Molly arrived for the surgery completely worn out, with her three kids following closely behind.
For weeks, she had been having trouble falling asleep. Not only was it difficult for her to fall asleep, but she was unable to stop herself from lying there every night with her legs twitching and hurting.
Her capacity to work, care for her children, and even her attitude was all being negatively impacted by the exhaustion.
She had previously had restless legs during the last weeks of her previous two pregnancies, but each time it went away after delivery.
There was no clear explanation this time. Even a pregnancy test had been taken by her. It was unfavorable. She had reached her limit.
The prevalence of restless legs syndrome, commonly referred to as Willis-Ekbom disease or RLS, is more than most people realize. It affects five to ten percent of people, albeit to various degrees of severity.
It is increasingly common as people age and is twice as common in women as in men.
It is typified by an overwhelming need to move the legs, which is typically motivated by extremely unpleasant sensations, such as water trickling down the leg, an electric shock feeling, a gnawing discomfort similar to a toothache, or the crawling sensation of insects moving beneath the skin.
Five to ten percent of people have restless legs syndrome, though the severity varies.
The impact on sleep can be devastating because symptoms are usually worse below the knee, virtually always worse at rest, and consistently worse in the evening and at night.
The symptoms are momentarily relieved when you move, but they return as soon as you stop.
In most cases, the reason is unknown, although dopamine signaling in the brain is likely to be involved.
There may be a hereditary component to the illness because it runs in families.
Along with underlying medical disorders like renal disease, diabetes, Parkinson’s disease, and an underactive thyroid, it can also be brought on by certain medications, such as some antidepressants, antipsychotics, lithium, beta blockers, and the anti-sickness drug metoclopramide.
Molly first had RLS, which affects about one in five pregnant women.
However, Molly’s story contained a hint that led me to the true offender.
She was now in her early forties, and she almost casually noted that her periods had altered. They were now heavier, lasted a day or so longer, and came more frequently—every 24 days as opposed to her normal 29.
That change was important. A lack of iron, an essential nutrient that aids in the body’s oxygen delivery, can result in restless legs syndrome. Iron deficiency is also known to be triggered by heavy periods.
I requested a blood test, which verified Molly’s diagnosis and identified persistently low iron levels as the cause of her RLS.
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The good news is that the first step in resolving the issue was determining the cause.
Molly started taking oral iron supplements with a glass of orange juice since vitamin C greatly enhances the absorption of iron. Additionally, she had a contraceptive hormone coil installed, which has been demonstrated to lessen menstrual bleeding.
Her symptoms gradually subsided as her iron levels rose. She finally fell asleep.
Importantly, iron deficiency is not limited to women who experience heavy periods. Red meat, some fish, legumes, and leafy green vegetables like spinach and kale are common sources of the vitamin. RLS can affect anyone who doesn’t receive enough iron.
Furthermore, this impairment seems to affect some persons more than others. Before the symptoms of restless legs completely go away, some patients’ iron levels must be kept substantially above the minimum threshold on a blood test.
Dr. Philippa Kaye is a physician, writer, and broadcaster.
However, you shouldn’t handle this on your own because too much iron can be dangerous; your doctor should keep an eye on your levels at all times.
One of the most common and curable causes of restless legs syndrome is iron deficiency. The first thing you should discuss with your doctor if you have RLS and have never had your iron levels checked.
If a deficit is the cause, a cheap daily supplement could completely transform your nights. It’s a straightforward blood test.
Reviewing your medications with your doctor is the next step if iron is not the problem. Certain medications might cause or exacerbate restless legs, but you should never abruptly stop taking any prescribed medication without first consulting a doctor.
Examining additional possible triggers is also worthwhile. Both alcohol and caffeine are known to exacerbate symptoms, so it’s worthwhile to try reducing back or stopping them briefly to see what occurs.
Keeping a food and symptom journal might be beneficial for some people; for example, some people find that eating salty foods exacerbates their symptoms.
Everyone should practice good sleep hygiene, but those who have restless legs should pay particular attention to this.
This entails making sure the bedroom is dark, cold, and quiet, avoiding phones and devices before bed, exercising earlier in the day rather than right before bed, and maintaining regular sleep and wake hours.
Heat is especially beneficial for RLS; stretching or massage, along with a warm bath or a heat pad on the legs before bed, can significantly improve the condition.
Medication can be helpful when lifestyle modifications are insufficient. In addition to choices for pain and sleep, nerve pain medications such as gabapentin and pregabalin are used to treat restless legs.
Once the typical first-line treatment, a class of medications known as dopamine agonists—more frequently linked to Parkinson’s disease—is now used seldom and usually not over an extended period of time.
In addition to causing weariness, nausea, and dizziness, they may eventually make the illness worse.
Talking therapy can also be beneficial; RLS has a significant negative influence on quality of life, and assistance with the psychological effects of persistent sleep disturbance should not be undervalued.
With restless legs, the situation is different. About 25% of people report that their symptoms get better or even go away with time, whereas about a third report that they get worse.
Please see your doctor instead of continuing in quiet. Sometimes the solution is easier than you think, and a restful night’s sleep is closer than you think, as Molly found out.
