Newby wants comments

[killiank]

Hello everyone...I am searching for some answers. I know this is long, but if anyone can clue me in on anything, I will be very grateful. I know that some have symptoms much worse than I do. You have my sympothies. The torture that I go through is bad enough without severe daily bouts. I also realize that it is getting worse as I get older....

I am a 36 year old male. I have had RLS for the last year and a half. I seems to progressively have gotten worse. However, it is intermittent; I will have symptoms for a few days and then it goes a way for a few days to weeks. I have only had symptoms a couple of time during the day. It started out only in my lower left leg the over time moved to my upper left leg then to my upper right leg and then the lower right leg; there it remains.

I do know for sure that a lot of Antihistamines trigger episodes, especially Theraflu cold medicine so I try to avoid them unless I am really sick. I have tried to experiment with other things like alchohol, and caffine usage. I have went periods with out either and still have periodically had RLS symptoms. Then when I am not having symptoms, I will try to trigger them by having some alcohol or coffee everyday and will not have any symptoms for a a couple of weeks. Is there a time period it take for these chemicals to start causing the symptoms? I am now experimenting with frequency of exercise (running and weightlifting) to see if there is a correlation. Has anyone herd of this?

I have asked my family and none of them have a history or heard of RLS. I was told my my mother though, that I had Epilepsy when I was a small child. After she mentioned it, I do remember taking medication until I was about 8, but the seizures happend young enough that I don't remember any of them. I tried to discuss this with my doctor. I finally got him to do some lab tests and my iron is fine. When I finally told him that I wanted to try some medications. He suggested that I try Tylonol PM and see how that helped. I does not seem to help. When I have a cold and take Nyquil I don't have any problem. Problem is that by the time I notice that I will have RLS problems that night, it is too late to take something for it..

Any suggestions or comments from other's experiences are greatly appreciated. Thanks a million!

Kodie

[jumpyowl]

As you say you seem to have intermittent RLS. It is not yet clear what triggers it in you, but it is known that caffein, alcohol, antihistamines and many of the antipsychotic medications aggravate the symptoms. Antiidepressants are especially notorious since health care providers usually prescribe it first without providing treatment for the symptoms. Wellbutrin is the only one that is not too bad.

In general any medication that contains a dopamine antagonist will be bad for your RLS. A well selected dopamine agonist, such as Mirapex or Requip not only help in about 80% of the cases but also serves as a diagnostic tool (if it works).

How much was your ferritin level? The lower limit of the normal range is 20 microgram/ml, but anything under 50 is asking for trouble.

That may be significant that you had epilepsy as a child because anticonvulsive drugs often prescribed for RLS at lower doses (such as Neurontin). And also of course anti-Parkinson drugs.

I believe that caffein et al will not cause RLS symptoms but will aggravate them once you have them daily.

About the exercise and its effect, perhaps Heron from Alaska can comment on that, as she is our fitness queen.

This what the algorithm for RLS says about intermittent RLS:

Intermittent RLS

RLS that is troublesome enough to require treatment but does not necessitate daily therapy

Daily RLS

RLS that is frequent and troublesome to necessitate daily therapy

Refractory RLS

Daily RLS that is treated with a dopamine agonist with one or more of the following outcomes:

o Inadequate initial response despite adequate doses

o Response that has become inadequate with time despite increasing doses

o Intolerable adverse effect

o Augmentation that is not controllable with additional earlier doses of the drug

TREATMENTS:

INTERMITTENT RLS

Nonpharmacological therapy

• Determine ferritin level and administer iron replacement

• Mental alerting acitivties to reduce boredom

• Abstinence from caffeine, nicotine, and alcohol

• Consider if the use of antidepressants, neuroleptic agents, dopamine-blocking emetics or sedating antihistamines may be contributing and if they can be discontinued.

What about insomnia or insufficient relaxing sleep? Probably not bad at this level yet.

[Heronak]

Hey Kodie,

Regarding exercise & RLS I have yet to find a strong correlation between them. I did notice, during a period when I was doing fairly intense & frequent weightlifting, that my RLS was worse, but then taking a break from lifting did not decrease the symptoms. Go figure.

Over the last several years I've had long periods of high intensity cardio training (cycling, mainly) and did not notice any differences between these times and my less active times.

All the best,

Heron

[Guest]

Thanks for your replies. My doctor did not tell me what my Ferrotin levels were but that they were normal. I will make a point to ask him.

Kodie