What You Need to Know

Iron deficiency without anemia has been associated with increased fatigue, depression, cognitive impairment, decreased work capacity and restless legs syndrome (RLS). Prior to diagnosis, an RLS healthcare provider may check a patient's iron (ferritin) levels to see if they have low iron.

"Keeping iron levels mid-range (75mcg/L and above) correlates to RLS symptom improvement," RLS Foundation Executive Director Karla Dzienkowski, RN, BSN, said. "Every individual with RLS needs to know their ferritin level, as it is a key component in the management of RLS symptoms."

Iron is essential for all living cells in the body. It works with the oxygen in your body to produce energy for your cells. When an individual has low iron stores, the amount of iron going into the bone marrow increases. When someone is severely iron deficient, as much as 99 percent of the body's iron will go directly into bone marrow, effectively starving other organs, including the brain, of iron.

There are a number of ways for someone with RLS to ensure that they keep their iron stores up. Eating meat, fish and liver provide the most absorbable form of iron for the body. While leafy green vegetables also contain iron, it is not always broken down adequately by the human digestive tract. Thus, the same amount of iron in a vegetable may not deliver the same amount of iron as in meat or liver.

Additionally, many RLS sufferers turn to supplementation to assist with their iron intake. Iron pills should not be taken with food, milk, antacids, calcium supplements or medications used to treat acid reflux, as they drastically reduce iron's absorption into the body. Some individuals increase this absorption by taking their iron pills with either Vitamin C or orange juice. It is essential for someone with RLS to consult with their physician before taking any supplements or altering their current RLS treatment plan, as this helps ensure the proper monitoring of iron levels, as well as looking out for the development of iron overload known as hemochromatosis.

In severe cases, some individuals with RLS use intravenous iron infusions. Currently, there are five different formulations of IV iron available for use:

• iron dextran
• iron sucrose
• iron gluconate
• ferumoxytol
• ferric carboxymaltose

It is important to note that the low molecular iron formulations present a low risk for allergic reaction, and therefore IV iron usually only considered if iron pills fail to improve iron stores.

The Foundation has a number of publications available in the Member Portal that cover iron and RLS, including our brand new Medical Bulletin. Not a member but need information? Send us an email at info@rls.org and we'll get you what you need!