Restless Leg Syndrome
PeterSmithUK.com © 2016 (#1)
Restless leg syndrome sounds funny but it’s no joke, symptoms involve sudden jerking leg movements that are outside your control and an intense ache/uncomfortable feelings in the legs so you have to move them, and what makes this RLS really horrible that this often occurs as you are falling asleep or even when you’re asleep and it wakes you up. So RLS causes insomnia and insomnia can wreck the quality of your life.
RLS is quite common it’s not known precisely how many people it affects, a 2011 review gave an estimate between 4% and 29% of adults have their sleep disturbed by RLS[i].
The exact cause of RLS is not fully understood, it’s believed to involve dysregulation in the dopaminergic activity in the brain. Dopamine is a neurotransmitter involved in signalling muscles to move, people with Parkinson’s disease struggle with movement and a loss of dopaminergic activity is believed to be at the root of Parkinson’s.
How to Treat Restless Leg Syndrome
In my practice I’ve had success treating RLS with nutritional supplements aimed at restoring balance and health to the brain in general and focusing on dopamine.
Begin by improving the health of your brain in general which may be sufficient to restore balanced dopamine activity and in addition if necessary try supplements that promote and restore dopaminergic pathways.
As I repeatedly discuss elsewhere the first thing to do when you want to treat any condition involving the brain whether it be a neurological or mental health conditions is you want to eliminate everything from your diet and lifestyle that could be causing persistent hidden background inflammation in your brain.
Elsewhere I discuss in detail inflammation in the brain and how to combat it (see…) to treat depression, bipolar and other mental health problems but you can use the same information and techniques as part of your treatment plan for RLS. In brief inflammation is a normal healthy reaction in the body that you want to occurs during when you either have an infection or an injury, an appropriate and proportional inflammatory response by the body to a threat such as virus infection is a good thing that you want to occur so that you immune system can combat the infection, but when you don’t have an infection or injury you don’t want any persistent inflammation in the body. Low-level inflammation can persist in your body without you being aware of it and this kind of hidden or sometimes called silent inflammation can cause wear and tear on almost any part of the body and is probably involved in accelerating all degenerative and ageing diseases. So for example low-level hidden inflammation in your heart and arteries is at the heart no pun intended of cardiovascular disease, the person who has a sudden heart attack will have had hidden inflammation in the cardiovascular system for years if not decades prior to the event, chronic persistent inflammation in the joints causes arthritis, persistent hidden inflammation is implicated in the development of type II diabetes and many seemingly all conditions involving the health of the brain including: Alzheimer’s disease, Parkinson’s, and mental health problems including depression, bipolar syndrome and schizophrenia; oh yes and RLS[ii].
To combat persistent hidden inflammation in your brain do the following 5 things:-
1/ Follow the anti-inflammatory diet.
See the Anti-Inflammatory Brain Diet
2/ Do brain training to stop overactive stress responses elevating inflammatory chemicals in your brain.
See Relaxation Response Brain Training
N.B. meditation and relaxation brain training are not the same thing.
3/ Improve your intestinal bacteria microbiome.
Not only is RLS associated with inflammation and a significant weight to reduce inflammation is to improve digestive health but RLS has been seen to directly improve as a consequence of treating IBS and/or SIBO[iii] [iv].
See the Gut Brain Axis (my pages on that are still under development, in the meantime I recommend books such as The Microbiome Solution and Brain Maker).
Basically you want to: cleanse your intestines of friendly bacteria if you have SIBO or a poor digestive system and a history of bad diet I use preparations such as Dr Christopher’s Lower bowel formula to achieve this see How to Cleanse the Colon together with an initial low FODMAP diet, follow this with territorial bacteria and yeasts such as Saccharomyces boulardii to make it easier to then finally repopulate your intestines with friendly bacteria and finally and most importantly continuously feed your microbiome with a varied diet rich in plant-based polyphenols and prebiotic foods i.e. a high FODMAP diet to maintain your digestive wellness.
You can test to see if you have SIBO with a simple breath test however treating SIBO can be really challenging and I recommend you consult with a practitioner experienced in treating digestive health problems including SIBO, IBS, IBD; including myself I hasten to add.
