Restless Legs Syndrome natural treatment with supplements, vitamins, herbs, exercise, and weight loss

About 5 percent of the U.S. adult population is affected by restless legs syndrome. RLS is defined by four essential criteria needed for clinical diagnosis which are established by the International Restless Legs Syndrome Study Group.

These signs and symptoms are:

1. The urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs. While symptoms can vary from person to person, they are generally described as an urge to move the legs accompanied by burning, creeping, crawling, aching, tingling, or tugging sensations in the legs.
2. Symptoms are worse during rest or inactivity
3. Symptoms are partially or totally relieved by movement such as walking or stretching.
4. Symptoms are worse at night with periodic limb movements.

As a direct result, patients may experience daytime tiredness, mood disturbance, and inability to perform daily activities, which can have a substantial negative impact on quality of life. The dopamine neurotransmitter system appears to be mostly involved with this condition. Restless legs syndrome is mostly thought of as a condition that affects adults, but it is also fairly common in children and teenagers. Older men who suffer from RLS at night are almost twice as likely to have erectile dysfunction as those without the condition. The mechanisms underlying the association between RLS and erectile dysfunction could be caused by hypofunctioning of the brain chemical dopamine in the central nervous system, which is associated with both conditions

Natural treatment of restless legs syndrome
Reduce or eliminate coffee including decaf, tea, cola beverages, cocoa from all sources including chocolate.
Stop or reduce smoking and drinking alcohol.
Reduce or eliminate any type of stimulant, including herbal teas, dietary supplements -- especially those of a stimulating nature such as tyrosine, SAM-e, phenylalanine, St. John's wort, most of the sexually stimulating herbs -- and over the counter cold medicines -- particularly cold medicines. 

Exercise and movement help a lot. Take long, daily walks for at least an hour, especially in the morning. The more tired your body becomes, the better you will sleep and the less likely your legs will move in bed. If you can, walk several hours a day.
Perhaps massage, warm or cold baths, and acupuncture could benefit.
Weight loss could help.

Follow the suggestions on how to sleep deeper.

Some herbal remedies and supplements that may help:

An herb to try is valerian root. 

We have also received emails that mucuna pruriens taken in the morning may be helpful.
Magnesium mineral may be of some benefit to some individuals.

A case study of two individuals showed D Ribose supplement to be of benefit.
Some people claim treatment with vitamin B may reduce the frequency, intensity, and duration of nocturnal leg cramps but more research is needed to determine whether B vitamins really work or make it worst in some people. B vitamin supplements are best taken in the early part of the day in a low dose. I suspect high doses of B vitamins could cause insomnia. If you have been taking B vitamins or multivitamins and you still have symptoms, stop them all for a while to see if your symptoms improve.

I am not sure if kava is helpful but it is worth a try.
Good Night Rx is a formula that helps with sleep. I have not tested it for restless legs syndrome, but it helps one sleep deeper. Take one capsule three to four hours before bed on an empty stomach.
Iron pills may be a treatment for RLS in some people.

I am very sensitive to any caffeine. I get restless leg syndrome from any caffeine -- even in regular tea, cocoa, chocolate, regular cola, regular coffee, etc. 

   Yes, some people are very sensitive to caffeine and have sleep disruption from even small amounts.

My husband and I both have some problems with RLS, but his is worse than mine. We have found that a calcium / magnesium supplement (300 mg calcium and 200 mg magnesium) a day plus an extra 200mg of magnesium at dinner controls the RLS for us, in addition to trying to eat more dark green leafy vegetables. Thanks for your website, it is very helpful.
   If anyone else has benefited from a combination of calcium and magnesium, do let me know.

