Tingling in hands and feet, "lobster claws" and fatigue. Is it TETANY??

Gabrielle,

I am so thrilled to hear from you! How cool is it that you and Naomi are friends?!

Thank you for being so thoughtful with this process. Let’s continue the thread here since I feel like it’s more aptly named. Yes, I would be more than happy to answer any questions you have. As you can probably tell, I’m really hoping that one day I can get to the bottom of this. I’m hoping it might be helpful for others who may be having similar symptoms, too.

Ask away. I’ll be here 🙂

Eva

First I just want to thank you deeply for taking the time to be so thoughtful with my yoga troubles. I am so touched and appreciative! To give you more context, I’ve have 2 primary care doctors over the past few years each time my annual physical results turn out fine, as as a result, neither of them were really able to give me much information. You are indeed right that this is a process and since I’ve been having this issues for a few years now, I think I’m learning to be more patient and open about the possibilities of what’s to come.

Now, on to your questions!

1>> How many times per week were you practising when you first had the problem in your hands?

I had been practicing hot yoga for about 7-8 years before the first time the hand problem occurred, and had done 2 successful thirty day challenges with no problem. When it started, I think I was probably practicing maybe.. 2/3 times a week. From what I can tell, it happened out of the blue one day (as opposed to happening gradually over time). The first time it happened was one of the worst occurrences- I had to take a taxi home because I was so tried and drained and my hand muscles hurt all the way through the muscles of my forearms.

2>> How many times per week do you practise now?
Now I rarely practice. I’d say… it’s more on and off. Maybe I’ll go to 4 classes in one month, and then I won’t go for 2 months at a time, and then I’ll do a few more classes the following moth. It’s very sporadic.

3>> Did you get the problem EVERY time you did yoga?
Since this started happening, it’s happened 95% of the time I take a hot yoga class. So basically at this point, every time I go, I anticipate it will happen, and have to factor that in to my day (i.e. I’ll make sure to only go to class if I know I don’t have any plans after class since I know I will be super tired).

4>> How long did it hang around and make you feel uncomfortable after each class?
The “lobster claw” and tingling in my hands lasts anywhere from 5-20 minutes, depending on the level of severity that day. However, the overwhelming fatigue and burning sensation in my eyes, and overall dizziness/drowsiness will last me the rest of the day until I go to sleep! Sleep is usually the only guaranteed thing that will make it go away.

Here’s one thing I think I should mention that may be important:
I’ve always associated the hand cramping/pins and needles with the extreme fatigue/drowsiness. These things happens together during yoga class. But in the past year, the extreme fatigue has been happening with any kind of physical activity i do (gym, running, biking). The cramping only happens when I take hot yoga classes OR sometimes when I go into a sauna! It’s possible they are related, but it’s possible they are separate issues. But one thing for sure is that being in a hot room makes my hands cramp up.

5>> Did it stop you going back as frequently as you would have liked?
Yes, as mentioned above, I only go to hot yoga classes sporadically now. Given my weird symptoms, I probably shouldnt even be going, but sometimes I just miss it so much and I want to be on the mat in a hot class! However, I still try to stay physically active 3-4 times a day, but I have to limit how long I can work out because I get tired very easily.

6>> Do you still get the lobster hands problem?
Yes, only when I do hot yoga or am in a hot room (steam room, sauna).

7>> You say the issue is exacerbated by Locust (when your arms are under your body) and those words imply it appears before Locust. What poses has this problem presented at? Could be different poses.
It varies. It’s happened as early as the first pose (half moon) to the middle of the sequence. However, if I’m in a class and it hasn’t happened yet, locust pose will almost always trigger it/set it off.

8>> What do you think is meant by the term over-breathing?
I think maybe taking in too much air from my nose? I always breath in through my nose and out of my nose when I am doing yoga. Given that, the only thing I can GUESS it means is that I am breathing too hard/too deeply from my nose. Particularly when I am in poses that are challenging for me, like triangle, i tend to focus on my breath a lot as it’s what keeps me focused and grounded, which helps me stay in the pose. Maybe it means my breaths are too shallow and rapid? I tend to breath faster when my heart rate is up in a challenging pose (and in hot yoga, a lot of the poses are challenging!)

9>> Why do you think you are over-breathing?
This is a really good question. This past winter, I went to Asia to visit some family and had to go see a doctor related to a weird allergy I had. This doctor was a well-known traditional oriental medicine doctor (who also practices acupuncture, acupressure and all sorts of other venues of chinese medicine). I mentioned to him off hand that my eyes get red and I get very tired when I work out. He asked me a series of questions, and guessed that one of my symptoms was hand cramping without me even having to tell him! He said this was a classic case of hyperventilation.

