a glass of tonic water with a slice of lemon

People took quinine pills for decades to prevent leg cramps. Quinine comes from the bark of the cinchona tree in South America. The dose was substantial–200 to 300 mg. Researchers have described the mechanism of quinine’s action as “unclear” or “obscure” (Journal of Clinical Pharmacology, June, 1995). In other words, they really don’t know how, or even if, it works (Consultant Pharmacist, Feb., 2008).

One theory has it that a high dose of quinine makes muscles less “excitable.” We have come up with a novel new theory that would explain why a tiny “dose” of bitter tonic water might in fact work to prevent or ease leg cramps (see below for details).

Doctors Prohibited from Prescribing Quinine:

The Food and Drug Administration banned quinine in over-the-counter pills because of fears of serious side effects. Later, the FDA advised physicians that they should never prescribe quinine for anything but malaria. Not surprisingly, the agency was loathe to ban tonic water. The public backlash would have been fierce. After all, the amount of quinine in tonic is small. (A glass of tonic has one tenth the prescribed leg cramp dose of quinine.) Recommending quinine to patients with leg pain or cramps might be considered malpractice. That left people like this reader in a terrible quandary.

Q. For years I have suffered with leg cramps; debilitating, put-you-on-the-floor leg cramps.

I used to be able to buy a leg cramp medicine in pill form from the pharmacy. The medicine was a complete success.

On a trip to Walgreens I purchased another bottle of the leg cramp medicine. After taking it for a few days, I noticed I was getting those leg cramps again. I went back to the pharmacy and told the pharmacist the pills were worthless. His answer was, ‘that’s because the FDA made them take the quinine out of it.’

They still sell leg cramp medicine, but it does not work at all. I just love it when some government agency decides what’s best for me. If you watch virtually any commercials on TV about virtually any drug, you will hear the magic words that XYZ med is not meant for everybody. You can bet your life that one of the side effects is death, in rare instances of course. The thing is that the FDA has approved all these dangerous drugs that are advertised, but we can no longer get quinine.

I have read that mustard will take care of the problem of leg cramps. It’s probably the salt in the mustard that does the job. It takes about 4 pain-filled minutes to work. Pour a little salt in the palm of your hand, lick it off and chase it with a little water. It works.

With so many new drugs coming on the market, how much money did that drug manufacturer have to pay to get it approved? I guess there wasn’t enough money in quinine. By the way, if you’re thinking of getting your quinine by drinking tonic water, you would have to drink two litres a day.

This will probably not be posted, we don’t want to upset the FDA. It might give them cramps.

A. The FDA banned quinine because it does occasionally cause serious adverse reactions in susceptible people. Such individuals can develop a deadly blood disorder.

As little as one 5-ounce glass of tonic water can be disastrous for these vulnerable people, though we hope that the FDA never bans tonic water. Other quinine side effects may include nausea, stomach cramps, ringing in the ears, headache, anxiety, blurry or double vision, irregular heart rhythms, skin rash and fever.

We do understand your point. The FDA allows many dangerous drugs on the market. Watching drug commercials on television is a scary proposition, especially when the announcer says things like:

“Call your doctor if you have high fever, stiff muscles and confusion to address a possible life-threatening condition or if you have uncontrollable muscle movements, as these can become permanent. High blood sugar has been reported with Abilify and medicines like it and in extreme cases can lead to coma or death.”

What’s the Right Dose of Quinine vs. Leg Pain & Cramps?

So how much tonic water would you have to drink to get a pharmacological dose of quinine? The doctor-prescribed dose to prevent leg cramps has been between 200 and 300 mg. A liter of tonic contains around 83 mg of quinine.

That means one eight-ounce glass has about 20 mg. You would have to drink about 10 glasses to get the dose of quinine that doctors used to prescribe to prevent leg cramps. That’s not practical and may not be necessary.

A New Explanation for Tonic Water’s Effectiveness:

We used to wonder why some people would report success with a small glass of tonic water to prevent or treat muscle cramps. It defied pharmacologic logic. They also reported fast action. Too fast! It takes time to absorb the quinine from the stomach, get into the blood stream and affect the muscle. We suspected it might be a placebo effect.

Well, we have changed our minds thanks to a whole new understanding of leg cramps. Here are some stories from readers that opened our eyes to a new explanation:

Earlene in Washington reports amazingly fast results with tonic water:

“I use regular tonic for occasional leg cramps. I keep a single serving bottle in the refrigerator, take a swallow or two as needed and the cramp stops in seconds. I tried the routine without the swallow of tonic and the cramp persisted. So it seems to be that tiny amount of quinine that does the trick. I have type 2 diabetes and a sip or two doesn’t affect my blood sugar levels.”

