Restless leg syndrome affects millions of people, and seems like a silly and strange diagnosis – almost like a make-believe or phony disorder just to sell more pills or something. If you peruse the internet you will quickly find that the disorder isn’t understood at all. The cause is generally unknown, and any theories about what causes it or will make it go away are fine examples of wild speculation.
I am very excited to report what I think is truly a breakthrough in understanding of the disorder. Even though it may sound well outside the realm of how the scientific community might explain or describe something, and relies on a great deal that is known to me, but not necessarily the modern scientific community, it represents a breakthrough nonetheless.
I can, in myself and in several others that I communicate with, turn restless legs on and off with great reliability. It has everything to do with what I refer to as the “cellular energy concentration.”
Our cells contain fluid that is called intracellular fluid. In that fluid is, for simplicity’s sake, salt and sugar. The concentration of salt and sugar in the intracellular fluid changes based on many different factors. For example, the lower your metabolic rate goes, generally the more difficult it becomes to retain salt. The elderly, who have the lowest metabolic rates and level of cellular metabolic intensity suffer from much higher rates of low salt levels – known as hyponatremia.
http://www.ncbi.nlm.nih.gov/pubmed/7490395
HYPERnatremia, or having too much salt in your cells (-emia refers to blood, and blood levels probably only detect abnormalities in extreme circumstances – I say “cells” to loosely refer to what are normal, undetectable fluctuations in these levels throughout the day), just so happens to cause “neuromuscular excitability.”
Because of my interest in raising metabolic rate and keeping the hands and feet warm (a sign of decreased stress hormone production), I have played around with and recommended to others a very helpful trick – which is to increase dietary intake of salt, calories, and carbohydrate in proportion to fluids (from drinks and that naturally found in foods themselves), particularly at the time of day when symptoms of hyponatremia and low metabolism present themselves (different for everyone I find, but a “normal” human being will experience the greatest tendencies to enter this state in the morning – experiencing greater coldness in the extremities, more frequent urination, bad moods including irritability and anxiety, etc.).
Following this step increases the concentration of the intracellular fluid. The result is an increased core temperature, increased warmth of the hands and feet, feeling calm and relaxed, and so forth. However, if you take this too far, it can result in some of the following symptoms: very heavy pulse, an uncomfortable sensation of excess heat in the hands and feet, trouble falling and staying asleep, irritability, headache, and sometimes the triggering of an uncontrollable urge to move your legs in a twitch-like fashion – restless leg syndrome.
What’s even more interesting is that intracellular fluid concentrations seem to follow a 24-hour wave-like pattern. The typical peak in human body temperature and presumably intracellular salt and glucose concentrations is between 6-8pm. The typical trough is 12 hours prior to that. What is fascinating is that the lower you drive it in the morning, the higher it seems to go in the evening. You will note that many intermittent fasters that follow a morning fast/late night binge eating pattern report freezing cold hands and feet all through the day and intense warmth and vascularity in the evening while following such a pattern. And it is, of course, the modern way to eat lightly of smoothies, breakfast cereals, skim milk, juice, and coffee during the day and then eat voraciously of extremely salty, calorie-dense food with a low water content in the late evening – all with very little physical activity. I personally find this to be an amazingly good formula for triggering restless legs.
So, in short, restless leg syndrome seems to be caused, at least in some cases, by mild, undetectable HYPERnatremia for lack of a more official phrase to describe it. I prefer to say that the cellular energy concentrations have become too high – a consequence of taking my general metabolism-stimulating advice to eat more (carbohydrates and salt in particular) and drink less when body temperature is below normal a step too far.
The irony is that letting cellular energy concentrations dive too low seems to create an overcompensation effect later in the day. So, it’s important not to skip meals during the day, drink too many fluids, avoid salt, or eat low calorie-density foods exclusively during that time. By increasing cellular energy concentrations in the morning you can actually prevent them from peaking to aggravating extremes in the evening.
The solution for restless leg syndrome is really quite simple, and something that I am confident would provide relief to a large percentage of sufferers – all without any drug interventions, harsh dietary restrictions, or other nonsense:
- Eat calorie-dense food with lots of salt and a low water content early in the day, rather than late in the day. Later in the day, foods that are high in water content and not so calorie dense – like fruits, vegetables, root vegetables, legumes, soups, and salads are better choices.
- Exercise vigorously – especially later in the day when cellular energy levels reach their peak. This helps burn up some of the glucose and expel some salt via sweat. Although I haven’t played around with it, saunas and things that make you sweat might suffice for those unable to do vigorous exercise for whatever reason.
