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Is Restless Leg Syndrome Real? Myths and Facts about RLS

Is restless leg syndrome real? Read on to discover the myths and truths about this elusive condition.
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Recently, some articles and stories have called into question the legitimacy of Restless Leg Syndrome (RLS). According to these stories, RLS is simply a condition fabricated or made to appear worse by the pharmaceutical companies to sell more pills.

However, is this information true? Is RLS a real condition, or is it a fabrication of the medical industry. Read on to learn about the real facts of RLS, as well as many myths surrounding the condition.

What is RLS?

According to a study on RLS conducted by Galway University Hospitals in Ireland in 2006, restless leg syndrome is identified as a sleep disorder and a sensorimotor disorder. The condition is identified as an uncomfortable sensation in the legs (sometimes the arms) that causes a person to move. Often, the symptoms appear after prolonged sessions of rest. Most people feel the most symptoms at night or in the evening. In many cases, RLS causes sleep disturbance.

According to the study, RLS symptoms are deep in the legs, and are often described as being in the shin bones. The pain appears between the shin knee and ankle. Sensations can include feelings of shocking, buzzing, tense, worms under the skin, “crawling out of my skin,” itching, numb, or electric feelings. In some cases, heat is considered an aggravating condition. In others, heat is a calming tool for the sensations.

Most patients can resist the urge to move for a while, but must eventually give in to the movement, much like the compulsion in Obsessive Compulsive Disorder. While moving, most patients feel complete or partial relief.

The History of RLS

The first recorded instance of RLS was in 1685 in the book “The London practice of physick” by T. Willis. In the book, the disorder was described with the same motor features and sleep disruption issues that RLS sufferers face today. However, it made no mention of the sensory features that most modern patients complain about the most. A 1945 study conducted by the Acta Medica Scand Supply made the first mention of the sensory component of the condition.

In 1995, the International RLS Study Group published the first diagnostic guidelines for the condition. Since then, the National Institute of Health has created a modified guideline for the disorder. Current guidelines include for essential criteria for diagnosis, outlined in the next section.

How is RLS diagnosed?

According to the National Institute for Health, there are four criteria that go into diagnosing restless leg syndrome. There are no official tests for the disorder. The diagnostic criteria are as follows:

  • Symptoms which are worse at night and absent or lessened in the morning
  • Sensory symptoms triggered by sleep, rest, or relaxation
  • A strong need to move the limbs, often associated with dysesthesias(a strange feeling in the body) and paresthesias (tingling or burning of the skin for no reason)
  • Symptoms that are relieved by movement and as long as movement continues.

Doctors typically diagnose the condition based on the description of symptoms, the triggers, what relieves the symptoms, and whether the symptoms occur during the day or just at night. Tests can be performed, but only to rule out other causes. Children with RLS may be misdiagnosed as having “growing pains” or ADD.

The case against restless leg syndrome

For many years, and as recently as 2008, many individuals have questioned the legitimacy of the condition. Part of this skepticism arose from the fact that the first drug approved for RLS was not approved until 2005. A 2006 commentary published in the PLOS Medicine Journal investigated the issue and how the media can make certain conditions turn into fads. The article stated:

PLOS Medicine Journal Report

“The articles also reinforced the need for more diagnosis. About half reported that the syndrome is underdiagnosed by physicians (“.relatively few doctors know about restless legs. This is the most common disorder your doctor has never heard of” [17]) and under recognized by patients (“.many people can suffer in silence for years before it is recognized” [18]). One-quarter of articles encouraged patient self-diagnosis and suggested people ask their doctor whether restless legs might explain various problems (including insomnia, daytime fatigue, attention deficit disorder in children, and depression). One-fifth of articles referred readers to the “nonprofit” Restless Legs Foundation for further information; none reported that the foundation is heavily subsidized by GlaxoSmithKline. No article acknowledged the possibility of overdiagnosis (the idea that some people will be diagnosed unnecessarily and take medication they do not really need).”

In short, the author of the article questioned the sudden prevalence of the issue and wondered if media attention was causing more people to self-diagnose for this condition than actually suffer from the disease.

While it is possible that some of the individuals who claim to have RLS may be misinformed (or a hypochondriac), there are still millions of people who actually suffer from the real disorder, which can actually be much more dangerous than a simple inability to rest at night."

The case for restless leg syndrome

There is too much medical history for RLS to conclude that the condition is completely made up by the pharmaceutical industry. This condition is real, and has real consequences. In fact, a 2012 study conducted by Harvard University followed 18,425 men reporting restless leg syndrome for over 8 years. During that time, 2,765 of the men died. According to the statistics from the study, having RLS increased the men’s mortality rate by 39 percent. That is a huge increase, which shows that RLS should be taken seriously and not swept under the rug or ignored.

