I have had quite bad rls for the last two years and over time, very little sleep. However I have tried to persevere without drugs, although my GP has prescribed low dose codeine (15mg) which helped at first but I now try not to take. My rls is currently much better. It hasn’t gone away but it’s sort of manageable and I can now sleep well for about 7 hours without drugs for two out of three nights. For bad nights I can take one cocodamol (over the counter in uk) which usually allows me some (5 hours) peaceful sleep. I still occasionally use cold water leg bathing, and/or stretching, red light lamp therapy, and gun massager on really bad nights.
How did I get here? Well I’m really not sure, but I offer these ‘Rules’, most of which I garnered from this wonderful blog, in the hope that these are what has made the difference, and in the hope that others can get to the same place.
1. Be dopamine aware. Cold, hunger and mild pain sharpen dopamine receptors so a walk in the cold before bed can help. A drastic cold shower can bring down body temperature and give a small dopamine rush in the night if you are desperate.
2. Full-on anti inflammatory diet. That means NO sugar or grains. All calories from lots of vegetables, eggs, meat, fish, olive oil and yoghurts plus small amounts of fruit, cheese, coffee and alcohol. Fill up on vegetable purees, ferment your own yoghurt and eat lots of it including the whey. (I use Easiyo).
3. Fast overnight for 12 to 15 hours. Just coffee for breakfast then two meals a day. Never eat snacks. I make prune and flax bars with water, oat bran and coconut oil and have these as a dessert.
4. Regular exercise. A walk everyday. Take stairs not lifts. Try to go and stay outside for most of the day.
5. Take iron pill every second day late afternoon. (I use Floradix). Take daily dose of multivitamins and multi minerals including high dose fish oil and 600mg alphalipoic acid everyday after lunch.
6. Take 2g L taurine, 800mg marine magnesium and 400mg L theanine every night at bedtime. Take 800mg magnesium citrate when you wake in the night. This all helps scavenge the extra glutamate associated with rls and relieves hyperarousal.
Is this all a bit of a faff? Well yes, but so much better than drugs and all good for general heath especially when you are nearly 76. I do hope these details can help someone else.
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Bluebboat
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Thanks Madlegs. I think I built up to that amount of magnesium slowly over the years as it seemed the only thing that helped. Its now probably not necessary to take that much.
Have you also tried TRE (trauma releasing exercises)? I am soooo relaxed after I have done my shaking exercises. I just think it's strange that no one seems to link restless leg resolved with shaking.
Very helpful and reinforcing. I follow 97.5% of your "rules." My largest exception is allowing whole grains that I've recently discovered, especially farro, which is a great substitute for rice. I read the book that Eryl recommended regarding low inflammatory diet ("A Statin-Free Life" by Aseem Malhotra), which changed everything for me. It includes much of your list. (Note to self - I think I need more outside time...). Thanks for your post; it's a keeper!
Absolutely. I was able to get off gabapentin (and any other RLS meds) with this process. Also, I don't take nearly as much magnesium - this and other aspects require personal calibration.
Thanks for confirmation PoorRichard that these ‘rules’ are making the difference. It’s all desperately hit and miss and takes time to try different strategies. But I think there now is some consensus among us about a central core of self help ideas for those whose rls is idiopathic.
Take magnesium citrate 150mg 2 - 3 timesa day. Or take magnesium citrate twice a day and then take one calcium magnesium 333/167mg at bedtime. It should relax you and help you sleep better. Consult your doctor first before trying this. Good luck
Hi Bluebboat - I also follow 90% of what you say - your anti-inflammatory advice is spot on. However I find the medicine of choice for me is vaping cannabis flower (prescribed by my doctor) as it instantly relaxes my legs and makes me sleepy. I thought some people might be interested on the timing and effects of the different magnesium.
Magnesium glycinate: Bedtime.
Magnesium glycinate (or more accurately, bisglycinate) pairs magnesium with two molecules of glycine—an amino acid that supports protein status in the body, but has also been found to promote relaxation and improve sleep quality in clinical trials.*
The combination of magnesium and glycine is highly bioavailable, meaning it's easy for the body to absorb and you shouldn't need to take it with a meal. Unlike other types of magnesium supplements that are less absorbable and can, let's say, stimulate the bowels, taking magnesium glycinate should not send you to the bathroom. All things considered, this is a supplement that is best taken at bedtime when you're looking to wind down from the day and prepare for a night of deep, uninterrupted sleep.* The exact timing will vary based on the supplement, but we recommend taking mbg's sleep support+ supplement, formulated with 120 milligrams of magnesium bisglycinate and other sleep enhancers jujube and PharmaGABA® in each serving, one to two hours before bed.*
Magnesium citrate: Earlier in the day, with a meal.
Another popular type of magnesium supplement, magnesium citrate also tends to be pretty easy for the body to absorb (though not as easy or gentle as magnesium bisglycinate). It pairs magnesium with citric acid to assist with absorption. This supplement is most often taken to address low levels of magnesium in the body, although technically all magnesium complexes that effectively deliver the mineral to your body are helping bump up your magnesium status.
However, magnesium citrate does have a natural laxative effect in higher doses, so it can also help get things moving down there. Unlike glycinate, you probably won't want to take this one right before settling in for the night as it could wake you up to use the restroom. Instead, taking magnesium citrate earlier in the day with some food, around breakfast or lunchtime, will help ensure it's properly and pleasantly absorbed.
Magnesium oxide: Earlier in the day, with a meal.
Magnesium oxide—magnesium and oxygen ions—is one of the less bioavailable forms of the mineral. This simple and affordable pairing is often used to fulfill magnesium needs and encourage bowel movements, getting things moving in the gut. To assist with absorbability and avoid possible stomach discomfort, it should always be taken with a meal. Taking magnesium oxide earlier in the day is also a prudent move, as again, those bathroom trips might interrupt your wind-down routine or slumber.
Magnesium malate: In the morning.
Finally, this supplement pairs magnesium with malic acid—which has been shown to promote energy production in some studies. For this reason, most people will want to take this supplement in the morning hours or at the start of their day. (It's a popular supplement to take before a.m. workouts.) While it is more bioavailable than magnesium oxide, it should still be taken with some food to minimize the chance of uncomfortable side effects.
Whatever way you time your magnesium supplement, taking a daily supplement at roughly the same time will help you get into a rhythm and ensure you don't skip a day.
Wow ! That is quite a lot of information. I might add if one takes gabapentin, magnesium should be taken at least 2 hours before taking gabapentin as it interferes with the absorption of gabapentin. And calcium and magnesium should be taken 2 hours apart. The same with iron tablets.
Thank you Goldy for this detailed information. I need to think about it as I have read somewhere on this forum that glycine has a kind of stimulating effect on the brain. Not sure where I read it and whether I have got that right. All other info on all the confusingly different types of magnesium is really helpful and much appreciated.
I have one small suggestion. I would take the iron one hour before bed every night, not every other. This may make a world of difference, or not. When you run out, I would switch to ferrous bisglycinate.
This is my first entry on the forum, though have been reading it every evening. I've tried very hard to stay away from drugs but am now a week away from taking pregabalin after coming of a small dose of cannabis, taken daily over 6 mths (causes nausea now and less effective). I will try taurine before going onto pregabalin. I appreciate your post, and all the other posts too. Amazing support group. I've had RL all my life but has become severe over the past 18mths. It is dreadful, not sleeping and walking through the night. I also have lost far too much weight from lack of appetite due to the insomnia (I think) Time to find a better solution. Thanks again to all of those who give support.
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