Restless Legs Syndrome - 4 Less-Known Causes | Chris Kresser

4 Little-Known Causes of Restless Legs Syndrome

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Restless legs syndrome is a seemingly simple condition, but the cause is often difficult to pinpoint. Find out four potential contributing factors and how to address them.

dietary causes of rls
Can certain dietary choices cause RLS? Stockbyte/Stockbyte/Thinkstock

Few things are more frustrating than lying in bed at night exhausted, but not being able to fall asleep because of an uncontrollable urge to move your legs. This phenomenon, known as restless legs syndrome (RLS), affects between 4% and 29% of adults in Western populations, and is a major contributor to sleep loss. (1, 2)

Pinpointing the cause of RLS has been an active research topic for years, but the condition is still not fully understood. The symptoms have been convincingly linked to impaired dopamine function in the brain, but the cause of this dysfunction is still being explored.

In this article, I’ll review four factors that could contribute to RLS, as well as steps you can take for improving your symptoms.

1. Systemic Inflammation and Immune Dysregulation

Restless legs syndrome has been associated with numerous conditions involving systemic inflammation and immune dysregulation. (3) One review paper published in 2012 investigated health conditions that were reported to cause or exacerbate RLS symptoms, and found that 95% of the 38 different health conditions that were strongly associated with RLS have an inflammation or immune component. (4) These conditions include Parkinson’s disease, multiple sclerosis, ADHD, Alzheimer’s disease, Celiac disease, Crohn’s disease, rheumatoid arthritis, sleep apnea, diabetes, and depression.

As further evidence, an elevated blood level of C-reactive protein (a marker of systemic inflammation) has been associated with increased RLS severity. (5) A small crossover trial found that a hydrocortisone infusion, which reduces systemic inflammation, reduced RLS symptoms. (6)

Researchers have proposed three potential mechanisms to explain the association between RLS and inflammatory or autoimmune states: direct autoimmune attack on the nervous system; genetic factors that could predispose an individual to RLS and be triggered by inflammation or autoimmunity; and iron deficiency caused by inflammation, which I’ll talk more about below.

 

What to do: If your RLS is a symptom of underlying systemic inflammation or immune dysregulation, the goal should be to find and treat the root cause. As I’ve mentioned many times in the past, gut infections are often the culprit—even if you don’t have noticeable digestive symptoms—so get your gut tested.

If you already have a diagnosed inflammatory or immune condition such as those I mentioned above, the best first step you can take is to adopt a “low-inflammatory” diet and lifestyle. This means eating a nutrient-rich, low-toxin diet based on whole foods; getting enough sleep every night; prioritizing stress management; and incorporating regular movement into your day.

You can also check out the bonus chapter about autoimmune disease from my book, as well as explore other information on my site about reversing autoimmune disease, the autoimmune protocol, the role of the microbiome, and alternative therapies such as LDN.

Do you have restless legs syndrome? Find out what might be causing it, and what to do.

2. Small Intestinal Bacterial Overgrowth (SIBO) and IBS

Some of the more recent research on restless legs syndrome has focused on a connection with small intestinal bacterial overgrowth (SIBO) and IBS, which is often caused by SIBO. One study found that 69% of RLS patients also had SIBO, compared with only 28% of controls. (7) They also found that 28% of RLS patients had IBS, compared to only 4% of controls. And according to the 2012 review I mentioned in the previous section, 32% of the 38 conditions associated with RLS are also associated with SIBO. (8)

A strong association between SIBO and RLS doesn’t mean that SIBO is causing RLS in these patients. But a few trials have found that in patients with both SIBO and RLS, their RLS symptoms improve after being treated for SIBO. (9)

For example, one double-blind, placebo-controlled study reported that treatment with the antibiotic rifaximin—the standard treatment for SIBO—significantly improved RLS symptoms in patients with both conditions. (10) This, of course, does suggest a causal link between SIBO and RLS.

What to do: If you have both RLS and SIBO, the best option would be to find a functional medicine practitioner who has experience dealing with SIBO and get treated. That said, two steps you can try on your own are a low-FODMAP diet and probiotics. Low-FODMAP diets reduce the amount of fermentable carbohydrates that “feed” bacteria in the small intestine, and a couple studies have shown that probiotics can be as effective as antibiotics for treating SIBO. (11, 12) I’ve found the probiotics S. boulardii (a beneficial yeast), and MegaSporeBiotic to be helpful.

One important note about low-FODMAP diets, however, is that it’s generally not a good idea to stay on one indefinitely. Low-FODMAP diets eliminate sources of prebiotics, which can improve symptoms by starving pathogenic bacteria, but can also starve your beneficial bacteria. The best approach is to follow a low-FODMAP diet until symptoms subside (and your SIBO breath test is normal), and then gradually re-introduce prebiotic foods (or supplements) to support your gut microbiome.

3. Vitamin D Deficiency

As I mentioned in the introduction, one of the most-researched theories about the cause of restless legs syndrome is impaired dopamine signaling, which has led to the conventional treatment of RLS by dopamine agonists (i.e. chemicals that can bind to and activate dopamine receptors). Unfortunately, these treatments can become less effective over time, and can even result in a worsening of symptoms.

And while replacing neurotransmitters might be an effective way to manage symptoms in the short term, the goal should be to figure out why dopamine signaling is impaired in the first place.

This is where vitamin D comes into play.

