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NMU 92 – Two Natural, Proven Treatments for Restless Legs Syndrome: Vitamin D and Iron

Nutrition / Natural Medicine Update No. 92 (June 18, 2018)

with Dr. James Meschino


Topic: Two Natural, Proven Treatments for Restless Legs Syndrome: Vitamin D and Iron

Source: Journal Sleep and Breathing (2015)


It is estimated that 7-10 percent (possibly up to 15%) of the U.S. population has a condition called Restless Legs Syndrome.  It is a bit more common in women than in men. Restless legs syndrome (RLS), also called Willis-Ekbom Disease, causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them.  Symptoms commonly occur in the late afternoon or evening hours, and are often most severe at night when a person is resting, such as sitting or lying in bed. This makes it difficult to fall asleep, thus leading to daytime fatigue, lack of productivity, and compromised quality of life. The chronic sleep deprivation can lead to problems with severe depression and anxiety.

It is well documented that low iron levels can cause restless legs syndrome (RLS), which is correctable in these cases with simple iron supplementation. But not all cases of RLS are caused by iron deficiency or a marginal deficiency in iron.  An important breakthrough study published in 2015, in the journal Sleep and Breathing, showed that low blood vitamin D levels can also be a commonly overlooked cause of RLS. This study showed that raising vitamin D blood levels to above 50nmol/L significantly reduced the severity of restless leg syndrome scores in RLS patients who had blood levels below this value at the outset of the study. This is an important finding because the drugs prescribed for RLS are associated with potential for addiction and/or significant withdrawal symptoms. The drugs commonly prescribed for RLS include Gabapentin, Benzodiazepines (i.e. Valium) and Opioid drugs (i.e. Oxycodone). For those with RLS, they should have their blood iron and vitamin D levels evaluated. If the serum ferritin is below 20ng/ml and/or if vitamin D blood level is below 50nmol/L, then these nutrient deficiencies should be corrected through targeted supplementation to get these values into the ideal range. Studies suggest that this approach will resolve a large percentage of cases.

Other natural interventions showing promise in resolving RLS include taking probiotic and prebiotic supplements, as bacterial overgrowth (often seen in irritable bowel syndrome) is also a common finding in many cases (possibly 69%) of RLS. Note also that use of alcohol, smoking (nicotine) and caffeine are known to aggravate RLS and thus, should be avoided or greatly minimized in RLS patients.RLS is also associated with other health conditions and other factors which include:

  • End-stage renal disease and hemodialysis
  • Neuropathy (nerve damage).
  • Use of certain medications such as anti-nausea drugs (e.g. prochlorperazine or metoclopramide), anti-psychotic drugs (e.g., haloperidol or phenothiazine derivatives), antidepressants that increase serotonin (e.g., fluoxetine or sertraline), and some cold and allergy medications that contain older anti-histamines (e.g., diphenhydramine)
  • Pregnancy, especially in the last trimester; but in most cases, symptoms usually disappear within 4 weeks after delivery.

If you experience RLS and don’t have end-stage kidney disease, are not pregnant or using the drugs I have cited as potential causes of RLS, then ask your doctor to evaluate your iron and vitamin D status. If either of both of these values are low, then get them into the ideal range using supplementation, with your doctor’s guidance and monitoring. Avoid or minimize alcohol, caffeine, and nicotine, and consider taking a probiotic supplement each day (and possibly a prebiotic supplement to support the growth of the friendly gut bacteria). RLS can be a very aggravating, annoying and a life-changing condition that can lead to depression, compromised quality of life, and in some cases addiction to narcotic drugs. So, RLS patients should be proactive in the management of this condition as much as possible.

I have included the references for this information in the text below.



1. National Institute of Neurological Disorders and Stroke

2. Addiction and Withdrawal Side Effects of RLS Drugs:

3. IBS, Bacterial Overgrowth and Restless Leg Syndrome and Use or Probiotics:

4. Vitamin D Supplementation Improves RSL: Wali S, Shukr A, Boudal A, et al. The effect of vitamin D supplements on the severity of restless leg syndrome. Sleep Breath. Vol 2:579-83. 2015

5. Iron Supplementation Improves RLS Wang j, O’Reilly, Venkataramen R et al. Efficacy of oral iron in patients with restless leg syndrome and low-normal ferritin: A randomized, double-blind, placebo-controlled study. Sleep Med. Vol 9:973-5. 2009.


Eat Smart, Live Well, Look Great,

Dr. Meschino

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