To successfully treat and prevent recurrence of restless legs we need to understand and — if possible — remove the underlying causes and risk factors. We need to ask: "What else is going on inside the body that might allow restless legs to develop?"
Accurate diagnosis of the factors behind restless legs consists of three steps:
|Juvenile Rheumatoid Arthritis||26%||Unlikely|
|Iron Deficiency Anemia||1%||Ruled out|
|Sleep Apnea||0%||Ruled out|
|Iron Need||0%||Ruled out|
|Diabetes II||0%||Ruled out|
|Low Serotonin||0%||Ruled out|
When at rest, do you ever experience 'odd feelings' in your legs, and feel the need to move them in order to stop those feelings? This is known as Restless Legs Syndrome.
Possible responses:→ Don't know
→ Yes, slightly / occasionally
→ Yes, definitely / often
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]
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]
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]
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.
Tryptophan, a serotonin precursor, has been shown to help a small percentage of RLS sufferers. [Am J Psychiatry 143(4): pp.554-5, 1986]
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]