Examining Restless Leg Syndrome

restless-legs-syndrome_300Restless leg syndrome (RLS) is an inflammatory condition with similarities to other autoimmune diseases and chronic illnesses. As such, conventional doctors do not know the cause of RLS. However, they agree that something triggers inflammation that affects the nerve pathways involved. Let’s take a closer look at what RLS is and what causes it. I’ll also discuss some important ways to reverse it without taking prescription medications.

Defining RLS

RLS, a predominately nighttime neurological disorder, afflicts as many as 12 million Americans. It is characterized by an uncontrollable urge to move the legs or even involuntary leg twitching while at rest. It usually takes place at night, but it can also be a daytime phenomenon during prolonged periods of sitting. Sufferers often report a feeling of tingling, aching, itching or slight burning deep in their lower legs. Moving the legs seems to make them feel better. Sometimes, the sensations are in the thighs, feet, hands or arms.

Conventional Medicines For RLS

The prescription drugs that doctors typically prescribe for RLS include:

  • Quinine sulfate (still relatively safe and effective, despite new Food and Drug Administration controls).
  • Dopamine (brain neurotransmitter) stimulators: Mirapex, Neupro, Requip and levodopa. Sinemet quickly causes augmentation and rebound. (That is, it soon stops being effective.)
  • Benzodiazepines for sedation: Valium, Ativan, Xanax, Klonopin, etc.
  • Anti-seizure medications: Tegretol, Lyrica, Neurontin, etc. (These are addictive.)

What Worsens RLS?

We know that there are certain chronic health conditions associated with RLS. That’s because when there is inflammation in one organ system, it’s also likely to be in others.

More importantly, we should be asking: “What things worsen the underlying inflammation of RLS?” Some food constituents that worsen RLS as reported by bloggers can include: aspartame (the artificial sweetener NutraSweet), caffeine (in coffee, tea and certain cola drinks), gluten (proteins found in wheat, barley and rye), monosodium glutamate (MSG), alcohol, tobacco (nicotine), and refined sugar (when you consume too much for too long). 

We also know that certain prescription medications seem to make the condition worse. Medications reported to exacerbate RLS include some antinausea drugs, antipsychotic drugs, antidepressants and cold/allergy medications. Sleep deprivation seems to make it worse for many RLS sufferers.

Contributing Causes For RLS

Can RLS be caused by nutritional deficiencies? We know that the minerals magnesium and calcium relax muscles. And classic symptoms of low magnesium include tremor, muscle fasciculation, twitches, involuntary jerks and even tetanic cramps (the familiar “charley horse”). Those symptoms have similarities to RLS.

Previously, I have wondered how a healthy person could become magnesium-deficient if each of us has a built-in homeostasis mechanism to keep magnesium in proper balance (intestinal absorption, kidney excretion and bone deposition/exchange).

Yet I’ve since learned that it is easy to become low in magnesium and that magnesium deficiency is not being reported. Medical doctors routinely check for magnesium in the serum of “healthy” patients, yet this is a poor nutritional evaluation because only 0.3 percent of total body magnesium and less than 1 percent of total body calcium are measureable in the blood. Moreover, the peer-reviewed science tells us that the diagnosis of low magnesium or low calcium is vastly underestimated. [1]

The RDI (recommended daily intake) of magnesium is the minimum daily intake established by the government, yet this level even appears to be too low for great health. [2] A government study shows that 68 percent of Americans do not  consume even the recommended daily intake of magnesium (420 mg a day for adult males) and that 19 percent of Americans do not  consume even half of the RDI of magnesium. [3]

Magnesium is reportedly becoming depleted in our soil and is also becoming less absorbable. Worse, many common prescription medications and hormone imbalances also lower our magnesium. [4] For more comprehensive information (it’s interesting reading) about the real problem of magnesium deficiency in the United States, go here, here and here.

Deficiency Situation

Deficiencies of folate [5] (a B vitamin) and iron [6] have also been shown to be associated with RLS. That’s probably why they are used therapeutically by RLS sufferers.

Furthermore, nutrient deficiencies can contribute more readily than we have been led to suspect.

