Relax those fidgety legs and put an end to the restlessness.
According to research or other evidence, the following self-care steps may help you kick the
discomfort of RLS:
- Balance your blood sugar
- Replace sugar, refined flour, and alcohol in your diet with small,
frequent meals containing whole grains, fish, nuts, seeds, and fresh fruits and
- Cut the caffeine
- Help reduce the severity of RLS by steering clear of coffee, tea,
and other sources of caffeine
- Keep an eye on iron
- See a healthcare practitioner to find out if you have an iron
deficiency that could be contributing to your restless legs syndrome
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full restless legs syndrome
article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and
dietary and lifestyle changes that may be helpful.
About restless legs syndrome
Restless Legs Syndrome (RLS) is a poorly understood condition that causes leg symptoms
shortly before going to sleep—symptoms that are temporarily relieved by movement.
Occasionally the condition may also involve the arms. It can cause sudden jerking motions of
the legs and can lead to insomnia.
RLS is most common in middle-aged women,
pregnant women, and people with severe kidney disease, rheumatoid arthritis, and nerve diseases (neuropathy).
Restless legs have also been reported to occur in people with varicose veins and to be relieved when the varicose
veins are treated.1
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What are the symptoms?
RLS is characterized by an almost irresistible urge to move the affected limbs because of
unpleasant sensations beneath the skin, which are described as creeping, crawling, itching,
aching, tingling, drawing, searing, pulling, or
painful. These symptoms occur primarily in the calf area but may be felt anywhere in the
legs or arms. The sensations are typically worse during rest or decreased activity, such as
lying down or sitting for prolonged periods.
Severe symptoms are treated with dopaminergic agents, such as ropinirole (Requip),
pergolide (Permax), and levodopa with
carbidopa (Sinemet); benzodiazepines, including diazepam (Valium) and clonazepam (Klonopin); and opiates (codeine,
oxycodone). Other medications include the anticonvulsant drugs carbamazepine (Tegretol) and gabapentin (Neurontin).
Symptoms may also respond to correction of an underlying medical condition, such as iron-deficiency anemia, kidney disease, diabetic neuropathy, amyloidosis, chronic venous insufficiency, or malignancy.
Dietary changes that may be helpful
Preliminary studies of large groups of people with reactive hypoglycemia have reported that 8% have restless legs.
These symptoms have been reported to improve following dietary modifications designed to
regulate blood-sugar levels;2 changes included a sugar-free, high-protein diet
along with frequent snacking and at least one night-time feeding.3 For patients
with reactive hypoglycemia, some doctors recommend elimination of sugar, refined flour,
caffeine, and alcohol from the diet; eating small, frequent meals; and eating whole grains, nuts and seeds, fresh fruits and vegetables, and fish. One study found caffeine ingestion to be associated with increased
symptom severity in people with RLS.4
Lifestyle changes that may be helpful
Anecdotal evidence suggests that RLS symptoms my decrease with a cessation of
smoking.5 Although additional research is needed to confirm such reports, a trial
of smoking cessation seems prudent for people who suffer from restless legs.
Vitamins that may be helpful
Mild iron deficiency is common, even in people who are not anemic. When iron deficiency is
the cause of RLS, supplementation with iron
has been reported to reduce the severity of the symptoms. In one trial, 74 mg of iron taken
three times a day for two months, reduced symptoms in people with RLS.6 In people
who are not deficient in iron, iron supplementation has been reported to not help reduce
symptoms of RLS.7 Most people are not iron deficient, and taking too much can lead
to adverse effects. Therefore, iron supplements should only be taken by people who have a
In some people with RLS, the condition may be genetic. People with familial RLS appear to
have inherited an unusually high requirement for
folic acid. Although not all people with RLS suffer from uncomfortable sensations,
folate-deficient people with this condition always do.8 In one report, 45 people
were identified to be from families with folic acid-responsive RLS. The amount of folic acid
required to relieve their symptoms was extremely large, ranging from 5,000 to 30,000 mcg per
day.9 Such amounts should only be taken under the supervision of a healthcare
In a group of nine people with RLS, 300 IU of
vitamin E per day produced complete relief in seven.10 Doctors who give vitamin
E to people with RLS generally recommend at least 400 IU of vitamin E per day, and the full
benefits may not become apparent for three months.11
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
1. Kanter AH. The effect of sclerotherapy on restless legs syndrome.
Dermatol Surg 1995;21:328–32.
2. Roberts HJ. Spontaneous leg cramps and “restless legs” due
to diabetogenic hyperinsulinism: observations on 131 patients. J Am Geriatr Soc
3. Roberts HJ. Spontaneous leg cramps and “restless legs” due
to diabetogenic (functional) hyperinsulinism. A basis for rational therapy. JFMA
4. Lutz EG. Restless legs, anxiety and caffeinism. J Clin
5. Mountifield JA. Restless leg syndrome relieved by cessation of
cigarette smoking. Can Med Assoc J 1985;133:426.
6. O’Keeffe ST, Gavin K, Lavan JN. Iron status and restless legs
syndrome in the elderly. Age Ageing 1994;23:200–3.
7. Davis BJ, Rajput A, Rajput ML, et al. A randomized, double-blind
placebo-controlled trial of iron in restless legs syndrome. Eur Neurol
8. Botez MI. Neuropsychological correlates of folic acid deficiency:
facts and hypotheses. in: Botez MI, Reynolds EH, eds. Folic Acid in Neurology, Psychiatry
and Internal Medicine. New York: Raven Press, 1979.
9. Botez MI. Folate deficiency and neurological disorders in adults.
Med Hypotheses 1976;2:135–40.
10. Ayres S Jr, Mihan R. “Restless legs” syndrome: Response
to vitamin E. J Appl Nutr 1973;25:8–15.
11. Ayres S, Mihan R. Leg cramps and “restless leg” syndrome
responsive to vitamin E. Calif Med 1969;111:87–91.