Neurology appointment

[Thorwart]

Hi, I've recently had my first neurology appointment and the consultant asked me if I've ever had any STDs. I found this question a little odd when I was there about rls, has anyone else been asked this?

[Madlegs1]

Weird?🤔

[SueJohnson]

Very strange !

[Joolsg]

No, because it has absolutely nothing to do with RLS. How strange.What did he prescribe, if anything?

[Thorwart in reply to Joolsg]

He suggested gabapentin. He also asked if I wanted to have bloods for std screening. He said it was to rule out any underlying infection but it all sounds a bit odd to me

[Joolsg in reply to Thorwart]

Bloods to ascertain serum ferritin, serum iron etc is normal.But the STD connection is a new one on me!

Raising serum ferritin above 100, preferably 200 helps the majority of RLS cases. If raising levels with iron pills/infusions and stopping anti depressants and other exacerbating meds doesn't settle RLS, then gabapentin taken at night only would be the next step. Good to hear he didn't suggest dopamine agonists.

[SueJohnson]

That's good that he knew enough to suggest gabapentin. The most important blood test you want is to check your ferritin. 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.

[SueJohnson]

On the gabapentin many doctors do not know how to take it. Beginning dose is usually 300 mg gabapentin . It will take 3 weeks before it is fully effective. After that increase it by 100 mg 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. Most of the side effects of gabapentin 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 even in a multivitamin, don't take it within 3 hours of taking gabapentin as it will interfere with the absorption of gabapentin and don't take calcium within 2 hours for the same reason. 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...

[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 including HRT, 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, fennel, 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, CBD, 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 can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute.

By the way it would really help us to give you advice if you would indicate on your profile what country you live in and your gender.