Restless Legs Syndrome (RLS) Discussion Board

Last year about this time with increased yard duties I began drinking quantities of lemonade. Long story short, I discovered that it was relapsing RLS symptoms after a ten year hiatus of symptom free (another long story). I now drink lemonade only in very limited quantities. But the RLS returned again this year. This time it was the Gatorade Zero. The second ingredient of Zero (after water) is citric acid. I guess citric acid doesn't like me. Perhaps this info will help one or more of you with this dreadful symptom. [ And a 'Hi' to Viewsaskew. It's been a long time.]

A few people get good management of RLS with the low oxalate diet. However there is often a delay with success due to the time it takes for symptoms to resolve. Oxalate crystals in the site of RLS symptoms appear to be caused more by the movement in and out, storage or release, than their presence.

The oxalate issue is a combination of oxalates being excessively absorbed in the gut, high levels in blood and then blocking excretion of further oxalates in the kidneys. This leaves them nowhere to go but to be stored in the body. For kidney stone prone people they form stones, in RLS sufferers it appears to be storage in leg muscles which result in symptoms.

Citrate is produced naturally in the kidneys to stop stone formation. It can also break down oxalate crystals stored in the body if consumed. I use Garcinia cambogia which is high dose citrate, and early on made my legs burn as the oxalate crystals released. Dreadful RLS symptoms ensued.

On another forum someone mentioned apple cider vinegar helped their RLS. This is often high in citrate and most likely helped the oxalates clear the kidneys, reduced blood levels and stopped storage of crystals. This stopped symptoms.

What you have may be the opposite. The citrate in the drinks is releasing stored oxalates making symptoms worse. There are no studies on this but the anecdotal success of the low oxalate diet combined with the papers on oxalates, kidney stones and autism, make it an interesting consideration.

It may not relate to oxalates at all for you, but if it is, you are lucky in that you may have an avenue to explore.

neph! Hey!
BTW - I am in Los Angeles these days. Hope you are doing well. Glad to hear the RLS is still primarily gone. Hope it remains as such.

nephriticus wrote:Last year about this time with increased yard duties I began drinking quantities of lemonade. Long story short, I discovered that it was relapsing RLS symptoms after a ten year hiatus of symptom free (another long story). I now drink lemonade only in very limited quantities. But the RLS returned again this year. This time it was the Gatorade Zero. The second ingredient of Zero (after water) is citric acid. I guess citric acid doesn't like me.

Lemonade and Gatorade Zero contain artificial flavors/colors and sweeteners, which are known to exacarbate RLS (especially sweeteners). Personally, I'm sticking to water and unsweetened tee/coffee.

Citric acid may activate something that exacarbates RLS (possibly including oxalates), but I'd expect you'd need a lot more than you'll get from a Gatorade. Citric acid is in fruit, vegetables and salad. I'm not sure how much vitamin C is in a Gatorade, but most drinks contain just a little bit, say what you would get from an apple or two. Does eating sour fruit or salad exacarbate your RLS too?

You could do a test: Get some citric acid (vitamin C) powder and take a teaspoon, solved in water, which is an order of magnitude more than you would get from a Gatorade. If you get symptoms, it's the citric acid. If not, it's the sweeteners. Then you'll know what to avoid.

From the kidney stone people:

"Citric acid is an organic acid and a natural component of many fruits and fruit juices. It is not a
vitamin or mineral and is not required in the diet. However, citric acid, not to be confused with
ascorbic acid (vitamin C), is beneficial for people with kidney stones."

XenMan wrote: "Citric acid is an organic acid and a natural component of many fruits and fruit juices. It is not a
vitamin or mineral and is not required in the diet. However, citric acid, not to be confused with
ascorbic acid (vitamin C), is beneficial for people with kidney stones."

Then I stand corrected, and my experiment should be conducted with citric acid instead. Thanks for pointing this out. Citric acid is available as supplement too, although probably not as easy to get as vitamin C.

I would not know whether the cause be citric acid or artificial sweeteners but it prolly is just as well to avoid the artificial sweeteners anyway. I do not remember orange juice ever bothering me but I've never drank it to hydrate while laboring. Water for hydration is just fine and I wish it was such an easy answer for you continuing sufferers. Thanks for your responses. {Viewsaskew: I'm in Washington State now right across the Strait of Juan de Fuca from Victoria, B.C., Canada}

nephriticus wrote:{Viewsaskew: I'm in Washington State now right across the Strait of Juan de Fuca from Victoria, B.C., Canada}

Beautiful place!

Regarding Histamine Intolerance...Citric Acid also wrecks havoc with mast cells in the body. Citric Acid is usually made from mold that’s often grown on corn. They say that the aspergillus is filtered out but I know from my own and other’s experience with Histamine Intolerance that this isn’t the case. Mold is a histamine and mast cell trigger. Sometimes I have an olive craving so I buy the ones in water and there is always citric acid so I soak and rinse them repeatedly for an hour. As long as I am careful about the other foods I consume that day, and keep my histamine level low, I can sleep moderately well that night. I’m not sure if the OP has histamine intolerance but both the lemon juice and the citric acid in lemonade would be triggers. If you lower your histamine levels, then some people are able to tolerate small amounts of lemon.

yawny - you mean manufactured citric acid only, right? It;s just the mold bits that are the problem, and not the citric acid itself? So lemonade made from lemons with nothing added should be fine? (for histamine sensitive people)

Beth, yes, manufactured citric acid. Homemade lemonade would still likely be a problem for people with Histamine Intolerance as the common advice is to absolutely avoid all citrus. From my research, I’ve seen some people are able to tolerate small amounts of lemon juice such as a light squeeze, or half a teaspoon. And it really matters how full your histamine tank is already and if you’ve lowered the inflammation in your body. A few weeks ago I had some lemon zest in a homemade Indian coconut cream sauce and slept ok but after doing this sort of thing I immediately go back to a strict low histamine diet to lower my histamine tank for several days to a week. Instead of continually aggravating our condition, most of us adapt by using tart alternatives for recipes like I use powdered camu fruit, lemon thyme, or the spice sumac, to replace lemon in homemade hummus, or in a salad dressing. I carefully choose what I break my diet for and a glass of lemonade isn’t top of my list but chocolate definitely is.