- Drink more fluids in the afternoon and early evening, particularly water – just not so much to trigger waking with a need to urinate while sleeping, or so much that you trigger frequent or clear urination, which should always be avoided. Early in the day, make sure not to drink so many fluids or eat so much water-rich food (like fruit or smoothies) that frequent or clear urination is triggered.
- Be cautious about consuming too much salt or overeating at dinner time.
Those of you who suffer from restless legs and experience chronic cold feet at night when you are experiencing these episodes, or frequent urination at night, please let me know in the comments section – as this would hint at multiple mechanisms for triggering this disorder.
As of December 1, 2012, you can read a great deal more about the physiological principles alluded to in this post in the book Eat for Heat.
I’ve had bouts of RLS off and on for years. Thinking back on it, I think my experiences mostly fit your theory. I haven’t had a bout recently, so this is mostly from memory. The times when I would experience it would generally be when I didn’t eat much for breakfast or lunch, then eat a calorie-dense dinner, particularly one with a lot of easily digestible starch, such as white rice. And when it did occur, drinking water and stretching usually helped, but not immediately. I’d usually have to wait until I peed before I felt like my muscles would relax. Just my experience anyway.
I never thought that RLS was silly or made up because as soon as I heard about it I knew exactly what it was. It is something that I have experienced on and off since I was a child — long before there was any medication or any commercials to indicate that it was not a normal phenomenon. Mine typically only occurs when I am in a car or in a plane and I am overly tired. I haven’t connected it to any dietary patterns, but I haven’t considered that aspect. Luckily, it typically goes away for me once I can actually lay down in a bed and sleep.
However, I do also wake frequently at night to pee. I have had that issue since I was in high school.
Kay, I had read some damn health article many years ago about urinating before going to bed. I started following that religiously and now feel so uncomfortable if I don’t do so right before bed.
I sometimes feel very pee-ish when I am trying to fall asleep and have to get up a few times and do a little dribbling. Luckily i wake up only once in the night to pee after I fall asleep. Of course this screws up my sleep. How do you manage to get adequate sleep if you get up frequently? Do you drink liquids before bedtime? If not then the cellular theory above could be a good indication.
Hello PeeKing – although your blog didn’t actually say to me that you get RLS but, for those who do, I found that just drinking twice as much as I used to drink about a half hour before bed gave me a great RLS free sleep. Also, avoid highly salted foods just before bed (such as store-bought hummus). I think the hydration affects our electrolites and creates better movement in our cells somehow. Anyway, to my surprise, it didn’t make me get up to pee more. A tip for getting back to sleep is to have a soft black sock handy which you can drape over your eyes once you lay down. The total darkness from the sock stimulates melatonin production for sleep and the sock also cuts out noise as it drapes over your ears also. Sweet dreams!
Have never had RLS – but severe trouble falling/staying asleep – oh yes. I’m wondering if there’s a connection here. I do tend to eat more at night, less during the day. I’m going to switch this up and see how it goes. Will let you know how it goes.
Love your blog Matt!!!
I often have a very heavy feeling in my upper legs. Sometimes I feel little muscles twitching. I can suppress the feelings by cooling, using tiger balm, stretching and by raising my legs higher than the rest of my body. It is usually worst at night which makes it difficult to sleep. But when I have this they are also very weak and it is often triggered or worsened by heavy use of my legs. Back when I always felt shitty and tired (low metabolisms for sure) I had this really bad and after a leg workout my legs could feel like this for two weeks straight and be very weak the whole time.
I’m not sure if you can call this restless legs though, maybe it’s more of the opposite (?). I’ve had some minor success with magnesium though (but the Mg supplement I’m taking now doesn’t seem to do the trick).
oh but it does give me the urge to shake, move or tense my legs.
I sometimes experience RLS at night with the subsequent problems of sleeping, the method that works most of the time is drinking about a pint of water then returning to bed. I believe the cause of the restless legs is as said an electrolyte concentration imbalance, also because a lot of people claim that putting a bar of soap under their feet alleviates the problem. Soaps are negatively charged and the major electrolyte of the extracellular fluid is the cation sodium (positively charged). It would be fun to know if anyone has tried Earthing as an alternative solution?
I wonder if this is somehow related to premature uterine contractions that slow down upon drinking lots of water at once.
I have always assumed it was some progesterone decline induced by stress or maybe magnesium deficiency.
speaking of water and charges, this guy has some revolutionizing ideas..
I heard Dr. Dan Kalish say it was down to a major dopamine deficiency, so he prescribes tyrosine. He sees it a lot in sufferers of PTSI and Parkinson’s disease.
Matt, could you clarify please: where you say salt, do you mean the sodium part of salt? Salt is sodium chloride.
