TITLE 1: “Restless Legs Syndrome: The Nutrition Connection”
TITLE 2:
DATE: November 1998
AUTHOR/S: By Victoria M. Wood, MPH, RD, Certified Nutrition Specialist
KEYWORDS:
• Diet/exercise
ABSTRACT OVERVIEW: This is THE article on nutrition and it’s possible connections to
RLS.
COPY OF ARTICLE:
The RLS Foundation is not aware of any published, scientific studies on the dietary treatment of RLS.
If dietary supplements are used and alterations are made, they should be incorporated into an overall
treatment plan that individual patients and their healthcare providers develop.
Let’s play nutritional Jeopardy! The answer: “This condition may indicate any number of
health problems, including nutritional deficiencies, maldigestion, food allergies or even
environmental toxicity or chemical sensitivity.” The question is, of course, “What is restless legs
syndrome?”
Biochemical Individuality
During the 15 years I’ve been in practice, I’ve seen many cases of RLS; even though their
symptoms look the same, I do not use the same protocol for every patient. The reason for this is
that one of my nutrition teachers was Roger Williams, PhD, a pioneer in biochemistry. While I
never actually met him, it was through reading his books that I learned his concept of
biochemical individuality. He recognized that each of us is genetically unique, requiring slight
variations in nutrient intake in order to function optimally. His research showed that in any group
of 15 to 20 people there can be a range of nutrition requirements from person to person that
varies by as much as 700%! The right dose is critical to any therapeutic intervention using
nutritional supplements. A person with RLS is a perfect example of someone for whom the
recommended dietary allowance of certain vitamins and minerals may be woefully inadequate.
Functional vs. Allopathic Medicine
Another reason for treating RLS differently in different people is that while RLS has a
specific diagnostic definition, I see it as a number of symptoms that need to be evaluated from a
functional medicine perspective. Functional medicine is the field of health care focused upon
assessment and early intervention into the improvement of physiological, cognitive/emotional,
and physical functioning. In contrast, allopathic medicine intervenes at a much later point and
generally treats symptoms with drugs, surgery, or both. While the allopathic method often brings
much-needed relief from painful symptoms, it is the functional approach that seeks to understand
the underlying reasons for those symptoms.
In addition to nutritional assessment and therapy, there are other functional medicine
interventions. They include phytochemicals and botanical medicines, structural alignment,
exercise, homeopathy, acupuncture, and environmental assessment and intervention.
Nutritional Investigation
While most of us think that nutrition begins with the foods we eat, it really begins long
before that with the farming of foods. The continuum looks like this. So even before we begin to
look at our diets and how their quality may affect our health, we might ask where our foods came
from, beginning with the quality of the soil. For the past 30 to 40 years, American soil has been
fertilized with only nitrogen, potassium, and phosphorous—the three nutrients needed to make
plants grow. And while plants have just 15 essential nutrients, humans have 50. So if there is no
selenium or chromium in the soil, the plant might not care, but the human body does! In fact,
when I do nutrient testing on my patients, I see the following deficiencies quite often.
Chromium—needed to regulate blood sugar, prevents neuropathy
Copper—aids iron absorption and collagen production, vital to heart function
Selenium—makes glutathione peroxidase to reduce oxidative stress
Zinc—aids protein synthesis, wound healing, blood-sugar balance
Magnesium—key nutrient for enzymes, prevents tremors, relaxes muscles
B-6—deficiency associated with neuropathy, neuralgia, paresthesia
Folic acid—deficiency symptoms include muscle weakness
Calcium—muscle cramps and spasms result from deficiency
Of these eight nutrients, five directly influence the musculoskeletal and neurologic systems.
How many RLS patients are routinely asked about the quality of the foods they eat? And how
many have been properly tested for nutritional deficiencies?
A primary recommendation I make to all of my patients is that they include organically
grown foods whenever possible. Several studies have shown that the nutrient levels of fruits and
vegetables grown on organically fertilized soil are much greater (by as much as 1,600%) than
ones grown using commercial fertilizers. Another benefit is what those foods do not contain:
herbicides, pesticides and fungicides. Have those chemicals been adequately tested for their
ability to affect an individual’s neurologic system? Why not consider an eating plan that includes
only organic foods for a six-week period to determine what benefits you might derive? Patients
have reported anecdotally that their RLS symptoms have abated when they consumed a
pesticide-free diet.
