Hi all,
My GP has agreed to increase my dose of gabapentin from 1200 mg to 1500 mg, as the dreaded RL is back with a vengeance. She said to take 600 mg three hours before bed and 900 mg two hours before bed (after my telling her I've been taking 600 and 600 at those times), but I'm wondering if it will absorb properly like that, because I'm sure I've read somewhere that 600 mg is the maximum the body can absorb at one time. Does anyone have any experience/advice to impart?
Thanks in advance 🙂
You should take 600 mg 1 to 2 hours before bed, 600 mg 2 hours before that and 300 mg 2 hours before that.
Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium(salt), foods that cause inflammation, ice cream, eating late at night, estrogen including HRT, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, eating late at night, stress and vigorous exercise. It is a good idea to keep a food diary to see if any food make your RLS worse.
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, vibration devices like therapulse, 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.
Wow, that was quick! Thank you. If I take the 300 dose five hours before bed, won't it wear off during the night?
Having had RL for over 40 years (only mildly to begin with - ah, those were the days), I've done the food and activity diary thing numerous times. I even tried the daft 'bar of soap in the bed' thing 😆. Alcohol actually helps a bit. Too much swimming makes it worse, as does anything that aggravates my back. I take high strength vit D, a multi-vit and high strength magnesium, all earlier in the day.
Nope - I take 1500 mg and that is the way I take it.
Thank you for the advice, Sue. I'll let you know how I get on!
You really should only increase the gabapentin by 100 mg at a time since by increasing it by 300 mg may be more than you need. And according to the Mayo Updated Algorithm on RLS on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin." After that you would need to switch to pregabalin because you don't want to take it any earlier and as Joolsg said you can take pregabalin all in one dose. The equivalent amount is 1/6 the gabapentin amount.
Anyway once you have found the amount of gabapentin that controls your dose ask for 100 mg capsules so can try lowering the dose by 100 mg every 2 weeks until you find out how much you really need.
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.
If you haven't already check out the Mayo Algorithm which will tell you everything you want to know about RLS including about its treatment.
Have you had your ferritin checked? If so, what was it? 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, don't eat a heavy meat meal the night before, fast after midnight and have your test in the morning before 9 am if possible. 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.
The RLS-UK website sets out how to take gabapentin. Your GP needs to read it.Take it in 3 split doses 2 hours apart with 300mg as the earliest dose. If you need to increase again- you may want to switch to pregabalin as that is more readily absorbed and can be taken in one dose.
Thank you for the info😊 - and sorry for the late reply
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