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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by jerrympls on June 7, 2003, at 3:36:38
My sister has been having restless legs at night while attempting to sleep. I did quite a bit of research on the subject including treatments, causes, etc. - but no where did I find that it could be diagnosed with a simple blood test.
Her family doc said they diagnosis Restless Legs Syndrome by testing the level of FERRITIN - which coincidentally is part of hemoglobin/iron level work-up. Anyway, the dr. said she had a level of 12 which he said was LOW - meaning she DID have restless leg syndrome. I looked at my recent test results and found my ferritin level to be even lower at 7.
One of the main treatments for RLS is a medlike Mirapex - but it also seems that iron supplements can help as well.
Anyway, for those of you out there who are amateur psychopharmacologists - is this test a TRUE measure??
Thanks!
Jerry
Posted by djmmm on June 7, 2003, at 8:58:50
In reply to Anyone heard of a blood-test for RLS?, posted by jerrympls on June 7, 2003, at 3:36:38
> My sister has been having restless legs at night while attempting to sleep. I did quite a bit of research on the subject including treatments, causes, etc. - but no where did I find that it could be diagnosed with a simple blood test.
>
> Her family doc said they diagnosis Restless Legs Syndrome by testing the level of FERRITIN - which coincidentally is part of hemoglobin/iron level work-up. Anyway, the dr. said she had a level of 12 which he said was LOW - meaning she DID have restless leg syndrome. I looked at my recent test results and found my ferritin level to be even lower at 7.
>
> One of the main treatments for RLS is a medlike Mirapex - but it also seems that iron supplements can help as well.
>
> Anyway, for those of you out there who are amateur psychopharmacologists - is this test a TRUE measure??
>
> Thanks!
> JerryTesting ferritin levels is the only test I have heard of for diagnosing RLS. Ferritin is an iron storage protein. Iron deficiency can cause a number of problems, most recent research suggests RLS may be the result of iron deficiency within ferritin stores or decreased ferritin protein.
Serum ferritin level is directly proportional to the amount of iron stored in the body. A normal level ranges from 12-300 for males and 12-150 for females. For women, the results can be misleading the test is given during menstruation. A poor diet can also effect iron levels.
Posted by Paulie on June 7, 2003, at 12:09:32
In reply to Anyone heard of a blood-test for RLS?, posted by jerrympls on June 7, 2003, at 3:36:38
A person can have a low ferritin level and not have RLS. You cannot say because a person has a low ferritin level, i.e., that person has RLS.
A person with RLS though may have a low ferritin level which can intensify symptoms. It's a possible secondary cause out of several. Supplementation can be given if ferritin level is <50ng/ml.Etiology
Primary RLS
RLS is a central nervous system disorder.9 It is not caused by psychiatric factors or by stress but may contribute to or be exacerbated by these conditions. There is a high incidence of familial cases of RLS, suggesting a genetic origin for primary RLS.8 The exact mode of inheritance is unknown.8,10Secondary causes of restless legs syndrome include iron deficiency, spinal cord and peripheral nerve lesions, pregnancy, uremia and some medications.
Secondary Causes of RLS
Iron Deficiency. RLS may be associated with iron deficiency. A patient's iron stores may be deficient without significant anemia. Recent studies have shown that decreased iron stores (indicated by serum ferritin levels below 50 ng per mL [50 µg per L] can exacerbate RLS symptoms.11,12 Patients with newly diagnosed RLS or RLS patients with a recent exacerbation of symptoms should have their serum ferritin levels measured.
for more info
http://www.aafp.org/afp/20000701/108.htmlPaul
Posted by jerrympls on June 7, 2003, at 13:14:04
In reply to Re: Anyone heard of a blood-test for RLS? » jerrympls, posted by Paulie on June 7, 2003, at 12:09:32
> A person can have a low ferritin level and not have RLS. You cannot say because a person has a low ferritin level, i.e., that person has RLS.
> A person with RLS though may have a low ferritin level which can intensify symptoms. It's a possible secondary cause out of several. Supplementation can be given if ferritin level is <50ng/ml.
