Heal Thyself—Kicking Restless Legs Syndrome
By Kristin Bjornsen
Julie Lutz calls it the creepy crawlies and describes the feeling as ants marching around in her skin. Her 8-year-old daughter, Anna, stands and says, “It makes me do this,�?shaking her legs around.
Both of them are describing Restless Legs Syndrome (RLS), a condition that is often hereditary. RLS manifests as discomfort, prickliness, or pain in the legs (and occasionally the arms) and as an overwhelming urge to move them, especially when trying to sleep. “Even if someone held a gun to my head and said, ‘Don’t move,�?I’d have to move them,�?says 46-year-old Julie. “It’s irresistible.�?/FONT>
Almost 10 percent of Americans have symptoms of RLS, and yet many sufferers have never heard of the condition, and they often don’t discuss their symptoms with a doctor. “It’s such a hard sensation to explain to someone,�?says Julie. “That makes it so awkward to go to a doctor and try and describe it.�?
Although researchers don’t completely understand RLS yet, they’ve identified several potential causes: deficiencies in dopamine, iron, or certain minerals; nerve damage; and more rarely, hypoglycemia and hypothyroidism. Doctors can prescribe a host of drugs for RLS, including medications for Parkinson’s disease, hypnotics, antiseizure drugs, and antidepressants, most of which modulate dopamine or serotonin levels. But most also carry serious side effects such as depression, breathing problems, memory loss, weight gain, headaches, dizziness, sexual dysfunction, and augmentation (intensification of symptoms in the late afternoon). What’s more, some of the drugs can lose their effectiveness after extended use.
“Parkinson’s drugs stop working after a while, raising the concern that they may be damaging or exhausting the biochemistry of that area of the brain,�?says Jacob Teitelbaum, MD, director of The Annapolis Center for Effective CFS/Fibromyalgia Therapies and author of Pain Free 1-2-3 (McGraw Hill, 2006). “The long-term issues are really concerning.�?Luckily, a plethora of more natural—and often more effective—options can target the underlying causes of RLS.
Pin it down
Identifying a specific cause can be tricky. While RLS often (pardon the pun) runs in the family, you can also develop it from secondary medical conditions, such as hypoglycemia, diabetes, and hypothyroidism. In these cases, treating that condition may relieve the symptoms. Certain medications can trigger RLS as well. Common culprits include calcium channel blockers, antinausea medications, some cold and allergy medications, tranquilizers, and phenytoin (an antiseizure drug). Tricyclic antidepressants like Elavil and lithium can contribute to RLS as well, Teitelbaum says.
Hormonal changes, especially pregnancy, seem to play a role, too. Although Julie had always been an extraordinarily active and restless sleeper, that only intensified when she became pregnant with Anna in 1996. RLS symptoms plagued her 24 hours a day, making it difficult for her to sit still. She paced her office, avoided going to movies, and, during plane flights, did leg squats at the back of the plane.
After Anna’s birth, Julie’s symptoms subsided somewhat, afflicting her only at night. Nevertheless, it would take her about two hours to fall asleep, which caused fatigue during the day.
What upset her more, though, were Anna’s symptoms. The restlessness afflicted Anna both day and night, with a level of severity rare in children. This frightened Julie because RLS often worsens with age. “With myself, I can put up with it and stay positive, but with my daughter, it’s been hard to stay positive,�?she says, her voice breaking. “She’s been a very sleep-deprived 8-year-old.�?/FONT>
Amino power
Although Julie found some relief at night using the antiseizure drug Klonopin, the drug actually exacerbated Anna’s symptoms. At wits end, not knowing how to help her daughter, Julie and her husband, Rob, began to research RLS. They found evidence pointing to the importance of balanced amino acids, the building blocks for dopamine and other neurotransmitters. One amino acid in particular seemed to play a starring role: L-theanine.
Julie and Anna began taking 100 mg three times a day last November and say it has improved their symptoms tremendously. While Julie still takes the Klonopin as a sleep aid, Anna uses only the L-theanine. “Since [she started taking it], Anna hasn’t had any symptoms at all during the night,�?Julie says.
L-theanine is found in green tea and is available as a supplement at health stores. RLS sufferers should opt for the supplement form, rather than the caffeine-laden tea.
According to Teitelbaum, “L-theanine is one of the single best nutrients for inducing deep sleep, [which is vital for RLS sufferers], although it doesn’t necessarily target Restless Legs Syndrome specifically.�?He suggests trying 1,000 mg of tyrosine (a precursor of dopamine) in the morning as another source of relief.
Sufferers can also opt to have a doctor analyze their blood and urine to detect possible amino-acid deficiencies and tailor a specific treatment to restore proper levels.
Ironing out RLS
Although L-theanine has worked well for the Lutz family, a primary frontline defense for RLS is iron—and iron levels should be the first thing checked if someone exhibits RLS symptoms. “Low iron is a potent trigger because the part of the brain that makes dopamine is iron-dependent,�?Teitelbaum says. About 25 percent of RLS sufferers have low iron levels, so supplementing with iron is “one of the most effective treatments for eliminating the underlying condition.�?
According to Teitelbaum, a blood ferritin level below 40 or an iron percent saturation below 22 percent warrants supplementing with 70 mg of iron plus 150 to 1,000 mg of vitamin C daily for three to six months. Take them on an empty stomach for maximum absorption.
Mind your minerals
Mineral sufficiency represents another key piece in the RLS puzzle. Sidney Baker, MD, a private practitioner specializing in integrative medicine in New York, says a mineral imbalance may underlie RLS and other neuromuscular irritability complaints.
Although doctors can measure ballpark levels of these minerals through blood and urine analysis, no clinically precise tests exist for mineral sufficiency, Baker says. In the absence of definitive tests, you can experiment by adding minerals in a safe manner to your diet. “You’re your own best laboratory,�?Baker says. In what he calls the “thumbs-up test,�?he suggests adding one mineral at a time to your diet, after consultation with your doctor. Begin with magnesium for 20 days and if symptoms improve, voilà! If not, move on to the next mineral.
Start with one capsule of magnesium daily and up the amount until bowel movements turn slightly loose—then back off the dose a little. If the magnesium doesn’t help, try taking 1,000 to 1,500 mg of calcium daily. If you’re thumbs still aren’t up, move down the mineral line to potassium, 99 mg three times per day. Next at bedtime try 500 to 1,000 mg of torreine, an amino acid that acts like a mineral in the body. Finally, failing that, move on to 50 to 100 mg of zinc daily. “These amounts aren’t very much,�?says Baker, “but it’s amazing how they can hit the bull’s eye.�?/FONT>
A larger look
Besides taking supplements, try avoiding caffeine, nicotine, and alcohol. Also, kick those restless legs into gear with exercise. A University of Kentucky study found that lack of exercise was associated with higher rates of RLS. Work your muscles while you’re at work by sitting on a stool with your legs dangling, or by elevating your desk so you can stand. Yoga has also been shown to help with RLS.
At night, slow things down by calming your mind and body. Relax, meditate, bathe, use hot or cold compresses on your legs, or massage them.
While you experiment with these lifestyle and supplement strategies, keep a diary documenting which methods work. This can help you pinpoint potential triggers and effective treatments for you. Whether the underlying cause is an imbalance of iron, minerals, or another factor, identifying the root of the problem will help more than masking the RLS symptoms with a drug, says Baker. The wisest approach, he adds, is to provide the body with what it’s missing—naturally: For chronic conditions especially, “Mother Nature does the healing, and doctors should provide the raw materials.�?nbsp;
Courtesy of Alternative Medicine
http://www.alternativemedicine.com
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