The role of vitamin D in dopamine signaling is only beginning to be investigated, but some evidence indicates that vitamin D could play an important role by increasing levels of dopamine and its metabolites in the brain, as well as protecting dopamine-associated neurons from toxins. (13)

RLS has been associated with vitamin D deficiency in several studies, and disease severity has been inversely correlated with vitamin D levels. (14, 15, 16) One study has also found that vitamin D supplementation improved the severity of RLS symptoms. (17)

What to do: If you have RLS, one of the easiest first steps you can take is to get your vitamin D levels tested. A good range to shoot for is typically between 25-50 ng/mL, but if you have an autoimmune disease or another chronic health condition, I prefer to bring vitamin D levels up to 35-60 ng/mL. One way to supplement vitamin D is cod liver oil; I recommend extra-virgin cod liver oil. You can also take a D3 supplement, such as this one that contains both vitamin D and vitamin K2. And of course, you should get regular sun exposure to bring your vitamin D levels up naturally.

4. Iron Deficiency

Iron deficiency isn’t exactly a “little-known” cause of restless legs syndrome; in fact, it’s probably one of the most well-researched areas relating to RLS. Iron is required for proper dopamine signaling, but its role is much better established than that of vitamin D, and it’s pretty clear that iron deficiency in the CNS can cause RLS symptoms by impairing dopamine function. (18)

Several studies have found that low iron levels in the cerebrospinal fluid and in the brain occur more frequently in patients with RLS compared with matched controls. (19, 20) And this difference isn’t always reflected in serum ferritin levels.

Other abnormalities in iron metabolism have also been observed in RLS patients, and many conditions that increase the risk of RLS (including pregnancy and end-stage kidney disease) are known to cause iron insufficiency. (21, 22)

Further, iron supplementation significantly improves or even eliminates the symptoms of RLS in many patients. For example, RLS patients with low-normal serum ferritin experienced significant improvements in their RLS symptoms after 12 weeks of iron supplementation. (23) And oral iron was as effective for treating RLS as pramiprexole, a dopamine agonist, although the response rate for both treatments was relatively low (46.7%). (24)

The tricky thing about iron deficiency is that the solution is often not as simple as taking an iron supplement. Iron deficiency is frequently secondary to SIBO, gut infections, or other inflammatory states, which explains at least in part the association between RLS and these conditions. Iron deficiency caused by infection or inflammation is mediated primarily by the hormone hepcidin, which at high levels can decrease serum iron and reduce iron absorption from the GI tract. (25)

One cause of increased hepcidin levels is the production of IL-6, an inflammatory cytokine present in most inflammatory diseases. Another cause of increased hepcidin levels is the presence of lipopolysaccharides (LPS), which are components of gram-negative bacteria that can enter circulation as a result of SIBO or other gut infections. Thus, increased levels of circulating IL-6 or LPS can result in iron deficiency, and subsequently, RLS.

What to do: If you have RLS and iron deficiency, the first step is to identify why you’re iron deficient. If the cause is blood loss (such as from heavy menstruation in women) or dietary insufficiency (such as in vegetarian or vegan diets), increase your consumption of iron-rich foods such as liver and red meat. You can also consider an iron supplement; I recommend Proferrin ES and bovine ferritin, because they are better absorbed and better tolerated than plant-based iron supplements. 

However, if the cause is SIBO or a gut infection, increasing iron intake can often make matters worse by creating an environment that promotes pathogen growth and inflammation. (26, 27, 28) For this reason, it’s best to address the gut before (or at least concurrently with) adding iron supplements.

As you can see, restless legs syndrome is complex, and several factors could come into play when trying to figure out the cause. As with many other health conditions, RLS is best seen as a symptom which signals that something else is amiss, and it’s necessary to dig deeper to find out the root cause, and how to treat it.

Do you suffer from restless legs syndrome? If so, has this article helped clarify what might be causing it? Share your experience in the comments.

293 Comments

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  1. Excellent Article! I was suddenly hit with a severe case of RLS. Yeah – NO Sleep! I do remember being treated for Iron Deficiency Anemia as a child. Anyway – after exhaustive internet searches I have come up with Iron supplementation as the “solution” – Night and Day difference! My Ferritin level was 49 and I am supplementing with once daily of Iron (as Ferrochel® ferrous bisglycinate chelate) 18mg. Of course I have not yet discovered the source of my Iron deficiency. This article is spot on http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/restless-legs-syndrome/what-is-rls/treatment.html

    • Hi Richard,

      Regarding your iron deficiency, it may not be just the iron if you suffer from anemia. My mother went to a Functional Medicine Doctor last year to get a second opinion on her anemia. When people say anemia, they think iron. But here’s the but. It turned out that she was copper deficient. Once she supplemented with copper her anemia went away . Copper is essential for the manufacturing of hemoglobin and can mimmick anemia. Doctors don’t know to check for copper deficiency as they are quick to recommend ferritin. Supplementing with ferritin without knowing if it is actually a copper deficiency can create problems especially for diabetics. Here’s the other plus. Once her copper levels were normalized, her total cholesterol dropped from 312 to 220 in 4 months. My advice is to go to a Functional Medicine Doctor to have your copper levels checked along with other deficiencies.

      • Hi Sam – thanks for your comment. I have not been diagnosed with Anemia. In fact my Ferritin level is within the “normal” range and most doctors would not look further. But from the Hopkins Medicine link above “Since the 1950s, it has been known that iron therapy, even without the presence of anemia has benefits for RLS symptoms. Studies have shown a strong relation between body iron stores as determined by serum ferritin and the severity of the RLS symptoms. A study has shown that in patients whose serum ferritin was < 75 µg/l, oral iron therapy (325 mg ferrous sulphate twice a day on an empty stomach) on average improved RLS symptom after 3 months." My Ferritin is only 49 – not anemic, but low in the RLS scheme of things. I will look into Functional MDs in my area – because everything I have found was on my own. Regular doctors offer little other than Parkinson drugs.

  2. If we look at the medications that make RLS worse then it might help us understand it

    Cold and Flu remedies
    Actifed, Avamys, Benadryl, Chlortrimeton, Comtrex, Contact, Corcidin, Dimetapp, Drixoral, Fluticasone, PediaCare,Piriton, Rhinolast, Sinutab, Sudafed, Tavist, TheraFlu, Triaminic, Tylenol (flu, cold, PM, allergy), Vicks.
    Note that many cough syrups may contain antihistamines, especially if they are recommended for cold or flu symptoms. Always try to choose non-drowsy options.

