The editorial was in the March 5, 2014 issue of Neurology the medical journal of the American Academy of Neurology and was authored by Boston Medical Center neurologist Sanford H. Auerbach, MD.
Restless Leg Syndrome is a disorder of the nervous system. It is characterized by throbbing or other uncomfortable sensations in the legs with an uncontrollable urge to move them. Symptoms typically occur at night when a person is relaxing or getting ready for bed and can increase in severity during the night. Most people with RLS have difficulty falling asleep and staying asleep, which can lead to fatigue. Many people with RLS report that their job, personal relations, and activities of daily living are strongly affected as a result of their sleep deprivation. They often have difficulty concentrating and brain fog.
The editorial was in response to an analysis of 12,556 men who were followed over time by the Health Professionals Follow-Up Study, published in the same issue of Neurology, which showed multiple disease associations with RLS.
The team found patients with RLS had a higher mortality rate than similar men, and showed an especially strong tendency toward cardiovascular disease and hypertension. In addition, men with RLS were more likely to be diagnosed with lung disease, endocrine disease, as well as diseases of nutrition and metabolism and immune system problems.
Researchers suggest that restless leg syndrome is a meaningful biomarker for serious disease, and that RLS screening may become more common as a tool for primary care providers to identify patients at risk.
I have had personal success with patients simply by adding magnesium and calcium at bedtime. They both calm muscles and nerves. Calming botanicals such as valerian, passion flower, lemon balm, and skullcap can also be added to support sleep and relaxation. You can also assess RBC nutrients such as magnesium, calcium, and potassium through many functional laboratories. In addition to assessing nutrient status they do play a significant role with blood pressure regulation and overall cardiovascular health. This provides a better indicator of nutrient status, compared to the serum.
I would also recommend an organic acid test. An organic acid test can identify imbalances occurring in the body that precede abnormal findings on a CBC or an MP. Organic acids are products of metabolism that can sensitively identify nutrient deficiencies that lead to metabolic roadblocks. Organic acids go a step further then measuring nutrient concentrations by measuring whether the nutrient is functionally adequately. Abnormal concentrations of organic acids in the urine can provide a functional marker for metabolic effects of nutrient deficiences, genetic polymorphisms, impaired enzyme function, toxic exposure, neuroendocrine activity, and intestinal bacterial overgrowth. Organic acid testing can indicate the functional need for specific nutrients, diet modification, antioxidant protection, detoxification, and other therapies.
There is also some evidence that indicates low iron levels in the brain being associated with RLS. A CBC w/diff and an Iron Panel (Serum Iron, Ferritin, % Saturation, TIBC, UIBC) can identify an iron deficiency.
Restless leg syndrome may only be just a small part of the picture. It may be a simple nutrient deficiency in many cases, however, it is important to look deeper into the patient’s health. This includes thoroughly reviewing the patient’s history looking deeper into the cardiovascular system and other inflammatory markers. Looking deeper into the above factors can provide an effective treatment plan for patients with restless leg syndrome.
Dr. Michael Jurgelewicz, DC, DACBN, DCBCN, has been studying wellness for the past 10 years. He has a B.S. degree in Health & Wellness, a B.S. degree in Anatomy, and is a Doctor of Chiropractic. He is Board Certified in Nutrition by the American Clinical Board of Nutrition, a Diplomate of the Chiropractic Board of Clinical Nutrition, has completed Functional Medicine University with a Certificate in Functional Medicine and has studied under both world renowned thyroid expert, Dr. Datis Kharrazian and Chiropractic Neurologist, Dr. Frederick Carrick. He is also active in continuing education through the Clinical Nutrition Certification Board. http://www.thefunctionalmedicinecenter.com
S. Auerbach, A. S. Walters. Restless legs syndrome: A predictor of lower physical function. Neurology, 2014; DOI: 10.1212/WNL.0000000000000298