B. in the U.K. also uses a small amount of tonic water:

“Tonic water has been and is a great remedy for my nighttime leg cramps. I drink about 3 fluid ounces before bed and have no side effects. It’s a great relief!”

Salome in Australia shares her success in treating RLS:

“I was suffering from restless leg syndrome (RLS)  for over 6 years. It’s worse at night, but I also suffer during the day. Going to the movies it was shocking.

“I am 66 yrs old. Last weekend I started looking on the web and came across someone who was using tonic water. I tried it. I began drinking a 3/4 glass of Schweppes Tonic just before I sleep. What a find. What a gem. I sleep like a baby. No more restless legs at night nor during the day

“I had pain down my leg in front and that’s gone too. My hubby is happy, I am happy and a HUGE thanks to Schweppes for putting some quinine in the tonic. If you know of anyone who has RSL tell them to give it a go. I am loving my legs now.”

Is There an Explanation for Quinine’s Effectiveness?

Until recently we thought about quinine’s action as pharmacological. We assumed someone would have to swallow a fairly big dose (200 to 300 mg) to achieve an effect. As mentioned, that would require at least 10 glasses of tonic water and take a long time to go to work.

More recently we have come up with a whole new theory to explain the benefits of quinine. It involves TRP (transient receptor potential) channels. These channels are found throughout the body and respond to sensations such as taste, heat, cold and pain. They can be activated by a variety of flavors including vanilla, cinnamon, ginger, garlic or chili peppers. Bitter flavors can also stimulate TRP channels. Guess what? Quinine is about as bitter a taste as you can get.

There are TRP channels in the mouth, throat and stomach. When they are stimulated they immediately impact nerves in the spinal cord. These messages in turn can affect the neurons that are overwhelming muscles and triggering cramps or possibly restless leg sensations. Because this is a neural pathway, the effect is very fast compared to a classic drug effect. That would require a medication be absorbed from the stomach into the blood stream and eventually reach the cramping muscle. That can take 20 to 30 minutes. People report that a sip or two of tonic or a spoonful of mustard goes to work in under two minutes.

To read more about TRP channels you may wish to read this article and listen to our streaming audio interview with Dr. Bruce Bean. Just click on the green arrow in the black circle above his photograph:

Show 1054: The Scientific Explanation for a Weird Remedy

Other Remedies for Leg Cramps:

What else can you do to prevent those excruciating leg cramps? We recognize that some people cannot tolerate tonic water. Others find the taste unacceptable.

Visitors to this website and readers of our newspaper column sing the praises of soap as a preventive. They also like magnesium or potassium, pickle juice, V-8 Juice, turmeric, yellow mustard and apple cider vinegar. Salt may work, but many people are on low-salt diets, which is why pickle juice is probably out for such folks.

To learn more about how to use any of these these alternate approaches you may find our book, The People’s Pharmacy Quick & Handy Home Remedies, of great value. You will also find a list of our favorite foods for good health. Remember, Mother Nature’s medicine can frequently be found in your kitchen cabinet! For more information about these and thousands of other remedies, check out our publications. You may also find “Bed Soap” or “Leg Soap” worth considering.

Share your own leg cramp remedy below.

Revised 5/4/17

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  1. Handy Andy
    Fife Scotland.
    Reply

    I like to call myself Handy Andy, no prizes for guessing the real name. Any way I have had RLS. for some years now and I am on 4 pills per day every day. I would have given anything to have read all these comments years ago. Having read the majority of them I have decided to have a go with the last one I read from Kathleen Lawrence KS. Thank you Kathleen, I will also mix the tonic Water with my Orange squash which is concentrated and I usually dilute it 9to1 mixture. However I will have to experiment with that to get it right. I intend to discuss this with my Doctor prior to the start. This will give me time to sort things out and get it all prepared. I will be delighted to report back with all the results that I have retained. A huge thank you to all concerned .Handy Andy.

  2. Cliff
    Oregon
    Reply

    I not only get leg cramps but sometimes in my foot. The worst cramps I get though are in my hand and can be either one. Not fun when I am driving because my hand will try to close the thumb by turning it in. My remedy at that moment is simply to force my thumb back to normal position and wait for it to let up. I have tried tonic water, and sometimes it does nothing but in time gives relief.

  3. Serena P
    CA
    Reply

    For RLS and leg cramps try the Adidas slippers that have the acupressure nubs in the foot bed. I’ve been wear them as house slippers and have no had RLS since starting to wear them eight months ago.

  4. Justin
    UK
    Reply

    May I also add, dehydration can also be a cause of leg cramps.
    Perhaps the rehydration along with the quinine is what creates the desired effect.

    In some countries in the west, where the diet is made of traditional and processed foods.