>
> Etiology
>
> Primary RLS
> RLS is a central nervous system disorder.9 It is not caused by psychiatric factors or by stress but may contribute to or be exacerbated by these conditions. There is a high incidence of familial cases of RLS, suggesting a genetic origin for primary RLS.8 The exact mode of inheritance is unknown.8,10
>
> Secondary causes of restless legs syndrome include iron deficiency, spinal cord and peripheral nerve lesions, pregnancy, uremia and some medications.
>
> Secondary Causes of RLS
> Iron Deficiency. RLS may be associated with iron deficiency. A patient's iron stores may be deficient without significant anemia. Recent studies have shown that decreased iron stores (indicated by serum ferritin levels below 50 ng per mL [50 µg per L] can exacerbate RLS symptoms.11,12 Patients with newly diagnosed RLS or RLS patients with a recent exacerbation of symptoms should have their serum ferritin levels measured.
> for more info
> http://www.aafp.org/afp/20000701/108.html
>
> PaulHi Paul- thanks for your reply! Very interesting indeed! My sister started having increased symptoms after she broke her ankle. Even while on an opioid like hydrocodone,she still had "jumpy legs" (as she described it). I think her doc most likely used the ferritin level to make the diagnosis more sound because he's only a 4th year resident.
Anyway, thanks so much for the info!! I greatly appreciate it!
Jerry
Posted by noa on June 7, 2003, at 14:56:03
In reply to Re: Anyone heard of a blood-test for RLS? » Paulie, posted by jerrympls on June 7, 2003, at 13:14:04
Hmm.. this is interesting. I am assuming that the diagnosis was hypothesized based on clinical presentation--ie symptoms, and the ferritin test results were used to support the hypothesis.
Interesting for me and now I'm going to go take another look at my latest blood work. I remember my iron being fine, but I don't know which way they measured it.
But maybe it is moot as I probably don't have RLS per se but med-related akithisia that mimics RLS.
Posted by jerrympls on June 7, 2003, at 15:45:25
In reply to Re: Anyone heard of a blood-test for RLS?, posted by noa on June 7, 2003, at 14:56:03
> Hmm.. this is interesting. I am assuming that the diagnosis was hypothesized based on clinical presentation--ie symptoms, and the ferritin test results were used to support the hypothesis.
>
> Interesting for me and now I'm going to go take another look at my latest blood work. I remember my iron being fine, but I don't know which way they measured it.
>
> But maybe it is moot as I probably don't have RLS per se but med-related akithisia that mimics RLS.Noa- I agree with your reply (above). as far as using the ferritin as support for the diagnosis. And I also think that I have med-related akithisia that mimics RLS- but now that I think of it, even before I was on any med for depression, I'd have to kick my legs in bed to wear them out every night so I could go to sleep. Interesting.....
Posted by Paulie on June 7, 2003, at 18:20:28
In reply to Re: Anyone heard of a blood-test for RLS? » noa, posted by jerrympls on June 7, 2003, at 15:45:25
Testing for ferritin as a means of DIAGNOSIS for RLS is, in my opinion, unfounded.
For someone with RLS testing for a low ferritin level would seem to make sense. Used to determine cause of symptoms, not to diagnose.Paul
Posted by stjames on June 8, 2003, at 0:01:13
In reply to Anyone heard of a blood-test for RLS?, posted by jerrympls on June 7, 2003, at 3:36:38
> Anyway, for those of you out there who are amateur psychopharmacologists - is this test a TRUE measure??
No, not a "TRUE" measure as this test could indicate several possible conditions.
All people with low indicies on this test
do not have RLS & All people with RLS do not
have low indicies on this test, so this is not a "gold standard" test. Taken in context with other findings and patients presentation this
test would help solidify a Dx of RLS.
Posted by noa on June 8, 2003, at 11:05:05
In reply to Re: Anyone heard of a blood-test for RLS?, posted by stjames on June 8, 2003, at 0:01:13
James wrote:
>Taken in context with other findings and patients presentation this
test would help solidify a Dx of RLS.Yes, this is pretty much how I had conceptualized it, too.
