Dr Ginevra Liptan
By Ginevra Liptan, MD
* Links may generate a commission for this site
The throbbing, pulling or creeping sensations of Restless Legs Syndrome (RLS) can be miserable—and affect at least one third of all women with fibromyalgia. These uncomfortable feelings and urge to move the legs are often triggered by trying to relax or sleep, making it hard to fall and stay asleep. And it is not just the legs, some people experience the restless sensations in their arms or over their whole body! Since sleep is already a huge issue in fibromyalgia, it is really important to be look for and treat any condition that is making sleep worse.
If you answer yes to any of these questions, you may have Restless Legs Syndrome:
o Do you often get a strong urge to move your legs to relieve unpleasant sensations?
o Are the symptoms worse when you’re sitting still or lying down and resting?
o Do you get temporary relief from moving your legs or walking?
o Do the symptoms start or get worse in the evening or at night?
There are definitely medications that can help ease these symptoms, but many of them have significant side effects. Some very effective natural treatments for Restless Legs Syndrome to consider are iron, magnesium and cannabidiol (CBD).
Iron for Restless Legs
We know that restless legs is caused by low levels of the brain chemical dopamine, and many of the prescription treatments for RLS act to increase dopamine levels. Iron is a key player in the production of dopamine, so low iron levels in the brain may lead to low dopamine levels and restless legs symptoms. There has long been a suspected connection between low iron levels and RLS, and people with iron deficiency anemia often experience restless legs symptoms. However people with normal iron blood levels can still experience RLS, and it appears that it is the level of iron that reaches your brain that matters, not the amount floating in your bloodstream. One of my patients with severe RLS and normal blood iron levels had her symptoms eliminated after a series of intravenous (IV) iron infusions, which is the most effective way to get iron into the brain. One study found that IV iron infusions showed significant improvement of RLS symptoms in 76% of the subjects without any major side effects.
For patients with RLS I aim to get their ferritin levels (a blood test for iron) around 70 to maximize how much iron is getting into their brain. Typically any ferritin above 10 is considered “normal”, but if you have RLS it is worth a try to get your ferritin levels up into “optimal” range and see if symptoms improve. In my clinical experience, the results can be pretty dramatic, but be sure to talk with your health care provider before starting iron supplementation as your levels will need to be monitored to ensure they don’t get too high as that can be harmful. You want to find the amount of iron supplementation that keeps your ferritin around that optimal level of 70.
Some forms of iron can be hard on the stomach and cause nausea and constipation. I have found iron bisglycinate to be the best tolerated, my favorite is Opti-feren C by Pure Encapsulations. To optimize iron intake make sure to take it away coffee, tea, and calcium supplements as these can interfere with iron absorption. I often recommend taking any iron with dinner as most of us are not drinking coffee with dinner!
An alternative approach for those that don’t tolerate or absorb oral iron is to apply it transdermally. Yes, we can absorb some iron through our skin! Compounding pharmacies can make a prescription iron cream, although a few of my patients found it discolored their skin. For topical iron I prefer the PatchMD Iron Plus Topical Patch as it is less messy, cheaper, and has no skin discoloration issues.
In addition to getting ferritin levels up to optimal range, for those with severe RLS I will often add some specific nutrients that increase the ability of the body to utilize iron, like the active forms of B-6, B-12, and folate, found in MethylGuard by Thorne Research. For this purpose I have patients just add one capsule of MethylGuard per day.
Magnesium for Restless Legs
Magnesium is another beneficial mineral that can help RLS. Clinically I see this all the time and this study found it was effective for mild to moderate symptoms. Magnesium promotes muscle relaxation and soothes irritable nerve endings. The best form of magnesium for this purpose is magnesium glycinate 240mg to 480mg at bedtime. Magnesium glycinate is the type least likely to cause loose stool, one common and undesirable side effect of magnesium supplementation. Just like iron, we can absorb magnesium through our skin, so you can also apply magnesium oils and lotions directly to your legs. Remember that magnesium is a salt, so some oils can be irritating to the skin. My goal with Frida Botanicals magnesium cream was to make a potent cream that was still gentle and moisturizing. Some of my patients have found that a combination of oral and topical magnesium is the ticket to ease their restless legs symptoms while limiting the laxative effect.
Cannabidiol (CBD) for Restless Legs
Many patients have reported that cannabis (marijuana) eases their restless leg symptoms. This small study found 6 patients reported complete remission of their RLS with cannabis. Cannabis contains lots of different chemicals, so it is unclear which are specifically giving benefit for RLS, but CBD (cannabidiol), is suspected to be the key component of cannabis for RLS. In fact an Israeli company is currently studying CBD as a treatment for Restless Legs Syndrome.
CBD has strong muscle relaxant and nerve calming effects which can really ease the discomfort of restless legs. And just like iron and magnesium, CBD can be taken orally or applied topically to the legs. I have seen patients get improvement from CBD applied topically or a CBD tincture under the tongue before bed. And unlike cannabis, CBD does not have any psychoactive or mind-altering effects and if it is derived from hemp it is legal and accessible in all 50 states. If you want to learn more about CBD safety, effectiveness and dosing check out my other blogs here and here and my videos below.The throbbing, pulling or creeping sensations of Restless Legs Syndrome (RLS) can be miserable—and affect at least one third of all women with fibromyalgia. Learn how iron, magnesium and CBD can help.
Does Cannabis Relieve Symptoms Of Restless Leg Syndrome (RLS)?
