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Pins and needles, itchy, creepy-crawly… these are all terms used to describe the symptoms of restless legs syndrome, or RLS.
It can be hard to put this condition into words, but for those who have experienced it, the symptoms are unmistakable. Magnesium is one natural remedy that can help, but there’s so much more to addressing this condition.
Symptoms of Restless Legs Syndrome
Restless legs syndrome (also called RLS or Willis-Ekbom disease) causes unpleasant sensations in the legs. Professional opinions vary, but it’s thought to affect about 7-10% of the population.
RLS is a neurological sensory disorder and since it usually interferes with sleep, it’s also classified as a sleep disorder.
As the name suggests, RLS is most commonly experienced in the legs, but can also occur in the arms or other body parts. The symptoms can range from mildly annoying to severe.
RLS sensations are often described as:
- burning
- tingling
- itching
- being poked with pins
- throbbing
- electric sensations
- creepy-crawlies
- aching
This not-fun list of symptoms is basically the body’s way of urging the legs to move and shake off the feeling (hence the name restless).
Restless Leg Syndrome at Night
Restless leg syndrome is the worst when at rest and it’s more common in the evenings. It can prevent sleep or disturb it, which can lead to a whole host of issues.
More than 80% of those with RLS also periodically twitch and kick their limbs throughout the night, about every 15 to 40 seconds. This RLS-related condition is referred to as periodic limb movement.
All that sleep loss often leads to daytime insomnia, even resulting in depression. When left untreated, it can result in about a 20% decrease in productivity.
How Is Restless Legs Syndrome Diagnosed?
There isn’t a particular test for RLS. It is typically diagnosed by the symptoms, however other tests may be needed to rule out related conditions that contribute to it.
What Causes Restless Leg Syndrome?
It depends on the person, but there are a variety of conditions and factors in RLS.
In general, more women than men develop the condition, as do adults 40 years and older. Pregnancy increases the risk, as well as certain diseases, food sensitivities, and nutrient deficiencies.
Even more strange, left-handed people are more likely to develop RLS than right-handed people. This is thought to be caused by differences in brain structure between the two groups that affect the nervous system.
Other causes may be:
Diseases Affecting the Brain
Certain diseases like anemia, Parkinson’s disease, kidney failure, and diabetes can also include restless legs syndrome as a symptom. Damage to the basal ganglia, the part of the brain that causes muscle movements, has been linked with RLS. The disrupted neural pathways then cause involuntary movements.
Medication
Medications that alter brain function, like antidepressants and antipsychotics can cause RLS (even though some doctors use them to treat it). Even the more common cold and allergy medications can contribute to the symptoms. If you have bothersome leg sensations and are on medication, it’s always a good idea to ask your doctor about a possible connection.
Food Triggers
Poor diet can also trigger RLS. Sugar depletes magnesium in the body, which in turn can cause RLS symptoms. Stimulants like caffeine and alcohol also tend to make the problem worse.
Food allergies or sensitivities to substances like gluten and monosodium glutamate (MSG) can also trigger RLS symptoms.
Genetics
About 50% of those with RLS also have a family member with the condition, so genetics are thought to be at play here. In a paper published by the Nephrology and Urology Research Center in Iran, researchers found that Asians are less likely to have RLS, as are those in Iran compared to the US.
African Americans are also 20% less likely than caucasians to experience RLS symptoms. Genetics and racial differences thus seem to play a role in RLS.
Pregnancy
Many mamas experience RLS for the first time during pregnancy, but the symptoms disappear after birth. This is thought to be caused by fluctuating hormones and low levels of certain vitamins due to baby’s development using up nutrient stores.
Autoimmune Disease
A 2012 paper from Sleep Medicine Reviews found that out of 38 conditions associated with RLS, 95% of them were autoimmune and/or inflammatory diseases. Researchers hypothesized that an immune reaction to bacteria in the intestines or other antigens could cause RLS by attacking the central or peripheral nervous systems.
Those who had rheumatoid arthritis (an autoimmune condition) had significantly higher levels or RLS than those without arthritis. Even those who had osteoarthritis, which is associated with aging, had significantly lower levels of RLS than those with rheumatoid arthritis.
