The vitamin that can put a stop to agonising night-time leg cramps: Ask the GP DR MARTIN SCURR

My wife is woken up two to three times a night by painful cramp in her legs and toes. She drinks tonic water and she’s tried a spray. Is there anything else that might help?

Alan Jones, Swansea.

DR MARTIN SCURR replies: Nocturnal leg cramp, a miserable and sleep-depriving affliction, affects at least 60 per cent of adults. The pain can be severe, even unbearable, and linger for several hours after the cramp has gone away.

While we don’t know what causes it, some factors do appear to increase the risk such as certain medications (including diuretics, statins, steroids, morphine and some asthma inhalers), and several diseases (including liver and kidney failure, diabetes and hypothyroidism – an underactive thyroid).

People who drink a lot of coffee, or who lack certain nutrients (such as calcium), or have obstructive sleep apnoea (where they temporarily stop breathing as they sleep) may also be more susceptible.

Quinine can reduce the frequency and intensity of leg cramps, but is no longer prescribed because it can cause severe side-effects, such as dangerous heart rhythm problems.

While Indian tonic water does contain quinine the doses are too low to ease muscle cramps.

But there is another option – vitamin K2, also known as menaquinone. Its effectiveness was demonstrated in a recent study, published in the prestigious journal JAMA Internal Medicine, where 199 people over the age of 65 took the vitamin, or a placebo, daily for eight weeks.

Those taking the vitamin had fewer nocturnal muscle cramps than those in the placebo group, and any cramps that did occur were shorter and less severe.

The good news is that vitamin K2 is available in pharmacies. Encourage your wife to take 30 micrograms every day.

My daughter, now 50, has lived with debilitating eczema since she was three. She recently saw a dermatologist who suggested trying an immunosuppressant drug, but she is wary of the side-effects. Is there any other option?

Gillian Johnson, Devon.

DR MARTIN SCURR replies: I do sympathise: eczema can be very debilitating, causing dry, itchy skin that’s prone to scaling and oozing and, unfortunately, in some patients the condition can persist for a lifetime.

The accepted best care involves daily baths or showers using a soap-free cleanser, followed by the application of an emollient (this should have a low or zero water content) several times a day.

Eczema increases inflammation in the skin, and there is evidence that taking a bath at least once a week with diluted bleach – note, extremely diluted, i.e. half a cup or around 80ml of household bleach (6 per cent concentration), in a full bath of lukewarm water – can have an anti-inflammatory effect.

For severe cases a high-potency steroid cream may be suggested, using it for two weeks at a time, followed by a lower potency cream, again to tackle the inflammation. As high-potency steroids can thin the skin, they shouldn’t be used on the face. These creams can be applied before or after the emollient.

If all this fails, immune-suppressing drugs may be offered. These are tacrolimus, an ointment, or methotrexate, taken as a weekly tablet.

I respect your daughter’s concern about potential side-effects, so let me suggest other options.

There is good evidence that oatmeal baths and creams can help (oatmeal contains anti-inflammatory compounds).

Vitamin D can also help – taking 1,000 international units (25mcg) daily may reduce the severity of eczema, especially during the winter months.

Finally, there is moderate evidence that applying sunflower oil helps strengthen the skin barrier and, to some extent, reduces inflammation. It won’t do any harm to try this alongside your emollient.

These measures won’t interfere with anything the dermatologist might suggest and my hope is they may offer some improvement at least.

In my view… an afternoon nap can boost mind and body

A remarkable piece of research has looked at the effects of an afternoon nap on the performance of football players – and I think the findings are relevant for all of us.

Scientists found a 20-minute sleep in the afternoon not only improved the players’ stamina in subsequent sprints compared to those who didn’t have a nap, but also helped them perform better in intellectual tests.

The afternoon siesta is hardly a new concept, but research continues to prove its benefits.

What I find so curious is why more people don’t adopt it as part of their daily practice.

Before going out in the evenings, I have a 20 or 30-minute meditation – during which I close my eyes and try to calm my mind (and almost always fall asleep briefly). I find that it makes a huge difference in energy and enthusiasm. I recommend it.

• Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London W8 5HY or email drmartin@dailymail.co.uk — include your contact details. Dr Scurr cannot enter into personal correspondence. Replies should be taken in a general context and always consult your own GP with any health worries.