Sun
19
Apr
Restless Legs Syndrome
People with restless legs syndrome (RLS) often feel an intense urge to move
their legs, particularly when sitting still or trying to fall asleep. Unlike
those with nighttime leg cramps—a different condition—people with RLS don’t
experience pain. Instead, they may describe an uncomfortable "creepy-crawly
sensation" inside their legs. Walking relieves the symptoms, but as soon as
people settle down again, the urge to move recurs. The feeling is sometimes
described as "wanting to ride a bicycle under the covers."
RLS tends to run in families, often emerging or worsening with age. People with RLS frequently have another condition as well, called periodic leg movements in sleep (PLMS). People with PLMS kick their legs frequently during the night, disrupting their own sleep and that of their bed partner.
Since RLS is occasionally linked to other serious diseases, it’s advisable to see a doctor if you have its symptoms.
Conventional medical treatment for RLS usually involves taking a levodopa/carbidopa combination, better known as a treatment for Parkinson ’s disease. The drug quinine has been used in the past, but one double-blind study found no benefit.
Because of this and a risk of dangerous side effects, quinine is no longer used for this purpose.
RLS tends to run in families, often emerging or worsening with age. People with RLS frequently have another condition as well, called periodic leg movements in sleep (PLMS). People with PLMS kick their legs frequently during the night, disrupting their own sleep and that of their bed partner.
Since RLS is occasionally linked to other serious diseases, it’s advisable to see a doctor if you have its symptoms.
Conventional medical treatment for RLS usually involves taking a levodopa/carbidopa combination, better known as a treatment for Parkinson ’s disease. The drug quinine has been used in the past, but one double-blind study found no benefit.
Because of this and a risk of dangerous side effects, quinine is no longer used for this purpose.
Treatment
Proposed Treatments for Restless Legs Syndrome:
Preliminary evidence suggests that symptoms of RLS may be relieved by supplementation with one of several minerals or vitamins, including magnesium, folate, iron, and vitamin E. However, no double-blind studies have, as yet, found any of these treatments to be effective.
Magnesium
Preliminary studies suggest that supplemental magnesium may be helpful, even when magnesium levels are normal. An open study of 10 people with insomnia related to RLS or periodic leg movements in sleep found that their sleep improved significantly when they took magnesium nightly for 4 to 6 weeks.
Folate
Based on numerous case reports of improvement, folate is also sometimes recommended for RLS. Symptoms decreased in one study of 45 patients given 5 to 30 mg of folate daily. However, because this was not a double-blind experiment, the value of the results is questionable. Keep in mind that such high doses of folate should be administered only under medical supervision. Folate may be of particular benefit to pregnant women with RLS who are deficient in this vitamin.
Iron
A number of studies have linked RLS to low levels of iron in the blood. In one analysis of the medical records of 27 people with RLS, those with the most severe symptoms had lower-than-average levels of serum ferritin, one measure of iron deficiency. In another study in which 18 elderly people with RLS were compared with 18 elderly people without the condition, those with RLS also had reduced levels of serum ferritin. When 15 of these people were given iron, all but one experienced a reduction in symptoms. Those with the lowest initial ferritin levels improved the most. However, because this was not a double-blind study, it isn’t clear how much of the observed benefit was due to the placebo effect.
In contrast to these results, a recent double-blind study of 28 people found that iron didn’t relieve RLS any better than placebo. However, in this particular study, participants had normal levels of iron on average. The study didn’t effectively measure whether iron might help RLS among people with iron deficiencies.
One theory holds that mild iron deficiency may cause RLS by decreasing the amount of a neurotransmitter called dopamine. This theory is supported by findings that conventional drugs which increase dopamine activity (such as the Parkinson’s medication mentioned above) can also alleviate RLS.
Tests for anemia won’t necessarily pick up the low-grade iron deficiency that is linked to RLS. Be sure your doctor tests specifically for iron deficiency, not just anemia.
Vitamin E
Vitamin E may also help with this condition. Seven out of nine people with RLS given 400 to 800 IU daily of vitamin E experienced virtually complete control of symptoms, while the other two had partial relief. Other anecdotal reports suggest that vitamin C may be useful, and that vitamin B12 may benefit people with RLS who are deficient in this nutrient. However, until properly designed studies are performed, we cannot draw firm conclusions.
Preliminary evidence suggests that symptoms of RLS may be relieved by supplementation with one of several minerals or vitamins, including magnesium, folate, iron, and vitamin E. However, no double-blind studies have, as yet, found any of these treatments to be effective.
Magnesium
Preliminary studies suggest that supplemental magnesium may be helpful, even when magnesium levels are normal. An open study of 10 people with insomnia related to RLS or periodic leg movements in sleep found that their sleep improved significantly when they took magnesium nightly for 4 to 6 weeks.
Folate
Based on numerous case reports of improvement, folate is also sometimes recommended for RLS. Symptoms decreased in one study of 45 patients given 5 to 30 mg of folate daily. However, because this was not a double-blind experiment, the value of the results is questionable. Keep in mind that such high doses of folate should be administered only under medical supervision. Folate may be of particular benefit to pregnant women with RLS who are deficient in this vitamin.
Iron
A number of studies have linked RLS to low levels of iron in the blood. In one analysis of the medical records of 27 people with RLS, those with the most severe symptoms had lower-than-average levels of serum ferritin, one measure of iron deficiency. In another study in which 18 elderly people with RLS were compared with 18 elderly people without the condition, those with RLS also had reduced levels of serum ferritin. When 15 of these people were given iron, all but one experienced a reduction in symptoms. Those with the lowest initial ferritin levels improved the most. However, because this was not a double-blind study, it isn’t clear how much of the observed benefit was due to the placebo effect.
In contrast to these results, a recent double-blind study of 28 people found that iron didn’t relieve RLS any better than placebo. However, in this particular study, participants had normal levels of iron on average. The study didn’t effectively measure whether iron might help RLS among people with iron deficiencies.
One theory holds that mild iron deficiency may cause RLS by decreasing the amount of a neurotransmitter called dopamine. This theory is supported by findings that conventional drugs which increase dopamine activity (such as the Parkinson’s medication mentioned above) can also alleviate RLS.
Tests for anemia won’t necessarily pick up the low-grade iron deficiency that is linked to RLS. Be sure your doctor tests specifically for iron deficiency, not just anemia.
Vitamin E
Vitamin E may also help with this condition. Seven out of nine people with RLS given 400 to 800 IU daily of vitamin E experienced virtually complete control of symptoms, while the other two had partial relief. Other anecdotal reports suggest that vitamin C may be useful, and that vitamin B12 may benefit people with RLS who are deficient in this nutrient. However, until properly designed studies are performed, we cannot draw firm conclusions.