Causes of RLS

The exact causes for RLS are unknown. However, there are some conditions that lead to an increased chance of having the condition. According to the National Institute of Health, up to 10 percent of Americans may have this condition. CNN Health states that only about 3 percent of these individuals, however, have the condition severely enough to warrant treatment measures. Conditions that may lead to RLS are listed below.

Suspected Causes for RLS

Iron deficiency: According to Wikipedia, iron deficiency is responsible for up to 20 percent of all RLS cases. Blood ferritin levels below 50 µg/L leads to the issue in many patients.

Pregnancy: Pregnancy is a known cause for RLS. There is no treatment for RLS during pregnancy, because most of the approved medications for RLS are not approved for use during pregnancy. Fortunately, most of the RLS symptoms associated with pregnancy go away after delivery.

Autoimmune diseases: Wikipedia states that certain autoimmune diseases can also lead to RLS. celiac disease, rheumatoid arthritis, and Sjögren's syndrome can all lead to RLS, as can thyroid malfunction.

Vitamin deficiency: According to the NIH, vitamin deficiencies can also lead to RLS. A 2012 study published in Sleep Medicine showed that RLS sufferers a combination of Vitamin C and E helped patients show a reduction in RLS symptoms.

Anxiety and depression: A 2005 study conducted by the University of Illinois School of Medicine concluded that anxiety and depression was often linked to cases of RLS. The study did not confirm, however, that depression caused RLS, just that the two issues were somehow related.

Genetics: A 2006 study published in the Post Grad Medicine Journal indicated that genetics may play a large role in many RLS cases. Up to 75 percent of RLS cases are associated with genetic propensity, according to the study. The study linked several genes to RLS, including BTBD9, MEIS1, and MAP2K5. The chromosomes 14q, 20p, 12q, and 9p are also linked to the disorder.

Medications: Certain medications can also cause RLS symptoms, according to the NIH. Medications like antipsychotic drugs, anti nausea drugs, antidepressants, and sedating antihistamines can all cause RLS symptoms.

Chronic diseases: According to the National Institute of Health, chronic diseases can lead to RLS symptoms. Leading causes include Parkinsons disease, kidney failure, diabetes, and peripheral neuropathy.

Dopamine imbalance: According to Web MD, dopamine is often prescribed for RLS because the condition is caused by abnormalities in how the body uses dopamine. A dopamine imbalance may lead to other problems as well, including Parkinson's disease.

Neuropath disorders: A 1996 study conducted by the Baylor College of Medicine linked some neuropath disorders with the condition, including alcohol abuse, Charcot-Marie-Tooth syndrome type 2, diabetes mellitus, and radiculopathy.

Is RLS serious?

RLS can be a serious condition. While the full repercussions of the disorder are unknown, there are serious side effects. The Harvard study above listed a possibility of an increased mortality rate of nearly 40 percent for individuals with RLS. Other side effects of the condition include depression, a reduced quality of life, chronic tiredness, and an inability to engage with others due to lack of sleep. These issues can lead to a mental state that is unhealthy, as well as lead to other problems that are caused from lack of sleep, such as decreased mental activity and increases irritability.

RLS Myths everyone should know

There are certain myths that surround the condition of restless legs syndrome. It is important to refute these myths to help those who truly suffer from the condition. Trivilaizing a disease is never a good idea, and will only lead to additional pain and suffering. 

Myth 1: RLS is trivial

According to the Galway University study, most individuals (and even some doctors) consider RLS as a trivial condition. There are several reasons for this. One reason is due to the name. Restless leg syndrome sounds like a made-up name. Most people have experienced some feeling of “antsy” behavior that many consider a natural part of life. The high reports of RLS in studies about the disorder also cause some medical professionals to question the legitimacy of the issue.

Although some people with RLS have mild symptoms, many people have symptoms severe enough to warrant attention. As the Harvard study showed, there is a clear link between RLS and a higher mortality rate. Even if RLS does not kill the person with the condition, it does interrupt sleep and the quality of life that person can have on a day-to-day basis, which is something that should not be ignored.

Myth 2: RLS is “in your mind”

When RLS sufferers report their symptoms to friends, and even some medical professionals, they are met with scorn and told their symptoms are psychogenic. The strange symptoms of this condition often lead medical professionals to conclude that the disorder is not medically related, but rather related to the mind.

In many cases, RLS is associated with anxiety and depression. A 2005 study from the Institute of Psychiatry in Munich showed that individuals with panic disorders, depression, and anxiety disorders had a higher chance of suffering from RLS symptoms.