Also consider the possibility you are harbouring parasites and yeast or candida overgrowth.
4/ Do a GABA challenge test on the integrity of your blood-brain barrier and if it leaky fix it.
See Do You Have a Leaky Brain
5/ Try to identify and eliminate food and chemical allergies and sensitivities.
As well as eliminating hidden inflammation in your brain you should eliminate nutritional deficiencies particularly vitamin D and iron.
Supplement Vitamin D3
The mechanism whereby vitamin D effects restless leg syndrome and dopamine is not fully understood however the prevalence of RLS goes up as vitamin D levels go down[v], furthermore supplementing vitamin D has been shown to reduce RLS[vi].
Today we have completely changed our understanding of vitamin D when I first trained in nutrition the recommended daily intake was 400 IUs and we just didn’t worry about it however the new optimum daily intake is now considered to be 5000 to 8000 IUs for the average healthy person up to 10,000 IUs a day if you have a specific health concern requiring more vitamins D.
D2 and D3 are just not the same, I’ve seen the vegan websites selectively citing the few studies didn’t find a difference between D2 and D3 and selectively ignoring all the research did find a difference such as for example D2 can be toxic during pregnancy the D3 isn’t.
You can have vitamin D levels tested if you want, you should be aiming for 25-50 ng/mL for general health however you have chronic inflammation particularly involving and autoimmune condition push your vitamin D levels up to 35-60 ng/mL. To start with however you could just try supplementing 5000 IUs of D3 once a day together with the other recommendations on this page and see if your RLS goes away and then for general health continue taking 5000 IUs of D3 a day.
Make sure you’re not Iron Deficient
Iron deficiency can impede healthy dopamine metabolism and iron supplementation has been shown to improve RSL in people with low ferritin levels which is a measure for iron[vii]. Although the scientific evidence for this is thin testing and supplementing your iron levels is an easy thing to do. In fact as part of the overall treatment program I always recommend taking a multivitamin/mineral which will automatically deliver supplemental iron. If you do turn out to be iron deficient question whether or not you’ve got hidden intestinal parasites.
Supplements for Restless Leg Syndrome
Magnolia bark extract: I usually recommend this in tincture form but is also available in capsules a typical dose would be 1 ½ times what it recommend on the label i.e. 150%.
NAC cysteine: 1200 mg once a day on an empty stomach; try either first thing in the morning or last thing at night and see which one works the best.
L-tyrosine: 500 to 1500 mg on an empty stomach either last thing at night however that may be too stimulating and keep you awake so try taking it 40 minutes before dinner and if that’s still too late in the day try 40 minutes before lunch.
Rhodiola: I usually recommend 500 mg of 3% standardised Rhodiola twice a day but only six days a week, missing out one day a week prevent habituation.
If your RLS is worth cyclically with your menstrual cycle include:
Chaste Berry (Vitex agnus castus) and Black Kohosh (Cimicifuga racemosa)
To provide essential cofactors for the above remedies to work you should take the following:-
400 to 800 mg of magnesium, I usually recommend magnesium citrate and
a multivitamin/mineral I usually recommend Doctor’s Best Best Multiple 2 to 3 capsules a day. I recommend this product because it uses L-methylfolate as opposed to folic acid and a small percentage of the population have the MTHFR gene mutation and folic acid may cause and exasperate health problems; it is especially important to use methylfolate and not folic acid during pregnancy if you have the MTHFR gene mutation. On the other hand this product does not contain any iron and so I would recommend taking iron separately, in the UK Easy Iron from Higher Nature is an excellent product otherwise Floradix liquid iron works well.
I published a book on how to overcome insomnia and sleep better called Sleep Better with Natural Therapies by Peter Smith which includes alternative and natural medicine solutions for many other aspects of sleep problems besides restless leg syndrome. In my sleep book I break down the physiological steps that the body has to go through in order to fall and stay asleep and how to make those physiological steps work effectively whilst at the same time using self hypnosis techniques to train the mind to overcome the fear and stress of insomnia and start sleeping well.
I’m also available for consultations at my London clinic and for coaching sessions via Skype.