When considering restless legs syndrome, one of the most important considerations a potential deficiency of the mineral Iron. Iron is a micro-mineral that is generally poorly absorbed in the body. We require relatively small amounts of general health – adult men need to absorb about 1 mg/day and adult menstruating women about 1.5 mg/day (although this is highly variable). When women cease menstruating they drop to 1mg/day and during pregnancy the absorption of 4–5 mg/day is necessary. Iron plays an important role in the processing of dopamine (a neurotransmitter) in the brain. Dopamine deficiency is strongly associated with RLS and many medications are manufactured to support this pathway. Studies have shown that a serum ferritin concentration, lower than 45 to 50 mcg/L, has been associated with increased severity of RLS. One interesting paper documented that central iron deficiency in patients with RLS was detected through MRI and cerebrospinal fluid studies further supporting the correlation. Absorption of Iron is a complicated process but a few keys tips including taking concurrent Vitamin C (500mg per dose is usually sufficient); focussing on optimal absorption forms of Iron (amino acid chelate is superior and has not constipating effects); encouraging both haem (animal) and non-haem (vegetarian) sources of Iron in the diet and when cooking haem sources rare is best – overcooked will simply destroy all sources of Iron. High tannin rich foods and drinks such as black tea will prevent absorption so avoidance is key. Make sure you are properly assessed before taking Iron as complications can arise if you have too much in your body or suffer from Haemachromatosis.
Another important nutrient is Magnesium. It is absolutely critical for normal neurological functioning and acts as a muscle relaxant. There are a few trials that showed significant improvements but the best proof is the patient’s outcome. Common deficiency signs are chocolate cravings (especially dark chocolate), muscle cramps (especially calf cramps), insomnia, eye twitches and generalised fatigue and stress. There is some data to suggest that everyone is Magnesium deficient given the above deficiency signs but it is best to be properly assessed and have your dose calculated.