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Vitamin D and restless legs syndrome: Where does the research stand?

Posted on: November 8, 2013   by  John Cannell, MD

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Restless legs syndrome (RLS) is a chronic disorder characterized by unusual sensations in the limbs relieved with movement. The incidence may be increasing as recent studies show it affects between 7% to 10% of the general population in North America and Europe. However, many of these cases are mild. Sixty percent of cases are familial, but the exact mechanism is unclear except that the neurotransmitter dopamine is involved.

In 2003, the National Institutes of Health listed four major symptoms of RLS:

  1. An urge to move the limbs with or without unusual limb sensations.
  2. Improvement with activity. Many patients find relief when moving and the relief continues while they are moving. In more severe RLS this relief of symptoms may not be complete or the symptoms may reappear when the movement ceases.
  3. Worsening at rest. Patients may describe being the most affected when sitting for a long period of time, such as when traveling in a car or airplane, attending a meeting, or watching a performance. An increased level of mental awareness may help reduce these symptoms.
  4. Worsening in the evening or night. Patients with mild or moderate RLS show a clear daily rhythm to their symptoms, with an increase in symptoms and restlessness in the evening and into the night.

Is vitamin D involved?

It may be more (not less) common when vitamin D levels are higher, such as the summer. At least there are more internet searches for RLS in the summer.

Ingram DG, Plante DT. Seasonal trends in restless legs symptomatology: evidence from Internet search query data. Sleep Med. 2013 Sep 14.

Also, apparently it is less common among Blacks than Whites, the opposite of what one might expect if vitamin D deficiency was involved.

However, on the other hand, RLS has a latitudinal gradient, the further from the equator, the more common the disorder (R = -.74).

Koo BB. Restless legs syndrome: relationship between prevalence and latitude. Sleep Breath. 2012 Dec;16(4):1237-45.

Scientists have also found lower vitamin D levels in people with RLS than controls and that vitamin D levels are directly related to severity, the higher your vitamin D levels the less severe your RLS symptoms.

Balaban H, et al. Serum 25-hydroxyvitamin D levels in restless legs syndrome patients. Sleep Med. 2012 Aug;13(7):953-7.

As this disorder affects millions of people, more research is urgently needed into this field. The evidence vitamin D deficiency is involved is mixed.

4 Responses to Vitamin D and restless legs syndrome: Where does the research stand?

  1. Rita and Misty

    I wonder if there is a connection between magnesium and RLS?

  2. Ian

    I must say I have had personal experience of this frustrating condition.
    As a sufferer of fibromyalgia with some cervical spine stenosis, RLS was a major symptom for me continuously disrupting my sleep. Four years ago I started on magnesium citrate 400mg daily and the RLS declined. Once I started on vitamin D supplementation (5000IU daily) three years ago the RLS disappeared completely.

    However I also changed many activity and exercise habits, particularly reduced sitting at the computer.

    So I think the combination of all three changes resulted in the cure of RLS.

  3. Rebecca Oshiro

    There is a well-established connection between low iron and RLS. If you suffer from RLS you should have your ferritin checked.

  4. robin44101@yahoo.co.uk

    I agree with Rita & Misty above – I think there may possibly be a connection between RLS and magnesium. I have only my own personal experience to go on, but I used to get severe and frequent leg cramps for years (a disorder perhaps related to RLS?) even after taking 4000 ius of vitamin D for a long time. However after only ten days of magnesium citrate supplements the leg cramps went completely, never to return. I understand that this method is sometimes used to treat pregnant women with cramps. Also my wife’s RLS seems better after the regular use of magnesium – at least enough for me to get a night’s sleep!

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