Has anyone experienced Dystonia during AF?

I had my first episode last August while in the ICU during my flecainide overdose. Then I would get it occasionally when stretching my toes in bed —more noticeable when I was in PVCs. I would get this a few times a month. It stopped after my PVCs diminished. Each time my toes would be involuntarily clenched and twisted.

This last week while in the Cath Lab in AF and intermittent atrial flutter, it came back with a painful vengeance in which manually pushing my toes straight didn’t help. I even tried putting my knees up and pushing my toes Against the bed to flatten the spasms straight in vain. It was on and off for a few minutes and then on again while I was laying at the hospital. It stopped after my ECV when I resumed NSR.

This only has happened during arrhythmias. So I am wondering if I am alone or others have had this odd experience?

Magnesium is vital to the proper function of all three types of muscle.
The three most prominent symptoms of magnesium deficiency (80+% of the population) are
1) muscle cramps (skeletal muscle)
2) ectopics and arrhythmias (cardiac muscle)
3) constipation (smooth muscle)
I bet you have fasciculations (muscle twitching) too.
And these are all exacerbated by your Vitamin D intake.
😎 hit me!

Thanks PC
My oncologist wants me on vitamin D. My GP told me to hold for a bit because it was high. I am inside most of the day so I don’t get much D from the sun, and after holding D for 3 months I resumed on a real low 1000UNITS once or twice a week. Strange my lab from last week is still high..

No muscle twitches, no constipation, no restless legs. I take 200mg magnesium a couple times a week and I drink 2 low sodium v8 per day

I just checked my Almond Breeze nut milk. (Milk allergy) It has zero percent D. Where could I be getting D?

It's not the D in your case

200 mg Mg per week is precious little, esp if it's not elemental Mg. Look on the label for serving size (usually 2 tabs) and then determine Mg per serving. It should read “as Mg glycinate/citrate/..." or "as elemental Mg"). If there is no such indication, the weight is all citrate or glycinate or ...

Leg cramps are incredibly common. Dehydration is always at the root of this.
Your body detects low blood volume and tells the kidney to conserve water. In addition to ADH aldosterone is secreted by the adrenal cortex. This causes the renal tubules to absorb more Na (and water) from the urine. In order to maintain electrical neutrality Mg and K are excreted in exchange.
I'd get calf cramps in the early am, which I knew was a wake up call to up my Mg intake.

So avoid any dehydration and up your Mg until you reach bowel tolerance.

Then monitor your toes for cramping over the next few days.

PC MD:

During the height of the Covid Lockdown, I went on a 3 hour Desert Hike of 3 miles RT and around 1,200 Ft elevation change. The next day I got 2 separate cramps within several hours in my right Calf, and left upper Trap/Neck area. They were horrible making me almost completely immobile. Never had anything near this bad as far as cramps. Thought about going to the ER Room, but Covid Fear prevented me. The cramps/spasms slowly got better over the next 2 weeks. I don't think I was dehydrated by looking at the color of my urine. I had recently tapered off of Meloxicam. I was thinking I got some sort of rebound effect from discontinuing the Meloxicam.

Have you ever seen anything like this? It took at over 2 weeks to resolve the cramps despite my stretching and massaging. I believe my Mg was good as I take 500mg/day Dr's Best + Epsom Salt Foot Baths + Waller Water, and my blood tests and Exatests are good. Vit D3 also good at around 50ng/ml. K+, and a CMP done 2 days later was normal.

Hi TAF,

You seem to be doing all the right things. But I still say it’s dehydration. It’s insidious.
I hope that’s 500 mg of elemental magnesium.
Not familiar with meloxicam, But the coincidence certainly has to raise the question, as you have.
About the only thing I can add is to make sure your B vitamins are good. B6 is a cofactor in 100+ of the 300+ magnesium requiring reactions In the body.

Good Luck

I'm taking 600mg of magnesium glycinate each day. The bottle says that each tablet is 120mg of magnesium glycinate. Does that mean I am only getting 0.14x600 = 84mg of elemental magnesium? The web is telling me 14% of Mg glycinate is elemental Mg. No wonder I never had bowel problems. Thanks in advance.

