Expert Advice for Restless Legs Syndrome A Holistic Approach to RLS Treatment

Sure, medications can treat restless legs syndrome, a neurological disorder that causes a person to constantly move around. But what about alternative treatments? Find out one doctor’s natural remedies – how they work, the benefits and possible side effects… For those who prefer a holistic approach to treating restless legs syndrome, Jacob Teitelbaum, M.D., medical expert and medical director of the Fibromyalgia and Fatigue Centers of America, answers questions about how best to calm those jumpy limbs. What causes restless legs syndrome? We don’t know why people get restless legs syndrome. But there is an area of the brain that is the neurotransmitter of dopamines, which is very important. Dopamines are brain-signaling chemicals – the movement center of the brain. A dopamine deficiency is an iron deficiency. You need iron to make dopamine. How is RLS diagnosed? Usually with a sleep study, where people spend the night in a sleep lab to check if their legs are jumpy and interfere with sleep. I recommend that, instead of paying for a sleep study right away, people should just videotape themselves sleeping at night. Set up a video camera pointing at your feet with your head in the background. Sleep under a sheet instead of a blanket and you’ll see whether you have jumpy legs. Does physical activity help? Not really. When you walk around and you’re active, you have so many nerve signals going to your feet telling them what to do, where you are and so on that it overrides the signal to move your legs. That won’t affect what happens later in the day when you want to fall asleep or rest. Is RLS more prevalent in women than men? It’s very common to see restless legs syndrome in fibromyalgia patients. About a third of the people who have fibromyalgia have restless legs syndrome. These autoimmune diseases seem to predominantly [affect] women. It’s quite possible that restless legs syndrome has an autoimmune component. Why does it seem to affect women more? Think about it: If a woman carries a baby, she needs to be able to carry a baby without rejecting the little bugger. If you put a baby into a man, that immune system is going to say, “That’s not me!” and kick it right out. A woman is built differently to be able to carry babies throughout pregnancy. Because of that, some diseases are more common in men, but most autoimmune diseases are more common in women. Iron deficiency is much more common in women because until they go through menopause, there is a monthly iron loss with their periods. What can help? Treating an iron deficiency is effective. Iron is dirt-cheap and cures the problem. It costs five cents a day, and after six months, if you get the iron levels high enough, the restless leg syndrome goes away and you’re done. How can you check your iron levels? You should have a simple blood test called a ferritin test, and any doctor’s office can get it for you. If your ferritin level is over 60, you don’t need iron, but if it’s less than 60, studies show iron treatments will help your restless legs syndrome. Take vitamin C with the iron to absorb it, and do so on an empty stomach. Take it at bedtime until your ferritin level is at least 60. Is taking iron safe? Get the ferritin test, but again, you have to get the results from the doctor. If your ferritin level is under 60, it’s quite safe to take the iron. What side effects can be expected? A. Iron will cause a black stool, which it’s normal for iron to do. B. If you’re taking thyroid medication, iron can interfere with the absorption of that. Thyroid and iron should not be taken within six hours of each other. Also iron is better absorbed with vitamin C. C. If you get iron from liver and foods like spinach and vegetables, you need to add at least 100 milligrams (mg) of vitamin C with the dose. See if that works. D. Some people will get constipation, which leads me to the next one for treatment of restless legs syndrome, which is magnesium. Magnesium is kind of like your body’s natural Valium, but it gives you energy and calms down the nervous system. So, it’ll tend to decrease seizures and reduce tremors. It decreases restless legs syndrome – and it’s healthy for you. The magnesium has a mild laxative action, whereas iron is mildly constipating. So, that makes a great team. What are the therapeutic doses for the magnesium and iron? You can take 500 mg of magnesium a day. You can take it at bedtime so that it helps you sleep, or you can divide it up through the day. That is 200 mg per dose, but you can go as high as 500 if it’s not causing you uncomfortable diarrhea. I recommend the iron dose be 25-30 mg a day followed by 100 mg of vitamin C. The problem with iron is that taking more won’t really get your blood levels up much more quickly. It’ll just cause you to be constipated and nauseated. In fact, if you take it every other day, or three weeks on and one week off, you get almost as much absorption with less stomach upset. If you get a bit of gastritis, gastritis decreases the absorption. The bottom line is it’s OK to take iron at a level that’s comfortable because if you’re getting an upset stomach, you’re not getting the absorption anyway. What if you do get sick from taking iron on an empty stomach? If that happens, take it with food or lower the dose. There is an iron supplement out there called Floradix, which is an herbal mix. It doesn’t have much iron in it, but it’s easy on the stomach. And if you need to, can you still use medication? Yes and I’m going to recommend Gabapentin or Zolpidem. Those are both generic, and they’re both cheap. I would start with Gabapentin – 100-600 mg a day at bedtime [is] shown to help restless legs syndrome. For more information, visit our Restless Legs Syndrome Health Center. These following resources may provide valuable information and support to help you manage your condition: Foundations and Associations RLS Foundation This nonprofit provides current research, articles and support groups to people with restless legs syndrome. We Move This nonprofit organization has up-to-date medical research about restless legs syndrome. National Sleep Foundation RLS is among the variety of sleep disorders that the foundation offers facts and information about. Books Restless Legs Syndrome: Coping with Your Sleepless Nights by Mark J. Buchfuhrer, M.D., Wayne A. Hening, M.D., and. Clete A. Kushida, M.D. (Demos Health) Written by restless legs syndrome experts and sponsored by the American Academy of Neurology, this book explains the facts behind RLS, its causes and how to manage it. Restless Legs Syndrome: Relief and Hope for Sleepless Victims of a Hidden Epidemic by Robert H. Yoakum (Fireside) An RLS sufferer provides information on the causes and coping mechanisms for this disorder. 100 Questions & Answers About Restless Legs Syndrome by Sudhansu Chokroverty, M.D. (Jones & Bartlett Learning) The 100 most-asked questions about restless legs syndrome answered. Restless Legs Syndrome: The RLS Rebel's Survival Guide by Jill Gunzel (Wheatmark) An RLS victim and ovarian cancer survivor writes about fighting back when faced with debilitating challenges. Clinical Management of Restless Legs Syndrome by Wayne A. Hening, M.D., Mark J. Buchfuhrer, M.D., and Hochang B. Lee, M.D. (Professional Communications) This books explains how to accurately diagnose and treat RLS. Contemporary Diagnosis and Management of Restless Legs Syndrome by David Bruce Rye, M.D., Ph.D. (Handbooks in Health Care) A neurology professor and sleep disorders specialist discusses the causes, and diagnostic and treatment methods for restless legs syndrome. Blogs Restless Leg Syndrome Foundation Blog This blog gives readers information about restless legs syndrome and the RLS Foundation. Restless Leg Tips This blog provides tips and suggestions for people suffering from restless legs syndrome. Support Groups RLS Foundation Online Community Members can create profiles and connect with others. The Restless Legs Syndrome Foundation has a link that helps readers find support groups in their area. Southern California RLS Support Group This group provides information on meetings, expert medical consultations and patient letters for restless legs syndrome. What’s Your Restless Legs Syndrome IQ? Restless legs syndrome (RLS) might sound like a simple case of someone feeling on edge. After all, many people shake their legs when they’re antsy, bored or nervous. But there’s more to RLS than restless legs.