Exercise and physical activity
Dr. Marco Tulio de Mello and colleagues at Federal University of Sao Paulo-UNIFESP evaluated the effects of acute intensive exercise on sleep patterns in 22 volunteers with periodic leg movements, which are often associated with restless legs syndrome. Eleven subjects continued with 72 physical training sessions for roughly the next 6 months. Reductions in periodic leg movements were observed after both intensive and regular physical exercise. Intensive exercise increased sleep efficiency (actual time asleep) and rapid eye movement (REM) sleep, and reduced wake time after sleep onset. Chronic physical exercise increased sleep efficiency and REM sleep and reduced sleep latency (time to takes to fall asleep). The release of beta-endorphins, opioid compounds that provide a feeling of well-being, after acute intensive exercise are associated with reduced periodic leg movements levels. Med Sci Sports Exercise 2009.

D-ribose benefits restless legs syndrome.
We report on two affected male individuals, a father and son, ages 71 and 47, from a family in which three generations with RLS. To evaluate any potential benefit of D-ribose in this condition, each individual orally consumed 5-g doses of D-ribose daily at different trial stages. Each stage lasted 3 weeks with a 2-week washout period between stages. The initial stage involved a single 5 gm dose of D-ribose consumed at breakfast. Throughout the second stage, D-ribose was taken at breakfast and lunch. In the third stage, D-ribose was taken at all meals, breakfast, lunch, and dinner. Diaries by the subjects pertaining to their documentation and severity of restless legs syndrome symptoms was compiled. During the initial stage both men reported a general feeling of more energy and less fatigue, most notably after exercise, without any significant changes in their symptoms. With the increase in the daily dose of D-ribose, in the second stage, their leg twitching and the feeling to move during the day was reduced for 1 subject, and rarely present in the other. Both still experienced the unpleasant sensations during the night. However, during the final stage, a further increase in the daily dose of D-ribose eliminated their daily symptoms and the symptoms at night were of a lesser degree and had a later occurrence. Both men reported that D-ribose did not totally eliminate their discomfort, but the severity and onset of symptoms affecting their quality of life was substantially improved with D-ribose without any adverse reactions. J Altern Complement Med. 2008.

Iron supplements
The purpose of this study was to determine if symptomatic RLS patients with low-normal serum ferritin levels benefit from oral iron replacement. This was a randomized, placebo-controlled, double-blinded study. Eligible patients were randomized to oral iron therapy vs. appearance-matched placebo and followed over a 12 week period. After 12 weeks, IRLS scores decreased more in the treatment arm  than in the placebo arm. Ferritin levels increased more in the treatment arm than in the placebo arm. We observed a nonsignificant trend toward improved quality of life in the treated patients. This is the first double-blinded, placebo-controlled study to demonstrate statistically significant improvement in RLS symptoms using oral iron therapy in patients with low-normal ferritin. The findings from this study suggest that additional larger randomized placebo-controlled trials of iron as treatment for patients with low-normal ferritin are warranted. Efficacy of oral iron in patients with restless legs syndrome and a low-normal ferritin: A randomized, double-blind, placebo-controlled study. Sleep Med. 2009 Febrary. Wang J, O'Reilly B, Venkataraman R, Mysliwiec V, Mysliwiec A. Department of Medicine, Madigan Army Medical Center, 9040A Fitzsimmons Avenue, Tacoma, WA, United States.

Iron (ferrous sulfate) 325 mg in patients with serum ferritin levels <50 µg per dL. Ideal means of administration has not been established. Oral treatment may take several months to be effective and may be poorly tolerated. 

Magnesium mineral supplement use
Magnesium therapy for periodic leg movements-related insomnia and restless legs syndrome: an open pilot study.

Periodic limb movements during sleep (PLMS), with or without symptoms of a restless legs syndrome (RLS), may cause sleep disturbances. Anecdotal observations have shown that oral magnesium therapy may ameliorate symptoms in patients with moderate RLS. We report on an open clinical and polysomnographic study in 10 patients suffering from insomnia related to PLMS or mild-to-moderate RLS. Magnesium was administered orally at a dose of 12.4 mmol in the evening over a period of 4-6 weeks. Following magnesium treatment, PLMS associated with arousals (PLMS-A) decreased significantly. Sleep efficiency improved. Our study indicates that magnesium treatment may be a useful alternative therapy in patients with mild or moderate RLS-or PLMS-related insomnia. Sleep. 1998. Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University, Freiburg, Germany.