Gut Dysfunction
A 2011 study published in Sleep Medicine found a strong link between gut dysfunction and RLS. Sixty-nine percent of the RLS patients had small intestinal bacterial overgrowth (SIBO), compared to only twenty-eight percent and ten percent in the non-RLS control groups. Twenty-eight percent of those in the RLS group had irritable bowel syndrome (IBS), while only 4 percent in the control group had IBS.
If gut dysfunction is present, addressing bacterial overgrowth/imbalances and doing an autoimmune diet, like GAPS (Gut and Psychology Syndrome) is helpful. By fixing the gut, restless leg syndrome symptoms can improve or disappear.
Low Cortisol
Adrenal problems, like adrenal fatigue, can cause low cortisol levels in the body and even contribute to RLS. A 2008 study in the journal Neurology concluded that there was a link between restless legs syndrome and low cortisol levels. 50% of those in the study found symptom relief with the application of an anti-inflammatory hydrocortisone cream. Cold water therapy, or cryotherapy, also reduces inflammation.
How Do You Get Rid of Restless Leg Syndrome?
There are many different causes of restless legs syndrome. Like any condition, it helps to treat the root cause to bring about more than just symptom relief. Supporting the nervous system, eating the right foods, and taking certain supplements to correct deficiencies will all help address the root cause of RLS.
Prescription medications (usually anti-seizure medications) used to treat RLS do so by altering the brain’s chemistry and response to the nerve signals. The side effects of these drugs can be very dangerous. Common symptoms can range from everything from brain damage, to hallucinations, to twitching (what we’re trying to stop in the first place).
Even if these medications do help at first, the medical community suggests that the effectiveness diminishes over time.
Natural Remedies to Stop RLS
Even many conventional doctors will recommend lifestyle changes and natural methods before resorting to prescription drugs (which usually aren’t that effective for RLS). It may take a combination of things, but getting to the root cause is the best way to treat RLS.
Vitamins that help alleviate restless leg syndrome symptoms include:
Magnesium
Magnesium may be one of the most popular natural supplements for restless leg syndrome, and it isn’t hard to see why. Unfortunately magnesium deficiency is common in our modern society due to soil depletion. Sugar, alcohol, caffeine, certain medications, and even stress can deplete our body’s magnesium stores.
Researchers have found that certain muscles in the leg function differently in those with RLS, specifically the back left of the calf muscle, and the muscle to the right of the shin bone. Proper magnesium levels help these smooth muscle fibers relax and are essential to a healthy nervous system. Too much iron can deplete magnesium though, so it’s important to not overload on this supplement.
Selenium
Selenium supports dopamine function in the body, which is thought to be directly linked with restless legs syndrome. In an Iranian clinical trial, supplementation with 50 and 200 micrograms (mcg) of selenium significantly improved RLS symptoms. Both groups had good results, so researchers concluded that a 50 mcg dose would be more cost effective. Just one Brazil nut contains a full day’s worth of selenium, or about 77 micrograms.
Iron
Iron is also necessary for dopamine function in the body. Those with restless legs syndrome have been found to have too low iron levels in the brain.
About 30% of those with RLS can use iron supplements to reverse their symptoms. In a 2009 study published in Sleep Medicine, iron-deficient subjects saw a significant improvement in RLS symptoms after twelve weeks of iron supplementation. I like to get my iron from food whenever possible, but this is a good iron supplement to use when needed.
There are a few precautions though.
Too much iron can deplete magnesium, another nutrient linked with restless legs syndrome. In addition, too much iron may contribute to an increase in certain pathogenic bacteria in individuals with digestive issues. Plus, if your iron levels are too high, it can damage the heart, liver, adrenals and other organs. Some people also have a genetic disposition to iron overload called hemochromatosis, which often goes undiagnosed until there is severe damage.
If you choose to take iron supplements, be sure to follow up with your doctor to get laboratory measurements so your levels get into an optimal range.
Start by eating lots of iron-rich foods and see if you feel better. If your iron levels still test low, check with a natural health practitioner for guidance.
Vitamin D
Known as the happy vitamin, vitamin D is important for keeping the blues at bay. This vital nutrient also plays a part in restless legs syndrome.
Chris Kresser explains:
Some evidence indicates that vitamin D could play an important role by increasing levels of dopamine and its metabolites in the brain, as well as protecting dopamine-associated neurons from toxins. RLS has been associated with vitamin D deficiency in several studies, and disease severity has been inversely correlated with vitamin D levels.
