Preliminary Observation: Oral Zinc Sulfate Replacement is Effective in Treating Muscle Cramps in Cirrhotic Patients

Abstract

Background: While not life threatening, muscle cramps severely affect the quality of life of patients with cirrhosis.Aim: To determine whether oral zinc sulfate therapy decreases the frequency and severity of muscle cramps in cirrhotic patients.Methods: 12 patients with cirrhosis (5 Child’s A, 3 Child’s B, and 4 Child’s C), hypozincemia and muscle cramps at least thrice weekly received oral zinc sulfate 220 mg BID for 12 weeks. Patients answered a questionnaire regarding their muscle cramps symptoms at the beginning and end of the study.Results: Muscle cramps occurred in all patients at rest, mainly while sleeping (8/12), and in two patients also during exercise. Cramps were located in calves (10/12), feet (4/12) and hands (4/12) more commonly. Zinc supplementation improved cramps in 10/12 patients, and in seven of these patients the cramps completely resolved. One patient experienced mild watery diarrhea that resolved upon discontinuation of the zinc sulfate. No other complication of zinc supplementation was noted.Conclusion: A potential relationship between zinc deficiency and muscle cramps in the setting of cirrhosis has not been suggested before. Zinc supplementation may lead to improvement in symptoms associated with muscle cramps in cirrhosis.