RLS, Food and the wonder drug Pramipexol - Restless Legs Syn...

Restless Legs Syndrome

19,426 members13,023 posts

RLS, Food and the wonder drug Pramipexol

silkyreg profile image
19 Replies

I've reported, that intermittend fasting improved my RLS but christmas threw me out of it and I couldn't get back into anymore. My RLS is so bad that I have to eat to calm it down, my brain is screaming like a baby and I can't manage to overcome it. It's like the craving for a drug. But when I eat I break my intermittend fasting, it's a vicious circle.

I experience the following:

1) if I have an RLS attack eating would calm it, maybe because food is producing dopamin/serotonin in my brain

2) If I overcome this urge to eat, the RLS stops, maybe because it doesn't get energy from food

So food seems to be like a drug to my brain and RLS a symptom of withdrawal. But I've often experience the opposite as well: I get an RLS attack when I eat because I was hungry.

And I even wake up in the middle of the night and must eat something or I can't sleep anymore.

So food is like a drug: I feel bad when I take it but I feel also bad if I don't take it.

But food isn't the only problem that has connections to my RLS. When I become tired RLS starts as well. It is spooky that Pramipexol does wonders to my body. I took Restex prolong and it calmed my legs but I couldn't sleep. After being awake for about 40 hours I felt so bad that I took 1 Pramipexol 0,35 and it beamed me away. 30 minutes after I ingested it I went to bed and slept for 13 hours.

19 Replies

Hi, thanks for sharing this.

Interesting to hear of your relationship between food and RLS.

If you eat something you find particularly enjoyable then I guess it could boost your dopamine levels, but I imagine this is a psychological rather than a physical phemomenon.

There doesn't seem to be any consistent connection between your fasting, eating and your RLS.

It might be a particular foid, or class of foids that you're not eating or eating that might be the connection i.e.triggers.

Finding out more about dietary factors in RLS might be useful for you.

Great that you're finding pramipexole wonderful.

If your RLS is intermittent, then it might be best if you only take it when you need it. This might be difficult however.

One reason for this is because if you take it one night and not the next, then you may suffer "rebound".

The other is that, although I'm only guessing based on the dose you mention, but it sounds as if you're taking extended release pramipexole, not the immediate release. This might or might not help.

Although the dose suggest the ER version, the speed at which it worked suggests it isn't.

The other thing about pramipexole is that if you take it regularly, then it's recommended to keep the dose low. If you're taking the immediate release version, the dose you mention is probably too high.

In this case it may be better to take less, say no more than 0.25mg, which might mean you sleep less and it works but pethaps not quite so wonderfully.

" OK" in the longer term is better as a compromise against it being wonderful in the short term followed by failure in the longer term.

I hope you find an acceptable balance.

I wonder whether you fast simply because of RLS, or if you're trying to lose weight or for some other reason?

silkyreg profile image
silkyreg in reply to

>>If you eat something you find particularly enjoyable then I guess it could boost your dopamine levels, but I imagine this is a psychological rather than a physical phemomenon.<<

Maybe it's partly a psychological thing but i.e. chocolate is known for releasing endorphines, opiates, etc. in the brain. I don't like sweets and chocolate but I am a carbohydrate junkie. Carbohydrates increase the Tryptophane level in the brain and this amino acid turns into serotonine.

I don't suffer rebound by pramipexol and I don't take the ER version as it isn't allowed for RLS in Germany, unfortunately. The dose of 0,35 mg Pramipexol is very low as I've had 1,05 mg ER plus 0,35 mg as supplement if needed, but since I moved I have new doctors and they don't prescribe the ER version.

I try to avoid taking Pramipexol so I can take it in emergency cases because if I take it regularly it stops working and then I don't have anything that lets me sleep.

I started intermittend fasting cause a friend of mine recommended it as cure for many illnesses and we RLS patients are out of any other options, but not to lose weight.

in reply to silkyreg

Apologies for any misunderstandings.

You seem to have taken exception to my attempts to offer some help.

Nothing I wrote was intended as judgment or criticism merely matter of fact observations and explanations based on what you wrote.

Just a couple of points which you may find helpful.

