Restless Leg Syndrome (RLS) is a chronic neurological disorder. It manifests itself in pain, throbbing, a tingling sensation or restlessness in the legs, which disturb sleep. Sometimes, the arms are affected as well. In many cases, the cause of RLS is unknown. The symptoms are less or even have disappeared completely in the morning.
Sufferers feel the need to move their legs. Massages or walking make things better, but will interrupt a good night's rest.
Lack of sleep and therefore exhaustion have a negative effect on daily life and work. Those affected by RLS find it hard to concentrate, are tired most of the time and find it hard to cope during the day. This might even lead to depression.
RLS can be found in people of all ages, even in schoolchildren. However, it is important not to confuse RLS with ADHD, as both can present themselves in severe restlessness and concentration problems.
RLS symptoms are often misinterpreted
Many affected people don't really take the initial symptoms serious and therefore won't see their doctor. On the other hand, a visit to the doctor won't always bring the desired relief. In some cases - depending on the patient's medical history - the symptoms are attributed to a different illness altogether, e.g. arthritis.
Unfortunately, all too often the patient is told that his ailment is down to nervous tension or to an age-related insomnia with muscle cramps.
In most cases, RLS starts in middle-aged people and gets worse with age. There can be weeks or months without any symptoms.
The causes of RLS
Orthodox medicine often sees the causes as follows:
It's in the genes. As so often is the case with chronic diseases, the assumption is that the genes are at fault.
A dopamine imbalance. Dopamine is a neurotransmitter in the brain which, among other things, is responsible for effective muscle activity and coordinated movement.
Low iron levels. Chronic diseases, such as arthritis, insufficient kidney function, high blood pressure, degenerative disc diseases, diabetes, polyneuropathy, coeliac disease and also Parkinson's disease can often lead to RLS or manifest themselves in combination with RLS. With the treatment of these illnesses, RLS will get better, too.
Medication. Some drugs can worsen the symptoms of RLS and even trigger it, if there is a certain genetic disposition. Among the pharmaceuticals in questions are: anti-sickness drugs (prochlorperazine or metoclopramide), anti-psychotic drugs (haloperidol or phenothiazine derivatives), antidepressants which increase serotonin levels and also some meds against colds and allergies (antihistamines).
Pregnancy. Especially during the last trimester, RLS can develop which, however, will usually disappear within four weeks after giving birth.
Alcohol and sleep deprivation. Both can trigger RLS. Abstinence and regular sleep will get rid of the symptoms.
The diagnosis of RLS
There is no specific test that can be carried out to clearly diagnose RLS. However, the diagnose is usually based on four criteria. If those are met, RLS will be taken into consideration:
1. The symptoms get worse towards bedtime and are gone or considerably better in the morning.
2. The urge to move one's legs is so strong that it can't be resisted.
3. The more relaxed the sufferer is, the worse the symptoms get.
4. With movement, the symptoms get better, but only as long as the sufferer moves about.
Blood tests might be carried out to check iron levels and other deficiencies (minerals, other vital substances). Neurological tests can reveal if polyneuropathy is causing the symptoms.
Conventional therapy for RLS
As soon as all the tests have been carried out, the doctor will prescribe medication, depending on the results, for example, increase iron levels, adjust blood sugar levels or treat diabetes, change prescription drugs or tell us to stop drinking alcohol.
If no cause could be found, we are told that what we are dealing with is idiopathic or primary RLS, in other words, there is no explanation of what causes your RLS; in orthodox medicine, anyway.
That's when the "big guns" come out. The doctor might prescribe L-Dopa (Levodopa) to increase dopamine levels in the brain or Carbidopa (DDC inhibitors) which inhibits the synthesis of dopamine.
The patient is happy with the prescription, but some patients won't be able to take the meds for as long as it takes to show an effect. They soon suffer from dizziness, low blood pressure, nausea and vomiting. If the sufferer can sit it out, they will indeed feel the benefit of the meds eventually.
