Natural treatments for restless legs syndrome (RLS)
Restless Legs Syndrome (RLS) is characterized by an overwhelming urge to move the legs, often accompanied by a “creepy-crawly” sensation, particularly when at rest or trying to sleep. While conventional treatments typically involve medications, many individuals seek natural remedies to alleviate their symptoms. Some proposed natural treatments include supplementation with vitamins and minerals such as magnesium, folate, iron, vitamin B12, vitamin C, and vitamin E, although scientific evidence supporting their efficacy is limited. For instance, low iron levels have been linked to RLS, and correcting iron deficiency may benefit those affected. Other lifestyle modifications might include avoiding stimulants like caffeine and alcohol, engaging in regular exercise, and practicing relaxation techniques such as yoga and massage. Additional treatments like warm baths, compresses, acupuncture, and certain herbal supplements are also explored by some patients. While there is no definitive natural cure for RLS, many individuals find symptom relief through a combination of these approaches, underscoring the importance of consulting healthcare professionals before pursuing any treatment.
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Subject Terms
Natural treatments for restless legs syndrome (RLS)
DEFINITION: Treatment of the intense urge to move one’s legs, especially when sitting still or when trying to fall asleep.
PRINCIPAL PROPOSED NATURAL TREATMENTS: None
OTHER PROPOSED NATURAL TREATMENTS: Folate, iron, magnesium, vitamin B12, vitamin C, vitamin E
Introduction
People with restless legs syndrome (RLS) often feel an intense urge to move their legs, particularly when sitting still or trying to fall asleep. Unlike persons with nighttime leg cramps (a different condition), people with RLS do not experience pain. Instead, they may describe an uncomfortable “creepy-crawly sensation” inside their legs. Walking relieves the symptoms, but as soon as the affected person settles down again, the urge to move recurs. The feeling is sometimes described as “wanting to ride a bicycle under the covers.”
RLS tends to run in families, often emerging or worsening with age. People with RLS frequently have another condition called periodic leg movements in sleep (PLMS). Persons with PLMS kick their legs frequently during the night, disrupting their own sleep and that of their bed partner.
Because RLS is occasionally linked to other serious diseases, one should consult a doctor if symptoms of RLS emerge. Conventional medical treatment for RLS usually involves taking a levodopa-carbidopa combination, which is a treatment for Parkinson’s disease. The drug quinine has been used in the past, but one double-blind study found no benefit. Because of the risk of dangerous side effects, quinine is no longer used for this purpose.
Proposed Natural Treatments
Preliminary evidence suggests that symptoms of RLS may be relieved by supplementation with one of several minerals or vitamins, including magnesium, folate, iron, and vitamin E. However, there are no double-blind studies to support these treatments; therefore, their use remains speculative.
Magnesium. Preliminary studies suggest that supplemental magnesium may be helpful for RLS, even when magnesium levels are normal. An open study of ten people with insomnia related to RLS or PLMS found that their sleep improved significantly when they took magnesium nightly for four to six weeks. However, open studies are extremely unreliable because they do not factor out the placebo effect. Also, no double-blind studies on magnesium for RLS have been reported.
Folate. Based on numerous case reports of improvement, folate is also sometimes recommended for RLS. Symptoms decreased in one study of forty-five persons given five to thirty milligrams of folate daily. However, again, this was not a double-blind experiment; therefore, the meaningfulness of the results is questionable. Such high doses of folate should be administered only under medical supervision. Folate taken in nutritional doses may be of benefit to pregnant women with RLS who are deficient in this vitamin.
Iron. Research has linked RLS to low levels of iron in the blood. In one analysis of the medical records of twenty-seven people with RLS, those with the most severe symptoms had lower-than-average serum ferritin levels, one measure of iron deficiency. In another study, eighteen older adults with RLS were compared with eighteen older adults without the condition. Those with RLS also had reduced levels of serum ferritin. When fifteen participants were given iron, all but one experienced reduced symptoms. Those with the lowest initial ferritin levels improved the most. However, once more, these were not double-blind studies, so the results cannot be trusted.
In contrast to these results, a double-blind study of twenty-eight people found that iron did not relieve RLS any better than a placebo. However, in this particular study, participants had normal levels of iron on average. The study did not effectively measure whether iron might help RLS among people with iron deficiency. Studies in the late 2010s and early 2020s confirmed iron’s effectiveness in treating the symptoms of RLS in those individuals with secondary RLS caused by an iron deficiency. However, not all individuals with an iron deficiency have RLS, and an iron deficiency does not cause every case of secondary RLS.
One theory holds that mild iron deficiency may cause RLS by decreasing the amount of a neurotransmitter called dopamine. This theory is supported by findings that conventional drugs that increase dopamine activity (such as the Parkinson’s disease drug combination of levodopa-carbidopa) can also alleviate RLS.
Iron supplements might be useful for people with RLS who are also deficient in iron. Still, if one is deficient in iron, the deficiency is worth correcting. Note that tests for anemia will not necessarily pick up the low-grade iron deficiency linked to RLS. For that purpose, one will need tests that specifically evaluate iron levels, such as ferritin, serum iron, and total iron-binding capacity. If ferritin levels fall below 50 micrograms per liter, adding an iron supplement is likely to help RLS symptoms, and since vitamin C helps iron absorption, it may also be beneficial.
Vitamin E. Vitamin E has also been proposed for RLS. In one report, seven of nine people with RLS who were given 400 to 800 international units daily of vitamin E experienced virtually complete control of symptoms, while the other two people had partial relief. Other anecdotal reports suggest that vitamin C may be useful and that vitamin B12 may benefit people with RLS who are deficient in this nutrient. However, while these reports may sound good, they mean little because they were not double-blind studies.
Other vitamin deficiencies linked to RLS include vitamins B6, B12, C, and D. Additionally, some health conditions are linked to RLS, including kidney disease, fibromyalgia, underactive thyroid, rheumatoid arthritis, Parkinson's disease, and diabetes.
Several other proposed natural treatments for RLS include warm and cold compresses, hot baths and showers, compression wraps, and acupuncture. Lifestyle changes are also recommended. Preliminary studies suggest that Dangguijakyak-san and Shihogyeji-tang may be helpful supplements in treating RLS.
Patients should avoid nicotine, sugar, alcohol, and caffeine and increase exercise. Yoga, stretching, and massage are also helpful in treating RLS. Other proposed treatments include near-infrared spectroscopy (NIRS) and near-infrared light therapy (NIR light therapy), which involve treating legs with light beams with long wavelengths. NIR and NIRS are believed to improve circulation and influence peripheral vasculature in muscular tissue. They also encourage the release of endorphins and relieve pain.
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