Remedies for Restless Legs

Restless legs syndrome (RLS) is a neurological disorder that causes a person to periodically move their legs in response to an uncomfortable or unpleasant sensation in the legs.  In the United States, 5-15% of the population suffers from RLS.  Older people are generally more affected than younger people and the condition commonly occurs during the later stages of pregnancy. Typically, symptoms occur primarily during periods of inactivity and are usually worse in the evening or at night.  As a result, RLS frequently interferes with sleep, resulting in chronic sleep deprivation and an eventual reduction in quality of life.  In fact, if you have ever shared a bed with a person with RLS, you know that it is nothing to laugh about.  The reality is that many couples eventually sleep apart.   

A number of factors may be responsible for RLS.  Generally, iron deficiency is recognized as a reversible cause of RLS.  Additionally, vascular illnesses, diabetic peripheral neuropathy, kidney disease, reactive hypoglycemia, stress, alcohol, caffeine, nicotine and food sensitivities may also contribute. 

Pharmaceutical treatment may be utilized, including benzodiazepines and dopamine agonists, such as pergolide mesylate and ropinirole hydrochloride).  Thankfully, dietary modification and appropriate nutritional supplementation are all that is needed to successfully treat RLS in many cases. 

Nutritional Supplements:

Iron:
Approximately 25% of patients with RLS are iron deficient. In fact, research has shown that the uncomfortable sensations linked with RLS may be due to an imbalance in the brain of ferritin (a protein found inside cells that stores iron for later use).  The amount of ferritin in your blood is directly related to the amount of iron stored in your body.  As a result, testing the amount of ferritin in your blood is a routine test used by qualified naturopathic doctors to diagnose certain conditions, including iron deficiency anemia.   Iron is also necessary for the formation of dopa and dopamine from tyrosine.  Studies have shown that patients with RLS respond to treatment with dopamine agonists, suggesting that RLS forms as a result of reduced dopaminergic activity in the brain.  Therefore, the more severe the iron deficiency, the more severe the RLS symptoms. 

Iron deficiency can cause a number of problems other than RLS.  Although anemia is the most well known consequence of iron deficiency, having low iron can cause many other symptoms, even in the absence of clinical anemia.  These include fatigue, impaired mental concentration, lassitude, muscle fatigability, decreased aerobic capacity, mood disturbance, menorrhagia (heavy menstrual flow), hair loss, impaired immune function, intolerance to the cold and impaired capacity to regulate body temperature, abnormalities of the tongue, digestive disturbances and angular stomatitis (irritation and fissuring in the corners of the lips).

Common causes of iron deficiency include excessive menstrual flow, gastrointestinal blood loss (due to the use of NSAIDS or gastrointestinal disease), regular consumption of foods and beverages that inhibit iron absorption (tea, coffee, soy), insufficient intake of iron in the diet, and malabsorption (due to achlorhydria, Celiac disease, etc.)

Although iron may appear as the wonder supplement for treating RLS, iron supplementation in non-iron deficient individuals should be avoided, as it may increase the risk of cardiovascular disease and other chronic illnesses and can be very harmful in people with hereditary hemochromatosis.  Therefore, be sure to have your ferritin levels tested by a qualified naturopathic physician before beginning any iron supplementation. 

Magnesium:
One of the signs of magnesium deficiency is central nervous and neuromuscular irritability, which could be a factor in the development of RLS.  Inadequate magnesium intake is common in Western society due to a number of factors, including stress, alcohol consumption, caffeine intake, and pregnancy.

Folic Acid:
Severe folic acid deficiency can cause various neuropsychiatric symptoms, such as RLS, stocking-type tactile hypoesthesia (decreased sensation), depression, and decreased vibratory sense in the knees.  Folic acid deficiency is typically caused by malabsorption or inadequate dietary intake.  Fortunately, symptoms of folic acid deficiency can be reversed through folic acid supplementation.

Reactive Hypoglycemia, Stress, Alcohol, Caffeine, Nicotine, Food Sensitivities: 

All of these factors have been implemented in the development of RLS.   Therefore, in patients with reactive hypoglycemia (low blood sugar that occurs 1-3 hours after eating), it would be advisable to seek guidance on how to improve blood glucose control, as this has been shown to improve RLS in this population.  Furthermore, caffeine and nicotine are nervous-system stimulants and avoidance of these has been shown to eliminate RLS.  Therefore, it would be recommended to eliminate these substances for a trial period and see if symptoms resolve.  Additionally, alcohol consumption may cause a deficiency in nutrients linked with RLS, so I would advise avoiding alcohol for a certain period of time as well, and seeing whether symptoms resolve.  Lastly, food sensitivities can cause a vast number of problems in the body, other than just RLS, so it is very important to seek professional guidance from a trained naturopathic doctor in the proper detection and management of any food sensitivities one may have. 

Recommendation for Treatment:

The factors listed above are merely suggestions in the treatment of restless leg syndrome and are by no means an exhaustive list.  As each person’s case is unique from the next, please see your licensed naturopathic physician for a thorough assessment to ensure that your RLS is not the result of a more serious condition.  This will also help you to receive the most appropriate treatment.