Valerian root herb
A prospective, triple-blinded, randomized, placebo-controlled, parallel design was used to compare the efficacy of valerian with placebo on sleep quality and symptom severity in patients with RLS. Thirty-seven participants were randomly assigned to receive 800 mg of valerian or placebo for 8 weeks. The primary outcome of sleep was sleep quality with secondary outcomes including sleepiness and RLS symptom severity. The results of this study suggest that the use of 800 mg of valerian for 8 weeks improves symptoms of RLS and decreases daytime sleepiness in patients that report an Epworth Sleepiness Scale (ESS) score of 10 or greater. Valerian may be an alternative treatment for the symptom management of RLS with positive health outcomes and improved quality of life. Altern Ther Health Med. 2009 Mar-Apr. Does valerian improve sleepiness and symptom severity in people with restless legs syndrome? University of Pennsylvania School of Nursing, Philadelphia, PA, USA.

Email - This is not a study on valerian, just me and 2 other people that have RLS. I have been troubled with it for 15 years. When I sit down to relax is when it becomes a problem. Valerian is the only natural thing I have found that works. I take no other medications. I thought this might be of some interest to you. In talking with the few people that use valerian as I do for restless legs syndrome I found we were using it the same way. If the problem started we could take 2 to 3 capsules, 150 mgs each and the problem would go away in about 30 to 45 minutes. If I felt the problem before bedtime I would take 2 to 3 capsules 45 minutes to 1 hour before bed. valerian is not used as a daily thing, only if the restless legs syndrome was problematic. When at work and I was sitting it would cause problems also. I did the same, 2 to 3 capsules and it went away in about 30 to 45 minutes. I would try other things to make it go away also so I didn’t have the use the valerian, getting up and walking it off worked but was not useful if you were trying to go to sleep, but at work it was ok. Then if the RLS returned I would use the valerian. I would take hot shower and take the Valerian if it woke me up from sleep. I am a light sleeper so it was easy for the symptoms from restless legs syndrome to wake me.

Obesity and weight loss
People who are obese have an increased risk of developing RLS. In a study of more than 88,000 U.S. adults, Dr. Xiang Gao at Harvard Medical School discovered that obese men and women were more percent more likely to have RLS than normal-weight study participants. Abdominal obesity, in particular, was strongly linked to RLS risk. Dr. Xiang Gao thinks there are multiple mechanisms through which excess weight contributes to the neurological disorder. Neurology, April 7, 2009.

Causes of restless legs syndrome
RLS is an intolerable internal feeling of itching or creeping sensations in the legs that forces the affected person to move his or her legs to get relief. It usually occurs at the end of the day in bed or when seated. Primary restless leg syndrome probably has some genetic basis. Secondary causes include iron deficiency, neurologic lesions, pregnancy (folate deficiency or high level of estrogen?) diabetes, and uremia. Other possible causes include fibromyalgia, thyroid disease, B12 deficiency, and varicose veins. Symptoms may be induced or exacerbated by medications such as antidepressants, lithium, and dopamine antagonists (neuroliptics, metoclopramide), and H2 blockers. Caffeine also has been implicated in the worsening of symptoms.

   People who suffer from this condition often have debilitating psychiatric disorders, including depression and anxiety, which may cause the restless legs syndrome or be a result of the lack of sleep. Other risk factors are heavy smoking, unemployment status, hypertension, gastroesophageal reflux disease (gerd), arthritis, and diabetes. Sleep apnea and insomnia appear to be other risk factors, along with difficulty falling asleep (taking more than 30 minutes), driving while drowsy and excessive daytime fatigue. Subjects with self-reported restless leg syndrome also have a higher incidence of being late for work, missing work, making errors at work and missing social events because of fatigue more often than those without it.