I'm 71, male, physically and mentally active, and living a healthy lifestyle. I work full time at home as a self-employed writer and virtual world builder.

I have a question about cramping in my legs and feet. The cramping generally happens under three circumstances:
1. Occasional cramping in my left calf when driving and using the clutch to shift gears
2. When I'm mountain biking, I frequently get cramps in my feet when trying to put my feet in the pedals, and after a ride my right foot can cramp so badly that I have to wait a few minutes before driving. My left leg also cramps after a ride.
3. Very occasionally (maybe once or twice a year) I get extremely painful cramps primarily in my calves when my legs are extended and especially in bed.

I've had peripheral neuropathy in my feet for about 12 years. The cramps started simultaneously with the neuropathy. I've read in medical websites that cramps can be associated with neuropathy, but my doctor and a neurologist both insist that in my case, there is no connection between the neuropathy and cramping. However they can't tell me what's causing the cramping or how I can alleviate it.

Some background to give you a more complete picture:

I used to be very athletic, avidly running, mountain biking, and weightlifting. However in the late 1980s, my then doctor put me on hypertension medication (Hydrochlorothiazide and Lisinopril) and I began experiencing intense fatigue. Subsequent doctors dismissed my fatigue as imaginary and over the decades, gradually increased the dosage. I began having dizzy spells and feeling like I might faint. Doctors said it was normal.

I was exhausted much of the time, sometimes too exhausted even to move, and my exercise dropped from athletic to only slow walks around the block. Finally in 2011 I fainted three times. I tested my blood pressure and discovered it was very low, which led my doctor to stop the Hydrochlorothiazide and Lisinopril. My fatigue, dizziness, and fainting stopped immediately and have not recurred. In the nearly four years old patientsince then, my blood pressure has remained around 120/80, I've resumed hiking and trail running, I am now resuming mountain biking, and I will soon resume weightlifting. All of my exercise is in hilly terrain, usually very steep. When I'm pushing myself, I wear a heart rate monitor and try not to let my heart rate go much above 150.

My question is this: is there anything I can do reduce the frequency and/or severity of my cramping? It's potentially dangerous when I'm driving. A few months ago, my car was stationary on a road for about a minute because cramps prevented me from using the clutch. I could easily have been hit. Today after a one hour mountain bike ride on trails with some steep climbs, I felt fine while standing, but as soon as I sat in my truck to drive home and started the engine, the cramping started. I had to wait several minutes to drive because of fairly severe cramps in my left leg and right foot. My doctor and the neurologist he referred me to don't see it as a problem, but when I'm driving, the cramping scares me.

Do you have any suggestions?

Thanks,

Erik Bainbridge

Medical conditions:
- Mild macular degeneration in one eye
- Taking 6mg Terazosin daily for prostate issues
- Using Flonase for mild allergies
- Peripheral neuropathy in my feet (taking 1200mg Alpha-Lipoic Acid daily for it)
- Arteriosclerosis (taking 10mg of Simvasatin for it, but have temporarily paused taking it)

Blood pressure: typically 122/78, pulse 58
Total Cholesterol: 110
Triglycerides: 94
HDL: 43
LDL: 48
Glucose Fasting: 92
PSA: 1.9