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Vitamin B1 and B6 substitution in pregnancy for leg cramps

      To the Editors:

      We read with interest the article of Dahle et al. (Dahle LO, Berg G, Hammar M, Hurtig M, Larsson L. The effect of oral magnesium substitution on pregnancy-induced leg cramps. Am J Obstet Gynecol 1995;173:175-80) and make the following comments. To investigate the role of thiamine and pyridoxine in our clinic, 25 pregnant women (5 in the second and 20 in the third trimester) were given a combination of 250 mg pyridoxine (vitamin B6) and 250 mg thiamine (vitamin B1) orally twice daily for 4 weeks between January and June 1995. All these women were healthy and none of them had any nutritional deficiency; after normal pregnancies all were delivered of healthy babies. The patients were required to keep a daily log of the frequency and severity of the cramps. Ten of the patients were completely relieved of the cramps, and in 14 there was significant improvement. In only one patient was there no difference in the frequency and severity of cramps.
      Unfortunately we do not know the serum levels of vitamins B1 and B6 in these pregnant women. However, it is well known that the maternal serum levels of pyridoxine and thiamine are decreased during pregnancy.
      • Heller S
      • Salkeld RM
      • Korner WF
      Vitamin B1 status in pregnancy.
      • Hytten FE.
      Nutrition.
      • Pitkin RM
      Vitamins and minerals in pregnancy.
      We are not sure whether the effects of vitamin B1 and B6 on the cramps are due to the synergism with magnesium by ameliorating the utility of this ion. Because there is no commercially available pure magnesium supplement in our country, whereas vitamins B1 and B6 are sold over the counter, we recommend the supplements of these vitamins and we believe that they relieve the pregnant women of painful cramps.
      6/8/74267

      References

        • Heller S
        • Salkeld RM
        • Korner WF
        Vitamin B1 status in pregnancy.
        Am J Clin Nutr. 1973; 26: 1339-1348
        • Hytten FE.
        Nutrition.
        in: 2nd ed. Clinical physiology in obstetrics. Blackwell Scientific, London1991: 150-172
        • Pitkin RM
        Vitamins and minerals in pregnancy.
        Clin Perinatol. 1975; 2: 221-232