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Relief for Restless Leg Syndrome

Relief for Restless Leg Syndrome

You want to sleep, but your legs twitch, burn, or itch. Restless Leg Syndrome (RLS) often strikes at night, making it difficult to master one of the five pillars of good health, restorative sleep. People who have never experienced this condition may not fully appreciate how the condition can disrupt sleep and have profound repercussions on relationships, concentration, mood, and energy. Fortunately, holistic and integrative therapies provide many excellent strategies to alleviate symptoms of this frustrating condition.

What is Restless Leg Syndrome (RLS)?

The most comprehensive definition of RLS is "a brain, nerve, and sleep condition" that causes a strong urge to move your legs that is at least partially relieved by movement (1). Known also as Willis Ekbom disease, it's a fairly common condition. Some studies say that up to 10% of the adult US population may be experiencing RLS (1, 2).

RLS sufferers report different reasons why they feel compelled to move their legs again and again when reclining or when trying to sleep. Some say their legs itch, while others experience something crawling up their legs! Others may feel a burning sensation or feel something sharp is pricking their skin. Notably, muscle cramping and numbness of the legs are rarely reported in RLS. Interestingly, walking around and using the legs seems to override these symptoms, and the condition comes to awareness only when body weight has been removed from the legs when sitting or reclining.

RLS's most severe repercussions come from a lack of good, sound sleep. However, people often overlook the impact on relationships. RLS can negatively impact the spouse or partner of the sufferer if they sleep in the same bed. When one-half of the couple suffers from RLS, couples may turn to sleeping in separate beds, which can impair intimacy. Moodiness or irritability from lack of sleep can affect a whole family. RLS can result in (1):

  • Problems getting to sleep or getting long periods of uninterrupted sleep

  • Disrupting the sleep of others by moving or getting out of bed to walk

  • Feeling fatigued or having a lack of alertness following a rough night

  • Irritability, quick changes in mood, problems relating to people

  • Problems with memory, concentration, or keeping sustained attention

  • Mental depression or feeling anxious 

Symptoms of RLS

People experience a wide range of RLS symptoms, though there are some commonalities(1, 3):

  • The uncontrollable urge to move the legs when reclining

  • Various sensations in the legs: itching, burning, aching, throbbing, crawling 

  • Relief can be immediately obtained by movement, walking, or putting body weight on the legs 

  • Symptoms get worse at night 

  • May include involuntary kicking or movement called "periodic limb movement of sleep”

Who's Most at Risk for RLS?

Statistically, women are more at risk for RLS than men. And while more adults experience RLS, it's estimated that between 2% and 4% of children may also have the condition (2). As you get older, or if you are Caucasian, the risk of RLS goes up (1).

What Causes RLS?

Unfortunately, the root cause of RLS cannot be determined for some people (3). In this case, the strategy is to reduce the impact of the symptoms. There may also be an underlying driver for RLS. A few primary causes that have been identified are fluctuation of hormones or being pregnant, genes (especially if the condition starts before age 40), and certain medical conditions (3).

RLS can be secondary to a different health condition, such as diabetic peripheral neuropathy, some kidney conditions, issues originating in the spinal cord, Parkinson's disease, lack of iron or magnesium, repercussions from drug abuse (1), or varicose veins (2).

How is RLS Diagnosed?

There is no agreed-upon, specific diagnostic test for RLS. Rather, clusters of symptoms are identified as part of this syndrome (1). It is vital to get examined by a doctor if you think you are experiencing RLS because there could be an undiagnosed underlying condition that is driving the symptoms, and RLS is diagnosed when other conditions have been ruled out (4). Depending on your medical history and current symptoms, we may recommend a sleep study. If tremors exist or body movement is greatly affected, a referral may be given to a neurologist to rule out neurodegenerative diseases such as Parkinson's Disease. Otherwise, we could use various tests (blood, urine, stool, or saliva test) to determine if your symptoms are caused by:

  • Heavy metal toxicity or other neurotoxin exposures

  • Involvement of a kidney condition

  • Electrolyte imbalance

  • Iron deficiency

  • Low vitamin D 

  • Low vitamin B12 or folate (B9) 

  • Genetic issues (MTHFR genetic mutations that affect B vitamin status or the genetically-induced CPT2 deficiency disease)

What Can Trigger RLS Symptoms?