Posted by Simcha on June 8, 2003, at 11:42:10
In reply to Re: Anyone heard of a blood-test for RLS?, posted by noa on June 8, 2003, at 11:05:05
I've had Bruxism and RLS my entire life without knowing that these were things that could be treated. I always thought that my inablility to keep my legs still while at rest was just something that everyone experienced. I never really gave much thought to my Bruxism because it never occured to me that this was a treatable thing. Until...
I started SSRI's and other medicines for my depression. Then the Bruxism got worse. I was biting my tongue and cheeks at night to the point that, last time this happened, it took months for my tongue to heal properly.
These days I take 600mg of Neurontin at night. This alleviates my symptoms completely. Before this I took Klonopin 1mg at night. This worked too. Yet I believe I have a better quality sleep on Neurontin than I did on Klonopin. I also wake in the morning more clear headed.
The current pdoc asked me if I ever had been officially diagnosed with RLS. The truth is, I've never had any tests. All I can do is tell the doctors that at night for most of my life I've been unable to keep my legs still. They seem to think that this is evidence enough. As far as the Bruxism goes I have the ground down back molars and scars on my cheeks to prove it.
I wonder if RLS and Bruxism are related?
Posted by Willow on June 9, 2003, at 9:35:16
In reply to Re: Anyone heard of a blood-test for RLS?, posted by Simcha on June 8, 2003, at 11:42:10
SIMCHA
Nice to see you again. Hope all has been going well for you!!
> I've had Bruxism and RLS my entire life without knowing that these were things that could be treated.
Have you tried anything besides drugs for this with any positive results? My latest is exhaling through my mouth.>it took months for my tongue to heal properly.
I've been trying to think what I do to help speed this process. Guess the only good advice I can give is don't bite it in the first place!! (bad joke) The only thing that comes to mind is mouthwash, but I think this is just a temporary ten second relief.
> These days I take 600mg of Neurontin at night. This alleviates my symptoms completely. Before this I took Klonopin 1mg at night. This worked too. Yet I believe I have a better quality sleep on Neurontin than I did on Klonopin. I also wake in the morning more clear headed.
Goes to show how meds affect us each differently. I could have wrote the above but just reversed the meds. I'm best when I take a combination of baclofen, codeine, and clonazepam. Whenever I try to cut one out I'm either more tired or sore the following day. Mirapex did wonders for my muscle pain and stiffness, but it undid all good the effexor was doing.
>
> The current pdoc asked me if I ever had been officially diagnosed with RLS. The truth is, I've never had any tests. All I can do is tell the doctors that at night for most of my life I've been unable to keep my legs still.
My diagnosis is moderate to severe periodic limb movements, through a sleep study. After the sleep doc talked to me, he also dx rls and explained even though I don't have the urge to move the other muscular sensations can be symptom. My understanding is the rls dx is made through clinical history. And yes my ferritin is low too, which I've was quite disgusted with the doctors that had treated me previously for not discovering this, especially since it should have been tested given my family history of having an iron overload disorder. Which brings the point to mind that people shouldn't take iron supplements without having been dx with low iron.
> I wonder if RLS and Bruxism are related?
I do have both. I think the movements are a caused by the same triggers. With rls and plms the legs are mostly involved, for myself my upper limbs, mouth, shoulders, and neck are just as involved. My fatigue is brought on quite easily and when it affects me during the day, even before I'm aware of it I will get the twitches the same as when I sleep.The best thing I've found for treating the symptoms is not to get overtired and codeine. Ugh, thinking about this is discouraging.
WILLOW
Posted by Willow on June 9, 2003, at 9:49:31
In reply to RLS and Bruxism » Simcha, posted by Willow on June 9, 2003, at 9:35:16
Another thread below on tics mentions twitching eyes and movement disorders. Also, when tired my one eyelid will begin to twitch. I think it's all caused by same cause whatever it may be. Probably body chemistry, which I find hard to say out loud, but this theory of mine means I support research into drugs for such things.
In my youth, when I could still do as I desired I would have been on the bandwagon marked drugs are evil.
This is the end of the thread.
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