Now, I don’t actually think I hyperventilate. Now, I don’t actually FEEL like I am over-breathing. I feel like I’m breathe normally! But once the doctor told me about hyperventilation and the symptoms that come with it, I began to think maybe he’s on to something. After researching hyperventilation, that’s how I learned about tetany!

PHEW! Okay, I think this is A LOT of information. Please let me know next time if you need me to be more or less detailed. I am looking forward to your next round of questions! I hope these answers suffice!

Hi Gabrielle,

WHOA. Soo sorry for my delayed reply. I had no idea you had already responded!!! Usually I get a little note in my inbox, but I must have missed it.

Anywhere, here are my responses to round 2 of your Q’s:

10 >> Do you have a low salt diet? Do you have a diet where you don’t particularly monitor salt?

I do not have a low salt diet. I think I have regular salt intake for someone who eats pretty darn healthy (lots of whole fruits and veggies, limited processed foods, limited meat and dairy intake etc)

11 >> Do you take an electrolyte supplement? When? Which one?

For about 6-12 months I tried Pedialyte. But I also tried Liqumins ConcenTrace Trace Mineral Drops, Low Sodium for awhile and it didnt make any different

12 >> How much water do you drink? Per day? During class? Is it plain water?

I drink plain water from my NY tap as well as from the filtered water machine in my office. I have a 32 oz Nalgene water bottle that I take with me everywhere. I would say at minimum I drink at LEAST 120oz of water a day. If I’m working out, probably around 200 oz day?

During class I don’t usually drink THAT much water. I take small sips usually. I tend to drink more water before and after class.

13 >> What temperature is your studio at? How do you know?

I don’t know. I’ve gone to at least 3 -4 different studios since this started happening, so it’s probably been different at all the studios.

14 >> Is the studio in a humid location? Or dry? Do you know the percentage of humidity?

I also don’t know the % of humidity. I live in New York city and it gets quite humid in NY during the summer, but it’s dry in the winter. My symptoms occur year round, despite the weather.

15 >> How many people per class generally?

Also hard to say, since I’ve been so so many different classes. As you know, some classes can have 6 people, and some can have 40, depending on the time of day, location and room size etc etc.

16 >> Do many people have to stop and rest during class? Or is it just you that you perceive as having difficulties?

I can’t recall. I dont think there’s a general trend. Because I’ve had this problem for so long now, it’s hard to pin point, especially since I go to different studios around the city etc.

17 >> It’s both hands isn’t it? Never just one? What about any other extremities? Do you ever get any cramping in your feet or your legs? Any other sensations in the body that occur independently of, or along with the issue with the hands?

“Ummm. Realised you do get it in the feet.”

I do get it in my feet sometimes, but it’s in my hands 100% of the time. As I’ve mentioned before, the other VERY acute sensation that happens every time my hands cramp up is a burning/stinging feeling in my eyes (not to be confused with itchy. My eyes don’t itch) and they get very red. It very uncomfortable and makes me feel very TIRED. And then of course, there is the foggyness and dizziness, which adds to this over sensation of being depleted and unfocused and FATIGUED.

“I can’t recall you telling me if you have had blood tests. If you have been tested for Vitamin D levels. If you take any supplementation of any kind (not just electrolytes). Whether you have any other chronic conditions. And whether you have had any tumultuous event in your life in the last several years preceding the initial event that kicked off this regular occurrence.”

Yes, I’ve had blood tests. At least once a year for my physical. Doctors always tell me everything looks great. One doctor even used the word “enviable” to describe being in good health.

I take a few supplements: A daily vitamin, vitamin D in the winter because there’s not enough sun in NY during the winter months, fish oil, and maca. For awhile I tried rhodiola, but that didn’t increase my energy level very much.

Chronic conditions: I don’t think I have anything major. I have lower back pain every once in awhile and I have IBS, in which certain foods make me very gassy and bloated, but it’s not very severe by any means.

Tumultuous events: The last 2 tumultuous life events were 1. being robber in my NY apartment and 2. a bad breakup with an ex boyfriend. But both happened at least a year to 18 months before the symptoms kicked in.

Phew okay! Thank you, thank you, thank you!!! I will make sure to check back regularly for a response this time!!

With gratitude,

Eva