Yes, Mike
Unless it says "elemental" or "as magnesium glycinate" you are getting 120 mg of magnesium glycinate not 120 mg Mg.
The other mistake is to confuse serving size with a single tab.

Quote
PC, MD
Magnesium is vital to the proper function of all three types of muscle.
The three most prominent symptoms of magnesium deficiency (80+% of the population) are
1) muscle cramps (skeletal muscle)
2) ectopics and arrhythmias (cardiac muscle)
3) constipation (smooth muscle)
I bet you have fasciculations (muscle twitching) too.
And these are all exacerbated by your Vitamin D intake.
😎 hit me!

My legs hurt in the morning. I get PACs. My left tricep likes to do a dance in the evenings to its own beat. I’ve gone 48 hours sometimes without a visit to the throne room.

I run 6 miles a day in eastern NC. Bike later in the day often, each 6 days per week (I get Sunday’s off). It’s 90F right now with dew points in the 70s.

It’s dehydration plus hypomagnesia. You can’t do enough to fight it. I guzzle coconut water, take 10mEq KCl and 800mg (elemental as 8g bisglycinate) Mg daily. And the above still happen. I guess I could up the Mg even more (no bowel issues at 800mg).

So, yeah, keep an eye on proper hydration. When electrolytes are sub optimal to begin with the dehydration just shifts them around even more and exacerbates the imbalance.

Hi Wolfpack,

Your story Is so typical. I used to run a lot of marathons and then realized I was having occasional episodes of VMAF.
Then I found this forum and started making my own waller water. This was somewhat helpful. Until I discovered I was a urinary magazine waster, based on two Exatests bracketing a year of aqueous magnesium.

As I’ve posted before, to develop AF requires a defective substrate, autonomic imbalance, and electrolyte imbalance. For some the required threshold for all three is low and can be controlled by behavior. For others an ablation or the equivalent is the only path out. Both parents had AF (mom still alive at 96 with permanent AF but high HDL cholesterol). I've had ablations for both AF and AFL in Bordeaux (? defective substrate).

Vitamin D increases the absorption of both Mg and Ca. Since upping my daily dose to 5000 IUs, I've noticed less ectopics and no more leg cramps, even at the same daily Mg intake. And I can tell my bowel tolerance has increased.

But everybody's different.

Good luck

Quote
PC, MD
Until I discovered I was a urinary magazine waster, based on two Exatests bracketing a year of aqueous magnesium.

Vitamin D increases the absorption of both Mg and Ca. Since upping my daily dose to 5000 IUs, I've noticed less ectopics and no more leg cramps, even at the same daily Mg intake. And I can tell my bowel tolerance has increased.

I'm obviously a waster of magnesium also, with my crazy high bowel tolerance. What I've wondered is why it took till I was 49 to show up (I'm now 65).

Though I've taken potassium before, adding it in my form of "timed release" seems to be the icing on the cake for afib remission for me. My timed release is 2 tsp of potassium citrate (4 g elemental potassium) powder in a liter or so of water and consumed over the day. In my 16 year afib history, after starting with a 2.5 month episode, I'd had some long runs of NSR, including a two year run from about the end of year 1 to the end of year 3. This is when I was starting to get my program dialed in. I consistently added in the potassium drink in the beginning of May, 2019. I've had no afib since, nor even any hints. In the last two years, I've had two episodes, in January and April 2019 with the last one before that in April 2018 (all converted quickly with PIP flecainide). For completeness, for a new reader, my afib remission program is essentially what I suggested for my afibber son-in-law here.

If I wear a beat to beat recording Polar heart rate monitor strap during sleep, there are some PAC's (5-6/hr) and very few PVC's (0-1/hr). If I wear it during exercise, which I did during a class yesterday, I see some PVC's (9/hr) and a few PAC's (4/hr). But no runs of either, nor do I feel runs when not wearing a monitor - I wear a monitor infrequently.

Perhaps my high D intake (10,000 iu's/day) is one reason for my high mag bowel tolerance?

When afib first presented, I did get some leg cramps and had eyelid fasciculations (twitches). The fasciculations took several months of mag supplementation to resolve.

