Blood tests

[Boldgirl45]

Hi everyone. I live in Turkey, and my mum who has suffered for years with RLS and DAs is coming out to visit. She also suffers with chronic arthritis. I want to get her some blood tests while she's here, just to see if there are any deficiencies. Ferritin is obviously my first thought, and possibly B12. Any other common things I could test for that might affect this condition? Many thanks!

[Elffindoe]

There are a few underlying conditions that might be exacerbating or causing her RLS so it might be a good idea to eliminate these.

They are iron deficiency or B12 anaemia, vitmain D deficiency, diabetes, thyroid dysfunction, peripheral neuropathy and vascular insufficiency - arterial or venous insufficiency..

Unfortunately the inflammation caused by her arthritis will be making her RLS worse.

All iron tests are needed not just ferritin, this would include serum iron, transferrin saturation (TSAT) , TIBC and haemoglobin.

TSAT will indicate if it is safe for her to take iron therapy.

NOTE as she has inflammation due to the arthritis this may make her ferritin high. The normal recommendations for iron therapy according to ferritin levels do not take this into account. They only make recommendations for ferritin levels under 100. If your mum's ferritin is over 100 then this may be meaningless.

As long as her TSAT is below 45% she could take an iron supplement anyway even if ferritin is more than 100.

AS regards the DAs, as you may know it's best to wean off any DA and replace it with an alpha 2 delta ,ligand, either gabapentin or pregabalin.

Lots of information about these in other posts.

[Boldgirl45 in reply to Elffindoe]

This is brilliant, thanks so much!

[puzzler1 in reply to Elffindoe]

What a brilliant answer to Boldgirl's question. Mrs P is increasingly suffering badly from arthritis and I wondered if you knew of anything that might reduce the inflammation caused by this. She also has thyroid problems but isn't taking medication at the moment. She's due to have a blood test so we'll make sure they do a full iron test as you suggest and also see how the thyroid is.Thanks again for all your advice.

[Elffindoe in reply to puzzler1]

Certainly if Mrs P has thyroid dysfunction and her DR thinks she needs treatment then this is worth doing.

I'm not expert on arthritis but I do know there are several kinds.

The main ones are ostearthritis and rheumatoid arthritis.

The first is due to wear and tear of cartilage in the joints and this can cause some inflammation which is localised. Rheumatoid is a more systemic auto-immune disease and there can be more inflammation.

The treatment wil ldepend on which of these it is, I guess.

Treatment for osteoarthritis may start with NSAID, then progress to steroid injections then joint replacement, but I know little about rheumatoid.

Any anti-inflammatory treatment should help relieve RLS symptoms.

[Boldgirl45 in reply to Elffindoe]

Hello again Elffindoe. Just to check then - I’m going to get all of these iron tests you mentioned done (inc ferritin), B12, vitamin D, thyroid markers, diabetes. You also mentioned these conditions : peripheral neuropathy and vascular insufficiency - arterial or venous insufficiency. Do you know what tests would be advisable for those? Many thanks again for all your help.

[Elffindoe in reply to Boldgirl45]

The first indicators of peripheral neuropathy are symptoms.

Pain is like pins and needles, stabbing or burning and there may be paraesthesia i.e. numbness. It can also lead to weakness.

Physical examination plus symptoms are the first indicators of poor circulation.

Typical of venous insuffciency is varicose veins.

Other symptoms/signs may be redness/paleness, heat/cold, pain and loss of sensation.

If suspected then there are various investigations

[Boldgirl45 in reply to Elffindoe]

OK thanks so much