Addressing Tetany aka Hand Cramps During a Psychedelic Experience: Causes, Symptoms, Treatment

In this day and age of spiritual tourism, traveling to a psychedelic retreat in Mexico, Jamaica or Peru has become a trendy new habit for explorers of altered states or for those in deep need of a mental health reset.

While the media continues to report on the groundbreaking studies demonstrating psilocybin’s capacity to create neuroplasticity, break maladaptive behaviors and patterns and treat a range of psychiatric conditions, there is not much talk about some quite destabilizing side effects that may occur during the peak of the psychedelic experience. Encountering complications can definitely make one’s dive into their subconscious more challenging and quite unpleasant. One of these adverse reactions is tetany. 

What is Tetany?

Tetany, also known as involuntary cramps or muscle contractions, is a very common symptom when one’s peripheral nerves are overstimulated due to electrolyte imbalance and low blood calcium levels. 

What Does Tetany Feel Like?

A person who has experienced tetany will likely describe feeling their hands suddenly contracting and stiffening uncontrollably, as if a force beyond their control is tightening the muscles with an invisible vice. The sensation of your fingers involuntarily curling into an uncomfortable grip, resisting your commands, can be quite unsettling. The muscles become tense, creating an irritating feeling of stiffness and twitching. 

The spasms intensify, causing a series of rapid and repetitive contractions that disrupt the natural flow of movement, making your hands feel momentarily frozen in an unnatural position. If you’ve seen Edward Scissorhands, it might as well look like that, but with fingers instead of shiny blades.

The experience can be puzzling and at times even painful without any substance hitting your brain receptors. However, being acutely aware that you have lost muscle control during a psychedelic experience can make one feel vulnerable and can definitely contribute to the common anxiety that many experience during the come-up. This loss of muscle control can easily transform into fear and resistance, particularly against to the ego-death experience, which is a key factor in the decision-making process for many individuals seeking to undergo a psychedelic journey. 

Common Symptoms of Tetany

Some common symptoms of tetany can include:

Severe signs of tetany include:

• Laryngospasm (the vocal cords freeze, jam or close when taking in a breath.)
• Bronchospasms (when the muscles that line the airways contract).
• Painful, generalized muscle cramps.
• Vomiting.
• Seizures.
• Arrhythmia.

How to Prevent Tetany During a Psychedelic Trip?

Preventing tetany during a psychedelic trip is not difficult, and a facilitator or a trip sitter can easily prepare for potential complications in the event that the individual for whom they are holding space shows early symptoms.

Although many psychonauts and reddit users opt to fast before a psychedelic trip to increase the intensity of their experience, it may not be wise to deplete one’s storage of glucose right before consuming a moderate or heroic dose of magic mushrooms as glucose is the body’s main source of energy. In other words, those planning on maintaining an intermittent fasting regimen on the day of a psychedelic experience should avoid doing so without preparation, as our body and brain require essential nutrients and minerals to function properly. That is why experienced keto dieters or intermittent fasters will often drink plenty of water, include zero-sugar electrolyte additives, and complement their routine with a significant amount of magnesium and calcium supplements.  

To prevent potential tetany symptoms, one can consider:

• A health check before a psychedelic trip: Blood tests can be very helpful in indicating whether there are calcium and magnesium deficiencies prior a trip, which can help in addressing these insufficiencies and avoid unpleasant complications. 
• Proper nutrition: Many retreats prepare healthy meals that include a balanced diet of nuts, seeds, dairy products and leafy greens that would provide the necessary calcium, magnesium and vitamin D levels for proper bodily functions.
• Supplement adherence: Stick to taking your prescribed supplements if you have been diagnosed with any of the aforementioned deficiencies.
• Hydration: Proper hydration is a key factor in maintaining electrolyte balance. The general agreement amongst the psychedelic community is to avoid consuming caffeine or alcohol prior to a psychedelic trip as they can prevent one’s body from absorbing minerals and vitamins. If coffee is something you simply cannot exclude from your diet, stick to the general rule of thumb: for every cup of coffee, you should drink at least two cups of water to balance out your bodily functions.
• Addressing stress levels: Most retreats will often include yoga and massage therapy sessions before dosing their attendees. This is not a simple value add. Stress can affect hormonal levels which can indirectly impact a person’s calcium storage. The pre-trip preparation recommendations such as yoga, exercise and meditation can help in reducing stress and anxiety levels.

In the event you begin experiencing signs of tetany during a trip and a simple bottle of water isn’t sufficient to reduce symptoms, you should consider:

• Replenishing your electrolytes right away: The easiest, although not the healthiest solution, will be a bottle or two of Gatorade. However, in the event you have forgotten to bring your electrolytes, you can opt for adding ¼ tbsp salt and 1-2 tbsp of honey in a cup of water, coconut water and lemon juice. 
• Staying calm: Anxiety will only worsen the symptoms. Consider breathing exercises and changing your setting.
• Massaging and stretching your extremities: This will help with blood circulation.
• Asking your trip sitter to check your heart rate: Most psychedelic retreats have an ENT on stand-by who can diagnose the need for medical assistance. Oftentimes, it is not necessary if you’re able to replenish your electrolyte levels. 

We often find that the biggest clichés hold some truth. “You are what you eat” – and possibly drink – perfectly exemplifies this, highlighting how the nutrients in your system before and during a psychedelic trip can impact the quality of your experience. Psychedelic substances like psilocybin, DMT, MDMA, and LSD can drain the nutrient reserves in your body— especially when undergoing a challenging trip and experiencing intense emotions. If your body is depleted from critical vitamins and minerals, you may increase the probably of experiencing an anxious ego-dissolution, or in this case, tetany. To prevent an unpleasant psychedelic experience, please consult Psychedelic Spotlight‘s Guide to Your Diet Before, During, and After Your Psychedelic Trip.