Seratame ?

[BarnGir1]

I would like to know if anyone has tried Seratame for RLS. Thanks.

[SueJohnson]

Seratame can help somewhat but not if your RLS is more than mild. Let me ask you some questions so I can help you. Are you still taking ropinirole? If so does it completely control your symptoms? Have you tried any other medicine for your RLS and if so what was your experience with it?

[BarnGir1 in reply to SueJohnson]

Thank you for responding. I have had RLS since I was a child (the family just called it my leg switching ) but it never bothered me until about 5 years ago, around age 69. About 1985 I began to lose weight without explanation and slept long hours but remained very tired. After 6 months my GP diagnosed me with Chronic Fatigue Syndrome when he also discovered and gave a name to my RLS. While I continued to "switch" my legs, especially as I was falling asleep each night, RLS did not cause me any problems until about 5 years ago, about age 69. After a week of next to no sleep, I saw my neurologist (I also have migraines, since 12 years old) who prescribed Ropinerole which completely subdued my RLS for a couple of years. About 3 years ago I had a flare up of no sleep, saw my neurologist again who ordered iron tests because of my history of anemia. About 18 months ago I finished 3 iron infusions and have had blood and iron tests 3 times since which indicated all is within normal range. However, I have noticed in the past 6 months that I am having "breakthrough" spasms and pain in my feet and legs very intermittently, one or two nights each week, especially after 6 pm. I began adding supplements to include B6 and B2, melatonin, zinc, and 4 types of magnesium to my daily medication routine about 2 years ago and continue to take 5 mg of Ropinirole daily. In addition, I take 40 mg daily of both Prozac and Inderal for migraine (plus 100 mg of Ubrelvy for acute migraine). I also take 200 mg statin daily. I hope this is the type of information you were looking for. Please let me know if you have additional questions. Thank you for your interest.

[SueJohnson in reply to BarnGir1]

You are taking a number of things that make RLS word. Melatonin definitely can. I would stop it. Prozac also makes RLS worse for most. The only safe antidepressants are Trazodone and Wellbutrin. Statins make RLS worse. Nexlizet (Nustendi (UK) is a cholesterol lowering drug that is not a statin, but I don’t know if it exacerbates RLS symptoms. Ezetimibe (Zetia) - reduces cholesterol although It doesn't reduce cholesterol as fast as the statins, but according to Chris Columbus it didn't trigger his RLS although the FDA does show it increases RLS for some people and then there is Triglide which seems safe. You might want to discuss these with your doctor. A more difficult way to reduce cholesterol is to go vegan. My husband lowered his cholesterol from 221 to 131 this way.

By the way, it would help if you indicated on your profile what country you live in as this helps us with our answers.

[SueJohnson in reply to BarnGir1]

You mention iron levels, but did you have your ferritin tested as this is the one that you need to have tested for RLS. Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including multivitamins that have iron in them 48 hours before the test, fast after midnight and have your test in the morning. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you some advice. And don't let your doctor just tell you your ferritin is in the normal range because what is normal for others is not normal for RLS.

[SueJohnson in reply to SueJohnson]

By the way the maximum dose of ropinirole for RLS is 4 mg so you are exceeding it.

[BarnGir1 in reply to SueJohnson]

FYI - I live in the United States (Midwest) but for some reason I cannot successfully enter that on my profile.

My saturation is 22 and my ferritin is 80.

