Most With Restless Legs Syndrome And Night Terrors Do Well With Ferritin Supplements
This article is a collaboration between MedPage Today and:
SEATTLE — Children who have night terrors associated with restless leg syndrome appear amenable to treatment with ferritin supplements, researchers reported here at SLEEP 2015, the annual meeting of the Associated Professional Sleep Societies.
Eighteen of 31 children diagnosed with parasomnias in addition to restless legs syndrome or periodic limb movement disorder achieved relief from their movement disorders with iron therapy, said Neepa Gurbani, DO, a sleep fellow at Cincinnati Children’s Hospital.
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
- Iron supplementation improved both parasomnias and restless legs syndrome or periodic limb movement disorder in children with the coexistent disorders.
- Relief of parasomnias with ferritin, which is known to be effective in RLS/PLMD, suggests that RLS/PLMD may precipitate parasomnias.
At her poster presentation, Gurbani reported that 42% also showed a decrease in parasomnia symptoms. “Iron therapy leads to significant improvement in the periodic limb movement index and restless legs syndrome symptoms,” she told MedPage Today.
Ferritin levels were below 25 ng/mL prior to treatment these were raised above 50 ng/mL with 6 to 12 months of treatment .
Hidden Causes Of Restless Legs Syndrome
Amy Myers, MD
Amy Myers, M.D. is a functional medicine physician, trained and certified by The Institute of Functional Medicine. Dr. Myers earned her Doctor of Medicine at the LSU Health Science Center, and completed her Emergency Medicine residency at the University of Maryland Medical Center.
Dr. Myers retired from her functional medicine clinic, Austin UltraHealth, where she served thousands of patients, to empower those who were failed by conventional medicine. Shes a 2x New York Times bestselling author, and the founder and CEO of the health & lifestyle e-commerce brand, Amy Myers MD®.
Have you laid in bed at night exhausted, yet unable to go to sleep because you constantly have the urge to move your legs? Unfortunately, this scenario, known as restless legs syndrome , is more common than you think. And it can be very frustrating.
Restless legs syndrome is a pretty basic condition that affects up to 10% of adults in the U.S. However, the cause of restless legs syndrome is hard to determine. Conventional medicine treats RLS with harsh medications such as Requip, Mirapex, Horizant, and Neupro. These medications have harsh side effects such as stomach pain, constipation, nausea, vomiting or diarrhea. Whats more is that it doesnt get to the root cause of your restless legs syndrome.
Iron Supplementation May Be All It Takes To Reduce Symptoms Of Restless Legs Syndrome But Many Doctors Dont Know About It
People with restless legs syndrome experience an overwhelming need to move the legs, particularly at night or as they fall asleep. But a simple treatment that may help reduce RLS symptoms is often overlooked as a potential first line of defense.
âThe concern is that people are being started on medications first when iron might be a valuable treatment. Itâs simple, with relatively few side effects,â says Dr. John Winkelman, an RLS specialist at Harvard-affiliated Massachusetts General Hospital.
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Symptoms For Restless Leg Syndrome
If you are being affected by RLS you will notice some common signs. You may have RLS if you are experiencing two or more of the following Symptoms for Restless Leg Syndrome:
- Uncontrollable Jerking
- Painful Legs
If you are experiencing any of the above RLS Symptoms then you should treat it as soon as you can. It can effect your sleep and lead to poor health and lowered immune function!
Iron For Restless Legs Syndrome
Restless legs syndrome is a common medical condition that results inuncomfortable urges to move the legs, especially in the evening and at night,and often interferes with sleep. Low blood levels of iron are frequently seen inpeople who have RLS and the lack of iron may be part of the cause of RLS. Ironcan be supplemented either in pill form or through injections into thebloodstream. This review was performed to see if iron supplements are effectivein reducing the symptoms of RLS. Six studies of iron were included, whichtogether involved only 192 subjects. Results from the studies were conflicting,with some studies showing that iron was not effective but others showing somehelp for patients’ feelings of restlessness or discomfort. Because ofthe different ways in which the studies were done, we could not combine resultsfrom all of the studies to come up with an overall judgement of whether or notiron is effective. Two of the studies were limited to specific sub-groups of RLSpatients, who might be expected to respond to iron differently than would theRLS group as a whole. The study of RLS patients with severe kidney diseaseshowed a benefit of iron therapy. The study of RLS patients with low bloodlevels of iron did not consistently show a benefit of iron therapy at all timepoints. Iron did not cause any more side effects than the placebo medication.More studies are needed before we will be able to determine whether iron therapyshould be used for patients with RLS.
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Data Collection And Analysis
Selection of studies
Two reviewers used the titles and abstracts of theidentified citations to exclude trials that clearly did not meet theinclusion criteria of the review. If either reviewer thought that the trialmight possibly meet the criteria, the full paper was obtained for furtherexamination. The same two reviewers then reviewed articles that passed thisinitial screen to determine their fit with the review inclusion criteria.Authorship and results were not blinded. All types of disagreement wereresolved by discussion and consensus.
