Restless legs syndrome: causes and natural approaches

What is Restless Legs Syndrome

Restless legs syndrome (RLS) is a sleep-related movement disorder that causes a strong, nearly irresistible urge to move the legs, usually when you’re resting in the evening or at night. It also brings uncomfortable sensations in the legs, like itching, crawling, pulling, or throbbing, and moving can temporarily relieve the feeling. It typically happens in the evening or at night when sitting or lying down. Moving eases the feeling for a short time.

RLS also is known as Willis-Ekbom disease. The sensations associated with RLS can vary but are commonly described as:

• Electric feelings
• Aching
• Itching
• Burning
• Crawling
• Creeping
• Pulling
• Throbbing

These symptoms can lead to difficulty falling asleep or staying asleep, which may significantly impact daily life. RLS can affect individuals of all ages, but it is more common in middle-aged and older adults, and it tends to worsen with age.

Causes of Restless Legs Syndrome

Cause(s) of restless legs syndrome are not clear at present and it appears there are a number of factors involved.

One of them is excess weight, it seems being overweight is an important contributing factor. As our weight increases so does your risk for RLS according to the 2009 study by the Harvard Medical School. In the study researchers surveyed 88,000 men and women and found that those who were generally obese, with a body mass index higher than 30, were at 40% higher risk of developing RLS. Moreover, those with a high waist circumference had an even higher risk—60%.

This systematic review and meta-analysis of 15 studies comprising 197,204 individuals, shows that overweight and obesity were associated with increased odds for restless legs syndrome. It also found that women with obesity were more likely to have RLS as compared with men.

Scientists propose that the levels of dopamine, a neurotransmitter in the brain which controls both movement and the pleasurable feeling from eating, may be involved. According to this review restless leg syndrome involves a disrupted relationship between brain iron and dopamine signalling, not simply low dopamine overall. Symptoms worsen at night because dopamine activity naturally dips in the evening, unmasking the underlying circuit problem

Consequently losing weight overtime becomes of at most importance as it should alleviate and eventually correct RLS in many cases.

RLS can also develop in people who are not overweight, and in this case it has been linked to excessive nerve related inflammation. In such cases, specific nutrition and supplements supporting nerve health can make a real difference in symptoms.

Thirdly, it has been postulated that one of the causes of RLS is low iron. Research shows that enough iron is needed in the brain stem where pain signal is registered, and iron deficiency may cause pain by altering the structure and function of the brain stem which is reflected in altered nerve function that facilitates pain. Iron supplementation, lifestyle changes, and non-dopaminergic medications all play a role in long-term management.

It seems this could be the case even if the iron blood test results are within the ‘normal’ ranges but fall towards the lower range of the spectrum.

Nutrition and Lifestyle Factors to Consider

Nutrition and lifestyle can work alongside medical treatments to improve symptoms.

Eating nutritious diet rich in iron, vitamin C and B vitamins, magnesium, protein and good fats can help alleviate symptoms in some people.

Reducing caffeine, alcohol and nicotine, especially before bedtime, helps some people notice a difference as both substances can interfere with dopamine signalling and sleep architecture

RLS can also be alleviated by lifestyle factors including:

• Making sleep improvements – especially establishing a consistent sleep schedule which helps regulate the body’s internal clock, potentially reducing the frequency and severity of RLS symptoms
• Creating a relaxing bedtime routine and dark bedroom
• Stress management
• Undertaking moderate physical activity during the day can help reduce the severity of symptoms at night
• Spending tome outdoors
• Applying heat or cold to the legs or taking warm baths
• Regular stretching and gentle leg massage

The above actions can meaningfully reduce symptom burden for milder cases or work alongside prescribed treatment.

Summary

More research is needed to pin point causes of RLS. Thankfully, nutrition and selective supplements tailored for each individual do make a difference as they play an important role in dealing with RLS at present. This includes providing nutrients that help to reduce inflammation, to heal the nerves and increase production of dopamine in the brain.

Weight loss is of importance (where needed), and diet high in iron, as well as high quality iron supplements are important considerations.

As always, work with a knowledgeable health practitioner when undertaking any nutritional and/or supplementation programs, especially when you are also taking prescription medications.

Explore more of our key nutrition and good foods guides and articles in the Nutrition Hub →

Best of Health

Joanna Sochan
Wholistic Health and Lifestyle Therapist
Natural and Lifestyle Solutions for Abundant Health & Wellbeing

References

• Mayo Clinic: Restless Legs Syndrome overview
• Gao X, Schwarzschild MA, Wang H, Ascherio A. Obesity and restless legs syndrome in men and women. Neurology. 2009 April. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA 02115, USA.
• Journal of Affective Disorders: The association between obesity and restless legs syndrome: A systemic review and meta-analysis of observational studies
• Garcia-Borreguero, D., Silber, M. H., Winkelman, J. W., Hogl, B., Bainbridge, J., Buchfuhrer, M., et al. (2016). Guidelines for the first-line treatment of restless legs syndrome/Willis-Ekbom disease, prevention and treatment of dopaminergic augmentation: a combined task force of the IRLSSG, EURLSSG, and the RLS-foundation. Sleep Medicine, 21, 1-11.
• Connor, J. R., Boyer, P. J., Menzies, S. L., Dellinger, B., Allen, R. P., Ondo, W. G., & Earley, C. J. (2003). Neuropathological examination suggests impaired brain iron acquisition in restless legs syndrome. Neurology, 61(3), 304-309.

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Disclaimer: This content is for informational and educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making any changes to your health regimen, particularly if you are taking prescription or over-the-counter medications or have a medical condition.

Bio: Joanna Sochan is a Wholistic Natural Therapist and founder of Naturimedica Wholistic Wellcare. She has over 15 years of clinical experience working with complex health presentations, with a focus on gut health, food sensitivities, women’s hormone health (including perimenopause and menopause), metabolic health, weight regulation, and senior health. She works with clients Australia-wide and online, and also develops therapeutic programs, eCourses, and educational resources designed to support long-term, sustainable wellbeing. View full bio.