Restless Legs Syndrome (RLS) Discussion Board

A month back, my blood test showed mild low iron levels & I started taking Iron Supplements. Within 3-4 days, my RLS symptoms almost reduced by half. Unfortunately, by 6-7 days, I was suffering from severe constipation - having no bowel movement for 4 days. I didn't connect it to the iron tablets at all. I took Milk of Magnesia & got motion after days. But the constipation got worse even if I was taking milk of magnesia. I went to the doctor & he said it's because of the iron & he changed the iron tablet to one with a stool softener. But that also didn't really help, so the doctor said to stop iron for sometime. However, after stopping iron, my RLS symptoms increased again.

Has anyone else faced issues with Iron Supplements. What is the solution?

Can I take Milk of Magnesia & Stool softeners continuously with Iron? I am not pregnant or anything. Iron has been a lifesaver for me & I want to take it.

Not good to take continuously. Much safer for long term use (and more effective) is to use Miralax. OK to take Miralax with Iron

Very recently the RLS experts changed the order for the various RLS treatment procedures. Treating iron deficiencies (not just anemia, the critical parameter is ferritin), are first treated with oral iron supplements. For those who cannot tolerate oral iron, the next step is an iron IV. This is very new development that your doctor may not be familiar with. Even if (s)he is familiar with them, the treatment has to be done by a hematologist and most of them are only used to treating anemia and not RLS, so they often resist performing the treatment.

Here is a link to the iron recommendations:

https://www.sciencedirect.com/science/article/pii/S1389945717315599?via%3Dihub

Print a copy and take to your doctor. Highlight section 5.3.4.

"5.3.4. Expert-consensus clinical recommendations Ferric carboxymaltose should be considered as one of the first-line treatments in patients with RLS. IV iron treatment should not be given to patients with serum ferritin levels >300 m g/l or transferrin saturation >45%."

As well as taking iron tablets I take a tramadol daily and 60mg codeine about three times a week. This cocktail causes constipation.

This is my solution.
For breakfast almost every day I have a half cup of healthy yoghurt with 1/3 cup of All Bran, 1/3 cup of Active Balance cereal (fairly high in fiber and tastes good), a kiwifruit and a small pear chopped up. Pears are higher in fiber than apples and go well on cereal. I choose bread that is high in fiber too and generally check the amount of fiber in food.
Recently I've been taking a fairly high dose magnesium tablet too, not because it helps with my rls but it does help with the constipation.

I take 150mg codeine daily and have done so for several years. I have never suffered from constipation.
Started iron tablets last week, lets hope they don't be the straw that starts the constipation. I do drink a great deal of water.

I had constipation issues during the 2.5 yrs that I was on methadone, but put up with it. Interestingly enough, that problem went away when I switched to Tramadol ER. It will be interesting to see if my doctor wants me to switch back when I see her in 3 weeks. Even though the Tramadol is more expensive, I like the absence of constipation and the way that it has helped me with depression. The only thing that I miss about methadone is the way that I would start to feel some withdrawal symptoms about 4 hrs after I forgot to take it at lunchtime. With Tramadol, I don't get those warnings until about 8 hrs later, which means that I will not get much sleep that night.

As for iron supplementation, I stopped taking iron sulfate earlier this year and didn't see much change. But I was still taking methadone then.

Yankiwi wrote:
Recently I've been taking a fairly high dose magnesium tablet too, not because it helps with my rls but it does help with the constipation.

How high dose are you taking?

The magnesium is 550 mg. I also drink a lot of water.

My new GP wanted me to go on a keto diet but I said no. A) because I didn't think it would work and B) because I'd then have to take medication for constipation. She then suggested I go on a gluten free diet which I did for 28 days even though I thought the prospects of helping with my rls were nil. I was right.

stjohnh wrote:Not good to take continuously.

How long can it be taken without a problem?

stjohnh wrote: Much safer for long term use (and more effective) is to use Miralax. OK to take Miralax with Iron

Unfortunately, Miralax or anything similar is not available in my country

rlsgal70 wrote:

stjohnh wrote:Not good to take continuously.

How long can it be taken without a problem?

stjohnh wrote: Much safer for long term use (and more effective) is to use Miralax. OK to take Miralax with Iron

Unfortunately, Miralax or anything similar is not available in my country

Milk of magnesia can make your magnesium level go too high, especially if you are over 65 or have any kidney problems. Stool softeners are fine. Bulking laxatives like Citrucel, Benefiber, and psyllium are fine. I wouldn't take daily milk of magnesia more than a month without talking to my doctor.

rlsgal, It would help if you put your location in your profile. To do this, click on your user name at the top right of your screen, then user control panel, then the edit profile tab.

stjohnh wrote:Milk of magnesia can make your magnesium level go too high, especially if you are over 65 or have any kidney problems.

I am 45 & without kidney problems.

stjohnh wrote:Stool softeners are fine. Bulking laxatives like Citrucel, Benefiber, and psyllium are fine.

Already taking psyllium for a month - but that also doesn't help.

rlsgal70 wrote:

stjohnh wrote:Milk of magnesia can make your magnesium level go too high, especially if you are over 65 or have any kidney problems.

I am 45 & without kidney problems.

stjohnh wrote:Stool softeners are fine. Bulking laxatives like Citrucel, Benefiber, and psyllium are fine.

Already taking psyllium for a month - but that also doesn't help.

How much water are you drinking?

I think a lot of us find that our bodies require different things to work. From a very high fiber diet (helps me, but not quite enough), water intake, magnesium, stool softrners, exercise, to fiber supplements.

I do the following:
try to walk at least 2-3 miles a day
set aside at least 60 ounces of water in the morning to drink during the day along with the tea, juice and coffee I drink
Eat high fiber foods that provide a mix of fiber type - beans, oats, pears, romaine lettuce, etc.
1 magnesium capsule a day (2 every day along with the other methods give me very loose stools even while on opioids)

When I do that, I am fine. As soon as I travel (likely dehydration), or slack on the healthy foods...then I pay! I used to use a stool softener - worked very well. Eventually I was able to get the right mix of other things that I didn't need it. But, I add it in when I goof up with other things.

I read of a technique to press on the perineum - works REALLY well when needed! https://perinealpressure.yale.edu/

For several years I have on occasion pressed on the perineum to help. This does work.... I thought it was only me who did this !!

Polar Bear wrote:For several years I have on occasion pressed on the perineum to help. This does work.... I thought it was only me who did this !!

Smart woman!

How long & how hard to press on perineum? When do you do it?