Restless Leg Syndrome

Trying to get a good night’s sleep can be difficult as you get older.  The last thing you need is your legs feeling like they’re running a marathon while you’re trying to sleep. That description may sound a little humorous but there’s nothing funny about restless leg syndrome.  It can ruin your sleep and put you at risk for poor health.  Here’s what you can do about it.

What Is Restless Leg Syndrome?

  Restless leg syndrome, or RLS, is a condition in which your legs (mainly your calves and feet) can feel prickly, like bug-crawling sensations, or feel itchy, jumpy, have pulling/drawing sensations, and/or intense pain.  The most common response is that you want to get up and move around  – hence, the name “restless legs”. When you do move, your legs generally feel better.

RLS can affect anyone of any age – even children.  It does worsen with age, though.  RLS usually starts when sitting for long periods, usually later in the evening, and especially when lying in bed.  It can make traveling, sitting at your desk at work, at a movie, concert, etc, and sleeping, uncomfortable. It can really hamper the amount of sleep you get each night.

Researchers don’t completely know what causes RLS but it seems to be associated with:

• Peripheral neuropathy.  Diabetics often get this condition from nerve irritation in their legs and feet.  Sometimes the condition can affect the arms as well.
• Iron deficiency. People with anemia often exhibit RLS symptoms.
• Kidney failure.  People with hypertension and/or kidney disease can be anemic, or lose too much potassium through increased urination from blood pressure medication.
• Heredity.  The condition often runs in families.
• Hormone fluctuations.  Pregnancy, menopause, andropause, can aggravate RLS symptoms.  Yet, symptoms can disappear after childbirth and/or hormone re-balancing.

Although RLS itself doesn’t really cause any physical disability – the lack of sleep it can cause can lead to your overall health decline.  Lack of sleep can put you at higher risk for:

• Obesity – Sleeping less than 6 hours a night upsets normal functioning of weight-control hormones leptin and ghrelin. As a result, you gain weight and risk type 2 diabetes.
• Heart disease – obesity promotes heart disease through inflammation via chemicals called cytokines.  Inflammation promotes the development of dangerous plaques that can block blood flow and cause heart attack and/or stroke.
• Inflammation – your body needs to repair itself during sleep.  One of the repairs it undertakes is squelching inflammation. With lack of sleep, inflammation runs rampant in your entire body promoting arthritis, intestinal disorders, heart disease, and even cancer.

Treating Restless Leg Syndrome

When you go to your doctor with your RLS symptoms that’s just about all they need to make a diagnosis.  Some blood tests may be done to see if you’re anemic or have high fasting blood sugar levels as well.   Once diagnosed, though, your doctor may recommend:

• A sleep study. This measures how restless your sleep is at night and how many hours you are actually sleeping.  It can also determine if a sleep aid is necessary.
• Medications.  Requip and Mirapex are 2 prescription drugs used for RLS.  Sinemet is another drug sometimes prescribed.  It is actually a Parkinson disease medication that helps with involuntary muscle twitching.  Sometimes even epilepsy medications, or opioids (narcotic pain pills), or sleeping medications are given.

However, as prescription drugs only treat the symptoms of RLS, a more natural approach to treating it can be more effective in the long run.  As RLS can often be due to nutritional deficiencies, I first recommend my patients with RLS symptoms to try vitamin/mineral supplementation.  For example, I often recommend the following:

• Iron.  If blood tests show anemia.  Men need 18 mg a day, premenopausal women need 27 and postmenopausal women need 9 mg.
• B vitamins.  Many over-age 50 patients are critically deficient in B12 and folate (B9).  B12 is necessary for all nervous system functions.  Folate is necessary for helping normalize iron uptake and homocysteine levels.  Supplementing with 500 mcg of B12 and 1-2 mg of folic acid daily may help clear RLS symptoms.
• Magnesium and potassium.   Many Americans are magnesium and potassium deficient.  These vital electrolyte minerals can cause severe muscle spasms, twitches, pain – especially when lying in bed.  Magnesium 500 mg a day.  Potassium requirements are  about 2-3,000 mg a day.  If you’re dieting, exercising/sweating hard, you may not be replacing potassium adequately in your diet.  Eat high potassium-source foods like bananas, potatoes, almond milk, acorn squash, spinach, kidney beans and split peas.  Don’t supplement with a potassium pill unless your doctor recommends it.

Restless leg syndrome can be an uncomfortable condition that can leave you sleepless and irritable and less functional during the day. It can also put you at risk for developing more severe conditions or be prone to accidents.  If you experience RLS symptoms, see your doctor to determine if you have nutritional deficiencies and what the best course of treatment for you is.

Stay Well,
Mark Rosenberg, M.D.