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Hand Cramps: Normal? Salt? Low T? or something else?


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Hi all. I'm new here. I searched for "hand cramps" and "hand spasms", but didn't find anything useful yet. So hopefully this isn't a repeat post by the newbie...

Last night my hand spasmed/cramped again. To make a long question short, do any of you get hand cramps? If so, what do you do when they happen? And is it serious?

More info:

The first time my hand cramped was back in April. They've been happening more and more frequently over the past few months. I've had three hand spasms in the last seven days. Most of the spasms are on my dominant hand - but not all.

Last night I tried to open a small bottle of vinegar, but couldn't - the first time in my adult life that I couldn't open a bottle. I felt weak and uncoordinated. An hour later I got a hand cramp/spasm. My pinky and ring fingers on my dominant hand locked tight in a not-quite closed fist. I massaged it and stretched it, and it got better. This morning my hand is still achy and it is hard to type. I'm mostly using my pointer and middle finger on that hand. Other times, my whole hand makes a claw. One time, I even went double jointed on two fingers - another first - I had to switch my fork over to my non-dominant hand to finish dinner.  

My wife is freaking out about it. She read that Michael J. Fox's first Parkinson's symptom was hand cramps/spasms. My PCP said it is probably happening because I am ramping up my salt to help with POTS (I'm only at 2 tablets per day plus salty snacks). In my web searches, I only saw low sodium associated with hand cramps/spasms, not high sodium. My potassium, calcium and magnesium are normal.

I am not diabetic. My glucose varies a bit, but is in the normal range. I don't have abnornal variations in insulin.

I have low testosterone (I about to restart supplements). I have a bunch of dysautonomia symptoms (see below). I've taken very few meds up until now, and I've been mostly med-free for the past 4 months while they've been testing me for everything under the sun. I only got my dysautonomia diagnosis about a month ago, so I'm new to this.

My MRI (a month ago) was clear. I've been tested over and over for a bunch of autoimmune markers. I only have anti-smooth muscle antibody. I have allergies.

My hands and feet often go numb or have pins and needles.  Sometimes numbness happens to my whole hand/foot. Other times it's just my pinky and ring finger/toe. 

Some days my hand writing is worse - another possible Parkinson's symptom.  My hands aren't as steady as they used to be, but that is common with a lot of people. With constant fatigue, it just seems normal to not be perfectly steady.

It's always an adventure learning about new superpowers as Random Symptom Man! Look what my body can do...

If you have thoughts, please chime in.

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Just now, Random-Symptom Man said:

Hi all. I'm new here. I searched for "hand cramps" and "hand spasms", but didn't find anything useful yet. So hopefully this isn't a repeat post by the newbie...

Last night my hand spasmed/cramped again. To make a long question short, do any of you get hand cramps? If so, what do you do when they happen? And is it serious?

More info:

The first time my hand cramped was back in April. They've been happening more and more frequently over the past few months. I've had three hand spasms in the last seven days. Most of the spasms are on my dominant hand - but not all.

Last night I tried to open a small bottle of vinegar, but couldn't - the first time in my adult life that I couldn't open a bottle. I felt weak and uncoordinated. An hour later I got a hand cramp/spasm. My pinky and ring fingers on my dominant hand locked tight in a not-quite closed fist. I massaged it and stretched it, and it got better. This morning my hand is still achy and it is hard to type. I'm mostly using my pointer and middle finger on that hand. Other times, my whole hand makes a claw. One time, I even went double jointed on two fingers - another first - I had to switch my fork over to my non-dominant hand to finish dinner.  

My wife is freaking out about it. She read that Michael J. Fox's first Parkinson's symptom was hand cramps/spasms. My PCP said it is probably happening because I am ramping up my salt to help with POTS (I'm only at 2 tablets per day plus salty snacks). In my web searches, I only saw low sodium associated with hand cramps/spasms, not high sodium. My potassium, calcium and magnesium are normal.

I am not diabetic. My glucose varies a bit, but is in the normal range. I don't have abnornal variations in insulin.

I have low testosterone (I about to restart supplements). I have a bunch of dysautonomia symptoms (see below). I've taken very few meds up until now, and I've been mostly med-free for the past 4 months while they've been testing me for everything under the sun. I only got my dysautonomia diagnosis about a month ago, so I'm new to this.

My MRI (a month ago) was clear. I've been tested over and over for a bunch of autoimmune markers. I only have anti-smooth muscle antibody. I have allergies.

My hands and feet often go numb or have pins and needles.  Sometimes numbness happens to my whole hand/foot. Other times it's just my pinky and ring finger/toe. 