    Anti-depressants
    Many people living with RLS also live with depression and consequently are prescribed anti-depression medication. However some anti-depressants can actually make RLS symptoms worse. If you are prescribed anti-depressants and live with RLS, we recommend you monitor your RLS symptoms to see if your symptoms worsen after starting to take your medication. If so, speak to your medical practitioner to see if you can be prescribed an alternative medication.

    Selective Serotonin-Reuptake Inhibitors (SSRIs)
    Celexa (Citalopram), Cymbalta, Duloxetine, Effexor, Lexapro (Escitalopram), Mirtazapine, Paxil (Paroxetine), Prozac (Fluoxetine), Serzone, Venlafaxine and Zoloft (Sertraline).

    Tricyclic medications
    Ascendin (Amoxepine), Elavil (Amitriptyline), Etrafon (Perphenazine and Amitriptyline), Limbitrol (Chlordiazepoxide and Amitriptyline), Norpramin (Desipramine), Pamelor (Nortriptyline), Sinequan (Doxepin), Surmontil (Trimipramine), Triavil (Perphenazine and Amitriptyline), Tofranil (Imipramine) and Vivactil (Protriptyline) , as well as others, have been suggested as making the symptoms of RLS worse.

    Antacids
    Medications to treat nausea can worsen RLS symptoms. This class of drugs includes: Anitvert, Atarax, Benadryl, Bonine, Compazine, Phenergan, Thorazine, Tigan, Trilafon and Vistaril, Zantac.

    • My mom and wife had restless leg syndrome. Dr. Carolyn Dean an expert on Magnesium, suggests that increasing Magnesium consumption can reduce or eliminate restless leg syndrome. After increasing Magnesium supplementation to 600 mg, the symptoms were gone. I must add that the leg cramps also vanished.

    • Do you know whether Avamys administered at the recommended dose of 110 it once or twice daily for 4 weeks can lead to HPA axis disruption and a flare-up of autoimmune skin diseases?

    • I just started Celexa 6 weeks ago and I’m experiencing RLS for the first time ever! It’s no fun. I read that anti-depressants can alter dopamine levels, which is probably what’s happening. Anybody know what to do? My vitamin and mineral counts are all excellent according to my blood test 2 months ago…

  3. I have had serious asthma from a very early age accompanied by several visits to ER. Many of the drugs made me feel terrible. At age 68 I decided to get to the source. By reducing starch, trial and error, eating a very clean organic diet and limiting my exposure to as many toxins as possible, I am now living normally. No drugs of any kind for anything. When I was so sick the various allergists did the skin prick test to see what I was allergic to. The test showed many things that do not bother me now. I think my system was on such overload that I reacted to most anything. One major allergin was cats. As I got better and better I went to an animal rescue into the cat house. No reaction. My doctor can’t believe the change. The drugs that saved my life were also keeping me ill. I am now a healthy 72 and can hike many miles per day with zero issues. You might be on to something with the starches.

    • Starches [simple carbs] and simple sugars need magnesium to be metabolized into energy in the cell. If your magnesium levels are borderline it doesn’t take a lot sugar or starch to put you into a deficient state.

      Most of us in the US are already deficient in magnesium because of dropping levels in the soil used to grow our food.

      Many [including doctors] fail to recognize the symptoms and so the symptoms get treated with drugs instead of giving the body what it really needs to eliminate the source of the problem.

      Magnesium deficiency is either a causative, or contributing factor in many diseases people struggle with today.

      We have a lot to learn about all of the roles magnesium plays in human biochemistry, and the interactions of nutrients with each other. A good example of this is how vitamin D, vitamin K2, and magnesium need to be in balance in order for each of them to work properly in the body.

    • Watch for plants in the nightshade family (potatoes, tomatoes, eggplant, etc.) These all contain an inflammatory compound. I used to tolerate these, but no longer. Removing these from my diet had a tremendous benefit. I occasionally have a few bites and end up with painful joints within an hour. A great reminder to stay away from these foods.

  4. Hi my 9 year old daughter has recently started to get RLS at night, and more recently has commented that she is getting it at school during quiet times. She also has some stomach problems/food intolerance issues but not really established exactly what the problem is yet. However given that she had a lot of antibiotics when she was very young due to ear infections, i am wondering if gut issues are contributing to the RLS – either from poor absorption of nutrients/inflammatory response etc. i would love some advice if anyone has any!

    • You are probably correct, Sally!

      It is highly likely that gut dysbiosis from the antibiotics is contributing to malabsorption syndrome leading to poor absorption of magnesium and other nutritional cofactors. (vitamins D3, K2-MK7, etc.) and contributing significantly to the RLS.

      I would suggest a good soil-based probiotic such as Prescript-Assist to re-establish healthy gut flora. Make sure to use a form of magnesium that doesn’t have a laxative effect. The best forms I have found for maximum absorption and low laxative effect are magnesium malate, glycinate or taurate. Stay away from magnesium citrate unless constipated, also magnesium oxide should be avoided as it is so poorly absorbed (only about 4% gets assimilated).

      Keep in mind that glyphosate (RoundUP™ Monsanto) in the diet will compromise any attempts you make to heal the gut and restore the normal, beneficial bacteria. As a result I highly suggest restricting all grains (but especially wheat and oats) to organic, and keeping GMOs out of the diet. Most non-organic grains are heavily sprayed with glyphosate at harvest. It does not wash off.

      However, until normal nutrient absorption has returned, you can supplement magnesium with a topical form such as magnesium chloride hexahydrate (MCH) which is sprayed on the skin and absorbed directly, bypassing the usual digestive pathway.

