Flu like syndrome with myalgias and arthralgias may precede the onset of diarrhea. Hypocalcemia symptoms include parathesias, myalgias, muscle cramping, tetany, and convulsions. A systemic disease with arthralgic pain and myalgias has been observed in 1%. Adult patients have worsening myalgias, bone pains and fatigue which are followed by recurrent fractures. Myalgias may occur because of reduced carnitine production. Uncommon and rare side effects include muscle aches and pains (myalgias), and headaches.