Data extraction and management
We developed a data extraction form to aid in the collection ofrelevant and important data from included studies. As described abovein’Criteria for considering studies for this review’, weabstracted data on participants, interventions, and outcomes. We alsoabstracted on to this form the trial characteristics to be used in ourassessment of methodological quality. In addition, we collected data onpotential effect modifiers, including co-morbidities such as end stage renaldisease, baseline iron status, and pregnancy. Two reviewers extracted and cross-checked the data. We contacted study authors to obtainunpublished information, including outcome data not explicitly stated in thepublished papers. Disagreements concerning data extraction were resolvedthrough the third reviewer .
Assessment of risk of bias in included studies
Measures of treatment effect
Assessment of heterogeneity
Assessment of reporting biases
Surgery For Varicose Veins
Varicose veins are enlarged blood vessels, often in the legs, that overfill with blood. This increased amount of blood can lead to superficial venous insufficiency , which means your body cant properly circulate blood. As a result, the blood pools in your legs.
In a 2008 study, 35 people with SVI and RLS had a procedure called endovenous laser ablation to treat their varicose veins. Of the 35 people, 84 percent of them had their RLS symptoms significantly improved or completely eliminated by the surgery .
Again, more research is needed on this surgery as a treatment for RLS.
If youre interested in any of these less-researched treatments, ask your doctor about them. Of course, you can try hot and cold treatments on your own, but your doctor can tell you more about the other treatments and whether they might be able to help you.
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Establishing A Treatment Plan For Restless Legs Syndrome
When treating RLS, doctors must consider the severity of the condition and the extent to which it affects your quality of life. Due to the potential for side effects, doctors may prefer to avoid prescribing medication for mild symptoms that dont interfere with day-to-day life.
Since RLS can occur on its own or as a result of another medical condition, treatment for RLS symptoms may need to be approached differently depending on the root cause. Before proceeding with RLS treatment, experts recommend looking for other conditions that could be causing or aggravating RLS symptoms. Common culprits include:
- Sleep deprivation
- Renal insufficiency
- Medication such as antihistamines and certain antidepressants
For many people, addressing these factors may lead to a drastic reduction in RLS symptoms. However, if symptoms are still bothersome, or if they interfere with sleep, doctors may advise additional remedies.
What Foods Should I Avoid
If you have RLS, there are also foods that you will want to avoid because they can exacerbate the condition and make your symptoms worse. The top three foods to avoid are chocolate, sugary sodas, and fried foods. Additionally, you will also want to avoid any foods or beverages that contain caffeine, since this can stimulate your nerves and make your symptoms more severe. These include coffee, tea, energy drinks, and chocolate. Fattening or excessively sugary foods and beverages such as soda and processed foods should also be avoided. There is some evidence that suggests people who are overweight have an increased risk of RLS, as well as various other health conditions. Therefore, it is important to limit your fat and sugar intake, as well as eat a more balanced and healthy diet.
While diet alone may not necessarily cure RLS, eating a diet rich in iron, folate, and magnesium, as well as limiting fat, sugar, and caffeine intake can help to decrease the severity of RLS symptoms. In some cases, this may be enough to resolve the symptoms altogether, while in other cases additional treatments, such as medication, may be used to alleviate symptoms. Nevertheless, there are several health benefits that come from eating healthy, so why not give it a chance?
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Secondary Causes Of Rls
Iron Deficiency. RLS may be associated with iron deficiency. A patient’s iron stores may be deficient without significant anemia. Recent studies have shown that decreased iron stores (indicated by serum ferritin levels below 50 ng per mL can exacerbate RLS symptoms.11,12 Patients with newly diagnosed RLS or RLS patients with a recent exacerbation of symptoms should have their serum ferritin levels measured.
Neurologic Lesions. RLS has been reported in association with spinal cord and peripheral nerve lesions, although an exact pathologic mechanism has not been identified. RLS also may occur in patients with vertebral disk disease.8
Pregnancy. RLS affects up to 19 percent of women during pregnancy.13 Symptoms can be severe but usually subside within a few weeks postpartum.
Uremia. RLS occurs in up to 50 percent of patients with end-stage renal failure and may be particularly bothersome during dialysis when the patient is confined to a resting position.14,15 Improvement in symptoms of RLS has been seen after renal transplantation.16
Drug-Induced. Some evidence from published case reports indicates that RLS symptoms may be induced or exacerbated by medications such as tricyclic antidepressants,17 selective serotonin reuptake inhibitors ,18 lithium19 and dopamine antagonists.20 Caffeine also has been implicated in the worsening of RLS symptoms.21
Does Restless Leg Syndrome Ever Go Away
As a rule, restless legs syndrome does not go away on its own. In many people, the condition even worsens with age. However, if you take the necessary measures and follow your doctors recommendations, you can significantly improve your symptoms.
Restless leg syndrome can go away if you know how to deal with it. There are ways to help restless leg syndrome if it becomes a problem.
There are many things you can do to help restless leg syndrome:
Get regular exercise. Moderate exercise such as walking may help relieve restless leg syndrome symptoms. Buy cooling mattress.
Try taking magnesium supplements. Magnesium deficiency has been linked with restless leg syndrome. Studies have shown that taking magnesium supplements may improve restless leg syndrome symptoms.
