Dear Dr. Greenfield,

I am a 42 year old woman with RLS. I have it since I was 20, with alternating good and bad periods.

It affects me especially in my sleep. I am a 0+, Gatherer.

Are there any natural supplements I can take which could make a difference?

Thanks and kind regards,

Petra

Restless legs syndrome (RLS) and periodic limb movement disorder are characterized during waking by an irresistible urge to move the legs while awake, and involuntary leg movements while asleep.

For people with a family history of RLS, it is worth considering whether there is a genetic influence on the condition: researchers have found several genetic loci associated with RLS in an autosomal dominant inheritance pattern [1].

One of the genetic influences may involve an increased need for folate [2]. Individuals with polymorphisms for folate metabolism often do better taking an active form of folic acid such as folinate, rather than the commonly available folic acid supplements. Although folic acid improves methylation in all GenoTypes, GT4 Explorers are more prone to folic acid deficiency anaemia; GT1 Hunters and GT6 Nomads may also need folate to slow down their rapidly aging genes [3].

Researchers have also found that iron supplementation may improve the symptoms of RLS [2], reducing fluctuations in dopamine levels in the brain at night. Patients with RLS have lower levels of dopamine and respond to iron administration [4]. Caffeine, nicotine, alcohol and medication that affects dopamine levels may induce RLS as a side effect. It is recommended to check ferritin (iron storage) levels before supplementing with iron, as ferritin levels are often lower than average in RLS sufferers. There are strong indications that a gene regulating dopamine beta hydroxylase activity is linked to the ABO blood group locus [5], and altered dopamine levels may be associated with blood type.

Finally, osteopathic manipulative therapy has been found to decrease spinal facilitation in a small pilot study, relieving symptoms in many patients with RLS [6].

References:
1. Dhawan V, Ali M, Chaudhuri KR. "Genetic aspects of restless legs syndrome." Postgrad Med J. 2006 Oct;82(972):626-9. PubMed
2. Lee KA, Zaffke ME, Baratte-Beebe K.J. "Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron." Womens Health Gend Based Med. 2001 May;10(4):335-41. PubMed
3. Dadamp, P. The GenoType Diet. Broadway Books, 2007, ISBN 978-0-7679-2524-2
4. Patrick LR. "Restless legs syndrome: pathophysiology and the role of iron and folate." Altern Med Rev. 2007 Jun;12(2):101-12. PubMed
5. Wilson AF, Elston RC, Siervogel RM, Tran LD. "Linkage of a gene regulating dopamine-beta-hydroxylase activity and the ABO blood group locus". Am J Hum Genet 1988;42:160-166. PubMed
6. Peters T W, "Restless Legs", Osteopathy Today, October 2001. P12-13.