Sodium alginate

[Mum007]

I suffer with restless legs but also have a fixed hiatal hernia and GERD. Last night i felt like I was having a heart attack. I am trying to come off osemaprazole as it doesn’t appear to help. Last time I took gaviscon my legs went through the roof. My question is does anyone know which ingredient in indigestion medicine causes restless legs. I am thinking of trying sodium alginate on its own as I have heard this is the best ingredient but before buying was wondering if anyone knew which ingredient in gaviscon caused rls.

[Gmc54]

If you felt like you were having a heart attack it might be best if you get yourself checked out.

I take omeprazole. It's a prescription drug, sometimes I also add a couple of Bisodol.

[Hidden]

I can appreciate that you have two problems i.e. the GERD and the RLS.

I can see that you want something that helps with the GERD that doesn't make your RLS worse.

As regards Gaviscon, it doesn't appear that it has any indredient that ought to make RLS worse. It contains sodium alginate, sodium bicarbonate and calcium carbonate.

The alginate is just a thickening or gelling agent and isn't otherwise chemically active, the sodium bicarbonate and calcium carbonate are just acid neutralising i.e. they're alkaline.

However, if your experience is that it makes your RLS worse then it might be best to avoid it.

You don't say whether you take a medication for your RLS or not, but if you do AND you take the gaviscon more or less at the same time then one possible explanation is that the gaviscon somehow interferes with the absorption of your RLS medication.

On the other hand, esomeprazole, which I think is what you were referring to, is a proton pump inhibitor and these medicines are known to make RLS worse. This is because they inhibit the absorption of iron, vitamin B12 and magnesium. Deficiencies of these can make RLS worse. Iron particularly is a major causative factor in RLS.

Anything really that reduces acid is going to interfere to some extent with absorption of nutrients.

Three things you could do about the reflux -

One is to have a word with a pharmacist about other possible antacids that neutralise acid. Avoid proton pump or H2 inhibitor antacids.

Two is to take the antacid at least 2 hours after eating.

Three - Hopefully you've been advised about the non-pharmacological measures you can take to help prevent reflux. Doctors tend to simply hand out prescriptions without offering such advice. It might also help to see a dietician.

As regards your RLS -

Hopefully you have had blood tests for serum iron, transferrin, ferritin and haemoglobin. Also vitamin B12, vitamin D and magnesium.

If your haemoglobin is low then you have iron deficiency anaemia and this, in itself can cause RLS. However, if your haemoglobin is normal, but your ferritin is below 75ug/L then it would be a good idea to start taking an oral iron supplement. The aim of this is to raise your ferritin level to 100, at which level 50% of RLS sufferers gain some relief from their symptoms.

This is not an instant solution, it can take up to 3 months or more.

An over the counter iron supplement is a s good as if not better than a prescription iron. "Gentle" iron, ferrous bisglycinate is less upsetting for your digestive system. It should be taken 30 mins before or two hours after eating, not at the same time as an antacid and taken with a glass of orange or a vitmain C tablet. It is better to take it once every TWO days, not daily, although you can then take a double dose.

All these measures will help you absorb the iron better.

You can also take vitamin B12, vitamin D and magnesium supplments. These may not be as signficant as iron but can help if you have any deficiency. Magnesium, itself should be taken seperately from any other medicinne or supplement as it also interferes with absorption.

If you're taking ay other medications for any other condition, then these may be making your RLS. Most commonly these include antidepressants, sedating antihistamines but also some heart or blood pressure tablets as well as some antacids.

It might be worthwhile looking at other measures to prevent your symptoms. This would include looking at if there are any other things "triggering" your RLS. This would include added sugar, foods high in simple sugars, alcohol and caffeine.

There may be dietary factors and you could keep a daily food diary, recording what you eat each day and what your RLS is like that night.

If you are already taking an RLS medication, it's possible that the medication is making your RLS worse. It may be simply failing, but if you have been taking a dopamine agonist i.e. pramipexole, ropinirole or rotigotine for a while, these can, in time, make RLS worse.

As a last resort IF you're NOT yet taking any RLS medication and the RLS is disrupting your life, preventing you carrying out normal activities then you might consider seeing a dioctor about startying on one.

BUT, find out what medicines are better to try for RLS and what are best to avoid, becasue your doctor may be quite ignorant about this.

You can get the information you need from this forum.

Sorry about the length of my reply. I hope it helps.