Aloha fellow old fart (George),

Just to underscore the biological individuality theme, many months before eventually resorting to ablation I too used a Holter monitor to evaluate potassium.
During one 24 hour Holter monitor with no potassium supplementation I counted about 250 PACs per hour. Then I supplemented with 300 mg Q3H and saw the number of PACs drop to about a dozen per hour. Then I repeated another 24 hour Holter monitor without the potassium and the PACs rose again to about 250 per hour. This satisfies Koch's postulates to separate association from causation.
So needless to say even post ablation I’m always supplementing with potassium at least a gram a day in divided doses. Mg tolerance for me was about 600-700 mg but has recently increased due to increased Vit D presumably.

Pre-Ablation I used to referee soccer games and would frequently notice increased ectopics that responded within about 10 minutes to potassium. But if I supplemented with magnesium (Magonate) there would be no immediate relief.

Everybody knows that it is impossible to address a potassium deficiency in the face of a magnesium deficiency. So my thinking on this is that when my intracellular magnesium is borderline, any challenge to my electrolyte balance, especially dehydration, immediately manifests and quickly makes the borderline status markedly deficient. Because magnesium is required for any ATP reaction in the body, it’s extremely difficult to get back into sufficient intracellular levels to address the potassium and magnesium shortfall. Kind of a catch 22.

Quote
PC, MD
Aloha fellow old fart (George)

Yes, I can own that now!

Quote
PC, MD
So needless to say even post ablation I’m always supplementing with potassium at least a gram a day in divided doses

Wondered what form of K as my online friend who is a huge fan of 4g/day K for all, not just afibbers, suggests that citrate or bicarb is the least likely to cause issues? Also that the citrate will convert to bicarb in the body, with the benefit of adding more buffering capacity.

I need to get back on the Waller Water. Trouble is I’ve been working from home since March and I keep forgetting to stock up on bottled drinking water to dilute the milk of magnesia/seltzer water concentrate. Using my tap water is useless. It’s a well in Eastern NC with our bright red soil. 5.3 pH

George,

My problem is not potassium (gluconate). It’s all about the magnesium.

Blue devil er Wolfpack,

That’s a good plan. The problem is actually absorbing it. Aqueous magnesium is the most absorbable form of magnesium, but if you’re a urinary magnesium waster like me, you’re going to struggle. I assume you haven’t experienced any benefit in the absorption of Mg via increased vitamin D.

Quote
PC, MD
My problem is not potassium (gluconate). It’s all about the magnesium.

The problem is actually absorbing it. Aqueous magnesium is the most absorbable form of magnesium, but if you’re a urinary magnesium waster like me, you’re going to struggle.

My afibber son-in-law noted he could take in more Mg when he dissolved it in with the potassium citrate water and drank it over the day. I think he is using di-magnesium malate powder. Of course Waller Water consumed this way would accomplish the same thing.

Don't know if you've ever experimented with magnesium acetate. Make it with magnesium hydroxide & vinegar. It will also supposedly convert to bicarb in the body. More here. A fellow, ghg, initially posted about this around 5 years ago. His material is linked in my linked post. Essentially combine pure milk of magnesia (MoM) with vinegar (I use organic apple cider vinegar) in a 2:7 ratio. Reacts nearly instantly. I've also made my own MoM from powdered magnesium hydroxide & water. I put about 30 mg of the powder in 12 oz water and you get the same concentration as the MoM you purchase from the store. ghg was very enthusiastic about the mag acetate. He's another engineer...

His PDF

"On 4/20/2015, I discovered that ingesting magnesium acetate powder would be metabolized by the body into the elusive magnesium bicarbonate. This allows high dose magnesium bicarbonate supplementation to be achieved, bypassing all of the expensive very dilute bottled magnesium bicarbonate waters, and avoiding large amounts of baking soda, thus eliminating sodium overload. Since it is well documented in the medical literature, as far back as 1965, that the acetate ion metabolizes into bicarbonate in humans (and mammals), this discovery is not patentable over obviousness.

