Dr. James Schaller, MD
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POSSIBLE CAUSES OF RESTLESS LEG SYNDROME

After finding a number of patients from three states unable to find a solution to their restless leg problem, I have done some basic research to offer some options and causes that are often missed.

As you know, restless leg syndrome is not trivial, and the jerking of a patient’s leg while sleeping can undermine their sleep, work, school, driving, hobbies, sports and other activities.

Highlights of my research from academic sources:

  1. Magnesium — One of the constant medical findings of the last 15 years, which is profoundly and seriously unappreciated, is the magnitude of this key mineral in the brain, heart, and the entire body. It is unfortunate when smart physicians or scientists mock magnesium as being some new fad or dangerous in reasonable doses.

    Bluntly, if one does not read the vast medical research on this mineral they should be more timid with their mouth. I never realized how little I knew until I met an Internist and Neurologist who sent me literally over 500 articles on essential nutrients like magnesium from the leading journals in medicine. I had the curious habit of skipping over them in my reading — I was trained to think nutrition was trivial.

    Blood tests and even more sensitive red blood cell magnesium levels are not necessarily the best way to detect body tissue levels. We test by body tissue intracellular levels. We scrap the cells from under the tongue to test magnesium in the entire body, not just what is in the blood.

    If the massive amounts of body magnesium are low, you can have restless legs, cramps of the uterus and other muscles, migraines, and other problems. It is an essential mineral critical in 300 enzyme reactions in the body.

    Commonly, forms of magnesium offered are hard tablets of oxides, which may cause diarrhea, because they are poorly absorbed. When magnesium is chelated or connected to amino acids it costs more and is worth it. We have designed topical creams for application in children in which the magnesium is absorbed through the skin-an option for children who dislike pills or nutrient shakes. Liquid magnesium drops also exist as another option.

    By the way, it is unfortunate that many companies and physicians are on a pro-calcium fetish, and do not realize what happens when you give plenty of calcium instead of a balance of both calcium and magnesium. According to a classic toxicology textbook in conservative medicine, if you take a lot of calcium and only minimal magnesium, the calcium kicks the magnesium out of your brain and muscle cells.
  2. Zoloft (sertraline) the anti-depressant along with other serotonin antidepressants.
  3. Other psychiatric medications such as older tricyclic antidepressants (Elavil and Imipramine), lithium, and all types of antipsychotics
  4. Stimulants like caffeine and cold medicine stimulants
  5. Antihistamines
  6. Extremes in blood sugar can probably worsen. Diabetics have increased incidence. Low blood sugar may also worsen. Chromium helps control sugar extremes in the blood and is a poorly absorbed essential nutrient. We have found poor levels in 9/10 patients. Chrome Mate may be the best-absorbed form of Chromium.
  7. Iron deficiency or low amounts of the storage protein for iron, ferretin, are clearly associated with the disorder. Iron helps make dopamine. Ferretin should probably be at least 45 micrograms/L. Make sure you do not have a hemochromatosis in which excess iron is stored in the liver and other critical organs. Iron studies should probably be done every 10-12 weeks. The doctor should have an end point value in mind. Meaning, at some point you may be able to reduce or stop the iron.
  8. Alcohol withdrawal
  9. Genetic causes which are being studied
  10. Pregnancy
  11. Severe kidney disease
  12. Stomach surgeries may cause it for unknown reasons.
  13. Dopamine inhibiting drugs such as Compazine and Reglan.
  14. Opiate or narcotic withdrawal might worsen or cause temporarily. An example of an opiod is Darvon, Oxycontin, codeine or Percocet.
  15. Poor absorption or poor breakdown of protein in the gut might mean a person gets low amounts of tyrosine from their diet. (Only my hypothesis based on the fact that tyrosine is needed for dopamine creation). Tyrosine is an amino acid, which is one of many building blocks for protein.
  16. Folate deficiency might play a small role
  17. Hormone changes might play a small role.
  18. Extremes of exercise — profound exhaustion or inactivity-may worsen for unknown reasons.
  19. Benzodiazapine withdrawal-medications like Ativan, Klonopin, Xanax and Valium are members of this class. If someone is using them for panic attacks, social anxiety or general anxiety, and tapers them one might find a restless leg disorder uncovered.
  20. Chronic diseases like rheumatoid arthritis, leukemia, chronic lung disease, ALS, and Fibromyalgia increase incidence. Perhaps the illness or the medications used to treat it increase the incidence.
  21. Nerve damage may cause or worsen.
  22. Lyme Disease — if you have not been checked for this infectious illness by IgeneX labs with at least a Western Blot, using the Jones' Criteria on this web site, you have never been tested for Lyme. Routine labs are comical junk and have been a cause of many deaths.
  23. Babesia — the mild American form of this illness is often caught with Lyme illness. It must be tested by IgeneX and is associated with excess fatigue. I am not certain, but suspect it might be involved in restless leg.

Diplomate: American Board of Psychiatry & Neurology
Diplomate: Forensic Medicine & Forensic Examination


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