
What Do Leg Cramps During Morning Time Indicate?

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Hydration, exercise and investigations are needed
Detailed Answer:
Hi,
Thanks for posting your concern. As you have stated, you are an 80 year old male, known hypertensive on thiazide diuretic and known hypothyroid, on l-thyroxine 50 mcg, with a present complaint of early morning leg cramps while lying on bed. I will try to help you understand your problem and find a solution for the same.
The three very common causes that can cause such a symptom in this setting are:
1. Dehydration
2. Dyselectrolytemia, particularly an altered serum potassium level, and
3. Early osteoarthritis
As you are on a diuretic for your high blood pressure, an adequate water intake is the need of the day, unless otherwise specified by any doctor due to any kidney related problem. As you have not stated any renal problem, my understanding is, about 3 to 3.5 lit. of water should be consumed per day to avoid dehydration. This will additionally help you out of constipation, if any, which is very common problem at your age.
Secondly, you need to undergo a clinical examination by a specialist in medicine to rule out any abnormal physical finding and you also need certain tests as follows:
Complete blood count, urea, creatinine, serum electrolytes including Na, K, Ca, Mg, fasting TSH, fasting sugar, serum vitamin D and a Urine Routine Examination.
Based on your clinical findings, you may need to undergo some special investigations including imaging.
Thirdly, you may try out quadriceps exercise to prevent or halt knee osteoarthritis, which sometimes may cause such symptoms. The steps of the exercise are widely available in the internet. Please make sure that you don't injure yourself while doing such exercise.
Some less common causes which may need investigation if problem persists despite the above measures are vascular pathology involving lower limb vessels including DVT, spinal abnormality, vitamin B deficiency, vitamin D deficiency etc.
For any future help, you can write directly to me.
If you find this answer helpful, please close the thread and rate my answer.
Regards,
Dr. Kaushik Sarkar

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