Restless Leg Syndrome

Restless Leg Syndrome: Overview

Restless leg syndrome (RLS) is a metabolic sleep disorder that causes feelings in the legs that sufferers have described using words such as: tingling, numbness, pins and needles, tiredness, itching, uneasiness, pain, cramping, aching, burning, creeping, crawling, simply indescribable...

These feelings happen during rest or sleep, especially in the lower legs, and create an urge to move the legs about as a way of relieving or completely getting rid of these feelings.  If a person with restless leg syndrome tries to hold the legs still and not move them, the feelings only seem to get worse.

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Restless leg syndrome is epidemic.  It does not cause any damage to one's health, but it very often leaves the sufferer feeling drowsy during the daytime from not getting a good night's sleep.

Incidence; Causes and Development; Contributing Risk Factors

While restless leg syndrome can be a problem at any age, it seems to be most serious in people who are middle-aged and older.

The exact cause of restless leg syndrome is unknown.  There may be many different causes, including important underlying nutritional issues which will need to be resolved before symptoms improve.  RLS tends to run in families.

Although most cases of restless leg syndrome happen in healthy people, there is an increased chance of the syndrome occurring in people who have diabetes or chronic alcoholism, or who are pregnant.  Cases of restless leg syndrome caused by pregnancy usually clear up after delivery of the baby.

Signs and Symptoms

People who have severe restless leg syndrome may feel a kind of spastic flexing of their hips, knees and ankles when they lie down, as well as leg pains in the morning after they get out of bed.

Treatment and Prevention

The best treatment can often be arrived at only by active experimentation by the patient or in cooperation with a doctor who may wish to perform laboratory testing.

Signs, symptoms & indicators of Restless Leg Syndrome:

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Risk factors for Restless Leg Syndrome:

Aging

Autoimmune

Circulation

Diet

Caffeine Intoxication

Excess caffeine levels cause restlessness.  Caffeine has been shown to increase subjects' proneness to develop RLS at lower levels of blood glucose.  It is therefore no surprise that a xanthine-free diet (no coffee, tea, cola beverages, cocoa) has been reported to be another effective dietary measure RLS sometimes following a short period of caffeine withdrawal.  [J Clin Psychiatry 39: pp.693-8, 1978; Ann Intern Med 119: pp.799-804, 1993]

Hormones

Low Serotonin Level

Tryptophan, a serotonin precursor, has been shown to help a small percentage of RLS sufferers.  [Am J Psychiatry 143(4): pp.554-5, 1986]

Immunity

Metabolic

Hypoglycemia

Based on afternoon glucose tolerance testing, many patients with RLS – particularly if they also have spontaneous leg cramps – appear to have hyperinsulinism causing functional 'hypoglycemia' during testing.  In fact, some patients may have an attack of muscle cramps at the same time as their lowest level of plasma glucose.  In an open trial, a group of 350 patients with this type of glucose tolerance curve were placed on a sugar-free, high protein diet along with frequent nibbling and at least one night feeding.  The vast majority experienced a prompt remission or, at least, a striking reduction in symptoms.  [J Med Assoc 60(5): pp.29-31, 1973]

Musculo-Skeletal

Nervous System

Nutrients

Iron Requirement

Iron deficiency (specifically blood ferritin below 50 mcg/L) accounts for 20% of all cases of RLS.  A 2007 study observed RLS features in 34% of patients having iron deficiency as compared to 6% of controls.

Magnesium Requirement

Magnesium deficiency, which is known to increase neuromuscular excitability, can also cause Restless Leg Syndrome.  [Rom J Neural Psychiatry 31(1): pp.55-6, 1993]

Folic Acid Deficiency

Restless Leg Syndrome may be an early neurologic manifestation of folate deficiency, the most common of all the vitamin deficiencies.  Often the deficiency is not due to a poor diet, but to a genetic factor causing a folate dependency.  While not all RLS patients complain of uncomfortable sensations, folate-deficient patients always suffer from them.  [Folic Acid in Neurology, Psychiatry and Internal Medicine, New York, Raven Press, 1979]

Organ Health

Respiratory

Recommendations for Restless Leg Syndrome:

Amino Acid / Protein

Tryptophan / 5HTP

Tryptophan, a serotonin precursor, has been shown to help a small percentage of RLS sufferers.  [Am J Psychiatry 143(4): pp.554-5, 1986]

Diet

Sugar Avoidance / Reduction

See the link between Restless Leg Syndrome and Caffeine Avoidance.

Caffeine/Coffee Avoidance

Regardless of which form of restless leg syndrome you may be having, it is important to avoid caffeine and sugar during the day because both of these substances will increase the intensity of restless leg syndrome.

Drug

Conventional Drug Avoidance

Components used in the manufacture of drugs or supplements may be causing or aggravating the problem.  If you can remember having started taking a new medication/supplement shortly before the onset of symptoms, consider stopping it for a time to see if symptoms improve.  You may also wish to consider stopping all 'unnecessary' supplements to see if any of those may be causing it.

Mineral

Iron

RLS has been associated with an iron deficiency as measured by low ferritin levels.  The anemia that results from an iron deficiency may or may not have appeared yet; patients whose serum ferritins were lowest initially improved the most.

Magnesium

Magnesium deficiency, which is known to increase neuromuscular excitability, can also cause this syndrome.  [Rom J Neural Psychiatry 31(1): pp.55-6, 1993]

Nutrient

Essential Fatty Acids

If not caused by circulatory blockage, simply get more calcium and oxygen to your leg muscles by taking extra essential fatty acids, a specific form of vitamin E called Vitamin E2 (from Standard Process Labs, for example), and Calcium Lactate.

Vitamins

Folic Acid

If there is a circulatory problem (as evidenced by other circulatory problems such as atherosclerosis, hypertension, etc.), you may respond very well to extra folic acid and B12, as well as a product high in specific nutrients that strengthen and elasticize the vessel walls.  One such product is called Cyruta Plus, and can obtained through professionals handling Standard Process Labs products.  Folic acid at 5-50mg per day (a very large dose) may be helpful when the condition runs in the family; otherwise, it may only help the occasional person.  [Folic Acid in Neurology, Psychiatry and Internal Medicine, New York, Raven Press, 1979]

Vitamin E

400 to 800 IU per day of vitamin E has helped in cases of RLS.  In one trial involving 9 patients, 7 had complete relief following supplementation, one had almost 75% relief and one had 50% relief.  It may take up to three months for the full benefit to become apparent.  [Calif Med 111: pp.87-91, 1969]

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