Here is something I say often to new patients, “If you’re sitting on two tacks, and you take
one tack out of your butt, you don’t experience a 50% reduction in pain!” That means that you
may need to change more than one variable in the experiment known as your life in order to see
significant improvement in the out-come. Choosing organic foods
exclusively may give you the benefits you desire, but if it doesn’t,
perhaps an assessment of your digestion is in order.
The first time I see a person with RLS, we spend an hour
reviewing her or his medical and nutritional history. As we discuss
foods eaten and symptoms experienced, I look for the nutritional
common threads that link those symptoms together. The most
important part of that visit is to determine if the foods that are eaten
are digested optimally. Diet is what is eaten, but nutrition is what
the body derives from that food. Without good digestion, foods cannot adequately break down
into the vitamins, minerals, amino acids, fats, and water that the trillions of cells in our bodies
use for their function. How do we know if we have digestive problems? Generally, our bodies try
to get our attention with symptoms such as:
• Indigestion or sour stomach
• Excessive belching or bloating
• Gas immediately following a meal
• A sense of fullness during and after meals
• Abdominal cramping after meals
• Alternating constipation or diarrhea
• Roughage and fiber cause constipation
• Loss of sense of taste or smell
Of course there are many more symptoms that may signal poor digestion or absorption. But
unless those two areas are initially addressed, any nutritional intervention that follows will not
result in optimal wellness.
For example, zinc is a key nutrient (and a commonly deficient one) for digestion. Zinc is the
mineral that activates an enzyme in the stomach called carbonic anhydrase. Without this enzyme,
the parietal cells of the stomach do not receive the signal needed for the production of
hydrochloric acid (HCL). Without sufficient HCL, the whole cascade of events that culminates
in optimal digestion and absorption cannot occur. HCL begins the breakdown of protein into
amino acids. HCL is critical to calcium absorption. HCL also signals the pancreas to deliver both
digestive enzymes and bicarbonate to the small intestine where the bulk of absorption takes
place. And if
there is not enough
HCL to send
that signal to the
pancreas, the
acid from the stomach
will trickle into the small intestine without being neutralized by the bicarbonate. What symptom
will occur then? Ironically, without enough acid, a person may actually feel burning after eating!
It takes acid (HCL) to produce the bicarbonate that will then neutralize the acid!
What happens to the functions of the body if poor digestion and absorption persist for years?
Let’s look at one that affects RLS: the neurologic system.
We know that the neurologic system is made up of proteins that come from amino acids.
Amino acids require minerals for their uptake into the trillions of cells that make up our bodies.
In fact, of the more than 5,000 enzymes required for human metabolism, 4,300 use magnesium.
For example, tryptophan is an amino acid that comes from protein and is used to make the
neurotransmitter serotonin. If there is sufficient magnesium, the conversion of tryptophan to
serotonin will provide the brain and many other cells with the proper amount of that chemical.
However, if there are inadequate amounts of magnesium, that conversion will yield much less
serotonin, which may result in the symptoms associated with serotonin deficiency. Depression
and carbohydrate cravings are two possibilities.
In addition to magnesium, vitamin B-6 is also required for enzyme activation. Two of the
most commonly deficient nutrients are the same nutrients required by every cell in our bodies! It
is easy to see how the neurologic system may be adversely affected if foods that are low in key
nutrients are frequently consumed, or if poor digestion prevents even nutrient-rich, organically
grown foods from being well absorbed.
While a complete nutritional assessment will evaluate all nutrients, those affecting RLS
likely include magnesium, calcium, vitamin E, iron, and the B-complex vitamins.
Part two of this article will appear in the
February 1999 NightWalkers and will
examine the following topics and their
relationship to RLS
• Anemia
• Aspartame and caffeine
• Food allergies and chemicalsensitivities
• Leaky gut
• Liver function
• Antibiotics and dysbiosis