Restless leg syndrome (RLS) is a neurological condition that can severely impact one’s quality of life. Here’s the latest on using cannabis to treat the symptoms of restless leg syndrome.
For many people who suffer from restless leg syndrome (RLS), the worst part about the condition is not just the uncomfortable sensations they have to endure. Often times, RLS can have serious implications on one’s overall quality of life. In this domain, research is now suggesting that cannabis may provide relief from some RLS symptoms.
WHAT IS RESTLESS LEG SYNDROME?
Restless leg syndrome (RLS), sometimes referred to as Willis-Ekbom Disease or Wittmaack-Ekbom Syndrome, is a condition where people experience tingling and itching sensations in their legs, with an irresistible urge to move them. The syndrome was discovered and classified by Swedish neurologist Dr. Karl-Axel Ekbom in 1943.
RLS can affect people of all ages in various ways, although the symptoms often get more pronounced with age. Moreover, symptoms are usually at their worst when people are sitting or lying down; moving around can provide a certain degree of relief. Then again, RLS doesn’t affect everyone the same. There are also those symptoms that are not eased by moving about, such as any combination of:
- Unpleasant sensations of tingling, itching, or sensations like “ants crawling” on the legs
- Restlessness, tossing and turning in bed paired with sleeping problems
- Involuntary twitching and jolting of the legs during sleep or waking hours
- A constant urge to move the legs to relieve uncomfortable sensations
- Fatigue and sleepiness
What causes RLS is not exactly known, although it is believed that it can develop as a side effect from certain medications. Since it is unclear what the root cause of restless leg syndrome is, this also means that there are currently no effective ways to prevent it—but there are ways to alleviate the symptoms.
HOW RLS CAN AFFECT LIFESTYLE
One of the most frustrating aspects of this condition is that symptoms tend to worsen in the evening. Because of that, sufferers often have serious problems falling asleep and/or frequently waking up at night. As a result, RLS can sustain a huge impact on one’s quality of life.
But lack of sleep is not the only way RLS affects peoples’ lives; the pain and discomfort experienced can be enough for sufferers to avoid social gatherings where they would need to sit or stand for an extended time. As people are forced to withdraw from their social life, this can lead to isolation, anxiety, and depression.
It is estimated that up to 10% of people in the United States are affected by RLS. Although there is no cure for this condition, evidence is now mounting that cannabis can possibly help relieve some symptoms.
HOW CANNABIS CAN HELP RELIEVE THE SYMPTOMS OF RLS
Although restless leg syndrome has now been known for quite some time, it is only recently that treating the disorder with alternative methods, including cannabis, has come to the forefront. Previously, the only way to alleviate the symptoms of RLS was to use pharmaceuticals, massages, warm baths, hot and cold compresses, foot wraps, and specific exercises. Recent studies indicate that cannabis may help with RLS as well.
A study  performed at the Clinical Neurosciences Center at Bordeaux University Hospital found medicinal cannabis to alleviate RLS symptoms in a small group of subjects. For the study, six RLS patients were given medical cannabis containing CBD. Five of the six reported that their symptoms entirely disappeared after consuming cannabis. All of the participants in the study reported an improvement in their sleep after their treatment with cannabis ended.
In a study on “Sleep, Pain and Cannabis”  published in 2015 in the Journal of Sleep Disorders and Therapy, researchers mention the proven abilities of cannabis to relieve pain and promote sleep. In their report, the researchers suggest that cannabis could possibly help with such conditions as sleep apnoea or RLS—conditions that involve sleeping troubles and/or pain. However, the researchers do conclude that more research in this area is needed.
Although medical studies on using cannabis to treat RLS symptoms are sparse, there is plenty of anecdotal evidence among RLS patients that it can certainly make coping with the disorder easier. The word is still out on whether cannabis can directly address the underlying causes of the condition, but its relaxing, pain-relieving, and soothing effects may help patients get to sleep, and perhaps reduce some of their anxiety or depression symptoms too.
WHICH CANNABIS STRAINS ARE BEST FOR RLS?
If you want help with RLS, cannabis strains that have a sedating and/or pain-relieving effect can be best. Look for strains that are high in THC (to promote drowsiness) and/or high in CBD (to reduce anxiety) because such strains can help you achieve a good night’s sleep.
For fast relief, you can just smoke or vape these strains to enjoy their sedative and pain-relieving properties. You can also make them into edibles, oils, or even topical ointments so you have a variety of methods at hand. You can then keep track of which methods work best for you!
We recommend these cannabis strains if you’re seeking relief from RLS:
Purple Queen is a gorgeous indica-dominant Kush variety that can provide you with a deeply relaxing physical stone. Dreamland will not be far away after a few tokes of this one.
SPECIAL KUSH #1
Special Kush is another good candidate if you need help with RLS symptoms. This modern variant of an old-school Kush has a hash-like flavour and serious indica dominance (80%). Expect a robust body stone that relaxes the limbs and gently eases you off to sleep.
TREATING RLS WITH CANNABIS—THE TAKEAWAY
Even as we wait for more studies to unveil cannabis’ full potential for treating restless leg syndrome, many patients say it’s worth it to experiment with the herb to find relief. Anecdotal accounts may not be entirely verifiable, but the success stories are certainly growing in number. Hopefully, we can look forward to more research on treating RLS with cannabis in the near future.Restless leg syndrome can be more than an inconvenience—it can completely disrupt your lifestyle. Is cannabis able to provide relief from RLS symptoms? ]]>