Restless Legs Syndrome

Why it works: Folate deficiency is associated with RLS in some populations (especially pregnancy) and correcting deficiency may improve symptoms for those patients, but there’s limited high-qual...

Instructions: Important: there is no universally accepted RLS-specific folate dosing guideline — the standard clinical approach is to test and correct documented folate deficiency (and check vit...

Warnings: Masking vitamin B12 deficiency: High folic acid/folate intake can correct the hematologic abnormalit...

Studies: Meta-analysis & reviews (recent): A PLOS ONE systematic...

Why it works: Vitamin B12 is not an established, first-line proven treatment for Restless Legs Syndrome (RLS/Willis–Ekbom disease) — however, B12 deficiency can produce neurological symptoms (in...

Instructions: Key principle: Test first. If a person with RLS has low or borderline B12 (or has risk factors for deficiency — e.g., older age, vegan diet, gastric surgery, pernicious anemia, lon...

Warnings: B12 is generally safe (water-soluble) and toxicity is rare; there is no established tolerable upper...

Studies: Systematic reviews / meta-analyses:A PLOS ONE meta-analysis...

Why it works: GABAergic and sedative activity. Valerian contains compounds (notably valerenic acid and related constituents) that modulate the GABA system and other sleep-related receptors, prod...

Instructions: Clinical trial (RLS): The clearest RLS trial used 800 mg nightly of valerian root extract (capsules) taken for 8 weeks and compared to placebo in a randomized, triple-blind design...

Warnings: CNS depression / additive sedation: Valerian can cause drowsiness and may add to the sedative effect...

Studies: Randomized controlled trial (small): Cuellar NG, Ratcliffe S...

Why it works: There is biological plausibility and several clinical trials showing passionflower (Passiflora incarnata) can reduce anxiety and help sleep — mechanisms that plausibly reduce Restl...

Instructions: There is no single, universally accepted RLS protocol for passionflower. Below are commonly used, evidence-based dosing forms drawn from clinical trials and herbals references (use...

Warnings: Pregnancy and breastfeeding: Passionflower is possibly unsafe during pregnancy (may stimulate uterin...

Studies: Evidence that exists (relevant but indirect):Randomized tria...

Why it works: L-theanine has plausible neurochemical effects (increasing GABA, modulating glutamate and dopamine, promoting relaxation and better sleep) that make it worth investigating for symp...

Instructions: Because RLS trials don’t exist, these are practical, commonly used instructions based on sleep/anxiety studies and supplement guidance — not prescriptive medical advice.. • Typical...

Warnings: No guarantee of efficacy for RLS. Don’t replace proven RLS medical treatments (iron if deficient, do...

Studies: Below are representative peer-reviewed items and reviews abo...

Why it works: Acupuncture likely helps RLS by modulating neurotransmitters and pain pathways, improving local circulation and sleep, and reducing central nervous-system hyperexcitability. These...

Instructions: What practitioners / trials commonly do (examples from trials and reviews):. • Acupoints commonly used: leg points such as ST36 (Zusanli), SP6 (Sanyinjiao), GB41, BL60, and local p...

Warnings: General acupuncture safety guidance (practical warnings):. • Always use a licensed, trained practiti...

Studies: Cochrane review (2008) — concluded evidence was insufficient...

Why it works: Cellular / physiological rationale: magnesium is a cofactor for hundreds of enzymes, is involved in nerve impulse conduction and muscle relaxation, and helps regulate calcium and p...

Instructions: There are no universally accepted official dosing guidelines for magnesium as an RLS therapy. What follows is what clinical trials/pilot studies actually used (useful if you and yo...

Warnings: Upper limit for magnesium from supplements/medications (adults): the NIH Office of Dietary Supplemen...

Studies: Randomized clinical trial(s)Jadidi A. et al., Therapeutic ef...

Why it works: The leading theory is the iron–dopamine connection: many people with RLS have reduced iron availability in certain brain regions. Brain iron is required for normal dopamine product...

Instructions: a. Test first (always):. • Measure serum ferritin and transferrin saturation (TSAT) before treating. The modern RLS guidelines recommend treating when ferritin ≤ 75 ng/mL or TSAT <...

Warnings: Major warnings (things you must check before giving iron):. • Do not give iron if the patient has he...

Studies: Major randomized trial (IV iron):Earley et al., SLEEP (multi...