One study found that RLS is more frequent and more severe in those with vitamin D deficiency. This also indicates that a deficiency in vitamin D has a negative effect on sleep. (I cover why vitamin D is so important and best ways to get it here.)
Other Natural Remedies for Restless Legs Syndrome
- Lavender essential oil – A 2015 study published in the journal Nursing and Midwifery Studies found that a massage with lavender essential oil significantly improved symptoms. RLS sufferers received a 10 minute massage with lavender essential oil diluted to 1.5% twice weekly. Lavender also improves sleep quality and insomnia, which are often associated with RLS.
- Reflexology – Reflexology is when pressure is applied to specific pressure points, usually on the bottom of the foot. This pressure positively affects the nervous system. Researches compared a group of RLS patients receiving reflexology to those doing stretches and found both groups saw a decline in symptoms.
- Moderate aerobic exercise – Exercising releases endorphins, including dopamine which helps with muscle control.
- Detox baths – A warm bath with Epsom salts (which is magnesium sulfate) relaxes muscles and soothes RLS symptoms.
- Stress reduction – Practice relaxation techniques like meditation and these other stress-reducing tips.
- Massaging the legs – Get professional massage, or try these at-home massage options like my favorite massager or foam rollers on the legs. In one study, one third of participants no longer had RLS after massage, while the others saw significant improvement.
- Cold water therapy – May not sound fun, but neither are creepy-crawly legs! Try these techniques at home to decrease pain and inflammation-causing cytokines, improve circulation, and reduce sore muscles and spasms.
- Kick the caffeine habit – Avoid stimulants like alcohol and caffeine, which can worsen symptoms. These coffee alternatives can ease any withdrawal.
Restless Legs Relief During Pregnancy
In one study, pregnant women with low folate levels experienced an increase in depression and restless legs syndrome. Folate is found in foods like liver, but during pregnancy I also take a folate supplement (not folic acid!) to be sure my levels are high enough.
Iron and magnesium deficiency are other common problems in pregnancy that may contribute to restless leg, so consider some quality prenatal supplements if you have these symptoms.
Goodbye Restless Legs!
I haven’t experienced this problem myself, but it’s good to know there are so many options for alleviating restless legs symptoms naturally. If you suffer from restless legs, hopefully with these tips you can kiss restless legs goodbye and sleep easy!
This article was medically reviewed by Dr. Ann Shippy, who is Board Certified in Internal Medicine and a certified Functional Medicine physician with a thriving practice in Austin, Texas. As always, this is not personal medical advice and we recommend that you talk with your doctor.
Have you had restless legs syndrome before? What is/was your experience and how did you find relief? Leave us a comment below!
This is such good info!
Here’s one more interesting perspective: RLS can be caused by poor posture and movement patterns, too. I have been a structural integration therapist for 25 years. Across the board, the people who get RLS spend their days (and nights) in weird configurations that create restrictions in the flow of blood, lymph, nerves, and energy, and cause joint pain and restrictions in the fascia. The solution: PAY ATTENTION TO HOW YOU DO WHAT YOU DO, especially the things we do physically for any length of time.
When we look at it from this perspective, getting our chemistry balanced by adding in and subtracting the factors you mentioned, Katie, coupled with changes in posture and movement patterns that allow for optimal alignment structurally, the problem is solved. It’s such common sense. Don’t take the drugs!!
I have had RLS since I was a teenager. My father also has it. I’ve also had fibromyalgia for the last 20 years and am about to turn 50. This past year my RLS has gotten out of control. Its has always bothered me randomly in the evening or riding distances in a car. However it seems there has become a direct correlation between the amount of time I spend walking ( which I do for my job as well as for exercise). The more I am on my feet the worse it is at night. Or even just sitting down they immediately start acting up. My doctor’s started me on requip and I’ve had to double my dosage. I do yoga and stretching. Use a sauna. While the meds allow me to get to sleep, my legs will start acting up around 3 or 4 am each morning. I am going out of my mind. So frustrated. I want to start taking supplements to help. My iron is good. I already take turmeric to help with my inflammation. So I am going to try the magnesium. When and how is the best way to take supplements to help with the RLS? And is there anty interaction with the requip? Thanks foe any advice.