Tryptophan, serotonin and other neurotransmitters are made from amino acids, but these come from protein, NOT carbohydrate. Thrre are no amino acids in carbohydrates.

0.35mg of pramipexole is above the ideal maximum dose of 0.25mg and raises your risk of suffering augmentation.

silkyreg profile image
silkyreg in reply to

I didn't take it as critism what you've wrote but as very precious tipps! <3

Concerning carbohydrates read this: "Consuming tryptophan or a carbohydrate-rich, protein-poor meal increases brain levels of tryptophan and serotonin." ncbi.nlm.nih.gov/pubmed/640...

This is interesting as I am not a big fan of proteins like meat or eggs. My favourite dish is spagetti with tomatoe sauce and both have high amounts of tryptophane/tryptamine.

in reply to silkyreg

Thanks for the link. Tryptophan is in fact an amino acid but I can see that your quote is correct. The connection between carbohydrates and tryptopahn is insioin. It's a little more complicated than I tnought.

Eryl profile image

Great that you've noticed the connection between your rls and food, but I think your conclusion is inaccurate. It's my belief that rls is most often caused by inflammation of the nerve cells and that inflammation is most often caused by high blood sugar. High blood sugar is caused by eating high carb foods. Sugar is almost pure carbohydrate so I'd advise you to avoid sodas, cakes, cookies and fruit juices. Fasting alters the way the body deals with blood sugar so it's no surprise to me that it helps somewhat, but I find that just avoiding sugar and refined carbs as found in processed foods is much easier.

silkyreg profile image
silkyreg in reply to Eryl

I don't like sugar and rarely eat it. No cakes, no chocolate, candy, soda, etc. nothing. Surprisingly I even don't like fruit or juice anymore as I used to do. I was on RLS diet for some time avoiding sugar, sweeteners, gluten, cafein, etc. etc. etc. no difference to my RLS. The only thing I can say is that when I don't eat, my body and my legs crave and scream for food like a child in a supermarket for candy, but if I stay strong and don't eat the energy level goes down, my legs don't get energy to move and give up urging me, just like the child in the supermarket after some time when it realizes that it won't get the candy.

Lapsedrunner profile image

You seem to be saying that eating eases your legs, and not eating does as well?! I’m not sure I’m getting your point, sorry.

silkyreg profile image
silkyreg in reply to Lapsedrunner

Yes that's what I experience. I know it's crazy.

My only explanation is:

1) if I have an RLS attack eating would calm it, maybe because food is producing dopamin/serotonin in my brain

2) If I overcome this urge to eat, the RLS stops, maybe because it doesn't get energy from food and hunger produces melatonin thats calming

It is not a scientific explanation it's just a hypothesis

in reply to silkyreg

Hi, don't take this the wrong way, but in explanation of my earlier comments

Eating, in itself, as far as I'm aware has no effect on dopamine levels. However, eating something that you enjoy triggers our brain "reward" system. In fact anything you enjoy doing or you find rewarding triggers this system, sometimes referred to as the "pleasure centres".

The cells in this part of our brain use dopamine. In effect, when we doing anything we find pleasant, it boosts dopamine levels in this area.

One consequence of this is that anything we find rewarding and which boosts our dopamine levels we are more likely to do again.

I recall reading of an experiment done with rats by a behavioral psychologist back in the 1960s. An electrode was implanted in a rats pleasure centr and every time the rat pressed a lever if got a boost in its pleasure centre. The psychologist found that rats would press the lever anything up to 4000 times a minute and would carry on doing that until it dropped dead.

This led to the discovery that anything which boosts dopamine levels in this area of the brain can lead to addictive behaviour. i.e. repeatedly doing the same thing.

Pyschoactive drugs such as opioids and cocaine boost dopamine levels signficantly and that's how they induce euprhoria and that's why they're addictive.

Some people who take dopamine agonists for their RLS, which can also boost dopamine levels suffer an Impulse Control Disorder. i.e. they feel compelled to keep doing the same thing over and over again. I.e. they're addicted.

Whereas psychoactive drugs and dopamine agonists boost dopamine levels physically, food does not. Eating food that gives us pleasure increases dopamine levels, but this is more of a psychological effect.