Great article Matt. I never thought it was diet related. What do you think of wikipedia’s take on using iron, vit c supplementation etc. I only get very mild episodes of this so I have not really thought of it as a problem – bigger fish to fry!
Wow this is SO interesting!! I have chronic cold feet and also frequently suffer from the whole restless leg thing…. just last night I was up kinda late watching movies in bed (the restless legs usually kick in if I stay up later than usual). The normal sequence of events for me go something like this: cold feet for 2-3 hours after I get into bed (I use my electric blanket to stay warm until I warm up); then a short period of being nice and warm & comfy; then I overheat and have to stick my feet out the bottom of the blankets; then I get crazy legs that want to go running and can’t keep still. I’ve done the whole RBTI thing so I’m accustomed to not eating big at dinner and sometimes skip it altogether, so do you think taking a drink of water ought to be enough to calm my legs down? Of course the obvious answer for me is not to stay up that late but I just got three seasons of True Blood and I can’t stop myself :)
I suffer the same sequence of events concerning feet in the evening and I always thought and think it has something to do with stress hormones rising at night, due to not eating for a few hours – all reaching back to the body not being able to store much glycogen. That is exactly is what fks up my sleep – I fall asleep just fine, then wake up at 2AM and then every 60 to 90 minutes – might have something to do with circadian rhythms – instead of sleeping a bit more lightly during the “peak”, I wake up completely. And then again no trouble falling asleep… Usually I don’t wake up by the first peak – I sleep straight 3 hours, the best I can get.
I have RLS, along with all three of my kids. We also have thalassemia, which results is chronic anemia. Because of this, our ferritin is low. I have been told (by Mayo Clinic) that when ferritin levels are below 50, it can cause RLS. And, in general, when our iron levels are higher, we sleep much better. Recently, we had a run in with some moth balls which instantly caused anemia. Without realizing it, or explaining this to the kids, we all had horrible RLS that night – worst ever. And it continues now, months later.
We also have problems with nighttime urination. Is it because we are already awake due to the RLS, and therefore notice the need to urinate? Although it seems that as a family we do urinate much more than average.
We will be trying this and will let you know how it works for us. At present, we are all having a tough time at night with the RLS, so this is a good time to try it out.
OK, calorie-dense foods. What are those except for wheat and grains? Don’t get me wrong, pizza and pastries work wonders with my temps, but the trade-off is non-formed poo and a bad smell from the mouth. It never goes beyond that so I don’t think I have celiac.
Anyhow, what are my options except wheat? I have tried eating lots of salt, but if I have one teaspoon it’s not enough. Four tsps usually are, but then I always feel like I am going to die
I second this question. I do great with grains, my kids..not so much. So I’m trying to think of ideas for low water breakfasts that are not grain based. Anyone? Maybe something like hash browns and eggs?
I’ve found homemade french-fries/sautéed potatoes (made in tallow or coconut oil) with an egg or two (and lots of salt!) to be the perfect breakfast when I want something grain-free.
With all my medical,hormonal weird symptoms,RLS is something I luckily never have had. I know my mom experiences this frequently though.
I love this site, but it’s not what it use to be. Month ago when Matt said he was “rebooting” the site to get back to the basics I was thrilled. It’s much worse. The old articles were much better and the site is actually going from “against the mainstream” into the mainstream. Even the comments on here about grains, Paleo, etc. Sisson would be proud. There is a reason why most of the old gang aren’t on here anymore.
The central problem here is that neither Matt nor ‘fat-adapted’ Sisson have really figured things out. Both provide solutions that work for a few and work for short periods of time for most people. Sisson’s approach definitely leads to fat loss and then the consequent problems that Matt refers to kick in. The 180 RRARF then works great when coming off this low carb approach. But continue to eat to as suggested here and you will be packing on the pounds – take a look at Matt himself recently compared to his earlier days..
Both diets might then be best classified as intervention diets and both have their pros and cons. Perhaps the much derided mainstream might have just got it right…
I have not experienced this, but I also like to eat during the day…and I also don’t like the feeling of overstuffing myself. My husband on the otherhand loves to overstuff himself and then add a beer on top of that in the evening and he experience RLS quite frequently, he also does the only have a couple pieces of toast for the entire day thing, which I don’t understand.. it makes you a pretty grumpy person all day. Interesting theory, next time he has it I will ask him what he ate all day.
If eating a large meal at night can cause RLS, then wouldn’t people who practice Ori Hoffmekler’s “Warrior Diet” be suffering from RLS? Has anyone done that diet and experience this?
I get restless legs from time to time- only lightly. I have not determined a cause.
My friend however says she gets it really bad when she has msg??