Powdered Hawthorn berry is magic. Works instantly for me. But it must be a good quality source. No additives.
The thing that stinks the most with rls is that the outcome of treatments is not always the same. Sometimes one thing helps alleviate the symptoms completely, other times it doesn’t help at all. I’ve tried iron, magnesium, vitamin b, vitamin d, restful legs, ropinirole, mirapex. Gabapentin, etc… they do lose effectiveness if they help at all. Massage sometimes helps, other times does nothing. It’s like that with everything I’ve tried.
I have had RLS for many years, and consequently suffer from sleep deprivation. It’s in the family, grandfather, mother, sister. Alcohol makes it worse, but I find that walking barefoot on a cold floor helps.
It was a very informative article about restless leg syndrome. Thank you very much.
Hi – thanks for a great article. I’ve been having really achy legs at night around bedtime (of course) but think I’ve had it since I was a kid. My dad used to massage my legs when I was little and I clearly remember it making my legs feel a lot better. Lately I’ve been using a natural muscle cream made up of 7 herbs (Noxicare) and that almost always takes care of the problem and then I go right to sleep. I also use Village Naturals Muscle relief lotion. It’s not all natural but it does help when I can’t find my bottle of Noxicare or I’m out of it. It has Eucalyptus, Wintergreen and Aloe in it and it really helps a lot. I’ve also done foot bath using Epsom salts since my fibro doesn’t allow me to use the tub easily. That does help a little bit but not as much as a massage using one of these lotions.
Yes, I do suffer from RLS. Many of the things you talk about I have sispected.
What gives me the greatest relief is probiotics. Garden of life 5 day max is WONDERFUL!! I do not need the whole scoop after a bottle or 2. Also, Bluebonnet acidophilus is GREAT too!
Valerie, You can put it on your legs as well. I neglected to say I put it on my thighs as well as my lower back. But the directions say to apply to lower back.
Hope this helps you!
Diane Caprio – I will look into this, just curious – why do you apply to the back versus the legs?
I had RLS with both my pregnancies, it was worse with the 2nd one. I still have it every now and then almost 1 year after having my 2nd. The tried and true method that worked every time for me is a yoga pose, Viparita Karini, or… legs up the wall pose. You lay on the ground with your bottom as close to the wall as you like and you put your legs up the wall and just relax. It’s also great for blood flow and swelling.
as a huge sufferer of RLS, I have tried all of this in the past and have no success with any of it. I have had RLS for over 20 years, and have seriously applied myself to finding relief, not even meds work for this. The only thing that ever worked was Quinine, which they have removed from the market due to the risk of death. I certainly hope others find relief here.
Valerie, try Nature’s Inventory Night Time Leg Calm. I’ve used it for 10 years every night and found relief by using this. Go to Nature’s Inventory.com to order it. It has helped my sister and I, and she has RLS the worst! Apply to the small of your back and rub it in. I hope it helps you.
peripheral nerve excitability, and neuropathy from b12 deficiency, mh legs and feet drove me mad, i started taking methylcobalamin sublingual supplement, this has helped lessen the intensity and frequencey of rls, the hypersensitivity episodes on my thighs and face stopped,
i have hydroxicobalamin injections every 8 weeks, but have to buy the methylcobalamin high strength myself, after telling my neurologist of these results he just dismissed them
I have had restless legs in regard to food allergies.
Anyone with food allergies should determine if they have Candida overgrowth. This can lead to increased intestinal permeability, in which food particles can enter the blood stream causing the immune system to mount a defense. It is this defense that can cause many unpleasant symptoms, including but not limited to restless legs.
It is estimated that 70% of Americans have Candida overgrowth to some extent. The symptoms are many. Do the research.
Staying hydrated is another great way to treat the symptoms!
Hi Katie, love you column. I experience this briefly and was already on high doses of magnesium, which also requires a very large intake of water. What I found was that I wasn’t drinking enough water in the evenings, (when I was taking 400 of the 600 mg per day) and that when they begin–always in the early stages of sleep, a real nightmare–if I got up and drank 8 oz. of water, it would be relieved and still not miss my night’s sleep. Laying in bed and hoping they would go away was definitely not the way to go. Thanks. B