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Restless legs syndrome

MagazineSeptember 2001 (Vol. 12 Issue 6)Restless legs syndrome

Q-I suffer from acute cramps in the feet and legs, and am anxious to find a source of a magnetic product to wear, preferably on the feet

Q-I suffer from acute cramps in the feet and legs, and am anxious to find a source of a magnetic product to wear, preferably on the feet. Do you know of a company that I could apply to for advice? Or have you any suggestion as to how else I might fin

A-It sounds as though you are suffering from what is usually called restless legs syndrome. There are two types of RLS. The first is the variety you experience, with shooting pain in your lower limbs and often numbness. The other variety only affects motor control, with no cramping or pain, but the legs go into periodic spasms and sometimes seem to have a life of their own. The cramping variety is often worse at night, and is alleviated by massage or movement. The other strange feature of RLS is that it doesn't always affect the legs. Patients can experience problems with the lower back, the upper thighs or even the hands.

WDDTY is not a fan of so called magic bullets single substances or devices which claim to offer a magical cure. Although magnetotherapy has tremendous success in treating a variety of problems, there are many simpler solutions to your problem.

RLS is usually due to a biochemical imbalance something you're eating that you shouldn't be or a vital nutrient that you're not getting.

A classic cause is a folic acid deficiency (Botez MI, Reynolds EH, eds. Folic Acid in Neurology, Psychiatry and Internal Medicine, New York: Raven Press, 1979). The first area to investigate is whether any drugs you are taking are interfering with your levels of this vital nutrient, as many do deplete levels of folic acid. These include stomach drugs like H2-blockers, bile acid type drugs like cholestyramine and colestipol, oral contraceptives, certain antibiotics, steroids, and even painkillers and anti inflammatories like indomethacin, suphasalazine or common aspirin (see Alternatives, p 6-7). So, if you are taking aspirin or another painkiller to alleviate the pain of your leg cramps, you could be making the problem worse.

In a case report of three women with mild RLS and decreased sensation in the legs, all three recovered after treatment with folic acid. A similar result was seen in another three women with RLS and general muscle pain in response to folic acid treatment (Can Med Assoc J, 1976; 15: 217-22).

Although the optimal dose of folic acid is ordinarily between 400-800 mcg, in your case, WDDTY panel member Dr Melvyn Werbach warns, you may need to take doses as high as 5 mg three times per day. Such high dose levels should only be taken under medical supervision from an experienced qualified nutritionist.

Another classic cause of RLS as well as a related problem sponta neous leg cramps (SLC) is reactive hypoglycaemia, indicative of poor sugar control. In one study of more than 350 patients with RLS, SLC, or both, almost all had other symptoms of low blood sugar and tested positively for hypoglycaemia on glucose tolerance testing. During the test, the researchers also found that the low blood sugar brought on an episode of RLS pain.

In the study, the participants were put on a sugar free, high protein diet with small frequent meals and one small meal at night. Shortly after this, all symptoms were cleared or strikingly alleviated in the vast majority of patients. Recurrences of the problem were usually traced back to cheating on the diet within the past 12 hours (J Fla Med Assoc, 1973; 60: 29-31).

In light of these results, it's worth having yourself tested for hypoglycaemia (London's Biolab do such a test; tel: 002 7636 5959). If the glucose tolerance test shows that you have the condition, you may wish to work with a nutritionist, who will devise an appropriate diet and eating plan.

It's also a good idea to avoid caffeine and xanthine derivatives of any variety, which includes coffee, tea, all cocoa products and cola. One study of patients with RLS found that their symptoms improved markedly once they eliminated all caffeine products from their diet (J Clin Psych, 1978; Sept: 693-8).

Dr Werbach has evidence that RLS may also be caused by a deficiency of iron or an abnormal iron metabolism. In one study, one quarter of patients with RLS were shown to have low blood levels of iron (Neurology, 1960; 10: 868-73). In another study, simple iron supplementation resolved the problem (Acta Med Scand, 1953; 145: 453. Again, you need to make sure that any drugs you're taking aren't interfering with your iron intake these include cholestyramine, tetracycline, indomethacin and aspirin.


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