Some things can increase the frequency or severity of RLS symptoms (1):

  • Dietary alcohol or caffeine

  • Nicotine (from cigarettes, vapes, or even patches used for withdrawal)

  • Medications (ADD/ADHD, allergy, or heart medications)

  • Experiencing stressful situations or conditions 

Decreasing RLS triggers requires working with an involved, concerned, and alert doctor. Always consult with a doctor if you want to quit the heavy use of alcohol or any medication (especially heart or mental health medications). Please note that in cases of severe alcoholism, it can be deadly to withdraw from alcohol cold turkey. Nutritionists can help people withdraw from caffeine or alcohol (light to medium use) if assistance is needed. Doctors can approve the withdrawal of medications and prescribe lower doses over time if necessary. Lastly, mental health counseling may help reduce stress.

Potential Holistic & Integrative Treatments for RLS

While holistic medicine considers the whole person (not just the symptoms), integrative treatments benefit from conventional and alternative approaches to provide treatments customized to the person's needs. Pulling holistic therapies into integrative practices is very powerful. Integrative medicine offers advanced diagnostics, helping to find the root causes for symptoms, while holistic and Western medicine strategies are applied as treatments. In diagnosing RLS, underlying conditions should be either positively identified or ruled out as a cause. Considering the whole picture, including the medical history, current symptoms, and results from testing, one or more of the following therapeutic approaches could be used as part of a customized strategy to alleviate RLS symptoms:

1. Treat the underlying condition if one was detected. There are many potential causes for RLS, including diabetes, nutrient deficiencies, toxin exposures, or kidney issues. Each of these would be treated differently, depending on what was identified. 

2. Saunas. Saunas work quickly, relaxing muscles with heat, and helping detoxify heavy metals and toxins through sweat.

3. Relieve toxic load. As toxins within the body are released and purged, the body's natural healing properties are freed up to heal other things that need attention. Many strategies can help reduce built-up toxins:

  • Nutritional detox (metabolic detoxification) - Specific powdered or liquid supplements support the liver's ability to detoxify toxic chemical compounds.

  • Glutathione IV- Glutathione is a powerful antioxidant compound that can help the liver render toxins harmless. It also protects cells against damaging heavy metals and assists in the breakdown of organochemicals used in farming (insecticides, pesticides) and other environmental contaminants (5).

  • Ozone therapy / UVBI - Ozone therapy kills microbes in the blood without damaging blood cells. Ultraviolet blood irradiation can be added to the ozone therapy to increase the elimination of viruses, funguses, and bacteria. Removing these unwanted microbes reduces the demands on the body for healing, allowing healing to be directed elsewhere. 

4. Reduce potential triggers. Whenever a disorder, health condition, or disease manifests, it's always good to pare down the diet to a whole foods diet (meats or plant proteins, whole grains, fruits, and vegetables). Since alcohol and caffeine are potential triggers, it could be helpful to significantly reduce or eliminate them to see if they are involved in the RLS symptoms. Artificial ingredients (colors, flavors, preservatives) can also have odd effects on people, so try cutting them out and see if RLS symptoms go away.

5. Nutritional supplementation. Certain nutrients can help relax and restore normal function to the muscles and nerves in the legs.

  • Magnesium glycinate - Known to relax muscles specifically, this particular form of magnesium usually does not cause loose stools (as its cousin magnesium citrate is known to do).

  • L-carnitine - This amino acid protects muscles from damage and decreases muscle soreness.

  • Alpha lipoic acid - A superb antioxidant, ALA is a sulfur-based, anti-inflammatory compound that treats diabetic nerve damage (neuropathy).

