Restless Leg Syndrome
My mom suffers from what the doctors believe is restless leg
syndrome. She was prescribed a prescription which costs $130.00 for 30 days.
She does not have RX coverage so my question is: Are there OTC medicines,
herbals of any kind or other remedies to help her with RLS other than a pharmaceutical?
Restless leg syndrome is characterized by the irresistible
desire to move one’s body to avoid an uncomfortable sensation often at night
when attempting to sleep. The legs are
most often involved, but it can affect any of the limbs and more rarely the
trunk. No clear cause is known, but it
is more prevalent in women and might have a genetic link based on the fact it
is often seen in related family members.
It is understood that dopamine, a very powerful brain neurotransmitter,
plays a key role in the development of RLS.
Prescription drugs for RLS can often be effective but are
well known to cause, over time a rebound type effect. This is often characterized by the emergence
of symptoms earlier in the day or a worsening of symptoms if the medication is
not taken. The most popular drugs for
RLS are called dopamine agonists, meaning they enhance the effects of dopamine
in the brain. Not only do these drugs
cause most RLS symptoms to become worse over time, there is emerging evidence
they can influence certain behavior patters.
In 2007 the Mayo clinic released the first study to describe the link
between compulsive gambling in RLS patients who are being treated with medications
that stimulate dopamine receptors in the brain.
They recommend all physicians screen RLS patients for impulsive behavior
tendencies before prescribing a dopamine agonist drug.
One of the most well documented non-pharmaceutical
approaches to treating restless leg syndrome is iron supplementation. Iron plays a key role in the production of
dopamine. It seems particularly
effective if an individual has a ferritin level below 60 micrograms. Ferritin is the way your body stores
iron. Making sure your mom has had her ferritin
levels checked is a great place to start.
Iron supplements are extremely inexpensive and as noted can be very
effective in certain cases of RLS.
Other natural approaches to RLS can be effective but few of
them have rigorous scientific backing. Most are strategies passed among doctors who
have seen widespread success in their patient populations.
One of the most effective supplements seen to aid RLS is
high dose folic acid. Most reports from
clinical practice use anywhere from 10mg per day to up to 60mg per day. I have seen 20mg per day be very effective
and safe. High doses of folic acid are
often a prescription item but they can be found as OTC preparations as
well. The reason why the FDA mandates
high dose folic acid be a prescription is because taking too much folic acid
can mask a B12 deficiency. However, if
someone is eating foods rich in B12 like meat products, diary products and eggs
and taking a multivitamin with B12 there is very little chance they will have a
B12 deficiency. To be safe, your mom can
ask her doctor for a very simple blood test to measure B12 levels. Otherwise, folic acid is considered very safe
and has no known toxicity in humans.
Some people also find vitamin B6 and Magnesium to be helpful
for their RLS symptoms. Magnesium
deficiency is quite common in our population and this key nutrient plays a
critical role in muscle relaxation. The
exact mechanism of how B6 affects RLS is not clear but due to its low toxicity
and possible effectiveness it is often worth a try.
Other things to consider are removing exposure to dietary
and lifestyle influences that can worsen RLS symptoms. Dietary stimulants like coffee and chocolate
often worsen symptoms. In addition,
alcohol also seems to have a negative effect on some RLS patients and
discontinuing all use for a trial period of 4 weeks should be considered.
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