Restless Legs Syndrome (RLS), also known as Willis-Ekbom disease, is a neurological disorder characterized by an irresistible urge to move the legs, often accompanied by unpleasant sensations. These sensations are frequently described as creeping, crawling, itching, aching, tingling, drawing, searing, pulling, or painful and are typically felt beneath the skin. While medical treatments are available, lifestyle changes, particularly dietary adjustments, can significantly impact the severity of RLS symptoms and improve overall quality of life.
Understanding Restless Legs Syndrome
RLS is a common condition, affecting millions of people. It is characterized by an almost irresistible urge to move the affected limbs because of unpleasant sensations beneath the skin. These symptoms occur primarily in the calf area but may be felt anywhere in the legs or arms. The symptoms are often temporarily relieved by movement and tend to worsen during periods of rest, especially in the evening or at night. This can lead to significant sleep disturbances, exhaustion, poor concentration, and emotional distress.
Doctors divide cases into two types: Early-onset RLS, which begins before age 45, typically develops slowly and may be strongly influenced by genetics, and Late-onset RLS, which begins after 45, often progresses more rapidly and may be associated with other health conditions.
The Role of Nutrition in Managing RLS
Professional medical intervention is crucial in treating RLS, but don’t underestimate the impact your diet has, as well. A balanced, nutrient-rich diet supports both circulation and nerve function. The right diet is key to managing many diseases and to improving general quality of life. Dietary supplementation emerges as a notable option. According to the Official Journal of European Communities, dietary supplements are concentrated sources of nutrients or other substances with a nutritional or physiological effect, alone or in combination, marketed in dose form, namely forms such as capsules, pastilles, tablets, pills, and other similar forms, sachets of powder, ampoules of liquids, drop-dispensing bottles, and other similar forms of liquids and powders designed to be taken in measured small unit quantities. Dietary supplements include vitamins, minerals, herbs or other botanicals and amino acids.
Key Nutrients and Foods to Include in Your Diet
Incorporating nutrient-dense foods into your diet can be an easy and effective way to manage Restless Leg Syndrome symptoms. Several nutrients play a crucial role in managing RLS symptoms:
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- Iron: Low iron levels are often linked to RLS. Iron is vital to the functioning of the brain’s dopamine system, and brain iron deficiency is a known contributing factor to RLS. Maintain a serum ferritin (blood iron) level above 75-100 micrograms per liter. You can find heme iron (animal-based) in beef, poultry, seafood and fish; and non- heme iron (plant-based) in foods such as tofu, beans, fruits, vegetables, and enriched cereal, rice and pasta.
- Magnesium: Magnesium is vital to muscle relaxation, which can benefit those with RLS. It plays a role in regulating protein synthesis, nerve and muscle function. It is vital for the function of gamma aminobutyric acid (GABA) receptors in the brain, which initiate sleep. Low magnesium can cause a variety of health issues, including numbness, tingling, muscle twitching, cramps and muscle soreness. Good sources include almonds, lentils, asparagus, and spinach.
- Folate (Vitamin B9): Folate is imperative for healthy nerve function and may reduce RLS symptoms. People with familial RLS appear to have inherited an unusually high requirement for folic acid.
- Potassium: Potassium helps regulate muscle contractions and can be beneficial in reducing RLS symptoms. These are excellent potassium sources. Try bananas, sweet potatoes, yogurt, and fatty fish.
- Vitamin D: Studies indicate that low vitamin D levels might worsen RLS symptoms. Incorporating these nutrient-dense foods into your diet can be an easy and effective way to manage Restless Leg Syndrome symptoms.
- Vitamin B12: Vitamin B12 deficiency has been linked to neurological disorders, including restless legs syndrome.
- Vitamin C and E: Vitamins C and E both seem to help iron work better in the body.
Foods to Include:
- Fresh fruits and vegetables, especially dark leafy greens.
- Iron-rich lean meats, poultry, seafood and fish.
- Tree nuts, seeds, and legumes.
- Whole grains, nuts and seeds, fresh fruits and vegetables, and fish.
Dietary Changes to Consider to Avoid RLS Flare-Ups
While certain nutrients can calm symptoms, others can exacerbate them. If your restless legs feel especially active at night, check your diet for these common triggers:
- Caffeine: Research studies have shown caffeine to be an RLS trigger. Found in coffee, tea, energy drinks, and chocolate. Best avoided after midday. In addition to avoiding coffee and caffeinated tea, be sure to check ingredient lists for hidden sources of caffeine in soda, chocolate, energy drinks and other convenience foods.
- Alcohol: Another common RLS trigger is alcohol, which disrupts sleep, and in turn exacerbates RLS. Usually acts as a nervous system depressant but can have a paradoxical effect that causes rebound nerve excitability and disrupt sleep cycles. Try limiting it, especially in the evening. Watch for hidden sources of alcohol in products such as mustard, extracts, sauces (e.g., bearnaise or bordelaise) and fondue.