[Mum007 in reply to Hidden]

Thank you Manerva for your reply. I currently take no medication other than all the vitamins you suggested and the osemeprazole. I have had restless legs since I was a child (I am now 58) so it is probably primary restless legs. The iron helps enormously but occasionally my restless arms and legs go mad for a few nights - probably something I ate or drank. I have so far been able to keep off the stronger meds. However the chest and sternum pain comes and goes and I can only put this down to the hiatal hernia. I know PPIs are bad for you and I am not convinced they do anything other than stop the nausea and this is why I am desperate to find an alternative that doesn’t affect the restless legs. I suspect if my hernia is fixed (paraesophageal) then this will be an ongoing problem. My doctors surgery of which there are many doctors, are next to useless and only seem interested in dishing out the pills so it’s just a matter of trying to figure it out for myself.Thank you for your detailed input.

[Hidden in reply to Mum007]

The other medications for reflux are "prokinetics" e.g. domperidone. They speed up stomach emptying. However, these may also make RLS worse.

The other simple advice is to avoid bending or lying flat and avoid straining (when going to the bathroom). Sleep more or less sitting up.

Better to take frequent smaller meals in a day, instead of the usual few and often larger meals. Avoid foods that are too hot, too cold too spicy or too acid. Avoid alcohol.

A good idea to eat high fibre foods or add fibre.

You may know all that anyway.

Just to be on the safe side, if the pain is just in your chest then OK. You may also feel nauseus. However, if the pain goes into your left arm or into the neck or you struggle for breath or feel faint or if it happens when you are exerting yourself then do see a doctor.

Don't be too reluctant to start a medication for RLS. RLS for some people can significantly reduce quality of life, cause distress or lead to other health conditions. Chronic sleep deprivation, particularly, can cause serious problems.

It's a balancing act between the positive benefits if a medicine and its side effects. You do need to be knowledgeable about them.

[Jumpey]

I take gaviscon because I too have a hiatal hernia and it doesn't trigger my RLS. Good luck.x

[DicCarlson]

If you look in any modern pharmacy or drug store you would think there is an epidemic of excess stomach acid production. Really a whole wall of acid reducers and PPI medications, and that's just the OTC meds. This is probably the biggest disconnect between Allopathic Medicine (treating symptoms) and a more natural approach or Functional medicine (aiming at the cause). "Here's a pill, there - see it's better now" take it forever.

Natural medicine for GERD and related symptoms aims at the cause and most of them agree - It's Low Stomach Acid and a relationship with other conditions! I had GERD so bad - I would cough half the night and my teeth hurt from the stomach acid coming into my mouth!

The cause - and this is all conjecture on my part - is SIBO (Small Intestinal Bacterial Overgrowth). The cure - I take Additional Stomach Acid (HCL with Pepsin), Ginger and Digestive Enzymes with every meal. If I feel the GERD coming back I start my herbal protocol (4 weeks on, 2 weeks off) - Oil of Oregano, Berbine and Garlic. In addition I take fiber and Saccharomyces Boulardi (a yeast probiotic).

Lots of articles here...

draxe.com/?s=gerd

[Hidden in reply to DicCarlson]

There are quite a few causes of GERD and thanks for the information which may deal with most.

This is especially since SIBO can be a factor in RLS too!

However hiatus hernia is a mechanical problem and cannot be really resolved except by surgery.

The surgery involved is unfortunately thoracic surgery, hence very risky and is rarely performed anymore.

[Mum007 in reply to DicCarlson]

Yes I’ve tried virtually all those. The HCL with pepsin was great for about 6 weeks then my stomach started burning again so I presumed gastritis had come back so I stopped as HCL isn’t good for a damaged stomach lining. The trouble is knowing whether you have too much or too little acid. Doctors here just laugh if you ask for a test. As you say, too easy to give out a pill. So everything I am doing is what I have picked up online. Apparently I had no SIBO when I had a gastroscopy. I take DGL Occasionally, I do the warm water rocking on my heels trick first thing in the morning. I take the digestive enzymes at hard to digest meals and am largely gluten and dairy free. No chocolate, a little alcohol now and then, no tomatoes, oranges etc. is life worth living 😫. Maybe I’m just not co-ordinating everything properly. Can you tell me what your herbal protocol is. How much you take. This is for SIBO I guess.

[DicCarlson in reply to Mum007]

Again - I was never diagnosed with SIBO, but this has worked for me, but GERD seems to come back when I stop taking it. siboinfo.com/herbal-antibio...