7 Tips for Restless Legs Syndrome

octopus with restless legs syndromeDancing 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.

 

  1. Make sure you are eating enough protein.  [See my protein page for minimum daily requirements and best sources.]
  2. 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.
  3. 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.]
  4. Caffeine, alcohol, and nicotine can cause RLS or make RLS symptoms worse in some people, so avoid these and see if your symptoms improve.
  5. 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.
  6. 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.
  7. 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.
How about you?  Have you noticed any connections between food and your restless legs symptoms?
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REFERENCES

Basu PP et al.  Prevalence of restless leg syndrome in patients with irritable bowel syndrome.  World J Gastroenterol 2011;17(39):4404-7.

Gerrard JW et al.  Neuropharmacological evaluation of movement disorders that are adverse reactions to specific foods.  Intern J Neuroscience 1994; 76:61-69.

Gerrard JW and Richardson JS.  Periodic limb movement disorders and spells of profound muscle weakness due to airborne and dietary factors in humans.  Intern J Neuroscience 2004; 114:1483-1492.

Moccia M et al.  Restless legs syndrome is a common feature of adult celiac disease. Mov Disord 2012; 25(7):8877-881.

Peirano P et al.  Iron deficiency anemia in infancy exerts long-term effects on the tibialis anterior motor activity during sleep in childhood.  Sleep Medicine 2012; 13: 1006-1012.

Sagheb MM et al.  Efficacy of vitamins C, E, and their combination for treatment of restless legs syndrome in hemodialysis patients: a randomized, double-blind, placebo-controlled trial.  Sleep Medicine 2012; 13: 542-545.

Trotti LM et al.  Iron for restless legs syndrome.  Cochrane Database Syst Rev 2012; 16(5): CD007834.

Wang J et al.  Efficacy of oral iron in patients with restless legs syndrome and a low-normal ferritin: a randomized, double-blind, placebo-controlled study.  Sleep Medicine 2009;10: 973–975.

Weinstock LB et al.  Celiac disease is associated with restless legs syndrome. Dig Dis Sci 2010; 55:1667–1673.

 

 

 

 

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  • yvonne

    only with whey protein; not an isolate; do I get severe and I mean severe body and joint pain and restless leg. what is the connection. if someone has the answer, please send to avenues.ofhealth@yahoo.com. thanks

    • Sarah

      I have heard that sometimes dodgy manufacturers use whey powder as a preservative by culturing it with bacteria that naturally produce calcium propionate which is known to cause problems for many kids with hyperactivity disorders. I think the code in Aus is 282.

  • Krysta Harvey

    thank you for posting! my husband and i have recently started paleo eating and i have been sharing with my family how much our health has improved. i was looking for ideas for my grandma who has a lot of trouble with restless leg symptoms. it is so hard to find anyone who looks for root causes and tries to address those rather than just prescribing medications! i think some of these factors may be causing her symptoms so i’m sending this to her. thanks again!

    • Linda

      I have noticed that salt in my diet bothers my rls. My twin sister also has rls. Mine has been out of control for the past two weeks. I have not done anything different.

  • lilette

    I’d had restless legs syndrom for 3 months when I started the ketogenic diet at the beginning of April (for other purposes, so I was not expecting anything on this issue). The RLS stopped within a week, and has not returned since (it’s been 3 months). Asthma + seasonal allergies stopped completely as well (I’m not taking any medication for these now, for the first time in the last 35 years).

  • Jim Felder

    My wife has RLS which became progressively worse over the years and eventually begain taking ropinirole (Requip), which did control symptoms but with debilitating side effects. We both went on a plant based diet mainly so I wouldn’t have to go on statins and blood pressure meds. My cholesterol dropped from 215 to 140 and BP from 145/80 to 105/60, so mission accomplished. The amazing thing is that my wife’s RLS systems went away. She was able to completely discontinue the ropinirole. She has now been nearly symptom free for over 2 years. With experimentation, she has found that if she eats a meal with any added oil she will experience some mild symptoms. A very low fat plant based diet has basically given my wife her life back. Now she is the one that is absolutely adamant about sticking to our diet.

    As for your list of 7 tips, we don’t have to worry about protein. A plant based diet has more than enough that there is no need to focus on that. Same for iron and Vitamin C. We eat huge amount of leafy green vegetables and fruit, so we get all we need from our food. In fact she was borderline anemic when she at animal foods, but now has hemocrit levels at the high end of normal. As for food sensitivities, she is extremely sensitive to caffeine and it will drive her RLS nuts, so she absolutely avoid that. Even the small amount in chocolate can be a problem, so she limits to a small piece when she does indulge. 6 isn’t an issue, but you are right on the money with 7. During a bad patch she tried Paxil. She managed to keep taking it for a week, but her RLS was so bad that she basically didn’t sleep for more than an hour at a time for most of that week and several days after as the drug worked its way out of her system.