Is this not just more evidence to eat intuitively? If we can get to the place to listen to our bodies and respond accordingly, then we will have achieved some sort of equilibrium I think. Oversimplified, yes, but I’d say generally true.
Matt, I think you are really on to something with this – you can really help a lot of people! Thank you for everything you are doing!!
Coffee and caffeine causes “restless leg syndrome”.
Break the addiction to this poison and detox off it for a few months and this “disorder” should vanish (actually sooner).
nope sorry… done that, didn’t work.
Salty soy sauce causing Restless Leg Syndrome in sushi squid:
Dancing Zombie Squid Explained
http://www.youtube.com/watch?v=JGPfSSUlReM
It’s 1:55 am and I am awake with RLS, mild headache, dry mouth, stuffy nose, and a general “out of balance” sensation. I am just over 36 hours into carb loading and have been eating as much rice, potatoes, vegetables and fruits as I can hold along with reducing my water consumption. It sounds like I may have taken this too far especially in the evenings as I thought I needed to load up before bed so as not to wake up prematurely with low blood sugar. I am generally cold at night and experience RLS at night and when I sit for long periods of time.
Don’t drink coffee or have anything with caffeine, or chocolate, and sometimes don’t eat a meal at night, but do get restless legs. They stop when I go to bed, especially if I lie on my stomach. I can also reduce them a bit by watching tv on my left side. I used to think it was some kind of intestinal irritation, but I then I realised my arms were feeling it a bit too. If it’s about salt, why does it stop when I go to bed?
http://www.youtube.com/watch?v=2YZJt_Bw3eo&feature=related
(this clip convinces me)
PS I so get very cold feet some evenings, but not on the same day as RLS. Hope this helps.
I hae RLS from time to time. Definitely with long drives in cars where I can’t stretch out properly. But also, a few months back, I started eating a big bowl of air-popped popcorn after dinner with some melted butter and a little salt each night, and started getting RLS almost every night. When I stopped with the popcorn (all foods after dinner actually), the RLS went away again.
So…carbs? Salt? I always thought it was excess carbs that triggered it.
Also, I have begun IF for a couple weeks, only tea and cod liver oil in the morning, and then eating from about noon to 6pm, and haven’t had RLS as a result. I do drink water a lot too, always carry a bottle around to keep me from getting too hungry in the morning.
I’m pregnant and started getting RLS in the evenings a couple of months back. It went away as soon as I actually went to bed though. Turns out I was a bit low in iron….VOILA. No more RLS after taking supplemental iron. I also read magnesium can be a solution for some people. So far just about every ailment I have had in life has been helped or overcome by some mineral or other. What foods I eat when have no impact…I already tried that one.
Same here, Loops! I got RLS during the last part of my second pregnancy. I was low in iron according to the tests but I refused to take iron tablets because the ones they gave me during my first pregnancy made me have instant diarrhoea! I figured that they hadn’t done much for my iron levels – or for any other levels for that matter – so I stopped taking them. I also read – somewhere!!! – that there was a good reason for women having low iron levels during pregnancy, i.e. to ensure that bacteria (I think) wouldn’t be able to use the iron in your body as food, which in turn would ensure that pregnant women would be poor hosts for nasty bacteria, which would die through lack of food and not be able to harm the growing baby. God knows if this is true, but I’m a natural sort of gal, so I chose to believe it!
Once I had given birth, the RLS went again and hasn’t returned since.
My take on RLS is that low iron DEFINITELY plays a role – the family above with thalassemia seems to prove the point, too.
About 15 years ago, I suffered regularly from RLS but now rarely have an episode… maybe 1-2 times per year. I started taking vitamin B supplementation and injections (for other issues) and began to notice that I had fewer RSD episodes following my injections and as the time for another injection grew near RSD episodes increased in frequency and intensity until I received my B injection then dramatically decreased (and eventually resolved.) This process took several years and I continued on oral B supplementation for sometime as well and now am on a maintenance dose.
I am not sure how this fits with your theory but wanted to share. I am interested to know outcomes of others.
I had RLS and ‘burning feet’ for years until I dumped grains and gluten. Gone – although it is a symptom of me being ‘glutened’. I suspect it is nutritional deficiency in origin – that the gluten robs my body of certain nutrients during its processing in my body.
Interestingly, I now make for my husband, who is also very gluten intolerant, slow-rise bread which, although I generally eat low-carb we can both eat without any ‘gluten’ symptoms. I believe that is because not only is the gluten pre-digested during the long fermentation process, but it also provides something in the region of 50% more nutrition – mainly B vitamins including Thiamin which is needed for carb digestion, and which we are lacking in the Western diet. Well, not necessarily lacking, but when the struggle within the body to process the high-carb highly-processed Western diet constantly robs us of more nutritional elements than the food provides us with, it is a foundation for deficiency issues and damage.
