After a long day’s work, many of us look forward to the relief of a good night’s sleep. But imagine settling into bed, ready to drift off, only to be interrupted by an uncontrollable urge to move your legs.
This condition is known as Restless Leg Syndrome (RLS). It often strikes early in the evening or at the onset of sleep and can plague its victims far into the night.
If you experience RLS, there is hope. Recent years have brought new understandings of its causes, including specific nutrient deficiencies, as well as insights into how certain medications may trigger the condition. New treatments, such as nerve-stimulation devices, are providing relief for some patients.
Causes and Treatments of RLS
Dr. Alejandro Centurion, a neurologist with 25 years of experience in treating RLS, explains that the condition is primarily neurological or related to the nervous system.
Centurion recently joined EpochTV’s “Vital Signs” with Brendon Fallon to discuss the root causes of RLS and successful treatment options that he has used in his practice.
Dopamine Imbalance
The exact cause of RLS often remains unknown; however, Centurion identifies two significant contributors. One is related to dopamine transmission in the brain. Dopamine, a hormone and chemical messenger, plays a crucial role in various bodily functions, including movement. Research has linked low dopamine levels to RLS and other movement disorders, such as Parkinson’s disease. When dopamine levels are insufficient, the brain struggles to regulate movement as efficiently as it should, which may result in RLS symptoms.
From <span style="font-weight: 400;"><a href="https://ept.ms/Restless_VS" target="_blank" rel="nofollow noopener">Easing Restless Legs</a></span> on <span style="font-weight: 400;">Vital Signs </span> with Brendon Fallon on EpochTV.
Medication used in the past to treat RLS worked by increasing dopamine in the brain, said Centurion. However, these drugs’ effectiveness was shown to decline over time, and they could even worsen RLS symptoms by causing them to begin earlier in the day, he added. As such, these treatments have fallen out of favor with neurologists.
Currently, the most commonly prescribed medications are Gabapentinoids, which include Lyrica and Horizant. These medications, which bind to calcium channels in the nervous system resulting in reduced pain, don’t appear to cause augmentation and work well for many individuals without side effects, Centurion said.
Low Iron
It’s not fully understood how low iron levels can lead to RLS. However, it is believed to relate to iron’s essential role in oxygen transport and dopamine transmission in the brain and the potential for iron deficiency to disrupt these processes. Treating low iron levels can relieve RLS in some cases. A standard blood test can determine if your iron level is low. It’s not easy to measure iron levels in the brain; however, low levels in the blood can reflect low levels in the brain, Centurion said.There are different ways to check your iron status, including having a ferritin blood test, which assesses how much iron the body is storing and helps evaluate the degree of deficiency and the need for supplementation.
Iron Infusion
The solution isn’t always as simple as taking an iron supplement. Due to variations in iron absorption, effective supplementation may differ for each individual. Centurion gives an example of a patient on various medications to treat restless legs. She was taking iron supplements, eating red meat, and taking vitamin C to improve her iron absorption, but her levels were still low. After receiving intravenous (IV) iron, she got her levels above the needed threshold and her symptoms improved. For this reason, Centurion said he recommends that patients have their iron levels checked and supplemented under the guidance of a doctor.
Medications Linked to RLS
In recent years, further insights into the causes of RLS have emerged, which don’t necessarily involve nutrient deficiency. In some cases, RLS can also be a side effect of certain medications, including allergy medications like antihistamines and some antidepressants, Centurion said. Centurion gives an example of a patient who did not have RLS but was struggling with depression and poor sleep. His primary care doctor put him on an antidepressant. The patient also started taking the allergy medication Benadryl to help him sleep. Afterward, he developed restless leg symptoms. It was initially thought that low iron level might be at play, but testing showed they were within normal range.
Suspecting the patient’s medication was a factor in the onset of RLS, Centurion had the patient stop taking Benadryl and asked his primary care physician to switch the antidepressant he was taking. After making these changes, the patient’s RLS improved significantly, according to Centurion.
Promising New Treatment Options
Newly approved treatment devices, such as the Nidra peroneal nerve stimulator, are yielding promising results, Centurion said. The device works through peroneal nerve stimulation, which targets the nerve and its associated muscles. By stimulating these areas, it sends feedback to the brain that helps to reduce the unwanted movements and sensations associated with RLS.
Other treatments, such as weighted blankets or compression devices, also relieve symptoms in some patients. Centurion recommends seeking the guidance of a neurologist for prescriptions and treatments.
From <span style="font-weight: 400;"><a href="https://ept.ms/Restless_VS" target="_blank" rel="nofollow noopener">Easing Restless Legs</a></span> on Vital Signs with Brendon Fallon on EpochTV.
In summary, restless leg syndrome is a neurological disorder that can have a significant impact on sleep quality. However, deeper insights into its neurological causes have led to new strategies and treatments to bring relief, thus bringing a once elusive good night’s sleep now within reach of many sufferers.
Watch Easing Restless Legs on “Vital Signs with Brendon Fallon” for more insights on the triggers and treatments for RLS