Myth 3: RLS is only a leg condition

Many health professionals believe that RLS is a vascular disorder of the legs (dating back to a study from 1945). However, looking at the legs only is ignoring the pathogenesis of RLS. A 1996 study conducted by the Baylor College of Medicine in Texas indicated that RLS is a presenting feature of neuropathy, like alcohol abuse, diabetes mellitus, Charcot-Marie-Tooth syndrome type 2, and radiculopathy. This indicates that RLS is related to a central nervous system abnormality.

Myth 4: RLS cannot be treated

RLS is a condition that has many treatment options today that range from iron supplements, to vitamin increase, to dopaminergic treatments. Today, RLS is a fully treatable condition. For all but an estimated 3 percent of cases, diet, exercise, and supplements alone will be enough to eliminate or greatly reduce RLS symptoms.

Diet and Lifestyle Changes to Cure RLS                                      

For most RLS sufferers, there are several things you can do to cut back on symptoms and resolve the condition. These range from adding additional supplements to the diet to exercise. If you suffer from RLS, try making these changes to relieve your symptoms:


CNN Health states that exercise is a viable treatment option for some RLS symptoms. Moderate exercise, like walking, biking, and swimming can help relieve RLS symptoms. However, vigorous exercise can have the opposite effect. If you suffer from RLS and exercise a lot, try cutting back some rather than increasing your exercise time and intensity.

Diet change

Certain vitamins and minerals are effective at reducing RLS symptoms. Making a diet change can help you reduce or eliminate your symptoms. Look for foods high in the following vitamins:

Iron: Iron deficiency is one of the leading causes for RLS. You may be able to remove all symptoms by simply upping your iron intake. However, many iron supplements do not contain an absorbable form of iron. To get the purest form of iron, choose iron-rich foods. Iron-rich foods include: red meat, liver, egg yolk, beans, oysters and clams, dark greens, and poultry giblets. Since many modern diets have you avoid many of these foods, many Americans are deficient in iron.

Calcium: Calcium is important for bone health, but it also improves nerve function. A calcium deficiency may lead to symptoms of RLS. Calcium-rich foods include: Dairy products, dark greens, and sardines. Vegetarians must pay particular attention to ensure they have enough calcium in their diet.

Vitamin B12: B vitamins are important to the body at all times. This is also true for RLS. Vitamin B12 are related to some neurological issues, which can lead to RLS. Vitamin B12 also helps balance dopamine levels, which is a direct component of RLS. Foods high in vitamin B12 include: shellfish, liver, fish, red meat, dairy, and eggs.

Magnesium: Magnesium helps regulate the nerves and control RLS symptoms. In fact, calcium and magnesium often work together to improve nerve function. Magnesium rich foods include: Dark greens, seeds, fish, beans, avocado, and dairy products.

Vitamin C: The Sleep Medicine study showed that when participants with RLS took a vitamin C supplement of 200 mg per day, their symptoms decreased. Vitamin C-rich foods include: hot chili peppers, parsley, bell peppers, dark greens, kiwi fruit, and of course, citrus fruit.

Vitamin E: In the Sleep Medicine study, participants also took a daily supplement of vitamin E dose of 400 mg per day. Vitamin E is present in many foods, including: dark greens, nuts, tropical fruits, red bell peppers, and olive oil.

Folate: Folate is essential for brain health, and getting plenty of folate may also help keep RLS symptoms under control. Folate is responsible for creating dopamine in the body which may regulate RLS symptoms. In fact, one medical treatment for RLS is to take dopamine supplements. You will find natural folate in dried herbs, liver, dark greens, and beans.

Natural RLS supplements

If you do not want to go the medical route to treat RLS, there are many things you can do. Luckily, much of the cause of RLS is suspected to be diet and nutrient-related. This means that simply by altering your diet, you should be able to reduce your symptoms on your own without medical treatments. If you cannot get your hands on all of the foods listed above, or you cannot eat them for religious or dietary reasons, it may be helpful to supplement some of these vitamins in pill form.

Supplements for RLS
  • Vitamin B12
  • Vitamin C (not ascorbic acid)
  • Vitamin E
  • Iron
  • Folate
  • Calcium
  • Magnesium

These supplements can help fill in any gaps in your diet and may help you see results faster than through diet alone. Diet is a clear path toward reducing or eliminating RLS symptoms. However, if you feel psychologically impacted by your RLS symptoms, it is important to speak to a health professional right away.

The Reality of RLS 

RLS is a real condition and it is not “all in your head.” Millions of Americans suffer from this condition on some level or another. However, with diet, exercise, and supplements, you should be able to reverse most of the symptoms that you feel on a day-to-day basis and become a healthier, happier, more rested you.





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