Restless Leg Syndrome (RLS): A Deep Dive Into Symptoms, Causes, and Natural Treatments To Overcome This Condition
With up to 10 percent (1) of the population diagnosed with Restless Leg Syndrome, this perplexing neurological condition robs those affected of a restful nights sleep and ends up impacting day-to-day function and overall quality of life. Unfortunately, those with this condition are met with few answers and a long list of medications designed to provide relief at the expense of other side effects. Instead of going this route, it’s my job as a functional medicine expert to empower you with education and alternative remedies so you can address your symptoms from the source and find relief. So without further ado, read on to learn more about Restless Leg Syndrome, its symptoms, causes, and ways you can find relief, naturally.
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What is Restless Leg Syndrome?
Restless Leg Syndrome (RLS), also known as Willis-Ekbom disease, is a neurological disorder, characterized by an irresistible urge to move the legs, often accompanied by uncomfortable sensations deep within the limbs. Those with this condition commonly experience symptoms during periods of rest or inactivity, especially during evening or nighttime hours, which can severely inhibit sleep.
Symptoms of RLS typically include:
- Limb discomfort: An uncomfortable sensation in legs and arms described as itching, burning, creeping, throbbing, or pulling.
- Persistent urge to move: An uncontrollable urge to move your limbs by walking or shaking as a way to relieve limb discomfort
- Poor sleep quality: Difficulty falling and staying asleep due to limb discomfort and extra movement
- Fatigue and moodiness: A lack of sleep can translate into ongoing fatigue, moodiness, brain fog, and irritability
What causes Restless Leg Syndrome?
While the exact cause of RLS is unknown, researchers believe it stems from a combination of genetic factors and altered neurotransmitter activity, specifically involving dopamine. Researchers have also found that Restless Leg Syndrome can be closely linked to other health problems like iron deficiency/anemia, (2) fibromyalgia, (3) Parkinson’s disease, (4) depression, (5) rheumatoid arthritis, (6) peripheral neuropathy, (7) kidney problems, (8) and diabetes. (9)
In functional medicine we recognize that there can be a variety of contributing factors in addition to genetics such as environment and lifestyle choices. Some potential underlying causes of RLS from a functional medicine perspective include:
1. Nutritional deficiencies
Essential nutrients like iron, magnesium, and vitamin B12 play crucial roles in nerve function and muscle relaxation. Studies have found a link between deficiencies in these nutrients and the onset of RLS symptoms.
2. Inflammation
Chronic inflammation disrupts normal nerve signaling and can lead to neurological imbalances that can potentially contribute to RLS symptoms.
3. Hormone imbalances
Fluctuations in hormones - specifically dopamine and serotonin that are responsible for mood regulation and neurological function - are believed to also play a role in RLS.
4. Lifestyle factors
Studies have found that a sedentary lifestyle, poor sleep habits, and chronic stress can perpetuate and exacerbate RLS symptoms.
There is no specific test to diagnose Restless Leg Syndrome. Instead, your doctor would look at your symptoms and medical history and the criteria established by the International Restless Legs Syndrome Study Group to diagnose RLS. In order to be diagnosed you must experience the following:
- Uncomfortable sensations in your limbs
- An irresistible urge to move your limbs due to the uncomfortable sensations
- Worsened symptoms during periods of rest or inactivity
- Symptoms that are alleviated by movement
Additionally, diagnostic tests may be conducted to rule out other underlying conditions that could mimic RLS symptoms, such as peripheral neuropathy. It is also important to note that certain medications have been shown by the Restless Syndrome Foundation (10) can contribute to RLS symptoms such as:
- Antidepressants
- Antihistamines
- Anti-nausea medications
- Psychiatric medications for schizophrenia and bipolar disorder
- Blood pressure medications
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A conventional approach to Restless Leg Syndrome
Although conventional medicine does recommend some natural remedies for RLS, medications like muscle relaxers, dopaminergic medications, and sleep aids like benzodiazepines are usually prescribed in addition to these remedies.
Natural remedies for Restless Leg Syndrome
Instead of turning to medications that only act as a bandaid for your symptoms, avoid the uncomfortable side effects and try out some of these clinically-backed natural remedies for RLS relief.
1. Engage in regular exercise
Since inactivity can perpetuate symptoms of RLS, it is important to incorporate some type of regular movement into your day as this has been shown to significantly improve (11) symptoms. Try starting out with moderate types of exercises including stretching, cycling, yoga, or swimming a few times a week for 30 minutes.
2. Correct any nutrient deficiencies
Research has long found a connection (2) between iron deficiency and RLS. This is likely due to iron’s role in the synthesis of dopamine which is believed to be low in cases of Restless Leg Syndrome. Vitamin B12 is another common nutrient deficiency that is closely associated with RLS. In fact, a recent study published in Clinical Neurology and Neurosurgery (12) found that patients with RLS had significantly lower vitamin B12 levels than the rest of the population, with symptom severity correlating directly with the severity of the deficiency. Interestingly enough, symptoms of depression also worsened along with RLS-associated limb discomfort.
A functional medicine practitioner will be able to run labs on each of these nutrients to determine if deficiencies are a part of your health case and provide guidance on the right dosage for you. You can also up your intake of both iron and Vitamin B12 rich foods like dark leafy greens including spinach and kale, grass-fed beef, eggs, and wild-caught salmon.
3. Try natural supplements
- Magnesium: Another deficiency linked (13) to RLS, supplementing with magnesium before bed can improve symptoms, likely due to its ability to relax muscles and its role in proper neurotransmitter function. I recommend choosing a powdered magnesium supplement like The Magnesium from my supplement line The Collection, that can easily be mixed in a glass of water.
