Restless Leg Syndrome and status of folate and iron.




J Womens Health Gend Based Med

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Consumer Data: Folic Acid Iron Restless Leg Syndrome
Professional Data: Folic Acid Iron Restless Leg Syndrome


Restless leg syndrome (RLS), also known as Ekbom's syndrome, is a discomfort, not pain, verbalized as pins and needles, a crawling sensation, or cramping mainly in the calves but sometimes noted in the thighs or arms. The sensation generally occurs only during rest and inactivity and is quickly relieved by walking or moving the legs. Males and females are equally affected, and RLS occurs most commonly in the elderly. Iron deficiency, pregnancy, and renal failure are associated with RLS. This can be a very disturbing condition. When a person who has RLS tries to go to sleep, the tingling and cramping causes them to get up and move about to relieve the symptoms. Then when the person attempts to resume sleep, the discomfort returns, causing insomnia. More than 80 percent of people with RLS also experience a more common condition known as periodic limb movement disorder (PLMD).1

Benzodiazepines are the first-line therapy, particularly for less severe cases and younger patients. Clonazepam, lorazepam, triazolam, and temazepam have been effective. Opiates, such as codeine and oxycodone, have been used; however, tolerance develops and abuse potential becomes a concern since the condition is chronic.

A recent study conducted at the University of California San Francisco, collected data on women before, during, and after pregnancy and the prevalence of RLS. They recorded information on sleep disturbances and mood state and explored the effect of folate and iron status. The researchers focused on the third trimester when RLS symptoms were the worst. Compared to the women that did not experience symptoms, the women who did have symptoms of RSL demonstrated low serum ferritin (a protein that stores iron) and lower levels of folate. In the RLS group, the women encountered delayed sleep onset and a higher rate of depression. Rather than indications of iron deficiency or pernicious anemia, the restless leg syndrome was due to low serum folate levels in this sample of women. To minimize complaints of RLS, the authors suggested reconsidering the levels of ferritin and folate currently recommended to pregnant women. This may improve sleep quality and daytime mood.2


1. National Institute of Health. 2001.
2. Lee KA, Zaffke ME. Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. J Womens Health Gend Based Med. May 2001; 10(4):335-41.