Only temporary respite from IV iron? - Restless Legs Syn...

Restless Legs Syndrome

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Only temporary respite from IV iron?

howbeit-abroad profile image
8 Replies

Back again - thought I was done with RLS after my iron infusion but seems like the respite was only temporary.

Presently having symptoms from dawn until dusk, though some days are worse than others. Iron IV was 6 weeks ago; have just had bloods drawn for an iron panel so will see my neurologist when the results are in. Is it likely the iron was a bust or is there hope that it’ll still have some effect?

Depression was worsening on sertraline 100mg so was switched to venlafaxine (at a low dose, 37.5mg twice a day). Is that likely to make the RLS worse? Perhaps the switch from one to the other is causing problems?

Have tried bupropion in the past with limited success but only to augment an SSRI; not sure how well it would work for me on its own but I’d be prepared to give it a try to see if it’s the serotonergic drugs that have suddenly caused all this.

Depressed and twitchy. What to do? If my neurologist does decide to prescribe drugs, should I push for gabapentinoids? The protocols I’ve seen suggest they’re contraindicated in people with depression

(Have also tried: magnesium, B vitamins, potassium, L-methylfolate, trigger point massage, TheraPulse, cold showering the legs, very hot showers, quadriceps stretching, all to limited or no help. Kratom didn’t make a difference and just made me feel spaced out. Curiously I was using cough syrup containing an antihistamine last week and it didn’t seem to make the RLS worse.)

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howbeit-abroad
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howbeit-abroad profile image
howbeit-abroad

Current medications I’m taking:

- venlafaxine 75mg

- minoxidil 2.5mg

- topical finasteride, 0.5mg

- magnesium glycinate, B vitamins, 1000mg bromelain

ChrisColumbus profile image
ChrisColumbus

I'm sure I saw a post recently saying it can take a couple of months for an iron infusion to work, but the poster may have been referring to oral iron supplementation.... Will be interesting to know the iron panel results.

Some sufferers report that venlafaxine exacerbates restless legs, but others say that they've been on it with no ill-effects.

Just as a matter of interest, which magnesium salt did you try and how much? Magnesium only helps some people, but you do need to be taking either glycinate or citrate in sufficient quantity.

howbeit-abroad profile image
howbeit-abroad in reply to ChrisColumbus

Previously took magnesium citrate in some random doses, currently taking magnesium glycinate 1000mg.

ChrisColumbus profile image
ChrisColumbus in reply to howbeit-abroad

"It often takes several iron infusions to bring the body’s iron levels up to the appropriate levels." Healthline.com

I initially took 3x200mg of citrate spread through the day and it stopped my RLS within days; I'm now down to 2×200mg, and possibly could cut back further.

Glycinate is supposedly better than citrate in that it aids sleep and doesn't carry a diarrhoea risk. I'd have thought that 1000mg a day would resolve your RLS if Mg was an issue (although some sources in the US suggest 1330mg/day....)

I do wonder whether taking Mg at this level might interfere with absorption of iron from the infusion. I've no evidence for this, although oral Mg can reduce absorption of oral Fe. Frankly, if you're not getting any apparent benefit from the Mg I might consider at least temporarily cutting back on it.

If you continue with Mg it's suggested, as Sue says, to not take it within 3 hours of taking gabapentin.

howbeit-abroad profile image
howbeit-abroad in reply to ChrisColumbus

Hadn’t even occurred to me it might be interfering with iron uptake - will kick it for now then.

ChrisColumbus profile image
ChrisColumbus in reply to howbeit-abroad

The evidence for the issue that I've found mostly seems to lie with magnesium salts that have a laxative effect - so e.g. oxide and citrate. But I know that SueJohnson advises not to take magnesium (in general) within 2 hours of oral iron.

While there may be no impact on absorption from an infusion, if 1000mg of magnesium isn't stopping your RLS why not try a break from it, if not now before any subsequent infusion. Unless your doctor wants you on Mg for another reason of course

SueJohnson profile image
SueJohnson

It can take up to 8 weeks for an iron infusion to work so it is recommended to wait until then to have it tested again. That said it will be interesting to see your results. Often people need more than 1 iron infusion. Improving your ferritin to 100 or more helps 60% of people, but that leaves 40% that it doesn't help, and although some of the 60% will find it completely relieves their symptoms most won't. So yes I would suggest you start gabapentin. Reminder don't take your magnesium within 3 hours of taking gabapentin/

DicCarlson profile image
DicCarlson

Venlafaxine (Effexor) is not a very friendly drug. Getting off it is very problematic - fraught with discontinuation syndrome. A close friend was prescribed it for post-partum depression after the birth of a child (she's still on it 20 years later). She tried to get off it and the discontinuation syndrome hit her appearing like her depression was returning only worse. Depression is usually temporary - but still a nasty state of affairs. I was depressed before anti-depressants were invented! I read B-Vitamins were a treatment - and started on them - it lifted after a few months and I still take a high quality B-Vitamin (B-Right from Jarrow). Here's an article on some natural treatments. Good luck! Good health!

draxe.com/health/natural-re...

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