Another problem is that the drugs don't have a lasting effect. There is the known problem with "augmentation" which means that the symptoms of RLS will get worse with time, because the medication has stopped working. There is also the possibility that, as a consequence of the medication, the symptoms present themselves during the day instead, which makes driving a vehicle and sitting still at work, in the cinema or theatre difficult.
Other side effects of dopamine inhibitors are sudden psychological and behavioural disorders, such as impulsive or obsessive behavioural patterns (gambling, shopping etc). This makes it necessary to stop taking the meds so that the affected person can recover.
Other possible prescription drugs are: Benzodiazepines which are usually prescribed for anxiety or severe insomnia. Possible side effects are: getting addicted to them or sleep apnoea. Opioids to suppress pain. The side effects are dizziness, nausea, sleep apnoea and risk of addiction.
Anticonvulsants (antiepileptic drugs) can alleviate the tingling sensations in the legs, but at the same time can cause dizziness, fatigue and even ataxia (dysfunctions of coordinated movement).
The holistic treatment of RLS
From a holistic point of view, these four factors are mainly responsible for RLS and should be the main focus for a holistic therapy.
1. Vitamin D deficiency
A vitamin D deficiency is often found in connection with RLS. Scientists have carried out studies which showed that by supplementing vitamin D, the symptoms of RLS could be improved considerably. Therefore, the presumption is that a lack of vitamin D is connected to developing RLS and may also be directly linked to dopamine levels in the brain.
An optimisation of vitamin D levels can increase the dopamine levels in the brain. At the same time, vitamin D protects the dopamine-producing nerve-cells from toxic substances.
2. Chronic inflammation and imbalances in the immune system
Research showed that the symptoms of RLS are worse if the CRP (C-reactive protein) level in the blood is increased. Raised CRP is an indication that a systemic inflammation is affecting the body. A study revealed that an infusion with hydrocortisone, which is an anti-inflammatory drug, alleviated RLS symptoms. Cortisone is very effective when it comes to autoimmune disorders, possibly also an underlying factor in RLS, which can attack the body's own nervous system.
With chronic inflammatory disorders of any kind it is important to adjust daily life accordingly. That means to eat an anti-inflammatory diet (alkaline, nutritious, low in toxins, wholesome, antioxidant, lots of Omega 3 fatty acids with lower Omega 6 intake), low stress levels, regular exercise as well as taking antioxidants as supplements, such as Curcumin, Astaxanthin, OPC (Oligomeric Proanthocyanidins, Bioflavonoids) etc. Best to consult a nutritionist.
Also, a leaky gut could be the reason - often caused by an intestinal fungus (Candida), which leads us to ...
3. Disorders of the intestinal flora (dysbiosis)
A study revealed that 69 % of RLS sufferers who took part also suffered from a dysbiosis, compared to only 28 % of the healthy participants. In addition, 28 % of RLS sufferers also presented IBS symptoms, compared to only 4 % of the control subjects.
In a double-blind study, RLS sufferers were given antibiotics which destroyed all intestinal bacteria, but also alleviated the symptoms. Which proves, of course, that there is a connection between the gut flora and RLS. Luckily, research showed that probiotics can have the same positive effect on RLS as antibiotics. probiotics are widely available (e.g. Udo's Choice, Higher Nature).
4. Iron deficiency
We have already mentioned low iron levels earlier in the article. Due to its importance in relation to RLS we should refer to this aspect once more. Iron is mainly connected to the production of blood cells. We all know that a lack of iron can lead to anaemia. It is less known, however, that dopamine needs iron to function properly. Therefore, in case of an iron deficiency, this lack disrupts the function of dopamine in the brain, and RLS (among other ailments) can develop.
This is one of the main reasons why many pregnant women suffer from RLS which slowly disappears again after child-birth. Many women suffer from low iron levels during pregnancy, which usually levels itself out again after the child is born.
Insufficiently functioning kidneys also often lead to an iron deficiency. That's why kidney disease often comes with RLS symptoms.
