Complementary Medicine

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Jacob Teitelbaum MD, internist and author of From Fatigued to Fantastic!, researches treatments for Chronic Fatigue Syndrome and fibromyalgia. See full bio

March 18, 2009, Health

Iron Better than Requip for Restless Leg Syndrome?

Iron better than Requip for Restless Leg Syndrome?

Here's another study confirming what we've known for years: that treating low iron (even with normal iron tests) is critical for treating Restless Leg Syndrome (RLS), and I find it to be more effective than the medication "Requip."

In this study, patients with RLS with a mean ferritin of around 40 (which interestingly is the same cutoff we use as our measure for low iron, despite "normal" being above about 9) were treated with iron or placebo, and had a marked improvement in their RLS symptoms vs. placebo.

To put it in perspective, in a recently completed U.S. trial, patients taking Requip decreased RLS symptoms by less than 4 points more than the placebo did. Iron lowered RLS symptoms by more than 9 points more than placebo. This makes iron more than twice as effective as Requip!

For treating Restless Leg Syndrome, I give iron once a day on an empty stomach and at least 6 hours away from any thyroid hormone. I also add a good multi-nutrient vitamin powder. If medications are needed, I add Neurontin at bedtime, and will sometimes add Klonopin if fibromyalgia is also present (though the Klonopin may be addictive). I almost never recommend Requip.

To paraphrase, RLS is not a Requip deficiency!