- Sugar and Salt: Anecdotally, many people report that sugar, artificial sugars (such as those found in reduced-calorie and weight loss products) or salt increases their RLS symptoms. With salt, it is thought that excess fluid retention may stimulate sensory components in the legs that trigger RLS sensations.
- Gluten: A 2023 systematic review linked celiac disease and gluten intolerance to RLS. The researchers propose that cutting out gluten from your diet may help manage symptoms. If you suffer from gastrointestinal symptoms such as gas, bloating, abdominal pain, intermittent diarrhea and constipation, or anemia, then your provider may evaluate you for two disorders that impair iron absorption: small intestinal bacterial overgrowth (SIBO) and celiac disease. Celiac disease is a serious autoimmune disease triggered by gluten, a protein found in wheat, barley, rye and triticale. Twenty-five to 30 percent of people with Celiac disease have RLS. If you have RLS, it is very important to get a blood test for Celiac disease, because left untreated, it has the potential to do widespread damage to the body. A gluten-free diet can significantly reduce RLS symptoms in many patients with Celiac disease within 6-9 months.
- Highly processed foods: It’s no surprise that fast food, salty snacks, and packaged meals are often high in sodium and preservatives, both of which can strain circulation.
Additional Lifestyle Changes to Manage RLS
Diet is only one piece of the puzzle. Other small lifestyle changes can make a noticeable difference:
- Daily movement: Walking, stretching, and low-impact exercise improve circulation.
- Stress reduction: Yoga, meditation, or deep breathing can ease tension known to worsen symptoms.
- Sleep hygiene: Going to bed at the same time each night, keeping your room dark and cool, and limiting screen time before bed all improve rest.
- Leg elevation: Propping your legs on a pillow while resting can help blood flow back toward the heart.
- Quitting smoking
- Taking a warm bath before going to bed
- Massaging the affected area
- Using heat or ice on the affected area
- Using a foam roller
- Maintain a healthy weight: Obesity is associated with RLS, and maintaining a healthy weight in general can help to alleviate health issues.
The Importance of Consulting a Healthcare Professional
If RLS symptoms persist, consult a healthcare professional for personalized advice. If your healthcare provider determines that a vitamin deficiency is contributing to your RLS, then you may be directed to supplement your diet with iron, vitamin B12 or folate. Iron supplements should only be taken under the care and supervision of a healthcare provider. Also, please consult with your healthcare provider before taking any supplements, as moderate amounts of some minerals can cause toxicity.
When Dietary Changes Aren’t Enough
Sometimes restless legs persist despite lifestyle improvements. If your symptoms are interfering with sleep and daily life, it may be time to consult a specialist. At CVR, our board-certified physicians evaluate your circulation, medical history, and lifestyle factors to pinpoint the underlying causes of your symptoms. Remember, addressing underlying vein problems can significantly reduce or even eliminate restless leg symptoms for many people.
Research on Dietary Supplements and RLS
A review examined the potential of dietary supplements to manage RLS symptoms and reduce reliance on medications. A total of 10 randomized clinical trials involving 482 participants were analyzed, focusing on the impact of various supplements on symptom severity, sleep quality, and daytime sleepiness. Findings suggest some supplements may have positive results. Magnesium oxide and vitamin B6 significantly improved sleep quality and RLS symptoms, with magnesium showing greater effectiveness. Vitamin D supplementation did not show significant benefits. Oral iron has promising results, indicating potential efficacy but issues related to compliance and absorption. Both vitamins C and E positively affect RLS symptoms, likely due to their antioxidant properties. Valerian improved RLS and sleep but did not show a statistically significant improvement. Despite these encouraging results, a high risk of bias was noted in half of the studies, emphasizing the need for more rigorous research. Overall, this review suggests that dietary supplements may be a promising approach to managing RLS.
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Medications That May Cause RLS
Certain medications may cause RLS. Talk to your doctor about other drug options if you take:
- Antipsychotic drugs
- Antidepressants
- Sedating antihistamines
RLS and Pregnancy
A 2021 study involving 718 pregnant women found that approximately 22% had restless leg syndrome. Researchers attribute this to dopamine dysregulation, nutrient deficiencies, and hormone imbalances. If you’re pregnant and have RLS symptoms, you should talk to your doctor about getting your iron levels checked. If they’re low, your doctor may recommend eating more iron-rich foods or taking iron supplements. If diet and lifestyle changes don’t help, your doctor may prescribe anti-epileptic drugs, opioids, and certain benzodiazepines. According to a 2020 study, these drugs are safe to use during pregnancy. However, some may need to be stopped for breastfeeding. In many cases, pregnancy-related RLS goes away on its own after your baby is born.
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