There is a relationship between gut health and brain function/psychology. It has been described by a neurologist/neurosurgeon with postgraduate degrees in human nutrition, Natasha Campbell-McBride, M.D. I believe there is a similar relationship to other chronic nerve-related diseases, including RLS.

Campbell-McBride records the nutrient deficiencies commonly found in patients with neurological disorders such as autism, ADHD and dyspraxia to be most commonly: “magnesium, zinc, selenium, copper, calcium, manganese, sulphur, phosphorus, iron, potassium, vanadium, boron, vitamins B1, B2, B3, B5, B6, B12, C, A, D, folic acid, omega-3, 6, 9 fatty acids, taurine, alpha-ketoglutaric acid, glutathione and many other amino-acids” [7].

The Nutritional Difference

Since chronic inflammation usually begins in the gut, take a look at what foods you eat that could be contributing to an unhealthy gut flora and an unhealthy digestive lining. Refined sugar, bread and other processed foods all must be replaced by whole foods. I recommend that half the foods you eat be raw foods.

Fruits, vegetables and other whole foods contain the minerals, vitamins, antioxidants, fiber, healthy oils and phytochemicals that quiet down inflammation in your body, including problems in your nerve tissues.

Nutrient Supplements

Once digestive health and a clean diet are established, I’d then look to nutrients to help lower RLS symptoms. Here’s my list of supplements that work for many RLS sufferers:

  • Probiotics: necessary to establish a healthy flora and tissue lining.
  • Calcium, magnesium and zinc: minerals required for normal nerve function.
  • B vitamins: build healthy nerve tissue.
  • CoEnzymeQ10: an antioxidant and ATP-generator.
  • Fish oil or krill oil: (6 grams daily) fights inflammation and heals nerve tissue.
  • Sphingomyelin, phosphatidylcholine or phosphatidylserine: known to be healing specifically for nerve tissue disorders.
  • Ginkgo biloba extract: 40-80 mg twice daily helps improve nerve cell function and acts as an antioxidant.
  • Butcher’s broom: A study [8] reported: “Symptoms such as heaviness in the legs, tingling, and a sensation of tension all improved in the people taking butcher’s broom, whereas no improvement in any of these symptoms occurred in the placebo group.”
  • Valerian root: for symptom relief via sedation at night.

What Else You Can Do For RLS

Some additional simple ways to help relieve RLS include leg massages, hot baths/heating pads or even cool packs before bedtime applied to the legs. Acupuncture, exercise and yoga have also been used with success.

To feeling good,

Michael Cutler, M.D
Easy Health Options


[1] Wilhelm Jahnen-Dechent, Markus Ketteler. Magnesium Basics. Clin Kidney J (2012) 5 (Suppl 1): i3-i14.

[3] King D, Mainous A 3rd, Geesey M, Woolson R. Dietary magnesium and C-reactive protein levels. J Am Coll Nutr. 2005 Jun 24(3):166-71

[4] Wilhelm Jahnen-Dechent, Markus Ketteler. Magnesium Basics. Clin Kidney J (2012) 5 (Suppl 1): i3-i14.

[5] Patrick LR. Restless legs syndrome: pathophysiology and the role of iron and folate. Altern Med Rev. 2007 Jun;12(2):101-12.

[6] Oner P, Dirik EB, Taner Y, Caykoylu A, Anlar O. Association between low serum ferritin and restless legs syndrome in patients with attention deficit hyperactivity disorder. Tohoku J Exp Med. 2007 Nov;213(3):269-76.

[8] Vanscheidt W, Jost V, Wolna P, Lücker PW, Müller A, Theurer C, Patz B, Grützner KI. Efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Arzneimittelforschung. 2002;52(4):243-50.



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Dr. Michael Cutler

By Dr. Michael Cutler

Dr. Michael Cutler is a graduate of Tulane University School of Medicine and is a board-certified family physician with more than 20 years of experience. He serves as a medical liaison to alternative and traditional practicing physicians. His practice focuses on an integrative solution to health problems. Dr. Cutler is a sought-after speaker and lecturer on experiencing optimum health through natural medicines and founder of the original Easy Health Options™ newsletter — an advisory on natural healing therapies and nutrients. His current practice is San Diego Integrative Medicine, near San Diego, California.