Ask the Sleep Doc
As answered by our issue reviewers. Lourdes DelRosso, MD
Melissa C. Lipford, MD
Robert J. Thomas, MD
Rochelle Zak, MD
30 | Winter 2022 | Restless Legs Syndrome
Question: Can taking iron cure my Restless Legs Syndrome (RLS)? Dr. Zak: Before answering this question, I want to address the terms. You have asked about "curing" RLS. RLS is not like an infection where there is a medication (an antibiotic, for example) and once taken, the infection is "cured". Consider it more like hypertension, a clinical disorder that needs to be managed. That being said, RLS tends to occur in individuals with a genetic predisposition in the setting of low brain iron such that restoring that state can eliminate the symptoms. Therefore, the answer to your question is actually "yes" and "no". It is "yes", if the low brain iron is occurring for a specific and limited reason, such as insufficient iron in the diet or an episode of acute loss of blood, such as blood loss from surgery or frequent blood donations.
In these cases, once the iron loss is corrected, you can return to an RLS-free state. However, many people we see require higher levels of blood iron than they have at baseline to overcome the symptoms. These individuals need to have iron therapy long-term, which to me would say that it is not so much a cure as a treatment. Still others get no relief or only partial relief of RLS symptoms with iron alone and require another medication, such as pregabalin, or behavioral treatment, such as warm soaks before bedtime. Dr. DelRosso: Iron supplementation improves symptoms of RLS but it’s not curative. The symptoms of RLS can be exacerbated by many other factors (use of caffeine, medication effect, lack of exercise, presence of another disorder or condition, among others) so treatment and evaluation of RLS should be comprehensive and done by a sleep professional.
