I have been diagnosed with RLS and have tried both ropinirole and pramipexole with little or no relief. I am currently titrated off of both drugs. Along with the RLS symptoms (foot and shoulder movement) I have also had itching to varying degrees which is what started me on my journey to get the diagnosis of RLS. I initially went to a dermatologist and they correlated it with low iron. I have supplemented with iron and my iron level last test was 52 up from 6 but did not seem to have an effect on my other RLS symptoms. Initially I got some relief from the itching but lately it has come back with a vengeance. I have continued my supplementing iron, possibly more than is recommended as I am never sure of the absorption rates in my body of vitamins/supplements I have taken. I plan to get another iron level test next week at my annual physical.
Two questions I have for the forum. Is itching a commonly associated symptom with RLS, and secondly can too high a level of iron create itching if I am supplementing too much?
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jinolke
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Itching can be a symptom of RLS. If it were a symptom of too much iron, you would have a rash and/or hives.Do you? I suspect it is the RLS. It is good that ropinirole and pramipexole gave you no relief and that you are off them as up to 70% of people on them develop augmentation which believe me you don't want. You mention your iron level but my guess is that this is not your ferritin which is you want measured for RLS. When you see your doctor ask for a full iron panel. Stop taking any iron supplements 48 hours before the test and fast after midnight. Have your test in the morning. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your ferritin to be over 100 as improving it to that helps 60% of people with RLS and in some cases completely eliminates their RLS and you want your transferrin saturation to be between 20 and 45. If your ferritin is less than 100 or your transferrin saturation is not between 20 and 45 post back here and we can give you some advice. Dopamine agonist like ropinirole (requip) or pramipexole (mirapex) used to be the first line treatment for RLS, but no longer are because of the danger of augmentation. Instead ask your doctor to prescribe gabapentin or pregabalin. Beginning dose is usually 300 mg gabapentin (75 mg pregabalin). It will take 3 weeks before it is fully effective. After that increase it by 100 mg (25 mg pregabalin) every couple of days until you find the dose that works for you. Take it 1 to 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. (You don't need to split the doses with pregabalin) Most of the side effects of gabapentin and pregabalin will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin (200 to 300 mg pregabalin) daily." If you take magnesium don't take it within 3 hours of taking gabapentin as it will interfere with the absorption of the gabapentin. Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed as many doctors do not know much about RLS or are not uptodate on it at Https://mayoclinicproceedings.org/a...
Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium, foods that cause inflammation, ice cream, estrogen, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, stress and vigorous exercise. Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, using a standing desk, listening to music, meditation and yoga.
Many medicines and OTC supplements make RLS worse. If you list them here I can tell you if this is so and may be able to provide a safe substitute.
Great advice from Sue as usual! You may be in a position to use the resolution of an iron deficiency as the chief trigger for RLS. The best oral supplement is Ferrous Bisglycinate Chelate. It's non-constipating with no side effects. You can also get it as a patch from Patch MD, bypassing the digestive tract. I found this article about dermatitis and RLS...
I have had a great deal itching lately but I contributed it to methadone. Claritin makes it slightly better
Good afternoon jinolke. Sorry you are suffering so. Interestingly enough, I too periodically experience "itching." However, I never considered same to be inherent in RLS, but instead thought to be a side-effect of various of the RLS medications that I had been taking. Though these medications varied over the years and ran the gammet of most of those commonly prescribed, I did not link to a dopamine agonist. Instead, trial and error identified the source to be the opiods, including especially hydrocodone.
Oddly, though, since beginning to reduce my intake of tramadol (limited reserve because I won't sign a "Pain Management Plan" that treats me as a drug addict), I also regularly am experiencing itching that appears tramadol-induced. Apparently, once your system becomes "dependent" upon tramadol, itching may be a side effect of both titration or continued use at a variable dose.
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