Charting for Restless Leg Syndrome

Question

My 17 year old daughter has been dealing with Restless Leg Syndrome (RLS) for many years. She has also been bothered by anxiety attacks recently. One medical doctor put her on Zoloft for the anxiety and sent her to a sleep doctor. The sleep doctor said the Zoloft will make her RLS worse and changed it to Wellbutrin. Her regular doctor wasn’t happy because Wellbutrin is for depression not anxiety and my daughter doesn’t have depression. This was several months ago and my daughter stopped taking everything since nothing worked. I took her to a naturopathic doctor because I thought there was a more natural way to help her. After her first appointment getting to know some things about my daughter and other symptoms, she put her on 100mg of progesterone. She said it should help with her insomnia and possibly her legs.
Should I be concerned that at 17 she is on progesterone? She is not on any form of birth control. I am really at my wit’s end with this and just want to get her some relief.

Julie

Answer

Dear Julie,

RLS can be from a number of causes, such as iron deficiency, diabetes, thyroid or kidney disease, magnesium, folic acid or vitamin B12 deficiency. It is often genetic. Medications that can exacerbate RLS include antihistamines like Benadryl, or SSRI’s like Zoloft. In a young woman, it can be secondary to iron deficiency from heavy menses. So, it would help to have NFP charts to look at her menstrual pattern. Sometimes the RLS is worse in the luteal phase and progesterone may help if timed to her ovulation, which she could identify if using one of the more scientifically advanced methods of NFP. If not timed to her cycle, it may disrupt her normal pattern.

It would be helpful to have some blood work done to see if the ferritin (iron stores) is greater than 50 mg/dl. Looking for the other causes, as mentioned above would also be helpful. In the meantime, trying a supplement of magnesium and Vitamin E may be helpful. There are medications that can help both the anxiety and the RLS, like Clonazepam, though with the potential for addiction, usually other things are tried first.

Like in most disorders, charting the menstrual cycle can be very helpful, and should not be viewed as only for family planning.

Lynn Keenan, MD

Answered By:

Lynn Keenan, MD
Lynn Keenan, MD, Immediate Past President of the CANFP Executive Board, is a Clinical Professor at the UCSF/Fresno Internal Medicine Residency Program (now retired), Board Certified in Sleep and Internal Medicine, and Vice President of the International Institute for Restorative Reproductive Medicine. She earned her BSN at UCLA, her MD at Temple University School of Medicine, and completed her Residency in Internal Medicine at UCSF/Fresno. Dr. Keenan served on the Executive Board of CANFP since 2004, as President of CANFP since 2010, and graciously agreed to continue her service to CANFP on the Advisory Board at the beginning of 2019, upon her retirement from the Executive Board of CANFP

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