In the March 5 2014 online issue of Neurology neurologist and nationally-recognized sleep expert Sanford H. Auerbach MD published an article on restless legs syndrome (RLS) and discussed this condition as a possible biomarker for underlying disease.

Restless legs syndrome is a disorder of the nervous system and is characterized by throbbing or other uncomfortable sensations in the legs with an uncontrollable urge to move them. Symptoms typically occur at night when a person is relaxing or getting ready for bed and can increase in severity during the night. Most people with RLS have difficulty falling asleep and staying asleep which can lead to fatigue. Many report that their job personal relations and various activities of daily living are strongly affected as a result of their sleep deprivation. Sufferers of RLS also often have difficulty concentrating and many experience brain fog.

The editorial was written in response to an analysis published in the same issue of Neurology of over 12000 men who were followed over time which showed multiple disease associations with RLS. Auerbach found that patients with RLS had a higher mortality rate than comparable men without RLS and they showed an especially strong tendency toward cardiovascular disease and hypertension. Previous analyses of the same data discovered that men with RLS were more likely to be diagnosed with lung and endocrine conditions as well as metabolism and immune system problems.

Through these analyses researchers suggest that restless legs syndrome is a meaningful biomarker for serious disease and that RLS screening may become a more common tool for practitioners in order to identify patients at risk.

I have had personal success with patients simply by adding magnesium and calcium at bedtime because these minerals calm muscles and nerves. Calming botanicals such as valerian passion flower lemon balm and skullcap can also be added to support sleep and relaxation. You can also assess RBC nutrients such as magnesium calcium and potassium through many functional laboratories (provides a better indicator of nutrient status compared to the serum). In addition to indicating nutrient status these minerals play a significant role with blood pressure regulation and overall cardiovascular health.

I would also recommend an organic acid test because it can identify imbalances occurring in the body that precede abnormal findings on a CBC or an MP. Organic acids are products of metabolism that can sensitively identify nutrient deficiencies that lead to metabolic roadblocks. Organic acids go a step further then measuring nutrient concentrations by assessing whether the nutrient is functioning adequately. Abnormal concentrations of organic acids in the urine can provide a functional marker for metabolic effects of nutrient deficiencies genetic polymorphisms impaired enzyme function toxic exposure neuroendocrine activity and intestinal bacterial overgrowth. Organic acid testing can indicate the functional need for specific nutrients diet modification antioxidant protection detoxification and other therapies.

There is also some evidence indicating that low iron levels in the brain may be associated with RLS. A CBC w/diff and an iron panel (serum iron ferritin % saturation TIBC UIBC) can identify an iron deficiency.

Restless leg syndrome may only be just a small part of the picture. It may be a simple nutrient deficiency in many cases however it is important to look further into the patient's health. This includes thoroughly reviewing the patient's history looking deeper into the cardiovascular system and other inflammatory markers in order to provide an effective treatment plan for these patients.

by Michael Jurgelewicz DC DACBN DCBCN