      Here is a magnesium (MCH) source I like and use daily in addition to oral supplements:
      http://easemagnesium.com/discover-ease/?AFFID=234225

      Help heal the gut with coriander seed oil. The people at Activation Products have developed a technology to remove the oil from the seed without chemical solvents, and without generating heat or creating peroxidation, or rancidity. Here is, by far, the best coriander seed oil currently available:
      http://www.panaseeda.com/coriander/?AFFID=234225

      And here is where you can get the best price that I have found for the probiotic I recommended:
      http://www.peaceful-planet.com/prescript-assist/

      Save 10% on your entire order at Peaceful Planet by going here first, and getting the code:
      http://www.retailmenot.com/view/peaceful-planet.com?c=4742589

      AFFILIATE DISCLOSURE
      The above contains affiliate links, which means I may receive a percentage of any product or service you purchase using the links above. You will not pay more, and your purchase helps support my ongoing research and work. Thanks for your support!

  5. A whoo hoo moment! After 40 years of chronic RLS, and many many trials with medications, finally, success !! I have cut out a lot of sugar from my diet and sulfides. I ate when wandering at night, often a lot of fruit and biscuits.I craved sugar to combat the tiredness during the day to make things worse. Drinking alcohol ( I am a “bubbles” girl) and eating meat with preservatives in made things worse. So, by cutting out excess sugar, especially after midday, I am all but cured. And the weight loss is a bonus!!

      • Yes, caffeine is a diuretic that flushes magnesium from the body, and sugar increases your need for magnesium in order for the mitochondria to process sugar into fat or energy.

        Although there is more to the biodynamics of RLS, these are key and critical factors. Without sufficient magnesium in the muscle tissue, the muscle fibers cannot properly relax and as a result they twitch continuously in asynchrony and incidental synchrony. That’s what causes the “restless” feeling.

    • Sugar indeed.

      Coincidentally I stopped drinking sweet drinks (pop, juice, red bull) and my RLS stopped. If I happen to drink one sugary drink at night it comes back with a vengeance.
      Hope this helps someone.

      Cheers

      • Of course, binging on sugar [or simple carbs] or just a high sugar intake when your magnesium levels are borderline will cause your magnesium levels to plummet, resulting in muscle spasticity, hence RLS.

  6. I am envious of you all who had positive results on controlling your rls by taking mg, diet changes, b12, folate..etc. So far they didn’t work for me. They are great for my chronic fatigue and fibro but I haven’t found the key to controlling my rls.

  7. I have experienced the most chronic restless leg for the last eight years having to exercise up to 7 times a night during bad phases. I developed an intolerance to gluten and diary in the last two years and developed chronic acid reflux. It has taken two years (of been given all sorts of medication which hasn’t worked) to find a surgeon who suggested I wean myself off the acid blockers and start taking Apple cidar vinegar 3 times a day. My reflux has gone, by restless leg has improved out of sight and my body aches are improving. I strongly believe RSL is caused by an imflammed gut. I also go to the chiropractor regularly and she helps keep the RSL in check. I take probiotics as well drink very little alcohol, keep away from sweets and keep active (always have). A combination of all these things I promise will help.

    • I agree with your thoughts about gut inflammation and RLS>

      But I would take it further and add that the loss of nutrients available to the body due to the malabsorption that occurs with gut dysbiosis and inflammation, typically creates (among many other things) a magnesium deficiency. Statistics state that over 80% of Americans are magnesium-deficient.

      A common symptom of magnesium deficiency is muscles that cannot properly relax. This can result in tics, tremors, cramps, spasms, difficulty swallowing (especially tablets and capsules), “dancing feet”, and/or RLS.

      There can be sufficient magnesium intake and still be a deficiency in the body. Nutrients first have to be properly absorbed from the digestive tract into the bloodstream, but then still have to move from the blood into the cells in order to be of any use.

    • Whenever I take 1 T ACV (diluted of course) before meals, within a week or so my teeth start aching — not good. When I stop the ACV, the aching in teeth slowly goes away. Anyone have any tips (besides using a straw to quickly down the ACV) to keep teeth safe from the acid? I am convinced that what is healthy for the digestive tract is not healthy for the teeth!

    • Hi Kate,
      I was reviewing this site for my mom who has RLS. When I read your entry about chronic acid reflux, reminded me of my last 2 years. I had the same thing but had never really had a problem with heartburn before this time. I didn’t know it but I had an h pylori infection. It causes heartburn and lowers your stomach acid so you can’t digest properly… and a whole host of other problems. Have you checked for this?

    • Just one added note: Coincidentally I too treated my heartburn with ACV and it eliminated the problem! I started w 2 T three times a day. Unfortunately ACV alone does not kill the h pylori so if you have it, the little buggers will live on inside you and cause other issues. Doctors did not help me. I went 2 years and finally insisted on a stool test to test for GI infectioons. I researched how to treat myself without antibiotics and just received an all clear test after treatment.

