It’s strange but true. People should look into their meds, even if cramps and spasms aren’t listed as a side effect. Also, if I get my vitamin D naturally, why do I need a supplement to help absorb calcium?

DEAR READER: That’s a great question. Calcium is vital for the formation and maintenance of strong bones and for normal bodily functions such as the development and maintenance of strong teeth. It is required for the contraction and expansion of blood vessels, the secretion of enzymes and hormones, and the transmission of impulses of the nervous system. Vitamin D is equally important for the absorption of calcium from the intestines. The combination is most often used to prevent deficiency and to treat it in those who are calcium deficient.

An adequate daily calcium intake is 1,000 milligrams for people between the ages of 19 and 50; and 1,200 for those 50 and older. Food sources include milk, cheese, yogurt, tofu, salmon, fortified cereals and instant breakfast drinks.

An adequate daily intake for vitamin D is 200 IU for people between the ages of 19 and 50; 400 IU for those between the ages of 51 and 70; and 600 IU for those 71 and older. This fat-soluble vitamin is found in fortified milk products and cereals, egg yolks, butter, salmon, sardines, herring and beef liver. Aside from food sources, sunlight exposure for about 15 minutes a day is reported to provide the necessary amount, but don’t get too much sun.

Side effects of too much calcium with D include drowsiness, weakness, dry mouth, irregular heartbeat, difficulty breathing, nausea or vomiting and constipation, but the list goes on and on. If any of these symptoms are experienced, a user should contact his or her physician promptly.

You don’t indicate your age, so I am unsure whether you have issues with such disorders as osteoporosis; however, if your diet is adequate, I don’t believe you require a supplement, but this can be determined by a blood test. You will continue to receive some benefit from the calcium you take, even if you discontinue the D. Perhaps the answer is to take a good one-a-day vitamin. Speak with your doctor regarding his or her views on the subject. In the interim, read labels at your local grocery store when selecting foods. That way, you can determine whether you satisfy the recommended requirements through diet alone. If not, the next step might be to select some of the foods recommended so you can increase your intake naturally.

To provide related information, I am sending you a copy of my Health Report “Vitamins & Minerals.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

I have constant cramping in my legs, thighs, toes, hands, rib cage and arms. Lately, most of my cramping is happening at night when I go to bed. Both legs cramp up, and one of my feet twists to one side. These cramps are painful. I can turn over in the middle of the night and catch a cramp. I have had all types of blood work performed, and when my potassium was a little low, I was told to take a potassium pill. I cramped twice as much.

I have gone to internal-medicine doctors, rheumatologists, orthopedic specialists, family medical practitioners, OB-GYNs and cardiologists with no resolution.

I am currently taking Celebrex and magnesium oxide — specifically for cramping — which has helped, but not completely. I also take Singulair, Diovan, Prevacid, a garlic pill and Zocor at night only. In the past, I have taken some cramping medications, such as clonazepam, quinine tablets and others I can’t even remember the names of. Can you shed some light on my medical problem that might assist me with these awful cramps?

DEAR READER: You indicate you are in good health with the exception of your allergies. Let’s review your other medications. Celebrex is a prescription medication used to control the pain, stiffness and swelling of osteo and rheumatoid arthritis. Magnesium oxide and Prevacid are commonly used to relieve symptoms of acid indigestion. Diovan helps control hypertension and is sometimes prescribed for patients with heart failure who cannot take ACE inhibitor medications. Zocor is a statin drug designed to reduce bad cholesterol while increasing the good. Garlic is believed to help symptoms of arthritis and lower high-cholesterol and blood-pressure readings. And, when added to many foods, it simply tastes good. So it appears that you have arthritis, acid indigestion, hypertension and hypercholesterolemia (high cholesterol).

Statins have a bad reputation for causing muscle pain, cramping, fatigue, and muscle tenderness and weakness in some people. You appear to be one of them. I cannot clearly state that this is the cause of your problem, but it’s a good place to start. Speak with your physician to determine whether you can take a different cholesterol-lowering medication that isn’t a statin. Perhaps an over-the-counter such as niacin or an OTC with plant stanols and sterols might be effective. Because of your history, my inclination is to have you refrain from red-yeast-rice products only because they include lovastatin-like substances. Try drinking pickle juice or eating dill pickles for relief from your cramps. Last but not least, place one bar of soap (or more) under your bedsheet near the part of your body that cramps for additional relief.

To provide related information, I am sending you copies of my Health Reports “Understanding Cholesterol” and “Compelling Home Remedies.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title(s) or print an order form off my website at www.AskDrGottMD.com.