When food takes away more nutrition than it gives – and to be honest, much of the fractionated, denatured food out there does, we are in trouble…..
I am one of those with restless legs (which I always thought was an OCD thing, but maybe not?) and chronic cold feet at night (as well as waking up to urinate at least once during the night). The only thing that seems to help the nighttime waking is if I eat something mega-salty before bed (e.g. a spoonful of marmite). If I drink even half a cup of plain water, I end up urinating multiple times (totally clear), no matter what time of day. The only exception is if I am seriously hot or have just eaten something very salty and calorie-dense. Even then, it’s risky! I do tend to eat my larger meal in the evening, to try and keep warm at bedtime. In winter I cannot fall asleep without a hot water bottle!
I notice when i reduce my carbs my restless leg seems to subside. not sure if i’m imagining it or not. I am actually having an episode right now as i read this article and was barely able to sit here and finish the darn thing! some great ideas here. I will experiment with them and see what happens. its really annoying!!!
Generally I exercise in the first part of the day and eat very little until I gourge around 7pm.
1-2 hours later I have restless legs.
It lasts a few hours–maybe less if I stretch.
Interesting.
I have severe Restless Leg Syndrome and it affects me everyday. I can go days without sleep and frustration that sends you insane. I have tried everything I can think of and have tried many medications all seam to fail after time. I used to find strenuous exercise before bed (long distance runs) worked until I got heel spurs and plantar fasciitis. Now I can’t sit down to watch tv or stay off my feet long enough for them to heel. There seems to be help for people with light to very mild RSL but nothing for severe. It has started to affect my arms recently and I took my self to hospital before I lost the plot but ironically they made me wait for 6 hrs in a waiting room unable to sit still and eventually the doctor said he knew nothing about it and gave me two sleeping tablets and sent me home. Any help would be a life saver
My husband has been suffering wiith RLS for years. He saw a doctor that deals with this,some kind of neurological doctor who prescribed him Parkinson’s medication sinemet. My husband got total relief and wanted to kiss this dr’s feet!! It helped him for about a year and he finally got good sleep for the 1st time in his life! Then it wasn’t helping as much so the dr increased the dose. Then when it wasn’t helping much the dr tried requip which was all over the commercials at the time but it didn’t help. The next drug which was recommended by the dr was to try a med for seizures which is also supposed to help with dopamine levels. Scott said no way since we know someone on that and he appears doped up all the time. The dr then said he should try Percocet which is what he takes to this day. Actually he takes at night 45min before bed and he sleeps great! Good luck to you!! Sheila
“Those of you who suffer from restless legs and experience chronic cold feet at night when you are experiencing these episodes, or frequent urination at night, please let me know in the comments section – as this would hint at multiple mechanisms for triggering this disorder.”
This is me! I have RLS in combination with very cold feet during the day and at night. I almost always wear thick wool socks when at home to try to combat the cold feet, but the socks aren’t very effective. I often find myself having to run my feet under hot water to warm them up, especially before bed. Both my RLS and cold feet worsen after a night out drinking alcohol, but the symptoms are present without the alcohol as well. Besides adjusting my diet as prescribed in this article, what else do you think could be triggering the cold feet?
Tim,
I have the exact same symptoms as you do! Cold feet and hands in the evening. I find that walking maybe light jogging later in the evening helps and also I take a product called Midnight PM that helps me get to sleep, but I wake up feeling tired all day long. My RLS is not as intense but I have found very little outside of this that helps. My RLS also bothers me at about 3 pm every day and is off and on all night. I have low B12 levels but the shots did not help the RLS. Anyone try a chiropractor with success?
I’m 48 years old. Starting in April-May of 2012, I began to wake up frequently at night to use the bathroom. The number of times I woke up gradually increased to about two to five times a night.
I’m usually very skeptical of the claims of supplement makers. I take a multivitamin, cinnamon to reduce my blood sugar and niacin to reduce my triglycerides. (Both were recommended by my doctor). After doing much research online, I suspected that my problem was due to Benign prostatic hyperplasia (BPH)–a common condition of men 50+ yrs old. During a doctor’s office visit, I asked him about taking a supplement. He was positive about trying a supplement to relieve my waking up at night to go to the bathroom.
I researched several different brands and decided to try the Dr Max Powers Prostate Supplement. Within a week and a half of starting the supplements, I was only waking once or not at all at night. I’ve been taking the supplements for about 4 months now and recommend them.