  8. Paul 11-4-16 22.00

    For about 10yrs I have had restless legs syndrome ( RLS )

    My feet, calfs, thighs, hips, fingers, hands, forearms, biceps feel the aching and annoying pain, the feeling of something crawling up inside of my whole body, I’ve been on ropinirol 1mg for many years, I take 2 about 2hrs before bed, whilst waiting for them to start taking effect the pain gets stronger, when they start to work I go straight to bed to get the best effectiveness from them, I have to get up early as its not possible to lay in bed as legs start to twitch, I’ve cut down on chocolate which I found was making it worse, doctor says I’m not low in iron, i did invest in 2 halcyon bracelets which are pure copper and do work sometime, looking for any suggestions on foods or drinks that might help to take away the pain in the evenings

    • Try taking a low dose of natural thyroid. It is the only thing that will help mine. It is a horrible thing to go through.I am so sorry. 45-95 mg of Nature thyroid is what I take but you may need more.
      Walmart has a liquid vitamin b complex for around $4. I would take as much of it as you can. A calcium, mag, vitamin d that dissolves in water.
      Get your vitamin D checked. (don’t just take it unless you know where you are at. Vitamin B doesn’t build up like D)
      Get your prolactin levels checked.
      You have to stay away from any narcotics and if you are on anti-psychotics…that is your problem right there.
      barleans fish oil in lemon flavor Take at least 3 tablespoons a day but really you may need 9.
      If you are on parkinsons meds then your amino acids are going to be unbalanced and probably some depleted. (do you have add or bipolar this is your problem) Just fish oil won’t do it completely but it’s to complicated for me to tell you what to take.
      I would also have all your hormones checked and every vitamin mineral you can get checked, get it checked.
      You are unbalanced somewhere they can see in tests.
      Taking a low level of natural thyroid (has to be natural with t3) most doctors will not like you to do. They will scare you saying it will hurt your thyroid but that is not necessarily true, but whatever helps a crisis, helps 🙂 Be strong in asking to try it.

      Just taking a few supplements isn’t going to help you with this problem. You really would have change your whole diet and balance your amino acids. I am guessing you also have a hormone problem somewhere that needs supplementing. If you’ve ever had any kind of concussion or head injury check your prolactin. If you have any kind of gene mutations in the family like a.d.d or bi-polar most likely your amino acids are inhibited and your vitamin b will be off BUT it’s as different as a snow flake for each person.
      Keep searching and stay away from stimulants, narcotics.
      To much yeast in your system can help cause it too.
      Good luck

      • Hi Traci,
        Your post is so insightful. I have IC and terrible restless leg. I often feel that I have ADD. I take Prozac and there is a family history of bipolar. Can you elaborate more on that connection, if Prozac might be making the symptoms worse? Any insight or information is sincerely appreciated.

        Kind regards,
        Michelle

        • Dear Michelle,

          I have both ADD and have taken Prozac and yes, there has been (for me) a dramatic correlation of RLS along with consumption of Prozac.

          Helpful solutions:

          1. If possible stop anti-depressant or lower dose or take every other day. I have severe PTSD / depression due to childhood trauma but have found that I am still better without antidepressants in general. I am over 45 and discovered that taking transdermal bio identical estriol and progesterone eased my depression and ADD more than any pill.

          2. I agree with this website: Rub your legs, bottom of feet, even palms of hands with magnesium cream or oil. This helps a great deal.

          3. Before bed, consider sitting in front of TV with your feet soaking in a lovely warm tub of hot water with dissolved magnesium and Epsom salts.

          I hope this helps you or someone else. ☺️

          Faerie ?

      • Iodine may help, too. The whole body needs iodine, not just the Thyroid. A few drops if Lugol’s in water may help, and getting plenty of fish, seafood and seaweed in your diet is beneficial, too…..

  9. I was diagnosed with RLS in 1992 by a V.A. Dr. I had never heard of it. Mine was mostly in the calves – sometimes going up all the way to my thighs. In 1995 I had a heart attack and was put on multiple medications, including calcium. about 15 years later I read that being on calcium for a long time could be bad for you so I stopped taking calcium. Two weeks later my RLS pretty much disappeared. There have been the occasional twinges since they have been very mild. What would be the correlation between Calcium supplements and RLS

    • Low magnesium can cause RLS and heart problems and is required at least in the same ratio as calcium. Too much calcium is very bad. It is hard to find out whether you have a magnesium deficiency but taking it is safe. Read up carefully on Magnesium.

      • Thanks Dawn. I’ve been working on my magnesium intake for a while now. Not taking in too much. I believe in moderation in all things.

        • Calcium is terrible, tom levy does some really good work on it. I’d look up the death by calcium video. But magnesium is amazing.

    • My wife got rid of her RLS by increasing her Magnesium intake.
      Regarding inflammation in this article, a doctor should request a CRP test. Also there was a mention if ferritin deficiency which could exacerbate anemia. However, before a doctor prescribes ferritin for iron deficiency, he should request a RBC copper deficiency test. Low levels of copper can mimic iron deficiency and anemia. And with low levels of copper, there could be elevated total cholesterol. This was the case with my 95 year old mom. She has a functional medicine doctor. Once prescribed a copper supplement, her anemia vanished and high cholesterol normalized.

  10. Post Stevens Johnson Syndrome (SJS), I had all these symptoms and attacks on nearly every body system…as my mucous membranes, on 100% of my body, were struggling to survive…as I was.

    No professionals in Ohio knew what to do, so I had to take matters in my own hands.

    I went straight to my immune system. I removed all medicines, including vaccinations. Initially Britta filtered (now double filter with PUR…even trace amounts of prescriptions kept me in a SJS state), strict Certified Organic foods during a 2-cycle cell change over (I read somewhere that it takes 264 days for the body to completely change over cells, I did it twice), started removing gluten but found in the end I needed to go to a strict Blood Type diet.

    After I became eligible for Medicare, My healthcare improved incredibly, I assume because of the federal oversight, I had talk therapy.

    The restless legs things gradually stopped after about 2-1/2 years…but not before I started having pinched nerves..which I still deal with.

    4-1/2 years later I still have skin problems on 85% of my body, my gastro intestine systems is very vulnerable, but I no longer have that metabolic sick feeling and I am still alive which is different than the 60% of us (30% die in ERs because doctors don’t know NOT to give more medicine, and another 30% die within the next 3 years…I am assuming because of doctors, like I had, that wanted to keep trying to “do something.”

    Because ERs, hospitals, physicians are not required to report side effects of prescriptions…we suspect there are many more deaths in emergency rooms and by other methods. Ie…what physicians describe as “accidental overdoses” and what happens in patients who are given chemo”therapy.” And…with peer drive State Medical Boards, there is no oversight on physicians or hospitals…the things you find out when you are trying to save your life.