Melatonin is secreted from the pineal gland which receives nerves from the eyes. When it's light, signals from the eyes inhibit the gland and melatonin levels go down. When it's dark, the gland is no longer inhibited and melatonin levels go up.

Melatonin levels are therefore regulated by light and dark.

One of the effects of melatonin is to help us sleep and the hormone generally has a role to play in regulating our circadian rhythms including our sleep-wake cycle, cortisol levels, noradrenaline levels and dopamine levels, amongst others.

Melatonin inhibits hunger, this enables us to sleep without being woken by hunger.

So hunger doesn't regulate melatonin, it's the other way round.

Also Abookwriter says, some medicines used for RLS can cause eating problems. Gabapentin (and pregabalin) can increase the appetite. Dopamine agonists can cause an ICD i.e. compulsive eating.

It seems to be accepted that eating refined sugar can trigger RLS. I'm not entirely sure why this is.

Refined sugars are a reletaively simple carbohydrate molecule so they are either easily absorbed or quickly broken down into glucose which is absorbed. They are therfore "Fast" carbohydrates. Carbohydrates, that have more complex molecules are harder to digest and therefore slower.

Perhaps that's part of the explanation.

I'm not entirely sure that fasting changes energy levels signficantly unless extreme and prolonged. Energy is primarily obtained from glucose and the body normally maintains glucose levels within a narrow range in the blood. If there's too much insulin helps lower it partly by storing it. Of it gets too low, another hormone helps raise it, partly by releasing glucose from where its stored.

All that to say, there may be a relationship between your eating and your RLS, I haven't a clue why!

Sorry for the lecture, that's what I used to do.

JayPea518 profile image
JayPea518 in reply to

Thanks so much for that info. I am new to the site and am thrilled to discover such professional advice.

in reply to JayPea518

Sorry to disappoint you. There is no professional advice on this site. Members are just people who suffer from RLS.

Abookwriter2 profile image

Silkyreg, Manerva (she is a fountain of accurate RLS info) might recall MY sudden binge eating when on the smallest dose of ropinole and gabapentin (the devil of drugs as it causes memory loss, food cravings and more).

The ropinole causes obsessive compulsive eating, gambling and online shopping behavior-no kidding, I read it on this forum and experienced it myself-and the gabapentin caused carbohydrate craving for me. Together they took me from intermittent fasting diet to uncontrollable binge eating. Suddenly it was there and just as suddenly disappeared when I stopped the gabapentin.

Maybe the pramipexol is causing the same for you? I hate these drugs and am trying ara290-or ‘cibinetide’, a Peptide, that causes nerve regrowth to end this RLS/neuropathy. Look it up, search on iTunes podcasts for it and you’ll find a poSsible solution. Best to you.

silkyreg profile image
silkyreg in reply to Abookwriter2

I take fewerfew against neuropathy for several months and it really regrew the nerves in my legs and feet but no difference in my RLS

Abookwriter2 profile image

Feverfew...never thought of it for neuropathy but from what you're saying, it didn't help rls, then what is connection between nerves/neural pathways and rls? Frustrating.

Anyhow, hope the food cravings I experienced with no previous occurence or behavior from the drugs helps you. If it's a side effect (look it up and look online reddit or somewhere as you won't find it under the manufacturer's side effects) then it's just another issue with these drugs that we augment once taking and have to increase or move on to another.

silkyreg profile image

Here they tell that Pramipexole can cause weight gain and binge eating


in reply to silkyreg

Thanks for the link.

OMG, did I really use to take that stuff.

Mind you, I never really suffered most of the side effects

Strange that the site makes no mention of augmentation or impulse control disorder.

silkyreg profile image
silkyreg in reply to

Here they do


Xarasho profile image


To ease your RLS take a hot shower just before bed, and where very thick ski socks.

Take a small vitamin B complex tablet and a multi vitamin + minerals tablet. 2 hours before bed drink a glass of warm water mixed with a tab spoon of Apple cider vinegar ( if you don’t have any stomach and digestive problem,) These are the thing that used to help a lot, so try it

You may also like...