Night cramps are a problem that readers often ask me about: they are a common complaint and so far I have been unable to recommend an effective treatment.
But a study, published in JAMA Internal Medicine, has shown that in adults over 65, vitamin K2 (also known as menaquinone) reduced both the frequency and severity of cramps to a significant degree, without side effects. Finally we have something to recommend.
Vitamin K2 (also known as menaquinone) reduced the frequency and severity of cramps to a significant degree, without side effects, in adults over 65 years of age.
However, there is a warning: it should not be taken if you are taking warfarin, as this medication works by blocking vitamin K, which plays a key role in blood clotting. Vitamin K2 is available without a prescription; In the study, patients took one 200 mcg capsule daily.
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After a giardia infection, I seem to be left with reactive arthritis, which makes it difficult to walk and leaves my wrists swollen and painful. My GP has offered me steroids but says it has to be my decision due to the side effects.
James Chalmers, Cheshire.
Dr Martin Scurr responds: Giardia is a parasite found in water: Giardia infection (or giardiasis) is the most common waterborne stomach virus worldwide, but you don’t have to swallow it or be in infected water to get it: you can catch it eating food washed with contaminated water. .
Symptoms include diarrhea, abdominal pain and nausea, although some people do not show any signs of infection.
While it usually goes away within a week with treatment (antibiotics), it can sometimes persist for months, even years, causing complications such as gastrointestinal upset, bloating, weight loss, and even arthritis.

‘Reactive’ arthritis is caused by inflammation of the joints in response to an infection.
This is known as “reactive” arthritis and is caused by inflammation of the joints in response to an infection. You mention elevated inflammatory markers in your longer letter, which are a sign of this ongoing effect.
You’re lucky your GP caught this as it’s not something that’s normally on our radar.
I have seen many patients with giardia infection, but I have never encountered “reactive” arthritis as a complication.
However, a 2017 study concluded that it occurs more frequently than has been reported, showing that patients who had had giardiasis had a 50 percent higher risk of experiencing arthritis or joint pain. Since your symptoms are affecting your quality of life, I agree with your GP that it is worth suppressing the inflammation with steroids.
Hopefully, you will quickly clear your symptoms, possibly within a few weeks, and the steroids can be tapered off.
Don’t be too afraid of the side effects of steroids, unless you already have other contraindications, such as high blood pressure or type 2 diabetes. Strategies to reduce the potential impact include medications to reduce gastric irritation as well as calcium and vitamin supplements. D to help combat the risk of osteoporosis.
Once treatment is started, your inflammatory markers will be monitored along with careful diary of your symptoms so the dose can be adjusted. It would remain to be seen whether this treatment would continue for weeks, months or even a year, and why a program to reduce side effects would be important.
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I was prescribed atorvastatin, clopidogrel, and lansoprazole after a stroke two years ago. I feel like atorvastatin is affecting my balance and would like to reduce my dose. I already stopped lansoprazole because I thought it gave me diarrhea, but what do you think?
Vernon Sharp, Ashford, Kent.
Dr Martin Scurr responds: This combination of medications will be familiar to many people who have suffered an ischemic stroke, when a blood clot or other blockage cuts off the blood supply to a part of the brain.
Clopidogrel and atorvastatin have been prescribed to reduce the risk of having another stroke.
Clopidogrel prevents small blood cells called platelets from sticking together and forming a clot. Atorvastatin, a statin, reduces cholesterol and the risk of fatty deposits or plaques building up in the arteries. If a piece of plaque breaks off, it can cause a clot to form or directly block blood vessels.
Dizziness or unsteadiness as side effects of statins are rare. They may be a result of damage caused by your stroke.
Lansoprazole reduces stomach acid production to minimize irritation of the stomach lining caused by clopidogrel, reducing the risk of bleeding.
Lansoprazole may cause diarrhea, and stopping it to see if it helps is not as serious as stopping the statin; Since you have already done this, and if stopping it has helped, it is worth restarting lansoprazole to see if the side effect recurs.
As for your balance, I suggest you ask to be referred to a physical therapist.