    How did mine start? All my physicians ignored the side effects I was having to the medications they prescribed plus toward the end many abrupt changes were being made and then a nurse practitioner in the ER prescribed prednisone and a shot of Vistaril.

    I thank God for Jean and her daughter who are the founders of the Stevens Johns Syndrome Foundation, our National Certified Organic food program, for filtered water companies, for the researchers who did research on Gluten and Blood Type Diets and access to cell phones (never go to an ER without one…), internet and research in libraries and on the internet….and that I am fortunate to live in a time when that all came to fruition.

    I wish you all health…its so precious. Do what you can with food, removing chemicals and removing all stressors before you take meds…prescribed, over the counter, supplements.

    • This woman is a liar. She is extremely mentally unstable and goes to various sites claiming to have illnesses. Dont take her advice.

      • Hi all,

        This is my daughter Lauren. Everybody say hi.

        I love my daughter. She’s beautiful, funny, smart. Loves children and animals. She, and her brother, came into this world disadvantaged and I have always felt very bad for this.

        We, collectively, have had a very stressful experience (hence my medication for stress…the resulting side effects and SJS…) trying to break from family hierarchical traditions that include generational domestic violence. I took us out, but they wanted the love of their father and family and are very protective of him, of them, and the traditions…so here we still are…in the grasp of violence…

        I haven’t seen my daughter since the Stevens Johnson Syndrome diagnosis of August 2012. Please forgive her for not understanding. She is very angry, as she should be, she’s had a very tough life. I still am trying to help her find her way to health…too.

        I apologize for this inconvenience…

        • The violent past she is referring to is actually her hitting me and my brother while in her care. She is Bi Polar and manic. My dad divorced her because of this. She is on several websites stating she has all kinds of illnesses and giving bad advice. She doesn’t think she needs medication or medical care but she does. BADLY! The only reason why I even know about this is because she has been stalking me and threatening my boyfriend who is a police officer. If anyone can refer her to a psychiatrist, please do so. She won’t get any help and when she is manic, she becomes violent and dangerous. Thank you. Please know she is on welfare and section 8 so she cannot afford a regular doctor and may not know where to go. ANY help is appreciated by her family. Also alcohol addiction would help. Ive not spoken to her in years until she started emailing me so much and calling around about where I live. She needs help.

            • We have an elderly friend with dementia. She is looked after by her son and DIL. Apparently she was a difficult mother, often neglectful, for many years.

              I pointed out that she was probably affected by the food she was eating for years before the dementia set in. Gluten is known to trigger mental/neurological issues.

              My husband spent years in a gluten-induced fug. Irritable, even nasty, and could snap at a moment’s notice. I was a nervous wreck when he was driving as he didn’t have a clue where he was going. He would get very unstable blood sugar, although not diabetic, and that would make him snappy and irritable, too.

              Off the gluten he is a different person – tolerant, happier, more even-tempered, and no more brain-fog. I would not have believed the difference if I hadn’t witnessed it…..

              Our bodies can be very much controlled by the so-called ‘normal’ food we eat, and/or by the parasites that most of us are harbouring. I hated the way my husband was, and could weep for all the difficult years lost to gluten, especially when the kids were young, but now knowing why makes it all so much easier to understand.

              Like you Brenda, I recognise that the drugs were making everything worse for my ownhealth and had not actually healed anything. I have been gradually figuring it out on my own and have had far more success through diet and supplements than any of the awful drugs I was given over the years. My daughter and son don’t always understand what I am doing but they fortunately still love me and at least tolerate my ‘foibles’…..

  11. I take Magnesium Glycinate, Iron, vitamin C, methylated B vitamins, vit D, adrenal herbs, fish oil, cal/mag, MK7, CoQ10, vit E, taurine, selenium, trace minerals and probiotics…for 3 months and I still have RLS. I’m healthy except for hypothyroidism. The only thing that changed, and it’s weird…I had the typical RLS symptoms when resting before bedtime but those symptoms changed dramatically as soon as I started taking magnesium and iron. I could rest without any discomfort but as soon as I started falling asleep my body started jerking anywhere I have a joint (fingers, wrists, ankles, knees, hips, shoulders, neck), large muscle areas jump or tremor, and twitching everywhere. It has been a nightmare. My sleep doctor wants me to take Mirapex, a Parkinson’s drug, but I just can’t do it. Instead I’ve been taking cannabis every night and I get 4-5 hours of sleep. I’m hoping I can solve the problem before I’m forced to go on a pharmaceutical with all the difficult side effects.

    • Amy, I have been down so many of the same roads as far as leads/remedies, and things I’ve taken. I’ve had RLS for more than 3 years. I am tilting more and more toward the inflammation and SIBO hypothesis Dr. Kresser discussed. It’s sad, means there is probably no silver bullet to knock this thing out, at least in my case. Gonna have to do the hard work of completely changing my diet. Have already taken all dairy out, and that has helped by at least 50%.

      Anyway, you mentioned that you are hypothyroid, which is something I have suspected of myself, too. I don’t know if this will help you, but have you tried supplementing with a high quality nascent (electrified) iodine? I am just learning how crucial this nutrient is for endocrine health, thyroid, communication between all the glands, and detoxification, especially for breast tissue. I am taking Survival Shield X-2 Nascent Iodine from the Alex Jones Infowars.com store. My husband and daughter and I have been on it for about a month. My husband has felt a noticeable jump in metabolism and vitality. I would say, I am perhaps a little less tired. It hasn’t cured RLS or anything, but it could certainly help with your thyroid insufficiency, which is another exacerbating factor for you. I hope the best for you!! Sincerely, Rebecca T.

