Augmentation or weak Kratom??

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Eternityroad
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Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Augmentation or weak Kratom??

Post by Eternityroad »

Hi,
The last two months I have been experiencing an increase in return of restless legs symptoms after I have taken my normal dosage of Kratom. For the record I have been on Kratom for 3 years and before that I managed my condition with lortab.(8 years) Typically symptoms will return within a half-hour of taking a dose that has normally been effective for two hours. At that point I take 1 tsp of kratom every twenty minutes until symptoms are relieved. My normal dosage has been 1/2 tsp every two hours during waking hours and 2-1/2 tsp at 11:00 pm before bed. I then usually only dose once in the middle of the night. Over the past two months this bout of returning symptoms and subsequent Kratom-binge occurs every other day or every two days and most often between 5 and 9 pm. When I discovered this I upped the dose to 1 tsp at 5,7, and 9 pm. But sometimes symptoms return even after the increased dose. It also sometimes occurs in the middle of the night. BUT I never have the issue between 5 am and 11 am. In fact I usually do not dose at all during the early morning. I usually start in at 11 am with the usual 1/2 tsp and repeat every two hours until 5 pm, when I up the dose. The fact that I do not need any kratom in the morning would lead me to believe it can't be Kratom quality or I would experience symptoms in the morning or more often than I do now. Yet I am not ready to dismiss problems with the batches of Kratom I have used. I have also thought about asking my doctor for lortab, but my PCP is not the one who had been prescribing the lortab earlier.

I have heard about augmentation but know little about it. I appreciate any comments.

Ken W.

stjohnh
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Re: Augmentation or weak Kratom??

Post by stjohnh »

Ken,
I have not heard of augmentation occurring with kratom. Most likely is your disease is progressing, though weak kratom could be a cause as well.

RLS is caused by BID (Brain Iron Deficiency). Many people with RLS can have their symptoms markedly reduced or even eliminated with IV Iron treatments. This is the only treatment that gets at the basis for RLS (low brain iron). It has almost no side effects. The International Restless Legs Syndrome Study Group has elevated IV Iron treatment to first line therapy. This means that IV Iron is one of the first treatments doctors should try, not one of the last (as has been done for many years). If you can get your doc to prescribe IV Iron treatment, that is the way you should go. Unfortunately this is fairly new information and most docs, even those that frequently treat RLS, are not aware of it. Note that the blood test doctors usually do to check for low iron (ferritin test) only checks for low BLOOD iron, there is no test available for checking for low BRAIN iron. Oral iron usually doesn't provide a high enough blood level increase to help, folks need IV Iron infusions. Here is a link to the recommendations:
https://www.sciencedirect.com/science/a ... via%3Dihub
Blessings,
Holland

badnights
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Re: Augmentation or weak Kratom??

Post by badnights »

Or, you could have developed tolerance to the kratom. To see if that is true, you would need to stop the kratom for some time - I'm not sure, but I would think at least a week, preferably 10 days - then resume at your original dose and see if that's enough.

Kratom doesn't cause augmentation, as Holland noted. If you're taking another medication, one of the dopamine medications, then that could be causing augmentation.
BUT I never have the issue between 5 am and 11 am. In fact I usually do not dose at all during the early morning
That is normal for WED/RLS. The worst symptoms are in evening and early night. The best time is early morning (early in terms of when you would get up, not in terms of time past midnight).

EDIT: I forgot to add: think back to what happened a couple of months ago when things started to get worse. Did you start a new medication or supplement? An anti-histamine? Did you change your diet? Move? Lifestyle change? Donate blood? Have surgery? There are a lot of things that can trigger WED/RLS symptoms, including all the first-generation anti-histamines and numerous other medications (including many anti-nausea drugs, anti-depressants, & anti-psychotics).
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

Eternityroad
Posts: 138
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Augmentation or weak Kratom??

Post by Eternityroad »

Hi,
Thanks for both your replies. Sorry I am late responding but I have been ill for the last three days: low-grade fever and chills. Interestingly enough the restless legs presented no issues at all during my illness. Not in the slightest.

Back in mid-June I had a bout of pericarditis and was taking colchicine along with high doses of ibupropin to monitor the inflammation. When the condition improved I went off the colchicine but now take the ibupropin for arthritis only when necessary.

I am not taking a dopamine medication. It has been three years now that I am off the lortab. I hesitate to take a break from Kratom. I have no back-up relief. I would have to ask the Dr. for lortab and I am reasonably certain he would'nt go along with it.

As for daily meds for years I have been taking levothyroxine, fleudrocortisone and zolpidem.

Thanks for taking the time to respond.

Ken

badnights
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Re: Augmentation or weak Kratom??

Post by badnights »

I can't say for sure, I don't know enough about medical matters, but it seems as if your WED/RLS got worse without apparent cause - or maybe you did get a batch of kratom of lower potency.

If the disease did get worse, maybe it was something to do with the pericarditis (additional physical stress can exacerbate symptoms) or maybe even starting or stopping the colchicine. But all I could find on colchicine is that it might impair absorption of vitamin B12. Some of us think that a deficiency in any nutrient can trigger WED/RLS in susceptioble people. But usually enough B12 is stored in the body that it takes a year or more on colchicine to become deficient.

If it's the kratom the way to check that would be to order more - maybe even from a different supplier.

Does your doc know you are taking kratom?
Beth - Wishing you a restful sleep tonight
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I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

Eternityroad
Posts: 138
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Augmentation or weak Kratom??

Post by Eternityroad »

My current doctor who has only been my doctor for a couple of months does not know I take Kratom nor that I have RLS. I have been managing it so well I usually don't bring it up. The last doc I had was just happy I got myself off of lortab. Thanks for your input and ordering from another supplier sounds like a good idea.