    I believe that there is a massive epidemic of dehydrated people who end up experiencing severe symptoms due to prolonged dehydration.

    My parents for example. They have spent their entire lives drinking cups of tea (as all good English men do). Some of the regular dietary items include caffeinated drinks, cooked meats, pastries, pies, some cooked vegetables and sweet items (cakes/etc).

    Not enough fresh fruit or vegetables can be fatal for hydration, but also a massive lack of mineral water. And I would say that their diets are fairly well balanced but not one major deficiency. Water.

    Now, many other people in the west have an even worse diet, which can be mainly fast food high in unhealthy fats, sodium and cholesterol but also that lack water, plus lots of junk food such as soda, crisps (chips) and sweets (confectionary).

    That coupled with a lack of interest in exercise and an avid interest in entertainment, results in entire countries full of consumers who the owners of produce and products very wealthy but at the expense of their own health, and the health of society.

    Again, water, with it costing so little is seldom pushed.
    And even when it is, seldom do people bother taking notice.

    As people are too ingrained in what they perceive as life’s pleasures to realise that they are paying people to make them ill, waste their lives and ultimately die young, while the rich and famous vampire elitists, who unscrupulously enjoy a master race type of existence above all the worlds population enjoy the best of everything and are thanked by the sheep for the pleasure to pay them to ruin their lives.

    Ironic, really. And water. So delicious if served cold with ice (although not the healthiest way to live) and can not only improve your life but extent your life and be a real source of enjoyment on a hot day, or after exercise.

    H-2-O

  5. bea
    south Carolina
    Reply

    I was advised to drink tonic water for severe cramping by a doctor. I bought small 250 ml bottles of Walmart brand tonic water. One night my leg cramps were severe and unrelenting so I got up and gulped down all I could tolerate which was about 1/3 of the bottle. I got back in bed and had no more cramps that night. I didn’t believe at first because relief was too quick. Same thing last night. Quick relief. I’m a believer now!

  6. Dale
    NY
    Reply

    I, like my dad before me, have had occasional hamstring cramps since a young man (now 68), and they are excruciating. A few months ago a friend mentioned the merits of tonic water for his cramps. I was skepticsl but tried this a while later and was absolutely stunned at how effective it was and how fast the relief. I had a bad leg cramp this very eve that just would not relent. After 3 or 4 minutes of a baseball sized knot in the muscle I called for my wife to bring me a bottle of tonic water. I took 3 or 4 big swigs, and complete relief came in 40 seconds! Nothing I’ve ever tried before worked like this.

  7. Bea
    US
    Reply

    Bea from United States
    I have had major pain in my feet and legs. I push myself to walk and get around.
    Someone mentioned trying tonic water. It took me only one half of a bottle of tonic water from a major chain store. It was 67 cents, and I thought I was unsure of what was going on. My feet lost their pain and were just a little sore and no major leg pain or pressure. It is an awesome feeling to not have major pain in my feet and legs.

  8. Irene
    66048
    Reply

    This article, which mentioned ginger as a flavor that activates TRP, has helped me understand why my remedy works. I drink about a third of a cup a day of a mixture of an alcohol-free ginger beer with Canada Dry Ginger ale, both made from real ginger. I haven’t had leg cramps since I began this regimen. And the combination is much tastier than tonic water.

  9. DAVID
    SOUTHPORT, UK.
    Reply

    I have used Tonic Water for many years. I can go for sometime without the cramps and then they return. They are very painful as everyone knows. You can purchase diet Tonic Water which is fine for Diabetics. Do not need to drink very much for it to be effective. Would not be without it.

  10. Tom
    agra, oklahoma
    Reply

    I ran out of tonic water but used mustard and it helped.

  11. Barbara L
    AZ
    Reply

    It would be very helpful if our doctors would suggest these remedies – guess they never experience the pain and their quick ten minute visit isn’t enough to take it seriously. The above suggestions were enlightening and better than advice a physician has ever given me. I can see the reasons why the remedies could work and what I had been doing or not doing to bring about the cramps….it all makes sense.

  12. Kathleen
    Lawrence KS
    Reply

    My mother has suffered from leg cramps my entire life. I remember hearing her crying in pain and my dad doing his best to help her any way he could. As they got older, he too began having terrible muscle cramps all over his body, worse in his back and ribs. Until they discovered tonic water. When I talked to my Dr about my leg cramps, she suggested 4 oz’s of tonic water mixed with orange juice or cranberry juice.

    I couldn’t make myself do it, until today (just the thought of the flavor of the tonic water was too much for me). I can still get a little bit of the tonic water taste, but it’s not as horrible as drinking it straight and it absolutely works to knock out my cramps.

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