  • Jim Felder

    Oh, and I think the associations with iron, vitamin C, IBS and maybe even Celiac may be co-morbities with a low nutrient, athrosclerotic diet also known as the standard American diet. I have read that RLS may be tied to low oxygen in a particular motion related center of the brain. Low iron can reduce the overall oxygen carry capacity of the blood, but for it to be an issue only in one particular area there has to also be a poor profusion rate for that area. Athrosclerotic plaques can definitely effect profusion as can be seen in cardiac issue like angina. The progression of RLS prevalence and severity with age fits with proliferation of the number and size of plaques as does the reversal of systems of my wife when she started an anti-athrosclerotic very low fat plant based diet. In fact the diet we eat is very close to the diet developed by Dr. Caldwell Esselstyn that halted and reversed the arterial blockage for extremely ill heart disease patients that conformed to the diet. The diet worked for all 18 conforming patients in the first study with no further cardiovascular events in over 25 years. In a new study it was effective in reversing the heart disease of over 95% of the 200 conforming patients.

  • Omo

    These past few months I’ve been inflicted with RLS. I did notice that when I eat protein, whether it’s red meat or liver, it significantly reduced my restless leg syndrome. My blood test did show I had low.iron in my blood system. I started taking One a Day vitamin 50+ . I hope this helps.

  • grandmasitter

    I found a link between dairy products and RLS quite by accident and continue to be dairy and RLS free. On occasion I have had a cup of yogurt or ice cream and paid for it that evening. No more dairy for me.

  • Rachel

    Alcohol is a very big no-no. Even a sip of Ale or beer will set me off for the night. Sweets such as ice cream, cookies, cakes – no go. I found any carbs after 3 PM in the afternoon will drive me crazy. So basically I do not eat after 3 PM. The green leafy diet works best for me with protein in the morning such as an egg and salad in mid-afternoon. I only drink water now. I am able to basically be medication free most of the time. I do keep Mirapex on hand for those rare dinners out an take half dose of 0.125 before I eat and that typically will keep me pretty comfortable. One good thing is it is real hard to gain weight living like this. :-) but I sure miss my sweets.

  • Sarah

    Foods high in salycilates set me off, and half of things with the word flavour in it’s list – probably high in salycilates but as I have no idea what the chemical marked as flavour is, I can’t tell. I can’t have strong herbal teas at night and anything else high in salicylates. Having bicarb soda helps to relieve the sensation. I was wondering if it was an acid buffering issue. Any thoughts anyone? If I eat well I hardly every get restless legs – and that means eating diet that does not feed the bacteria in my gut that damage my gut wall that prevent me from digesting salycilates properly. Ie eat mostly meat and vegetables and little starch and sugars.

  • Esther

    I say: magnesium, magnesium, magnesium! I have had restless legs for years, even though I follow a neo-paleo/LCHF/westonpice combination diet (I am a grassfed raw milk/raw yoghurt/kefir user) also for like 4 years now. The extra supplements I use are Vit C -the fat-soluble powder (ascorbyl palmitate, 1000/2000mg) and water-soluble acerolapowder, also 1000/2000. And I use fermented CLO, vit d3 together with vit k2. But al this didn’t rest my legs. When I started with magnesium, both the oil on my skin and oral: no more restless legs!

    • Esther

      ..And I have to say: that is overnight! It’s also when I eat mackerel (lots of magnesium). I can have coffee, wine, no prob at all, but when I forget magnesium/food with magnesium I have symptoms the next day. So for me, it’s very clear.

      • Esther

        ..halibut, crab, spinach (never to consume raw), prunes, pineapple, nuts like almonds and pecans (raw, soaked well and then roasted!), and (pure, unsweetened) cacao are also foods rich in magnesium.

  • Tara

    Both my sister and I have suffered from RLS for 50 years ( I was 7 years old when it started and she was 6). We have finally discovered that the cause is 100% dairy. If we stay away from it, we have no RLS at all! It is very hard to do though. We LOVE dairy. Milk, cheeses, yogurt. Ahhhh….we really miss it, but not the RLS. Completely gone! One small piece of cheese or a sip of milk though and bam, it’s back for both of us. I really wish the medical field could find out why this food source is a problem for some of us. I would sure love to have my dairy back :(