      • Rebecca, thank you for your suggestions and kind words…my SIBO test just came back positive (high methane) so I’m now researching and wrapping my head around this new information. I think I’m finally getting how this and so many other things are rooted in the gut. As soon as I finish the antibiotic, then the Low Fodmap diet begins. I’m anxious not knowing if it’ll help the RLS so just dealing with RLS related anxiety is its own challenge. I want to be the best mom and wife I can be and RLS has made it difficult. I hope the best for you too!

    • You real need to get completely detoxified and I mean completely. I have an N.D. who uses an IV with H2O2, glutathione and Vitamin C. Or a Functional Medicine Doctor can do a detox. Regarding detox, there is a huge problem with glyphosates in our food supply. It’s everywhere especially in processed foods. High concentrations are found in soy and wheat. Sadly, glyphosates are showing up in organic food sources. Yes they are. I can’t stress a detox enough. You can take all the best supplements and eat organic foods, but if you are toxic, your liver will get overloaded and this wreaks havoc on all the processes of your body. More over, your doctor should order a complete thyroid panel with antibodies.

    • Calcium needs to taken with magnesium, vitamin D3, and K2 (MK-7) otherwise your body cannot properly utilize it.

      With calcium dysregulation, it can be deposited in soft tissues such as muscles, the pineal gland, thyroid, and even in the joints.

      Too much calcium without the magnesium co-factor can cause muscle problems including cardiac arrhythmias, RLS, facial tics, muscle spasms and cramping, and difficulty swallowing pills and capsules, among others.

    • Do you get enough salt in your diet? If not, try adding more (unrefined pure salt is best)? Also, try bananas or upping your potassium intake. These usually work for me.

  12. I’m happy to say I no longer have restless leg syndrome after 5 years of agony.

    I was prescribed a low dose antibiotic, Minocycline, for adult acne and was on it for over 5 years (I know, I should’ve known better but trusted my Dr.) A short time after I started taking my issues began. I didn’t put the two together because my father also has RLS, so when mine started I thought it was hereditary and, like him, I would just have to live with it. It wasnt until I ran out of my meds on vacation that I realized my legs didn’t hurt or kick on those days. I’ve been off the med for 6 months & haven’t kicked since. I think the antibiotic destroyed my gut health & that was to blame.

    I hope this helps someone

  13. I loved this article. I have said for years that the RLS that plagues me is because of the other problems that I have. I have been on PPI’s for 16 years, I have had bowel problems for 5 years, I have been diagnosed with IBS, I suspect SIBO and Leaky Gut Syndrome. I have been to 4 Medical doctors and none of them will put 2 and 2 together. My own father was a MD, but he was from the old school where he would check test after test, read article after article, do all that needed to do done to find the cause of a problem. Did that mean that he might have to work on this for a while, that he was not going to become a millionaire, that he might not have all the answers and would have to admit it, that he might have to go back to the drawing board again and again until he could get the right answer, that the gut was probably where the problem was, that there was more than one answer, that all people are not textbook so he would have to try other things, to Think Outside The Box; Yes, Yes, Yes, Yes, Yes, Yes, Yes, and Yes. I wish my dad was still living, so I could get some answers!!

    I believe there is a very strong connection between the omeprazole that I take for GERD, the Ibuprofen that I take for pain, the IBS, the SIBO, the RLS, the Mirapex that I take for the RLS, the fracture that I had in 2010, the severe joint problems that I have, the brain fog I get sometimes, the feeling tired all the time, the insomnia, the scale weight loss, but my belly area is getting larger, and several other symptoms. I have no doctor that will put all of this together and come up with an answer. I am very limited on my money, so there is NO functional doctor that I can go to because they all want money up front, or that will take payments , but I can not do that high of a monthly payment. So I have NO ONE who will help me. I am only 57, but I can not even go to the grocery store without problems arising. I have been married for 36 years, but I can’t even be a full wife to my husband in every respect!! I want to be able to enjoy a day with a friend. I wish a doctor would take interest in me and my case. I bet that doctor could learn alot from all my problems. Does anyone know of someone who would take interest in my health and help me? Nadine McCracken Brownsburg, Indiana

    • Nadine It is interesting to read your story. I feel compassion for you. I would like to help you. I am going through some interesting events in my life currently but feeling if I can help someone it will help me a lot. I have training in natural nutrition as a holistic nutritionist. I look forward to your response.

      All the best
      Kevin

      • Kevin,
        I am sorry for not responding until now. I have read your note and I am excited with the idea that you would like to help me and in doing so, it would help you, also. I am looking forward to a response from you. Do you want my address, my phone number, my e-mail address, or all three.
        Thank you for your interest.
        Nadine Mccracken Brownsburg, Indiana

  14. Fluoroquinolones – cipro, levaquin, avelox and a few others – chelate minerals from cells, especially iron and magnesium. In doing so they mess up all the enzymatic reactions that are dependent on these minerals and can cause mitochondrial dysfunction and chronic illness. Restless leg syndrome is one of the more minor symptoms of fluoroquinolone toxicity, but it is one. Here is a summary of an article noting that FQs chelate iron from human cells – http://floxiehope.com/2015/07/31/fluoroquinolones-deplete-iron-and-lead-to-epigenetic-changes/

  15. Great little overview! I’m a spine surgeon. I think I see 4-6 new patients a week with minimal routine abnormalities on MRI, but with horrible sleep disorders including RLS, chronic nonspecific pain, fibromyalgia, and not attributable to their radiographic spine abnormalities, none of which can be remedied with a scalpel. Some of this is obviously rheumatology but I just don’t think there is widespread knowledge of this stuff in the allopathic medical community. Else wise, they wouldn’t be seeing me in the first place…

  16. I have just (finally) been diagnosed with adenomyosis and anemia. Not that I’m happy about it, it’s just been a long road discomfort and frustration to discovery. I also have a small amount of RLS but I notice more when I get a load of gluten.

