To Your Good Health: Iron deficiency makes restless legs syndrome worse

Are you aware of any correlation between celiac disease and restless legs syndrome? My 72-year-old husband has had RLS for decades. He currently takes gabapentin and pramipexole, but still has symptoms. Plus, he has periodic limb movement disorder, which occurs while he’s asleep. He isn’t aware of it, but it can keep me awake; we sleep in separate beds when it gets bad.

The terminology can be confusing. Most people with RLS have periodic limb movements of sleep, which sound very similar to your husband’s symptom. PLMD is a separate sleep issue that doesn’t include other RLS features, such as an uncomfortable sensation in the legs while they’re at rest that causes an urge to move them. A person with RLS often has PLMS, but doesn’t have PLMD.

There is an increased risk of RLS among people with celiac disease. Most authorities tie these two together through iron deficiency. Unless celiac disease is managed with meticulous attention to diet, the body has difficulty absorbing iron.

Iron deficiency is very frequently found in people with RLS, and iron deficiency makes RLS worse. The diagnosis of iron deficiency needs to be made carefully because most people with RLS and iron deficiency do not have anemia.

A ferritin level, rather than a blood count test, is the best initial test. If he does have iron deficiency, then treatment with iron supplementation can sometimes dramatically improve those nighttime symptoms.