Restless Legs Syndrome
What is Restless Legs Syndrome?
Restless Legs Syndrome is a neurological condition that creates uncomfortable sensations in your legs. These feelings often happen when you are resting or trying to sleep. Your body responds with an overwhelming urge to move your legs to find relief.
The condition affects about 7 to 10 percent of adults in the United States. RLS can range from mildly annoying to severely disruptive. Many people with RLS struggle to fall asleep or stay asleep through the night. This sleep disruption can lead to fatigue, mood changes, and difficulty concentrating during the day.
Research shows that low iron levels in the brain play a key role in RLS development. Iron is essential for making dopamine, a brain chemical that helps control movement. When iron stores drop too low, dopamine signaling becomes disrupted. This disruption triggers the uncomfortable sensations and movement urges that define RLS.
Symptoms
- Uncomfortable sensations in the legs described as crawling, tingling, burning, or aching
- Strong urge to move your legs to relieve the discomfort
- Symptoms that start or worsen when you are resting or sitting still
- Symptoms that improve temporarily when you move or stretch your legs
- Symptoms that are worse in the evening or at night
- Difficulty falling asleep or staying asleep due to leg discomfort
- Involuntary leg movements during sleep
- Daytime fatigue and sleepiness from poor sleep quality
Some people with mild RLS may not notice symptoms every day. Early stages of the condition may only appear a few times per month. As RLS progresses, symptoms typically become more frequent and intense.
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Causes and risk factors
Low iron levels are the most common underlying cause of Restless Legs Syndrome. When your body does not have enough iron, your brain cannot produce adequate dopamine. Dopamine is a neurotransmitter that helps regulate muscle movement and sensation. Iron deficiency can occur from poor diet, heavy menstrual periods, pregnancy, blood loss, or conditions that affect iron absorption. Genetics also play a significant role, as RLS often runs in families.
Other risk factors include pregnancy, especially in the third trimester. Kidney disease, diabetes, and peripheral neuropathy can also trigger RLS symptoms. Certain medications may worsen the condition, including some antidepressants, antihistamines, and anti-nausea drugs. Lifestyle factors like caffeine intake, alcohol use, and tobacco use can make symptoms worse. Age is another factor, as RLS becomes more common as people get older.
How it's diagnosed
Doctors diagnose Restless Legs Syndrome primarily through your reported symptoms and medical history. There is no single test that confirms RLS. However, blood tests are essential to check for iron deficiency, which is a major underlying cause. Your doctor will typically order a ferritin test to measure your iron storage levels. Ferritin levels below 75 micrograms per liter are often associated with RLS, even if you are not technically anemic.
Rite Aid offers ferritin testing as part of our flagship health panel. You can get tested at over 2,000 Quest Diagnostics locations nationwide. Early detection of low iron stores allows you to address the root cause before symptoms worsen. Your doctor may also check for kidney function, blood sugar levels, and thyroid hormones to rule out other conditions that can mimic or worsen RLS.
Treatment options
- Iron supplementation if ferritin levels are low, typically targeting levels above 75 micrograms per liter
- Regular moderate exercise during the day, but avoid intense workouts close to bedtime
- Leg stretches, massage, or warm baths before bed to reduce symptoms
- Limiting caffeine, alcohol, and tobacco, especially in the evening
- Maintaining a consistent sleep schedule and good sleep hygiene practices
- Medications that affect dopamine levels for moderate to severe cases
- Treating underlying conditions like kidney disease or diabetes that may contribute to symptoms
- Working with your doctor to adjust medications that may be worsening RLS
Concerned about Restless Legs Syndrome? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
People describe RLS sensations differently, but common descriptions include crawling, tingling, itching, pulling, or aching deep inside the legs. The feeling is usually in the lower legs but can affect the thighs or even arms. Moving your legs provides temporary relief, but the sensations return when you stop moving. These feelings typically worsen in the evening and can make falling asleep very difficult.
Yes, low iron is one of the most common causes of Restless Legs Syndrome. Iron is needed to produce dopamine in the brain, which helps control movement and sensation. When ferritin levels drop below 75 micrograms per liter, RLS symptoms often develop or worsen. Checking your ferritin level with a simple blood test can identify if iron deficiency is contributing to your symptoms.
RLS is diagnosed based on your symptoms and how they behave throughout the day. Your doctor will ask about the urge to move your legs, when symptoms occur, and what makes them better or worse. Blood tests check for low iron levels, which is a major underlying cause. Additional tests may rule out other conditions like kidney disease or diabetes that can trigger similar symptoms.
A ferritin test is the most important blood test for RLS. Ferritin measures your iron storage levels, and low levels are strongly linked to RLS symptoms. Many experts recommend keeping ferritin above 75 micrograms per liter to prevent or reduce symptoms. Your doctor may also check a complete blood count, kidney function, and blood sugar to identify other potential causes.
RLS can often be managed very effectively, but there is no permanent cure. If low iron is the cause, restoring iron levels may completely resolve symptoms. Lifestyle changes like reducing caffeine and exercising regularly help many people control their symptoms. For cases related to genetics or other chronic conditions, medications can provide significant relief and improve sleep quality.
RLS symptoms typically worsen in the evening and at night, but they can occur any time you are resting. Long car rides, sitting through movies, or working at a desk can trigger symptoms during the day. The circadian rhythm affects dopamine levels, which is why symptoms are usually milder in the morning. Physical activity during the day can help reduce nighttime symptoms.
Foods rich in iron can help if low ferritin is contributing to your RLS. Red meat, poultry, fish, lentils, beans, and dark leafy greens are good iron sources. Vitamin C helps your body absorb iron, so pair iron-rich foods with citrus fruits or bell peppers. Magnesium-rich foods like nuts, seeds, and whole grains may also help reduce muscle tension and improve sleep.
Yes, pregnancy commonly triggers RLS, especially in the third trimester. Hormonal changes, increased blood volume, and lower iron levels all contribute to symptoms. About 1 in 4 pregnant women experience RLS. Symptoms usually improve or disappear within a few weeks after delivery. Talk to your doctor about safe iron supplementation and lifestyle strategies during pregnancy.
Iron supplements are the first treatment when ferritin levels are low. For moderate to severe RLS, doctors may prescribe dopamine-related medications like pramipexole or ropinirole. Gabapentin and pregabalin can help with nerve-related symptoms. Some people benefit from muscle relaxants or sleep medications. Your doctor will choose treatment based on your symptom severity and underlying causes.
Maintaining healthy iron levels is the most effective prevention strategy. Get your ferritin tested regularly, especially if you have risk factors like heavy periods or poor iron absorption. Avoid caffeine, alcohol, and tobacco in the evening. Establish a regular sleep schedule and practice good sleep hygiene. Stay moderately active during the day, but avoid intense exercise close to bedtime.