    I have 2 questions Does working out make anemia worse or is it just a “suck” factor for me to deal with during work outs? Knowing what the root cause of the anemia is from should I be tested for B12 deficiency too?
    Thanks,
    Tammy

  17. I have been diagnosed with neuropathy which is pretty much the same thing as RLS. I am on gabapentin. I know it started out as a severe case of plantar faciitis. I am also a pre-diabetic. For years I have faithfully taken ACV, probiotics, spirulina, vitamin D3, and other supplements. I am a walker and exercise. I have very strong legs. So, its quite the puzzle to me, as to why this has happened. I do stand all day at my job. My doctor says that standing (the pressure) has facilitated this process. I just don’t know what else to do.

    • Neuropathy and RLS (also known as WED, or Willis-Ekbom Disease), aren’t almost the same thing. They feel very different and it seems the cause is very different. Your neuropathy could be related to the pre-diabetes, as it’s extraordinarily common in diabetics.

    • Hey Jeannie…TTake your pre-diabetes seriously or it will turn into full blown. Your neuropathy should be a warning sign. You sound like you have a healthy lifestyle, is your weight and diet good?
      I have T2D for 2 years and it cost me open heart surgery, quadruple bypass.
      My RLS was so bad I was up to 1800mg of Gabapentin and it still gave me minimal comfort. I was RX Pramipexole .25mg. and it works like a charm.

    • I am a trained herbalist, here is a story you might gain from.
      I have two friends that have heart problems. I put them on vitamin K2-Mk7, 200mcg, D3, 10,000iu and vitamin A, 2500iu per day. The primary reason was to clean out calcification from their Coronary arteries, after tests were preformed we were successful.
      But the secondary effect was what convinced me that undercoboxilated ostiocalcin( free calcium) is the trigger for many Health problems. Both people had bad neuropathy, after 60-90 days of these supplements their neuropathy steadily improved to the point that they are both free of the pain and can walk without special shoes. They no longer take any meds other than the vitamins. I found a study out of India that said the same thing I discovered, vitamin K2-Mk7 had a huge impact on neuropathy.
      Good luck

      • I’ve read that high serum (free) calcium levels can actually be a result from not getting enough calcium in the diet. In other words, if one gets insufficient calcium, then it’s pulled from the bones, bone spurs and other problems result, and free calcium ends up in in the bloodstream.

        Whenever I take vitamin D (even in lower doses like 5,000iu), within a few days, my teeth start to get loose. I’m assuming that calcium, etc., is being pulled from my jawbone, thus causing the loose teeth.

        I’d be curious to hear your opinion on this.

    • Jeanine, I was on Gabapentin (Lyrica) for years. I decided to stop taking it for my fibromyalgia when I received information from a couple of specialists tying to figure out Gulf War Syndrome ( I served for 6 mos. in ’90 an ’91). I stopped the Lyrica and lost 20 lbs. I started taking CoQ10 Ubiquinol and it actually works better. Try the same and I’ll bet you lose weight and may even stop your pre-diabetes. Good Luck.

    • I have neuropathy and for years suspected a problem with B12. But every serum test came back at least normal and often high. It was quite a puzzle. Then I had a genetic analysis by Dr. Bob Miller and it turned out that I have SNPs with TCN1 and TCN2, the pathways through which B12 is driven from the blood into the tissue. And so it would back up in the blood, go unused in the tissue, and my deficiency occurred where serum tests could not detect it. Perhaps you may have a similar situation?

    • I have neuropathy and for years suspected a problem with B12. But every serum test came back at least normal and often high. It was quite a puzzle. Then I had a genetic analysis by Dr. Bob Miller and it turned out that I have SNPs in TCN1 and TCN2, the pathways through which B12 is driven from the blood into the tissue. And so the B12 would back up in the blood, go unused in the tissue, and my deficiency could not be seen. Perhaps you may have a similar situation? Also, for RLS I have tried a bajillion things including lots of oral Mg (different forms) and Ancient Minerals Mg oil rubbed into my calves. Nothing. But when I combined the AM Mg. oil with a little DMSO, that finally tipped the scales in my favor. Huge difference. By the way, if you google DMSO and end up at a place like WebMD, it will scare you and call it a “solvent.” It’s a supplement and can be extremely valuable in a multitude of applications.

  18. For me it was both arms (worse) and legs, but it turned out to be a gluten issue. As soon as I went raw vegan (which I did after going on a week-long retreat where everything I’d suffered for years healed, so I couldn’t fathom going back to pain food) the arms and legs stopped bugging me. Turns out though it’s not just wheat, but all grasses. When I went traveling for nearly 4 staying completely raw was more difficult but rice was always available and it caused lots of other problems, but it took a long time for me to connect it to the really disparate symptoms (such as plantar fasciitis).

    • The noxious effects of grasses, their grains and also seen in dairy products and beef are astonishing after the long history of bread, grains, cheeses, butter, milk and cream. I suspect that the problem is to do with pesticides, and glyphosate in particular.
      I have a neighbour who loves Round-up. I could move but can’t really afford to, and really wherever I go I may find the same happens again. People are so unaware of the toxicity. My dear ex-husband also loved glyphosate, path-clear etc. He has multiple cancers and other problems but just poo-poos any connection. His current partner seems aware of the likelihood that these things harm him, but he doesn’t listen to her either, he continues to expose his already sick body the these chemicals, and is on the medical road to treatment. I find it very sad.

  19. i dont know do i have it. i walk during the day not night. I have urge to walk every 45 to 75 minutes to make my legs to feel tired…if i sense they become less tired than usually i walk extra time

  20. I have found that a tablespoon of a Braggs ACV eliminates almost immediately 98% of the time. I feel like mine was caused by side effects to my thyroid meds in combination with oxalate issues.

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