RLS sufferers who take an iron supplement experience an improvement in most cases. During a study, the participants reported that they could feel the benefits of taking iron within 12 weeks.
Low blood iron levels can, however, be the result of a dysbiosis (disorders of the gut flora), an intestinal infection or other chronic inflammatory processes. Inflammation or dysbiosis can lead to an increase in hepcidin levels. Hepcidin is a hormone which - if there is an excess - lowers iron levels and blocks the re-absorption from the intestinal tract.
Therefore, in the case of a dysbiosis, taking an iron supplement will not have any effect. On the contrary, the situation can get worse because the iron which cannot be re-absorbed will worsen the dysbiosis in the gut. In this case, it is important to restore gut health first and then start iron supplementation.
The holistic approach - the basics
Apart from the above-mentioned measures, also the common basics of healthy living should be included in the therapy for RLS.
1. Stay clear of the usual irritants and neurotoxins, such as caffeine, alcohol and tobacco.
2. Optimise your diet, with lots of fresh ingredients, nutritious, alkaline-based, and if necessary, balance any deficiencies with the right supplements (iron, folic acids, magnesium, vitamin B etc).
3. Apart from iron (as explained above), we also should consider magnesium levels. Even if we think that there is no reason for action, it is advisable to take 400 - 500 mg of magnesium (chelated or citrate), best divided into two lots per day.
4. Regular exercise is important (stretching, hiking etc), and so is a regulated sleep-wake-cycle.
Additional holistic measures
There are some more holistic measures that can or should be applied when suffering from RLS:
Using chamomile or lavender oil, added to a good carrier oil, for leg massages or rubs can help to soothe symptoms.
Bathing the feet in Epsom salt, cider vinegar or sodium bicarbonate (in water) before bed-time or iced compresses can also help to lessen the symptoms.
Relaxation therapy should be carried out on a regular basis. Regular massages often help sufferers to feel better.
Acupuncture as well as a chiropractic treatment of the lower back helps many affected patients. A compressed nerve or an imbalance in the lower back can lead to RLS.
There are also some homoeopathic remedies which can help with RLS symptoms, However, it is best to consult an experienced homoeopath to find the suitable remedy.
- Rhus tox (well-matched with RLS symptoms)
- Tarantula hispanica (for very impatient, also angry RLS patients)
- Zincum metallicum (for tired and exhausted patients, where noise, touch and alcohol worsen the symptoms)
- Phosphorous (for insecure patients, where symptoms improve when lying on the right side and who like to drink lots of ice-cold water)
- Magnesia carbonica (for patients whose symptoms get worse with the weather and also while lying in a warm bed)
- Arsenicum album (for patients who don't like being alone, who feel anxious and often suffer from cramps)
- Causticum (for patients who also suffer from rheumatism and have cracking in their knees)
If you have found "your" remedy, take 5 globuli 3 times daily (D12 potency). For best advice, however, please consult a homoeopath.
To increase dopamine levels naturally, the following remedies can be taken: active vitamin B6 (p5p, pyridoxal phosphate), B12 (methylcobalamine), blueberry extract, MSM, the cowhage bean (mucuna pruriens, has been used in ayurvedic medicine for over 4000 years) and the humble beetroot.
(pic: apotheken-umschau.de)
Vitamin B complex is known to protect the nerves.
Vitamin C.
Selenium, as it is a trace element which stimulates dopamine production.
Infrared light irradiation.
A Relaxis pad. It is a vibrating pad which you can put under your legs in bed. As soon as the RLS symptoms set in, you can switch on the pad. Its vibration counter-act the symptoms, which can lead to an improvement of RLS and ultimately to a better sleep. http://myrelaxis.com/
KPU (kryptopyrroluria) - as in any chronic disease, KPU is a possible factor in RLS and should be ruled out. In the case of testing positive for KPU, the suitable vital substances should be given as required. More information on KPU at http://www.kpu-berlin.de/en/What_is_Kryptopyrrolurea.htm.
No matter which measures you decide on, please discuss their implementation with your health professional.
(source: zentrum der gesundheit)
