Calm Restless Legs

Get a step ahead of this common condition.
By Lisa Marshall

The English physician who first described restless legs syndrome (RLS) in 1683 wrote of “leapings and contractions of the tendons” so intense his patients were “no more able to sleep than if they were in a place of greatest torture.” Yet throughout the 1800s, RLS sufferers who complained of its hallmark “creepy crawly” or “itchy, burning” sensations were often called psychotic and committed to an institution. Even as recently as the 1990s, many doctors were skeptical, if not altogether ignorant, about the condition. “I’ve talked to people who say they went from doctor to doctor for 20 years, and no one knew what it was,” says Norma Cuellar, RN, an RLS researcher with the University of Pennsylvania School of Nursing. But today, thanks to a surge of research into restless legs, the once-obscure syndrome is a hot topic, and the estimated 12 million Americans who suffer from it can get the treatment they need.

Scientists believe that RLS, like Parkinson’s disease, results from poor dopamine metabolism, either because of a genetic trait (roughly 40 percent of cases) or an underlying health problem, such as iron deficiency. Those with restless legs often have an almost irresistible urge to move their limbs, particularly at night. The condition wreaks havoc on sleep and disrupts people’s work and social lives (just sitting through a movie can be impossible). In fact, RLS sufferers more likely suffer from anxiety and depression as well. “For a long time, people have felt they were underbelieved and underserved,” says Michael Weissberg, MD, a sleep specialist with the University of Colorado Health Sciences Center. “It’s ridiculous. RLS is extremely real.” Fortunately, real remedies exist for it. Here are four to try:

Iron: This nutrient appears to play an important role in dopamine metabolism and, thus, nerve health. More than a fourth of RLS patients are deficient in ferritin (the form in which your body stores iron). Before taking iron supplements, get your ferritin levels checked. Standard blood tests don’t measure it, however, so you have to ask for the specific test. Doctors recommend supplementation only if ferritin levels measure less than 50 ng/mL. For those with a deficiency, studies show that taking 200 to 300 mg of oral ferrous sulfate one to three times daily (depending on the degree of deficiency) can improve RLS symptoms if taken over several months. For optimal absorption, take the supplements on an empty stomach, an hour or two after your last meal. Intravenous iron therapy can alleviate symptoms faster and keep them at bay for up to six months. Since taking too much iron can cause you serious harm, make sure to have your iron levels monitored while supplementing.

Folic Acid: For 30 years, researchers have hypothesized that taking folic acid (a key component in nerve health) may alleviate restless legs, particularly when the condition runs in a family. “People who respond best to high doses of folic acid are people who have a family history of RLS,” says naturopathic doctor Dean Neary, chair of the physical medicine department at Bastyr University in Seattle. “Perhaps there is some deficiency that gets passed from gene to gene that causes malabsorption on the folic acid end.” Start at 5 mg daily, and if symptoms persist, you can work your way up to as much as 30 mg. Keep in mind that these dosages are very high (the RDA for folate is 300 to 600 micrograms), so work under the supervision of a healthcare provider.

Magnesium: Restless legs can sometimes occur because of an underlying electrolyte imbalance, says Cuellar. For instance, patients who have an eating disorder or who undergo gastric-bypass surgery, both of which disrupt electrolyte levels, often develop RLS. If an electrolyte imbalance is the culprit, taking extra magnesium may help. This mineral promotes muscle and nerve health, and anyone with RLS can safely supplement with it to see if their condition improves. Try taking anywhere from 200 to 800 mg of elemental magnesium a day at bedtime (start with a low dose, and move higher if necessary.)

L-theanine: Studies have shown that this amino acid, found in green tea, promotes the brain wave activity associated with deep relaxation. It’s also a critical precursor to the relaxing neurotransmitter GABA (gamma amino butyric acid). Even though there’s little research specifically on the use of L-theanine for restless legs, Jacob Teitelbaum, MD, medical director of the Fibromyalgia and Fatigue Centers, says it has proven itself as “one of the best natural remedies for sleep.” He recommends 200 mg of Sun Theanine one hour before bedtime.