Side note: I was in hospital for a day for the pericarditis and they confiscated the Kratom my partner brought in for me. I had put it in my backpack which they went thru. Luckily the drugs and such they were giving me kept the RLS at bay. I had had intense shoulder pain necessitating some IV pain meds. But I worry about if I ever need it during some future hospital stay.

ViewsAskew
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Re: Augmentation or weak Kratom??

Post by ViewsAskew »

Eternityroad wrote:
Wed Sep 09, 2020 5:36 am
My current doctor who has only been my doctor for a couple of months does not know I take Kratom nor that I have RLS. I have been managing it so well I usually don't bring it up. The last doc I had was just happy I got myself off of lortab. Thanks for your input and ordering from another supplier sounds like a good idea.

Side note: I was in hospital for a day for the pericarditis and they confiscated the Kratom my partner brought in for me. I had put it in my backpack which they went thru. Luckily the drugs and such they were giving me kept the RLS at bay. I had had intense shoulder pain necessitating some IV pain meds. But I worry about if I ever need it during some future hospital stay.
They went through your backpack????
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Eternityroad
Posts: 138
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Augmentation or weak Kratom??

Post by Eternityroad »

Yes. When he came to visit my partner brought my backpack with books to read and doses of Kratom and they opened up and confiscated the Kratom. Gave it back to me when I checked out.

badnights
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Re: Augmentation or weak Kratom??

Post by badnights »

Hospitals need to know what you're taking so they can respond appropriately if you have a crisis of some kind. It would be best if you had a doctor who knew about the kratom, who wouldn't freak out about it. That wouldn't help directly with future hospital stays, but indirectly it would, because your doctor could advocate for opioid meds during your hospital stay. It would be very good if your doctor at least understood that you have a disease that he's not currently treating that impacts your life so severely! I think it might be time to indoctrinate him. Don't downplay it though.
Beth - Wishing you a restful sleep tonight
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I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

Eternityroad
Posts: 138
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Augmentation or weak Kratom??

Post by Eternityroad »

Well stated and very reasonable. Thank-you. I have an appointment with PC physician Monday. Will go over it with him.

badnights
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Re: Augmentation or weak Kratom??

Post by badnights »

Good luck!
Beth - Wishing you a restful sleep tonight
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I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

Eternityroad
Posts: 138
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Augmentation or weak Kratom??

Post by Eternityroad »

It would be best if you had a doctor who knew about the kratom, who wouldn't freak out about it.
I told my doctor about my WED and my use of Kratom. I also asked him to give me a script of Hydrocodone to change things up with the Kratom. He refused, stating that because I was already taking generic Ambien for sleep, the powers that be would frown on my getting two class 1 substances. So he gave me a script for pramipexole. I am leary about taking it because of things I read here about withdrawal. He gave me .5, prescribed once a day and then later twice a day. I am tempted to tough it out with the Kratom though I still have bouts of restless legs where I dose up to 3 tsp. of Kratom until it all kicks it. Generally happens once a day. Any advice about Pramipexole would be appreciated.

I am a bit miffed at the doctor who doesn't trust me to know my body and won't give me the script of Hydrocodone even though I proved for 9 years that I could use it without abusing it. Yet he is always on my back to get a flu shot! (I haven't been sick with flu in over thirty years and have never received a flu shot.)

Thanks for input.

Ken

stjohnh
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Re: Augmentation or weak Kratom??

Post by stjohnh »

Eternityroad wrote:
Thu Nov 05, 2020 9:29 pm

...So he gave me a script for pramipexole. I am leary about taking it because of things I read here about withdrawal. He gave me .5, prescribed once a day and then later twice a day...
That is too high a dose of pramipexole. Starting dose is usually 0.125mg daily, max currently recommended for RLS is 0.25mg daily. I personally would start at 0.0625 mg daily. I took that and it worked fine until I didn't need it because of IV Iron infusions. That would be 1/8 of a 0.5mg tablet.

Also, if the doc will give you ambien OR hydrocodone, give up the ambien and get the hydrocodone, it is MUCH better for RLS than ambien.
Blessings,
Holland

Eternityroad
Posts: 138
Joined: Wed Jun 25, 2008 3:58 am
Location: Las Vegas, Nevada

Re: Augmentation or weak Kratom??

Post by Eternityroad »

Thank you,
I did think about giving up the ambien which I was taking for insomnia and not because of WEDS. Many nights I laid awake until 5 or 6 am while it wasn't every night that I had bouts of restless legs. And the ambien did nothing for the restless legs anyway. In other words we have separate issues here and falling asleep every night is more important than dealing with the RLS that rarely presents in the wee hours.

Yikes! I would have to try and cut that tablet in 8ths! That would be difficult to do without crumbling and the accuracy would be lost. I may just struggle along with the Kratom until it is no longer effective.

badnights
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Re: Augmentation or weak Kratom??

Post by badnights »

see if you can change it for 0.25 mg tablets. They come that small. Then you only have to quarter it, and they're scored so halving it is pretty clean.

When did the insomnia start? A lot of us get insomnia from opioid meds, I'm wondering if kratom has the same effect.

You could swap the Ambien for gabapentin or pregabalin/Lyrica (Lyrica might work better, since gabapentin's effects can be erratic). Neither is a sleeping pill, they're anti-convulsants, but they tend to solidify sleep. They also have some effectiveness in reducing WED/RLS sensory symptoms.

Then you could maybe get the hydrocodone too...... but I would have at least one appointment with him when you don't ask for it. You don't want him to think you're just goofing around. It's a big step but a good one you took, to bring him on board about the WED/RLS. Now he has to do some catching up, since he's using old recommendations as far as the dosing goes, and he should have checked your iron status. I forget, have you had your iron checked recently?
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

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