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Wednesday, November 12, 2008

Restless Legs Syndrome

Restless legs syndrome (RLS) is a neurological disorder causing restlessness and the urge to move the legs. A recent study, published in the January 1, 2008 issue of Neurology suggests that people with RLS have an increased risk for stroke or heart disease.
The subjects of the study were 3,433 men and women, with an average age of 68. They were participants in the Sleep Heart Health Study. Nearly 7% of the female participants and about 3.3% of the men had RLS, as determined by a questionnaire. The participants also answered questions about cardiovascular disease and stroke. The presence of RLS was associated with a two-fold likelihood of cardiovascular disease or stroke. This association was especially strong among those with severe symptoms more than 16 times each month.
Nutrition may play a role. In the journal Age, Ageing (May 1994;23(3):200-203), a small study was published, involving 18 elderly subjects with RLS and 18 controls. The serum ferritin was inversely associated with the severity of RLS symptoms. Ferrous sulfate was given to 15 of the subjects and the RLS score improved in eleven of the patients—with greater improvement going to those with the lowest ferritin levels. Another article in the journal Sleep (June 15, 1998;21(4):371-377) looked at 27 patients between the ages of 29 and 81 and found a correlation between the severity of symptoms and low ferritin levels.
Magnesium supplementation was used in a small pilot study published in the journal Sleep (1998;21(5):501-505). Ten subjects with RLS were given magnesium supplementation over a period of four to six weeks. There was a reduction in leg movements (from 33 to 21 per hour) and sleep efficiency also improved.
Exercise may also be beneficial. Another small study appearing in the Journal of the American Board of Family Medicine (2006; 19(5): 487-93) involved 23 subjects with RLS. They were divided into two groups. On group was put on an exercise program that included aerobic activity and lower body resistance training, and the other served as a control. At the end of the 12 weeks of the study, the group doing the exercise had a significant improvement in symptoms.
Granted, these are small studies. Considering that the treatments in these studies are very low-risk, they may be worth a try. Iron should only be given if there is a deficiency, so it is wise to check ferritin levels before supplementation. Magnesium is a very common deficiency and there are no side effects with supplementation (although taking too much magnesium can make the stools loose). Exercise should be recommended, even if RLS is not a problem.

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