Some days my hand writing is worse - another possible Parkinson's symptom.  My hands aren't as steady as they used to be, but that is common with a lot of people. With constant fatigue, it just seems normal to not be perfectly steady.

It's always an adventure learning about new superpowers as Random Symptom Man! Look what my body can do...

If you have thoughts, please chime in.

Diagnoses: (August, 2019) pots, anhidrosis, "just general dysautonomia", (2017) low testosterone, (2012) chronic sinusitus 

Symptoms: fatigue😴, brain-fog🧠, pre-syncope😵, bradycardia♥️, tachycardia♥️, exercise intolerance🏃‍♂️, nausea🤮, gastric emptying🚽, photophobia , tinnitus👂, muscle pain💪, joint pain😥, paresthesia👣, dry eyes👀, heat intolerance♨️, cold intolerance❄️,  burning sensation on legs🔥, sinusitus👃, canker soars🤐, kidney stones😖, allergies🤧, morning insomnia🛏️.

Rx: zantac, zyrtec, nasacort, olopatadine nasal spray, salt tablets, 

Things that help: more frequent smaller meals, resting, horizontal exercises.  

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@Random-Symptom Man - are you seeing a neurologist? Are you seeing an autonomic specialist? It could very well be that your cardio-vascular symptoms are a product of an underlying neurological problem - and vice-versa!!! How is your thyroid/ lyme titer/ vitamin B12 and D levels/ -- have you had an EMG, TTT …… so much more to explore! I wish you the best, hang in there and let them test you further!!!!!! 

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@Pistol - Thanks for the response and encouragement. My next appointment is with a neurologist and then an autonomic specialist. It's several weeks off.

To answer your questions:

  • EMG is neg/norm - negative for  peripheral neuropathy
  • TTT is pos for POTS
  • Sweat gland - positive for hypohidrosis
  • B12 is norm
  • D is norm
  • Lyme is neg (though no CSF tests)
  • Thyroid is fine
  • No parasites (endoscopy up and down)

I'm not sure what else to have them test at this point, or if further testing is suggested. 

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ANA negative or ANA mildly elevated and inconclusive so we are calling it negative? This is what happened to me. My bet is that you are in that nebulous 'inconclusive' range that gives you symptoms but doesn't give you a diagnosis. 

I do get hand problems like that. It is a combination of Reynaud's Phenomenon and Undifferentiated Connective Tissue disease. They vacillate between rheumatoid-arthritis and lupus being dominant. My blood has been positive for both. My ANA was initially inconclusive. 

It may be a waiting game. I would keep an eye on the Rheumatology bloodwork. 

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Your age & symptoms certainly don't scream Parkinson's (& could be a large number of other things) but there are things there that make it a possibility that you should definitely discuss with your neurologist, I am glad you have appointments lined up. 

More typical symptoms of PD would be slow shuffling gait, blank facial expression, "pill rolling" tremor & erectile problems in males. 

Cramps can of course be completely benign & occur in healthy people. I got them every now & again back when I was healthy, funnily enough not since developing dysautonomia. 

It is good that you got your blood electrolytes checked, but this only gives a snapshot at that time & doesn't rule out something being high or low in the interim. 

Quinine used to be prescribed for cramps but is now not used so much due to it causing renal problems. Other general home remedies for cramps would include tonic water & magnesium supplements (the latter are also great if you have constipation, but not so good if you are prone to diarrhoea).

Good luck with your appointments, I know just how frustrating waiting can be. 

B xxx

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I get hand and finger cramps occasionally.  It started around the time I was diagnosed with low B12.  I see this was determined to be normal for you--hopefully your doctor is well versed on this topic.  Low B12 can also cause autonomic dysfunction.  In my case I had a full blown relapse of POTS along with other neurological symptoms until I got B12 shots and supplements over a few months.  Low B12 is not uncommon.

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I agree with @MomtoGiuliana. I had low b12 all of my life and have received supplementation several times. I now have been on monthly shots for many years. I had low B12 when first becoming symptomatic with dysautonomia. I also used to get these spasms on my hands where the hands would turn into an " inverted claw " without me even knowing it. I have not had this for a while.  

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I used to get these scary painful spasms where muscles in my arm would bunch up and stay that way. I mean you could see them all bunched up. It cramped so bad. It felt like a bad Charley horse that just went on and on. It would last for minutes to an hour. The next day my muscles would be sore like fibers had been torn. This is common in CRPS which I had just gotten but you don't sound like you have that. Sometimes CRPS people go on to get dystonia. I don't know what I did right but I rarely get these anymore and they did not progress.

My guess is it's an electrolyte imbalance causing yours. Maybe you need to balance out the increased sodium in your diet with some potassium. Eat some bananas maybe.

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