Dancing in the dark? Muscle movements are regulated by dopamine (a neurotransmitter) in the brain and spinal cord. Dopamine tells leg muscles to relax at night, so without enough dopamine, muscles can remain hyperactive. In order to make dopamine, you need amino acids (either phenylalanine or tyrosine) from protein, and you need iron.
- Make sure you are eating enough protein. [See my protein page for minimum daily requirements and best sources.]
- You might have low iron stores. Ask your doctor to check your “ferritin” level, which tells you how much iron you have stored in your body. People with the most bothersome symptoms tend to have ferritin levels of less than 50 ng/ml. If your ferritin is low, it may help to increase your intake of iron-rich foods. Animal foods such as red meat and liver are especially good sources of “heme” iron, which is 8 times more available to our bodies than plant-based “non-heme” iron. Iron deficiency is especially common in infants, pregnant women, vegetarians, and vegans.
- Vitamin C improves the absorption of the iron found in plant foods and in traditional iron supplements, so if you do not eat animal foods, you may want to consider taking a vitamin C supplement. Vitamins C and E both seem to help iron work better in the body. [Doses that were helpful in studies were 200 mg of Vitamin C and 400 mg of Vitamin E per day.]
- Caffeine, alcohol, and nicotine can cause RLS or make RLS symptoms worse in some people, so avoid these and see if your symptoms improve.
- Food sensitivities have been shown to cause RLS in certain individuals. While any food could be a potential culprit, the ones documented in scientific studies are: milk, coffee, eggs, aspartame (Nutrasweet®), tea, chocolate, citrus, raspberries, strawberries, potato, beef and pork. Keeping a food and symptom journal by your bed can help you to notice possible connections between foods and RLS symptoms.
- Celiac disease, Crohn’s disease, and IBS-D are all associated with higher risk for RLS. Celiac disease is a serious autoimmune disease triggered by gluten, a protein found in wheat, barley, rye and triticale. 25 to 30 percent of people with Celiac disease have RLS. If you have RLS, it is very important to get a blood test for Celiac disease, because left untreated, it has the potential to do widespread damage to the body. A gluten-free diet can significantly reduce RLS symptoms in many patients with Celiac disease within 6-9 months. Even if you do not have Celiac disease, a gluten-free diet may be worth trying, as gluten is a common cause of food sensitivities.
- Medications can cause RLS, especially antidepressant medicines that increase serotonin activity (SSRI’s like Prozac® and Celexa®), and medicines that reduce dopamine activity (atypical mood stabilizers, such as Zyprexa® and Risperdal®). If you suspect a medicine may be causing RLS, please do not stop the medicine abruptly; discuss your concerns with your clinician.
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