Post Illness (RLS increased)

[Al8rsh]

I have had RLS for a few years now and have not been on any DA before. I started taking Iron(Ferrous Bisglycinate) 2 months ago. The first few weeks I experienced a gradual relief from RLS and then after almost a month I felt a sudden relief from RLS and there were days where I had no symptoms at all!
However, the sad part is I had a strong fever 2 weeks ago in which I started taking Panadol Cold and Flu which had Phenylepherine HCL( For 4 days ) and there was a day within these 4 days I had an allergic reaction and had to take a sedative antihistamine (pseudoephedrine) one pill only for one day.
However, It has been more than a week where I last took any pill containing Antihistamine and my RLS has been driven up the wall and it’s the worst that I have felt throughout my whole life, I can’t keep my legs nor my hands still .And it’s getting worse day after day It feels as if I’m augmenting but I haven’t taken any DA my entire life. What Could be the issue? I have also taken antibiotics in the days I was ill and introduced probiotics too. Also note: I fixed my sleep hygiene few months back, I also avoid any caffeine .

[Rustsmith]

First off, both phenylepherine and pseudoephridine are not antihistamines but are decongestants. Decongestants are not generally known RLS triggers but can do cause some strange things to many people.

My guess is that during your illness, your body consumed a large part of the iron stores that you had been building to fight your RLS. Iron in the form of ferritin is used by the body to fight infection and would therefore not be available to maintain your iron levels in your brain where it is needed for RLS. This is a guess, but I wouldn't be surprised that if you were to have your ferritin levels checked now (assuming that you are well), that your ferritin level would be much lower than it was when you started taking iron.

One thing that you might want to consider it taking your iron twice a day and ideally one of those times should be at bedtime which means that the other would be mid-morning. That doesn't double the rate of iron adsorption compared to what you have been getting, but it does increase it.

[Al8rsh]

Hi Steve,
Thanks for your response. I think that makes a lot of sense of what’s going on.I’m doing a blood test after 2 days ( because I have taken Iron yesterday) to check my ferritin levels and transferrin saturation. Will keep you posted.

Best Regards

[badnights]

I think Steve has nailed it, although I wouldn't recommend splitting an iron dose into twice per day. The lower the concentration of iron in your blood, the more will be absorbed into your blood from your gut, so there's a theory that waiting til nighttime to take the entire dose allows your blood concentration to drop nice and low, so that more iron is absorbed. (I've even seen it suggested to take twice as much every second day but that didn't seem to work for me.)

Maybe you can increase your iron dose, either temporarily or long-term.

The main thing I wanted to add is that this is a temporary dip in health, a temporary increase in symptoms. Allow yourself to recognize its transient nature, accept that things might be bad for a while, and don't expect anything of yourself while you're healing up.

You said an anti-histamine, though you named a decongestant. Did you maybe get the name wrong? Diphenhydramine is an anti-histamine that's well-known for increasing WED/RLS symptoms. If you took that one day, then your WED/RLS would have gone nuts. If you're physically sick, you're worried, and your WED goes nuts, it can take some time to recover from that.

[Al8rsh]

Hi Beth,
He definitely did!

I usually take only one capsule containing (25mg) of Ferrous Bisglycinate per night. Im thinking of doing a temporary increase of the dosage to two tablets per night for a few weeks/ months depending on the symptoms if it decreases gradually then switch back to the usual dosage. Is 50mg suitable?

And regarding the medications it was my bad actually that I haven’t named the whole ingredients in them so here it goes: For the allergy (per tablet) I only took it once: Rinofed /Triprolidine HCL BP (2.5 mg), Pseudoephedrine HCL BP (60 mg).
Panadol Cold and Flu (Non Drowsy per tablet): Paracetamol (250mg), Phenylephrine HCL (5mg), Guaifenesin (100mg).

It’s really a relief to at least know what might be the issue rather than experiencing all this and not knowing what might be the reason behind it.
Really appreciate your help guys!

Kind Regards

[badnights]

Bingo! you did take an anti-histamine: tripolidine. I didn't find out for sure but based on how long it's been around, I think it is a first-generation one and therefore likely to exacerbate WED/RLS.

So - iron stores depleted by illness, then a whack to your system from a drug that sends the WED/RLS into overdrive. According to some theories, the panic and worry about what's happening can push it to keep happening.

Re iron - I take 160 mg elemental iron (as ferrous sulfate or fumarate). That's admittedly high, but your dose is very low. As always, check with your doctor - but if I go below 100 mg, my symptoms get worse, and even though my ferritin was up in the many hundreds, my serum iron and transferrin were always low.