[SueJohnson in reply to BarnGir1]

If you can get another iron infusion that would be best as bringing your ferritin up above 100 can help with your augmentation. If you cannot, take 325 mg of ferrous sulfate or 25 mg of iron bisglycinate with 100 mg of vitamin C or some orange juice since that helps its absorption. Ferrous sulfate is fine for most people, but if you have problems with constipation, iron bisglycinate is better. Take it every other day, preferably at night at least 1 hour before a meal or coffee or tea and at least 2 hours after a meal or coffee or tea since iron is absorbed better on an empty stomach and the tannins in coffee and tea limit absorption. Since you live in the US ferrous sulfate is cheaper and for most people does not cause constipation but iron bisglycinate is much less likely to. If you take magnesium or calcium take them at least 2 hours apart from the iron since they interfere with the absorption of iron. Don't take tumeric as it can interfere with the absorption of iron or at least take it in the morning if you take your iron at night. Also antacids interfere with its absorption so should be taken at least 4 hours before the iron or at least 2 hours after. It takes several months for the iron tablets or iron infusion to slowly raise your ferritin. Ask for a new blood test after 8 weeks if you have an iron infusion or after 3 months if you are taking iron tablets.

[BarnGir1 in reply to SueJohnson]

Thank you for your interest and most valuable recommendations. I will keep you posted.

[SueJohnson]

You may be suffering from augmentation with your ropinirole since I gather it did used to control your RLS. The signs of augmentation are when you have to keep increasing your dose to get relief, or when your symptoms occur earlier in the day or there is a shorter period of rest or inactivity before symptoms start or when they move to other parts of your body (arms, trunk or face) or when the intensity of your symptoms worsen.

If so you need to come off it. To come off ropinirole, reduce by .25 mg every 2 weeks or so. You will have increased symptoms. You may need to reduce more slowly or with a smaller amount. Wait until the increased symptoms from each reduction has settled before going to the next one. You will suffer and may need a low dose opioid temporarily to help out with the symptoms especially as you near the end. But in the long run, you will be glad you came off it. Dopamine agonists like ropinirole are no longer the first line treatment for RLS. Gabapentin or pregabalin is. (Pregabalin is more expensive than gabapentin in the US.) The beginning dose is usually 300 mg gabapentin (75 mg pregabalin). Start it 3 weeks before you are off ropinirole although it won't be fully effective until you are off it for several weeks. 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 1-2 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 or 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. If you take magnesium take it at least 3 hours before or after taking gabapentin (it is OK with pregabalin) as it will interfere with the absorption of gabapentin and if you take calcium don't take it within 2 hours for the same reason (not sure about pregabalin). 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." 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 as yours obviously isn't or s/he would never have prescribed a dopamine agonist at Https://mayoclinicproceedings.org/a...

[SueJohnson]

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.

[ChrisColumbus]

Seratame is a comparatively expensive US branded supplement of magnesium, vitamins and a probiotic. It gets mentioned here periodically, but so far no forum member has really sung its praises. As Sue says, this combination of ingredients will probably only help milder cases of RLS. You already seem to have experimented with some of the constituents individually so I doubt that it will help you.

It won't help if you've augmented on ropinirole, (and the statin and the prozac you're taking may also be exacerbating RLS - statins do this for some, including me).

I see that SueJohnson has come back to you while I was writing this with detailed info about iron levels, coming off ropinirole and the alternative treatments so I'll leave this here for now.

Good luck!

[SueJohnson in reply to ChrisColumbus]

You've surfaced ! I've been wondering where you were.😀

[ChrisColumbus in reply to SueJohnson]

Holiday, and then what I've been considering as a bad cold caught from a visiting 2 year old. 🤧 Must test tomorrow....

[ChrisColumbus in reply to ChrisColumbus]

Negative for Covid at least!

[Eryl]

I have not tried Seratme, but I have looked at their site and agree with them that (as they say on the page seratme.com/seratme) inflammation is at he heart of almost every case of RLS and that iron infusion will only help one in five people and for the other peope it can be dangerous.

I have eliminated my RLS by avoiding all inflammatory foods from my diet and taking a few essential minerals and vitamins. You'll easily find lists of inflammatory foods on the internet or by seearching youtube. Taking a supplement without first eliminating all causes of inflammation will be pointless.

[DicCarlson]

Actually the Seratame website offers very good synopsis of RLS and the connection to inflammation. The puzzle is that inflammation is fairly invisible and hard to treat per se. Good reading right on the home page...

seratame.com/seratame/