Question: I am a middle-aged RN who works about 50 hours/week. I walk about 4500-7000 steps/day at work, do some walking on the outside, occasional treadmill. About 3.5 weeks ago, I started having some spontaneous low grade aching in my right calf, and for one day only, also noticed similar pain behind my right knee. There are no recent trauma events, prolonged airplane rides, etc. I have gradual worsening osteoporosis and take 1800mg Calcium, 2800 IU Vit D3, 150 mcg K-2, and am on Bi-Est 0.75mg and 150mg Progesterone daily. I've worked with a Naturopathic Doctor (ND) for several years. I also take Biosil with ch-OSA due to some research indicating it helps to increase bone density. I recently switched to Biosil's Bone Collagenizer Ultra and added an additional supplement with MCHC (Microcrystalline Hydroxyapatite), which also contains other ingredients, to include CA++. I believe my right calf symptoms started about a week or so after I started taking the full recommended doses of these. It initially felt like leg cramping and I thought it was maybe related to my Ca++ levels changing. Taking 200mg Magnesium at night seemed to temporarily reduce the symptoms. Over the course of about 2 weeks, the symptoms worsened, and I started questioning whether I was developing a blood clot, though there was no redness, increased warmth, red streaking or generalized leg swelling. About 2.5 weeks after the initial symptoms, I started limping at work due to the right calf hurting so much. As the day progressed, my right ankle developed spontaneous 3+ pitting edema. The left ankle was fine. I had an ultrasound done. It was negative for blood clot. Electrolytes were checked, all WNL. I was told I must have some micro tears of the muscle (?) and to use heat and elevate my leg, which I did the next 3 days. I've been unable to get in to see my ND, so I reviewed the combined ingredients of my meds and discovered I was taking 2900mg Ca++(!) I immediately reduced the combination of meds to bring my actual intake back down to 1600mg, while staying on the Biosil and MCHC product. I had a couple good days where the calf pain was totally gone, but again yesterday, the pain increased, my right ankle swelled to 2+ edema and today it is harder to walk. I am stumped. There is no increased warmth in the leg, my toes are equal temp bilat, pedal pulses are strong bilat. Do you have any additional suggestions for pursuing a better differential diagnosis? Symptoms are completely localized in the right lower leg from about the mid posterior calf down. The only other thing I have noticed is that when I sit at my desk at work, (I'm a nursing supervisor), I occasionally notice a very very mild burning sensation. Beginning signs of neuropathy (?). That doesn't explain the deep achy, tight muscle sensation or the localized ankle swelling. Sorry this is so long winded, I thought it was easier if you had the details up front. Thank you in advance for any suggestions you might have.

Thank you for your thoughtful response. So far I have started backing off on the MCHA and Calcium. The leg cramping and ankle swelling have slightly improved. My symptoms do seem to be somewhat dose related. I have noticed a bit of a nodular "knot" (dime size) in my right posterior calf, so I've continued to intermittently elevate and use warm rice packs (provides moist heat) to add comfort and assist with increased circulation in that area. I'm still attempting to get in to see my ND, but she has been out ill. Thank you again for your assistance.