Restless Leg Syndrome

Do you suffer from restless leg syndrome? I know a few people who do and it isn’t very pleasant to deal with.

According to WebMD – People who suffer from this syndrome have uncomfortable sensations in the legs (and sometimes arms or other parts of the body) and an irresistible urge to move their legs to relieve the sensations. The severity of RLS symptoms range from mild to intolerable. The medical term for this is Willis-Ekbom disease. This disease is considered an autoimmune disease as it is commonly associated with celiac disease (a severe gluten intolerance that causes a lot of dietary issues) characterized by several features such as malabsorption-related iron deficiency anemia and peripheral neuropathy.

This may scare you and probably should, but Boston University School of Medicine, Dr. Sanford Auerbach, a neurologist and associate professor of neurology and psychiatry, strongly believes that RLS/Willis-Ekbom is not a disease, but a symptom of something more dangerous going on in your body, unknown to you, such as a chronic inflammation that is constantly growing within. Dr. Auerbach says that RLS is a disorder of the nervous system and is a biomarker of a greater underlying disease. “Patients with RLS had a higher rate of mortality than similar men and showed an especially strong tendency toward cardiovascular disease and hypertension.”

So what causes RLS? According to the National Institute of Neurological Disorders and Stroke RLS can be related to or accompanied by some of these factors or underlying conditions: end-stage renal disease and hemodialysis; iron deficiency; certain medications such as antinausea drugs, antiphychotic drugs, antidepressants that increase serotonin; and some cold and allergy medications that contain older antihistamines like diphenhydramine; alcohol, nicotine, and caffeine; pregnancy (but it usually disappears within 4 weeks after delivery); neuropathy (nerve damage); and sleep deprivation or other sleep conditions such as sleep apnea. If these factors are removed from your routine, it may relieve the symptoms.

According to Chris Kresser of chriskresser.com, there are a number of little known causes of RLS, including conditions involving systemic inflammation and immune dysfunction that are associated with RLS such as – Parkinson’s disease, MS, ADHD, Alzheimer’s disease, Celiac disease, Crohn’s disease, Rheumatoid arthritis, sleep apnea, diabetes, and depression. Chris’s suggestion is to find and treat the root cause to help control RLS, so you should have your gut tested as the gut is most probably the culprit even if you don’t seem to have noticeable digestive symptoms.

Small Intestinal Bacterial Overgrowth (SIBO) and IBS are often shown to be associated with RLS. Something you can do on your own is to follow a low FODMAP diet and probiotics which can help reduce the amount of fermentable carbohydrates that “feed” the bacteria in the small intestine, as well high quality probiotics can be as effective as antibiotics for treating SIBO.

Vitamin D Deficiency. Vitamin D may play an important role in dopamine signaling which has been identified in helping keep RLS at bay. Vitamin D may increase the levels of dopamine and its metabolites in the brain which can help protect dopamine-associated neurons from toxins. RLS has been associated with vitamin D deficiency in some studies and vitamin D supplementation has shown to improve the severity of RLS symptoms. Get your vitamin D levels tested, even if you spend a lot of time outdoors. Good ways to supplement to bring your vitamin D levels up is to take cod liver oil, take a D3 supplement, and of course get regular sun exposure.

Iron Deficiency isn’t a “little known” cause of RLS, and is probably one of the most well-researched areas. Iron is required for proper dopamine signaling and is a main cause of RLS symptoms by impairing dopamine function. Iron supplementation significantly improves or even eliminates the symptoms of RLS in many people and in some cases is more effective for treating it as pramiprexole (a dopamine agonist). However, it may not be as simple as taking an iron supplement, because it is considered secondary to SIBO, gut infections, or other inflammatory states. It is important to find out why you have an iron deficiency first before trying to treat it. Also, increasing iron intake can make matters worse by creating an environment that promotes pathogen growth and inflammation (a catch 22). So for this reason, it is best to address gut issues before adding iron to your routine.

Pregnancy is another time where RLS can pose a problem. If someone already has RLS and becomes pregnant it can cause the symptoms to become worse, although pregnancy itself can bring on RLS. The possible causes are: low levels of minerals or vitamins, such as iron and folate; sleep deprivation due to changes in the body and discomfort; changes in hormones; and increased sensitivity of the senses. It can be helped with mild exercise and a healthy sleep pattern.

What symptoms accompany RLS? Some have described feelings of: aching; burning; crawling; creeping; similar to electric shocks; itching; tugging; and tingling. The only way to relieve the discomfort is to move the legs. These sensations may occur when the person is resting or inactive, not only during the night, but do worsen in the evening and at night, and might be relieved for a short while in the morning.

How can it be treated? Medication given for RLS will depend on the person, but could include: iron supplementation; alpha 2 agonists; painkillers (ibuprofen, NSAIDS); anticonvulsants to treat pain, muscle spasms, neuropathy, and daytime symptoms, such as Neurontin, or gabapentin; Benzodiazepines (sedative medications to help with sleep through the effects of RLS) such as Restoril, or temazepan, Xanax, alprazolam, Klonopin, or clonazepam; and Dopaminergic agents which raise brain dopamine levels and treat unpleasant sensations (these may cause adverse effects in older people). Parkinson’s disease and epilepsy drugs are sometimes used as they can help reduce involuntary movements.

Some home remedies include: drinking apple cider vinegar with warm water just before bedtime daily; warm baths (using epsom salts) and massages to help relax the muscles and reduce the intensity of symptoms; warm or cool packs; relaxation techniques can help reduce stress which can make RLS worse, so doing yoga, meditation, and tai chi could help; and exercise – using the legs more can help alleviate symptoms; magnesium could also help reduce the symptoms of insomnia in people suffering with symptoms; staying hydrated drink lots of water, avoiding caffeine and alcohol can also help.

Sleep is another big component of getting RLS under control as being tired makes symptoms worse. So – sleep in a cool quiet bedroom; go to bed at the same time every night and get up at the same time every morning; reduce the amount of light you are exposed to for an hour before bed; avoid stimulating drinks such as caffeine or sugar; avoid or reduce alcohol consumption and tobacco. Getting regular exercise or physical activity will help RLS but could also aggravate it. Try not to exercise in the evening as it will not be helpful.

Another similar sleeping disorder is called “Periodic Limb Movement Disorder” (PLMD) in which the limbs twitch or jerk uncontrollably while sleeping. It can also cause the person suffering to wake up frequently during the night and can reduce the quality and length of sleep which can then lead to RLS.

I hope this information has helped you or someone you know, as this can ultimately be a serious problem for yourself or them.

Have a great day and week ahead.

Blessings,

Louise