Take medications prescribed by your doctor. If restless leg syndrome is caused by an underlying health condition, your doctor may prescribe medications to treat the condition and improve restless leg syndrome symptoms.
Try wearing compression socks. These may help restless leg syndrome symptoms by improving blood flow in the legs.
Talk to your doctor about supplements or medications, such as gabapentin or pregabalin .
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Is Idna An Early Stage Prior To Ida In Rls
Iron deficiency can be classified into two levels, IDNA and IDA, according to the hemoglobin measurement value. In this study, RLS patients with IDA had the lowest hemoglobin, ferritin, and iron levels, as well as the highest transferrin and TIBC values as compared to IDNA RLS and NID RLS . Although there were no significant differences on hemoglobin levels between IDNA RLS and NID RLS , serum hemoglobin in IDNA RLS patients were lower compared to controls . In addition, values of iron parameters in the IDNA RLS group were between those of the NID RLS or the control group and the IDA RLS group . These results are consistent with the viewpoint of IDNA is a milder iron deficiency prior to the development of anemia. Of note, serum iron parameters are considered reflecting the peripheral iron status mainly in the erythrons , while iron storage in other organs need validated in IDNA subjects.
Therefore, there are heterogeneity in both IDA RLS and IDNA RLS. Although IDNA is generally considered an early stage prior to anemia , IDNA RLS is possibly not simply a prodromal stage prior to IDA RLS.
Home Remedies For Restless Legs Syndrome
Home remedies offer a simple way to improve RLS symptoms. Though more research is needed to confirm how effective these methods are, many people with mild to moderate RLS symptoms find relief from a combination of the following:
- Moving the legs: Moving the affected body part usually leads to relief from uncomfortable sensations, though symptoms may return when movement ceases.
- Implementing healthy sleep hygiene habits: RLS can cause sleep loss , but its also exacerbated by sleep problems. Try to keep a regular sleep schedule and ask your doctor for personalized sleep hygiene tips.
- Avoiding tobacco and eating a healthy diet: The Restless Legs Syndrome Foundation recommends reducing alcohol, caffeine, sugar, and salt and following a healthy diet rich in vitamins and minerals. In addition to relieving RLS symptoms, a healthy diet can help improve sleep quality.
- Exercising: Moderate exercise and stretching may help reduce RLS symptoms. That said, people with RLS should be careful with high-intensity activity, which may cause muscle cramps and stiffness that can exacerbate symptoms.
- Receiving massages or self-massaging: Some people find relief from RLS symptoms after massaging affected areas.
- Using heat or cold: RLS-related discomfort can often be tamed by applying a hot or cold compress or taking a warm bath before bed. Response to temperature may vary from person to person.
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Ask About Iron Supplements
Talk to your doctor about how much iron you should take, but John Hopkins notes that taking 325 milligrams of ferrous sulfate twice a day on an empty stomach for three months has helped some people improve their RLS symptoms.
Alternatively, you could try increasing your food sources of iron, including meat, poultry, fish and seafood, lentils, beans and spinach.
If lifestyle changes alone aren’t effective, medication therapy is also an option. While there isn’t one best medication for restless legs syndrome, Dr. Matta says there are different classes of drugs to try.
One of the most common types of medications used for restless legs syndrome are those that affect dopamine pathways in your brain, such as Ropinirole and Pramipexole. Some cases of RLS may be caused by a disruption of the dopamine pathways, according to the National Institute of Neurological Disorders and Stroke , so giving medicine that increases dopamine might help.
These drugs can cause unpleasant side effects like nausea and lightheadedness, though, so they’re often started at very low doses.
If you’re pregnant or have an underlying medical condition, medication may not be the right choice for you. Make sure to tell your doctor about your medical history and any other symptoms you’re experiencing.
Iron Supplements & Leg Cramps
Your body needs the essential mineral iron for your red blood cells to function properly as well as to transport and store oxygen in your blood and muscles. Iron also plays an important role in producing adenosine triphosphate, which provides your body with energy. Iron could have some benefits for you if you suffer from leg cramps, particularly at night. Talk to your doctor before taking an iron supplement to discuss the correct dosage and potential dangers.
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What Is Restless Leg Syndrome
People with severe RLS describe symptoms of the condition as an overwhelming urge to move their legs when they are at rest. They may feel pain, or the sensation of soda bubbles in their veins or worms crawling in their legs, with relief coming only when standing or deliberately moving their legs.
A study at Johns Hopkins University reveals that Essentially the brain sends the signal when its preparing to move a limb, even when you arent planning to move, so your body is ready and amped up, says Richard Allen, Ph.D., professor of neurology at the Johns Hopkins University School of Medicine. The only way to alleviate the feeling is to move.
B Vitamins And Folic Acid
In some studies with people with RLS, a low dose of vitamin B is noticed, which is necessary for healthy brain and nerve functions. Using vitamin B supplements along with the Folic Acid is normalizing the vitamin B dose, and it seems to be very helpful in the battle with RLS symptoms. It is necessary to mention that there are many types of vitamin B, and many of them are essential in RLS treatment. The best solution is choosing the vitamin B complex instead of just one of them.
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