HRT & RLS

[Katielove53]

Update on the issues with RLS v HRT. My last post i was in 8th week of HRT and no difference to menopause but RLS got considerably worse. At 15 weeks on HRT still no difference to menopause (worse if anything) and RLS still really bad. Drs visit today has increased my gabapentin to 900mg and changed my HRT to a combination of tablets and patches and increased dose. However my chemist does not have said meds and i have a wait for a few days. Once I am established on both meds I will check back in and report with an update.

[SueJohnson]

HRT contains estrogen which is known to increase RLS symptoms - think pregnancy.

[Birdland]

HRT also made my RLS worse. It’s unfortunate.

[67Waterman]

Hi Katie. Personally I did not find an increase in RLS with HRT patches. I stared on the patches when I lived in France, and I had the highest which were 120mg (in the UK they only prescribe 100mg). My RLS only started to suddenly get worse over the last three years (so at least three years after I started the high dosage HRT patches).

Apart from 100mg HRT patches, I am also on 40mg daily Citalopram for HRT. Both patches and Citalopram are miracle drugs for me.

As for RLS .... over the last 2 years, after about 15 years on Ropinirole, I suddenly started to get augmentation, and have now switched to 2100mg daily Gabapentin. This was a result of reading all the posts on here .... not because my doctor knew diddly squat about either drug or RLS.

For me, Gabapentin alone still does not stop the RLS, although it has relieved the day and evening time symptoms. For the night, I still also take 0.125mg Ropinirole together with the final dosage of 900mg Gabapentin ... otherwise I "shuffle" for hours and never get to sleep naturally.

If you need to chat, don't hesitate. Sally x

[Katielove53]

Hi Sally I’m glad that the HRT has worked for you. It’s new for me and the dose I was on didn’t seem to make any difference to the menopause symptoms but my RLS was worse. My doctor has now prescribed a combination of patch and tablet and has increased to 100g, I am to start taking them this evening wish me luck lol. It’s a complicated process because the tablets have to be taken on day 1 to 25 of your cycle but I am already on mine, so has to contact the gp again today to ask more questions. Anyway I am hoping that this together with the increase in gabapentin that I am able to get some relief and more than 7 hours sleep per week! It’s really starting to affect my mental state. I know these things take time, I will report back in a few weeks to let you know how I am getting on. Many thanks xx

[SueJohnson in reply to Katielove53]

Whoops - I missed that you said your doctor just increased your gabapentin to 900 mg. You may already know this but even 900 mg of gabapentin is a fairly low dose . According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily." Ask your doctor for 100 mg capsules and increase it by 100 mg every couple of days until you find the dose that works for you. Take it 1-2 hours before bedtime. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. If you take magnesium, take it at least 3 hours before gabapentin as it interferes with the absorption.of gabapentin. Have you had your ferritin tested? If so what was it? Increasing it to 100 or more reduces symptoms in 60% of people. If you take any other medicines or over the counter supplements, if you list them here I can tell you if any of them are likely to exacerbate symptoms and can perhaps give you a safe substitute.

[Katielove53]

Hi Sue Thankyou for your advice. I will see how I go on 900mg or gabapentin I’ve only increased since yesterday. I take magnesium but always allow for at least 3 hours in between taking another gabapentin as followed by the advice you have given previously. I try to take my last one 2 hours before bedtime but I don’t really have a bed time as such I try to go around 2am but am up half an hour later and usually venture back up after walking around the garden pottering around massaging etc but sadly don’t always get sleep. The other issue is when I do get some sleep my poor husband gets pummelled by my constant kicking so have to resort to the spare room. In terms of medication I take 20g fluoxetine daily, 900mg gabapentin, vitaminn and magnesium also cbd oil twice daily and now from today 100mg Utrogestan once daily and evorel 75 patches for hrt. With regards I getting my ferritin levels checked that is my next port of call when I can get in to the gp, it took ages for this appointment.