- Valerian root: This herb can improve RLS symptoms with one study showing that patients who supplemented with Valerian root experienced (14) significant symptom relief and improved sleep quality after just 8 weeks.
4. Take an epsom salt bath
Taking a warm epsom salt bath as part of your nightly bedtime routine can help calm restless legs and promote better sleep. Not only does the warm water relax your muscles, the addition of magnesium containing epsom salts can also encourage muscle relaxation and ease any discomfort related to RLS.
5. Book a massage or acupuncture appointment
Complementary therapies like massage therapy (15) and acupuncture (16) have been shown to improve a variety of health problems, including Restless Leg Syndrome, by reducing symptom severity with regular treatments.
6. Assess your diet
Set a good foundation for your overall health by assessing your diet to make sure it is made up primarily of clean, whole foods to ensure you are getting in a variety of important nutrients necessary to support healthy inflammation levels, proper nutrient levels, and neurotransmitter function. And since symptoms of RLS have been found to worsen with increased alcohol, sugar, and caffeine consumption, eating a diet based in whole foods will limit your exposure to these symptom triggers.
Seeking help from a functional medicine expert
Restless Leg Syndrome can be frustrating, but taking a holistic approach to managing its symptoms can lead to significant improvements in your sleep and day-to-day quality of life. By addressing nutritional deficiencies, reducing inflammation, and promoting overall well-being through lifestyle adjustments, you can work towards finding relief from RLS. Remember, everyone’s biochemistry is unique, so it's crucial to work with a practitioner who can tailor a plan that works best for your particular health case.
If Restless Leg Syndrome has been disrupting your sleep and overall well-being, schedule a telehealth consultation today to learn more about how we can help you with functional medicine. Together, my telehealth functional medicine team and I, will work with you on a personalized approach to reclaim your health that incorporates nutrition, lifestyle adjustments, and targeted supplements, such as iron, if needed.
As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.
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References:
- “Restless Legs Syndrome” National Institute For Neurological Disorders and Stroke https://www.ninds.nih.gov/health-information/disorders/restless-legs-syndrome Accessed August 2023.
- Allen, Richard P et al. “The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia.” American journal of hematology vol. 88,4 (2013): 261-4. doi:10.1002/ajh.23397
- Stehlik, Romana et al. “Restless legs syndrome is common among female patients with fibromyalgia.” European neurology vol. 61,2 (2009): 107-11. doi:10.1159/000180313
- Rijsman, Roselyne M et al. “Restless legs syndrome in Parkinson's disease.” Parkinsonism & related disorders vol. 20 Suppl 1 (2014): S5-9. doi:10.1016/S1353-8020(13)70004-X
- Hornyak, Magdolna. “Depressive disorders in restless legs syndrome: epidemiology, pathophysiology and management.” CNS drugs vol. 24,2 (2010): 89-98. doi:10.2165/11317500-000000000-00000
- Demir, Salih et al. “Restless Leg Syndrome and Sleep Disorders in Patients with Rheumatoid Arthritis and Its Relation with Anemia Parameters.” Acta medica (Hradec Kralove) vol. 64,3 (2021): 137-144. doi:10.14712/18059694.2021.24
- Jiménez-Jiménez, Félix Javier et al. “Association between restless legs syndrome and peripheral neuropathy: A systematic review and meta-analysis.” European journal of neurology vol. 28,7 (2021): 2423-2442. doi:10.1111/ene.14840
- Safarpour, Yasaman et al. “Restless Legs Syndrome in Chronic Kidney Disease- a Systematic Review.” Tremor and other hyperkinetic movements (New York, N.Y.) vol. 13 10. 29 Mar. 2023, doi:10.5334/tohm.752
- Akın, Seydahmet et al. “Restless legs syndrome in type 2 diabetes mellitus.” Primary care diabetes vol. 13,1 (2019): 87-91. doi:10.1016/j.pcd.2018.08.006
- “Frequently Asked Questions” Restless Leg Syndrome Foundation. https://www.rls.org/understanding-rls/faq#question3 Accessed August 2023.
- Aukerman, Melissa McManama et al. “Exercise and restless legs syndrome: a randomized controlled trial.” Journal of the American Board of Family Medicine : JABFM vol. 19,5 (2006): 487-93. doi:10.3122/jabfm.19.5.487
- Chaofan Geng, Zhenzhen Yang, Pengfei Xu, Hongju Zhang, “Possible association between vitamin B12 deficiency and restless legs syndrome” Clinical Neurology and Neurosurgery, Volume 223, 2022, 107477, ISSN 0303-8467, https://doi.org/10.1016/j.clineuro.2022.107477.
- Popoviciu, L et al. “Clinical, EEG, electromyographic and polysomnographic studies in restless legs syndrome caused by magnesium deficiency.” Romanian journal of neurology and psychiatry = Revue roumaine de neurologie et psychiatrie vol. 31,1 (1993): 55-61.
- Cuellar, Norma G, and Sarah J Ratcliffe. “Does valerian improve sleepiness and symptom severity in people with restless legs syndrome?.” Alternative therapies in health and medicine vol. 15,2 (2009): 22-8.
- Xia, Min et al. “Clinical Efficacy and Safety of Massage for the Treatment of Restless Leg Syndrome in Hemodialysis Patients: A Meta-Analysis of 5 Randomized Controlled Trials.” Frontiers in psychiatry vol. 13 843263. 11 Apr. 2022, doi:10.3389/fpsyt.2022.843263
- Huang, Kaiyu et al. “Acupuncture for restless legs syndrome: A systematic review and meta-analysis protocol.” Medicine vol. 99,3 (2020): e18902. doi:10.1097/MD.0000000000018902
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BY DR. WILL COLE
Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular The Art Of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum and the brand new book Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel.
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