I took a heaping teaspoon of magnesium acetate (10g) in the morning, and again in the evening, in a glass of water. The next morning I woke up feeling like I had taken a drink from the fountain of youth! This effect still remains. I have a huge increase in overall energy and a great increase in the feeling of “well being”. I am much more calm and can handle more stress as well, both of those are documented effects of adequate magnesium. My serum creatinine increased from 1.23 to 1.37 mg/dL. Dr Beckett’s research indicated human clinical trials of drinking magnesium bicarbonate dilute water also saw similar creatinine increase in test subjects. That was reportedly caused by increases in ATP and phosphocreatine, or energy reserves, caused by increased muscle metabolism, which is consistent with the huge increase in energy I have seen."



Edited 1 time(s). Last edit at 06/25/2020 05:47PM by GeorgeN.

George,

I would NEVER have guessed you were an engineer.

I keep a bottle of Philips milk of magnesia in my bedroom refrigerator. Every now and then I’ll take a teaspoon of the magnesium hydroxide to complement the citrate and glycinate.

I also keep a little waller water in there and take a swig or two every now and then as well.

But these are really only for emergency use which hasn’t been necessary post ablation especially post vitamin D. About the only thing I’ve noticed were leg cramps and occasional fasciculations and occasional ectopic awareness. But all of this has disappeared in the last few months, presumably due to the vitamin D.

George:

You say you increased your Creatinine from 1,23 to 1.37 and that it increased your energy----my creatinine is usually always a little high, the last labs it was 1.23 and I am high, lab values are 0.60 to 0.88 mg/dl. Don't understand why you think being higher than lab values is a good thing.

L

Quote
Elizabeth
George:
You say you increased your Creatinine from 1,23 to 1.37 and that it increased your energy----my creatinine is usually always a little high, the last labs it was 1.23 and I am high, lab values are 0.60 to 0.88 mg/dl. Don't understand why you think being higher than lab values is a good thing.

Hi Liz, that was a quote from ghg, who was the original poster. I was quoting from his linked PDF. It was not my value. Read his PDF for more detail.

My most recent value was 1.06 on 30 April. As you can see the reference range changes by gender according the Quest lab that I used. Reference ranges also change depending on the lab. See more on ranges here.
Reference Range
Male: 0.70-1.25
Female: 0.50-0.99

Again from ghg's PDF

"In short, Dr Beckett was trying to create a mineral drinking water, which complied with mineral water drinking standards to provide an increase in magnesium bicarbonate over the long term. Ghg, following the teachings of Dr Sircus, on high dose magnesium chloride (transdermal) supplementation came up with the idea of using magnesium acetate, which is essentially high dose magnesium bicarbonate (including transdermal) supplementation. Since magnesium bicarbonate only exists in very dilute solutions, high dose supplementation is difficult. One needs to make sure their kidneys are not severely impaired (creatinine < 1.8 or so). If your kidneys are marginal, then only do this under strict medical supervision by a kidney specialist. Get your magnesium levels checked with blood tests, both serum and "RBC" (red blood cell) to make sure you are not over doing it. Dr Sircus contends that without impaired kidneys, it is nearly impossible to overdo magnesium via oral or transdermal routes."

Quote
PC, MD
George,
I would NEVER have guessed you were an engineer.

HaHaHa!

ghg is George H Goble - "George H. Goble is a staff member at the Purdue University Engineering Computer Network and a 1996 Ig Nobel Prize winner.

Goble is commonly known as "ghg" since he has used that as a login id, and signature in digital communications, since the 1970s. He received his BS, MS, and PhD in Electrical Engineering at Purdue University."



Edited 3 time(s). Last edit at 06/26/2020 09:40AM by GeorgeN.

Quote
GeorgeN
ghg is George H Goble - "George H. Goble is a staff member at the Purdue University Engineering Computer Network and a 1996 Ig Nobel Prize winner.

Goble is commonly known as "ghg" since he has used that as a login id, and signature in digital communications, since the 1970s. He received his BS, MS, and PhD in Electrical Engineering at Purdue University."

The name rings a bell. Dave Barry wrote about him. This fellow used to ignite charcoal quickly by soaking in liquid oxygen (LOX) until the local fire department made him stop by classifying it as an explosive. It is, by the way.



Edited 1 time(s). Last edit at 06/26/2020 11:06PM by wolfpack.