not better." If you get leg cramps when you walk, see your doctor to rule out other conditions such as intermittent claudication, which is caused by poor blood flow to the legs.

Herbal extracts offer a natural way to soothe and relax spastic muscles. One of the most valuable is black cohosh, says Dr. Stengler. Also known as black snakeroot and bugbane, black cohosh root contains active substances called triterpene glycosides, antispasmodics that act as natural muscle relaxants. When muscles seize up with pain, take a 500-milligram capsule of the root powder twice a day

For acute cramps, two or three doses should be sufficient for a therapeutic effect, says Dr. Stengler. Don’t use black cohosh, during pregnancy, though, or for more than six months at a time. Bilberry contains chemicals called anthocyanins, a type of flavonoids that have muscle-relaxant properties. Bilberry also helps to improve circulation in the extremities. To reduce muscle cramping, take 80 milligrams three times a day of an extract standardized to contain 25 percent anthocyanidin. You should take it for at least a couple of months, but you can continue indefinitely if necessary, says Dr. Stengler.

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