Chiropractic Examination

Low Levels of Choline Can Contribute To Muscle Cramps


Muscle cramps are sudden and involuntary contractions of one or more of the body’s muscles. They often occur at night or at any moment stopped by a sudden Charley horse. These cramps can cause severe pain, making it impossible to move and use the affected muscle/s. They are usually brought on from:

Affected by muscle cramps

Muscle cramps are common and can happen to anyone, but often occur to:

  • Indoor/outdoor physical work employees
  • Pregnant women
  • The elderly
  • Infants
  • Individuals that are overweight
  • Athletes

Cramping Up

Muscle cramps can be a symptom of a variety of medical issues. It is typically dehydration and muscle strain from overworking/exercising the muscles, but it can also be a sign of medical conditions like:

  • Poor circulation
  • Mineral depletion low levels of magnesium, calcium, potassium, and choline
  • Diuretics
  • Low electrolyte levels
  • Nerve disorders are rare cases, but a pinched nerve or spinal cord injury can cause nerve compression that can lead to cramping
  • Tight muscles come from inactivity, and not stretching the body causes the muscles to contract involuntarily
  • Hypothyroidism, a thyroid gland that is less active than normal, can cause cramps
  • Liver disease

Muscle cramps can make daily activities difficult, if not impossible, to perform. They often happen at night, affecting proper sleep. This can lead to:

  • Pain hangover
  • Grogginess
  • Fogginess
  • Cautious body behavior – as an individual wants to avoid pain and more cramping, they begin to watch how they:
  • Step
  • Reach
  • Bend
  • Move
  • So as not to cause discomfort, pain, and further cramping, they develop awkward body positions that create more health problems from improper body posture.
Muscle cramps can happen to any muscle of the body. However, they present most often in the:
  • Abdomen
  • Ribs
  • Legs
  • Feet
  • Hands
  • Arms


This is usually sudden, sharp pain. Individuals can also feel or see a lump of muscle tissue under the skin.

When to see a professional

They usually go away on their own, not requiring medical care. However, seek medical attention if the cramps:

  • Are causing severe discomfort and pain
  • Severe swelling, redness, or changes in skin tone
  • Muscle weakness is present
  • They are occurring frequently
  • They do not improve with self-care
  • There is no connection with an obvious cause, like intense physical activity/exercise

Mineral Depletion

Choline is a nutrient that is just as important but not as well known as B vitamins.  Choline has a fundamental role in muscle physiology, and low levels could be a cause/contributor to muscle cramping. Choline is well-known for its function as part of the neurotransmitter acetylcholine. This is a chemical messenger that transmits signals between nerve cells and muscles. Acetylcholine is the physiological link that tells the muscles to contract. This is where medications can interfere with the messaging system.

Most believe that muscle cramps are caused by magnesium deficiency. This is true, but magnesium is not the only nutrient that could present muscle issues. Choline regulates intracellular calcium and muscle contraction. This is what helps bind calcium proteins to muscle receptors. Choline keeps minerals like calcium available to the muscles so they can use it instantly when they need to contract. Testing for choline status could be the key for individuals with skeletal muscle issues, which can be muscle cramping, general soreness, or another type of issue.

Prevention and Relief

Home self-care for prevention and relief includes:

  • Heat or ice application to the muscle/s and affected areas
  • Avoiding caffeine
  • Drink plenty of water before and during physical activities, indoor/outdoor work, exercise
  • Self-massaging the cramped muscle/s
  • Stretching before and after physical activities
  • Nightly stretching before bed
  • Chiropractic maintenance

Body Composition Testing


American Osteopathic Association. Muscle Cramp. Accessed 12/10/2019.

Merck Manual. Muscle Cramps. Accessed 12/10/2019.

Miller, Timothy M, and Robert B Layzer. “Muscle cramps.” Muscle & nerve vol. 32,4 (2005): 431-42. doi:10.1002/mus.20341

Nutrients, July 202

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The information herein on "Low Levels of Choline Can Contribute To Muscle Cramps" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

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Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*


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