Restless legs syndrome

[DonkeyRose]

Been suffering restless legs syndrome for a few years now. Friend suggested magnesium supplements daily. Any comments on this?

[ChrisColumbus]

A bioavailable form of magnesium helps some, including me, but the first thing to check is your serum Ferritin levels. Raising serum ferritin helps a majority of RLS sufferers. Please read the following from RLS UK:

rls-uk.org/_files/ugd/b0a19...

Have you had this measured, and if so what were the results?

There are also a whole range of medications that can trigger/exacerbate RLS. See this, also from RLS UK:

rls-uk.org/medications-avoid

Are you taking any of the listed medications?

Are you already taking any meds prescribed for RLS as some make RLS worse over time?

If your ferritin levels are good and you are not taking triggering meds, magnesium may help. See this recent post:

healthunlocked.com/rlsuk/po...

[SueJohnson]

Welcome to the forum. You will find lots of help, support and understanding here.

Have you had your ferritin checked? If so what was it? If not this is the first thing that should be done for RLS. When you see your doctor ask for a full iron panel. Stop taking any iron supplements 48 hours before the test, don't eat a heavy meat meal the night before and fast after midnight. 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 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.

Above all don't let your doctor prescribe a dopamine agonist like ropinirole (requip), pramipexole (mirapex)or Neupro (rotigotine) unless there is some special reason s/he feels you need it. They 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 as the peak plasma level is 2 hours. 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 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)."

If you take magnesium even in a multivitamin, don't take it within 3 hours of taking gabapentin (it is OK with pregabalin) as it will interfere with the absorption of gabapentin and don't take calcium within 2 hours for the same reason (not sure about pregabalin). 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(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. I have a list of more than 300 medicines and OTC supplements that make RLS worse and have safe alternatives for most of them.

Taking magnesium glycinate at night may help slightly but won't eliminated your RLS.

[DonkeyRose in reply to SueJohnson]

Hiya. I am taking sertraline, pregabalin. Depakote for bipolar, propranolol and zolmatriptan for severe migraines. Estradiol for menopause, vitamin D all year round, no pain medication any longer. RLS tends to come on in the evening. Any advice

[SueJohnson in reply to DonkeyRose]

Oh boy.

Sertraline makes RLS worse for most. A safe anti-depressant is Wellbutrin which is hard to get in the UK or trazodone which also helps anxiety and insomnia.

As mentioned Estradiol makes RLS worse for most and there are no safe substitutes.

Looking at your profile you mention avostatin .All 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, however don't take it if you have diabetes and then there is Triglide which seems safe. Berberine may help if it is mildly elevated. 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.

The propranolol is safe for high blood pressure if that is all you are taking as others aren't safe.

For anxiety the trazodone may be enough but if not buspar is safe.

Lansoprazole makes RLS worse for most. Unless you are sensitive to artificial sweateners I recommend Gaviscon Advance - be sure it is the Advance.

For overactive bladder which I have I recommend you check the pH of your urine with a simple test kit you can get on Amazon for about $10 and if it is less than 5, taking potassium will raise it and help with overactive bladder.

[SueJohnson in reply to DonkeyRose]

What are you taking the pregabalin for and how much?

[DonkeyRose in reply to SueJohnson]

25mg pregabalin I take for bipolar I think.

[SueJohnson in reply to DonkeyRose]

The pregabalin will also help your fibromyalgia.

[SueJohnson]

Time your medicines so that you take your thyroid medicine at least 4 hours away from any medicines that contain aluminum, calcium, iron, magnesium, simethicone, or sucralfate even in a multivitamin

[DonkeyRose in reply to SueJohnson]

That's interesting. I take all my morning medication only half an hour after levothyroxine religiously.