  • Vitamins B12 and folate - Vitamin B12 combats anemia and enhances nerve signaling that helps muscles contract properly. Folate (vitamin B9) helps the absorption of vitamin B12, helps combat anemia, and supports proper nerve function. Because a high percentage of people have genetic differences that inhibit the activation of B vitamins (called MTHFR genetic mutations), the best versions of these vitamins to take are the already-activated, "methylated" forms: methylfolate, methylcobalamin, hydroxy- or hydroxocobalamin, or adenosylcobalamin.

  • Iron - If anemia or iron deficiency is detected, iron supplementation may be necessary. A nutritionist or doctor can help determine the proper dosage and create a re-testing schedule to determine the sufficient amounts for your body.

  • CBD - Compounds from the miraculous cannabis plant ease pain and relax the whole body, helping many people get a good night's sleep. Notably, there have been reports of RLS going away completely when using cannabis (6), although more studies need to be done. However, CBD has been proven to reduce inflammation, address epilepsy and seizures, and ease the spasms that accompany multiple sclerosis. See TCIM's previous article about the benefits of CBD.

6. Acupuncture. Tiny needles pressed into the skin increase blood flow and oxygen to human tissue, an ancient therapy that continues to impress researchers to this day. An extremely flexible treatment that can be applied to many health conditions, acupuncture can be combined with low-dose gabapentin (prescription medication) to increase sleep quality in extreme cases of RLS (7).

7. Massage. Massaging the legs can help alleviate RLS when it occurs, but regular massage may also help reduce the severity of RLS over time. One study showed that combining foot, ankle, and leg massage with lavender oil reduced the severity of RLS symptoms in hemodialysis patients (8).

8. Add certain medications. For some, drugs that increase levels of dopamine can ease RLS symptoms by improving nerve cell communication (9). Medicines known as alpha2-delta ligands (such as gabapentin) interact with calcium channels, reducing excitatory chemical communication and disrupting pain signals associated with various conditions (10). 

9. Remove other medications. Certain medications may make RLS symptoms worse, for example, medicines that address mental health (antidepressants, antipsychotics) and even over-the-counter medications for allergies and cold symptoms (4). Heart medications and ADD/ADHD medications may also cause issues in some people; however, please do not withdraw from these medications without medical supervision! Work with your doctor to determine if it's even necessary to withdraw from a prescription, and if so, how to do it safely over time by gradually reducing dosage.

Executive Physicals & RLS Treatments

As you can see by the lengthy treatment list above, integrative and holistic medicine offers numerous pathways to better health for Restless Leg Syndrome (and many other current health issues)! Many people have reduced their RLS symptoms and even entirely resolved them by using multiple, customized therapies to address symptoms and (more importantly) by identifying any underlying drivers. We invite you to work with us if you suspect you have RLS.

If you last had a complete physical a long time ago, please schedule one of our Executive Physicals, during which we can assess the severity of RLS. Other tests may be run during the Executive Physical (such as blood and urine tests) so we can verify your overall health and help rule out undiagnosed underlying conditions that may be driving RLS.

If you’ve already been diagnosed with RLS by another care provider, you can still benefit from the holistic and integrative treatments listed above. We are here to partner with you through any health issue and advise you on the next steps as your health flourishes.


Jonathan Vellinga, M.D.

Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.​

Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.




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9. Silber MH, Buchfuhrer MJ, Earley CJ, Koo BB, Manconi M, Winkelman JW, Becker P, Berkowski JA, Clemens S, Connor JR, Ferré S, Hensley JG, Jones BC, Karroum EG, Koo BB, Ondo WG, Richards K, Sharon D, Trotti LM, Gr U, Walters AS. The Management of Restless Legs Syndrome: An Updated Algorithm. Mayo Clinic Proceedings [Internet]. 2021 Jul 1;96(7):1921–1937. Available from:

10. Gale JD, Houghton LA. Alpha 2 Delta (α(2)δ) Ligands, Gabapentin and Pregabalin: What is the Evidence for Potential Use of These Ligands in Irritable Bowel Syndrome. Front Pharmacol. 2011 Jun 9;2:28. doi: 10.3389/fphar.2011.00028. PMID: 21713059; PMCID: PMC3114047.


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