Targeted Nutritional Interventions
Iron. Due to the presumed link between iron deficiency or altered iron metabolism in the brain and RLS (Conner 2008), one of the more common alternative treatments for RLS is iron supplementation (Trotti 2009).
Various routes for iron supplementation have been studied as a treatment for RLS. Oral iron supplementation has been found to significantly ameliorate RLS in patients with low-normal levels of iron in their blood (Wang 2009). However, it is unclear if oral iron supplements are as effective for patients with no signs of iron deficiency (Davis 2000). Oral iron supplementation is also beneficial for treating RLS in the elderly, particularly those with low iron levels (O’Keeffe 1994). Intravenous iron supplementation in the form of iron dextran has also been found to significantly reduce RLS symptoms (Sloand 2004; Earley 2004). Although intravenous iron may be more effective than oral iron supplementation, it can cause severe complications including anaphylaxis (Silverstein 2004). It is important to note that only those with a blood test-verified iron deficiency should take supplemental iron. Ingestion of excess iron has been linked to cancer, atherosclerosis and other degenerative diseases.
Folate. Folate deficiencies may also play a role in the development of RLS. Pregnancy often precipitates signs of RLS (Manconi 2004) and folate levels are of paramount importance during pregnancy for healthy fetal development. Researchers have also found that pregnant women with low folate levels are more likely to develop RLS (Lee 2004), whereas women who take vitamins during pregnancy are less likely to develop RLS (Tunc 2007). Low levels of folate may also play a role in non-pregnant RLS patients (Patrick 2007). Older studies have found that folic acid supplementation can help treat certain paresthesias and other disorders of the peripheral nervous system as well (Botez 1976 and 1977).
Magnesium. Low levels of magnesium can cause neurons to become more easily excited, thus affecting a person’s mental status. As a result, magnesium supplements are often used to stabilize neuronal membranes and prevent abnormal activity in the nervous system (Trenkwalder 2008). Magnesium supplementation has been studied as a treatment for RLS. One case study found that magnesium supplements were able to relieve symptoms of RLS and improve sleep (Hornyak 1998). A novel form of magnesium – magnesium-l-threonate – may be even more effective for RLS because it is better able to gain access to the central nervous system (Slutsky 2010). However, the impact of magnesium-L-threonate on RLS has yet to be clinically validated.
Diosmin. The link between chronic venous disease and secondary RLS is well established (see above) (McDonagh 2007). Although it can be difficult to treat chronic venous issues, one therapy that has gained support is diosmin.
Diosmin is a natural venotonic that supports venous function, thereby preventing or reversing some of the changes of chronic venous disease. Used and researched extensively in Europe, micronized diosmin has recently been introduced to the United States and proven to be an effective treatment for chronic venous disease (Carpentier 1998; Maksimovic 2008). Although the effectiveness of diosmin for treating RLS has not been tested, it remains a promising possible treatment.
Green Coffee Extract. Diabetes is a well-known risk factor for secondary RLS. However, less appreciated is that pre-diabetes – subclinical elevations in blood sugar – may also cause RLS while remaining under the diagnostic radar of most physicians (Gemignani 2007; Bosco 2009).
A study examining subjects with impaired glucose metabolism unearthed a significantly increased risk of RLS in this population. RLS affected 41% of those with pre-diabetes, while only 18% of those with healthy glucose tolerance experienced the condition (Bosco 2009).
Maintaining healthy glucose metabolism, even for those not diagnosed with diabetes, may be helpful in RLS. Even slightly elevated blood sugar can damage delicate nerve cells and contribute to unpleasant sensations called paresthesias (Yagihashi 2007). Life Extension suggests that all aging individuals should strive to maintain blood glucose levels between 70 and 85 mg/dL for optimal health. Green coffee extract, with minimal caffeine content, represents a powerful tool for those aiming to maintain healthy blood sugar levels. It may also help control glucose elevations, which have been associated with RLS. However, this theory has yet to be tested in clinical trials.
Valerian root. Often used as an herbal sedative, valerian root has shown promise at reducing symptom severity of RLS. In an 8-week clinical trial, supplementation with 800 mg of valerian root daily resulted in improvements in daytime sleepiness and RLS symptoms (Cuellar 2009). Additional data also support the effectiveness of valerian root in treating insomnia in postmenopausal women (Taavoni 2011).