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CBD and Restless Leg Syndrome

Posted on August 5th, 2020

Modern medicine has come a long way, but we still don’t have cures for many common conditions. Instead, suffering individuals can only hope to manage their symptoms. And, more often than not, symptom management involves taking medications that simply alleviate pain and inflammation. While these do help, they may also trigger adverse effects. So, if you can find a more natural alternative, it could be quite beneficial. One extremely challenging, untreatable condition is restless leg syndrome; it affects about 10% of the American population. Thankfully, new evidence suggests that CBD may help offer some relief to those suffering from restless leg syndromes. So, today, we’ll closely explore what we know about restless leg syndrome and CBD, to help you decide your best course of action.

What Is Restless Leg Syndrome?

This condition is also known as the Willis-Ekbom disease; it can affect anyone, male or female, regardless of age. When you have restless leg, you experience an uncontrollable urge to move your legs. The urge comes because of feelings of discomfort. For most people, this urge strikes in the evening or at night, when your legs are rested. Moving helps ease the unpleasant sensation. Sometimes, the urge isn’t limited to your legs: this condition can hit your arms, chest, or head as well. While some report the sensation may happen to only one side of the body, it more commonly affects both sides . Some also find that the sensation will alternate between sides.

While it can affect any age, elderly individuals are most likely to suffer from restless leg syndrome. Medical experts consider it a sleep disorder since attacks often strike when you rest. However, symptoms might also occur during extended periods of inactivity. If you don’t seek medical intervention, your symptoms may get worse. Eventually, you may be unable to get a full night’s sleep or function properly during the day.

Part of what makes this condition so frustrating is that symptoms seem to appear randomly. They also widely vary, ranging from mild discomfort to almost unbearable pain. Some describe the sensation as throbbing, aching, or even itching. Once you’ve been diagnosed with restless leg syndrome, you should seek interventions to prevent symptom progression.

Now, doctors still don’t know this condition’s specific cause. But studies suggest that it could be linked to your genes: over 50% of people who suffer from this condition have a family member with the same symptoms. Other potential causes include:

  • Chronic diseases such as iron deficiency, kidney failure, and renal disease
  • Antipsychotic, antidepressant, and nausea medications
  • Pregnancy, especially in your last trimester
  • Other sleep disorders
  • Spinal cord conditions

While restless leg syndrome won’t threaten your actual life, it can certainly derail your quality of life. It has been known to cause exhaustion that affects performance at work or at school due to the inability to concentrate and change in mood. Currently, doctors recommend managing your condition with lifestyle changes such as healthy eating and exercise, coupled with targeted symptom relief.

CBD for Restless Leg Syndrome

Cannabidiol (CBD) is a compound found in the cannabis plant with many potentially beneficial properties. It can produce positive changes in your body because of how it interacts with your endocannabinoid system. This system is made of a series of receptors, scattered throughout your body, that work to maintain internal balance. While your body produces its own endocannabinoids, it also interacts with phytocannabinoids, like CBD, that naturally occur in cannabis plants.

Before we dive into how CBD can address restless leg syndrome symptoms, let’s clarify some basic CBD principles. You can extract CBD from any cannabis plant, but legal CBD is derived from industrial hemp plants, which have low THC and high CBD concentrations (marijuana plants contain the opposite mix).

Why is this an important distinction? Cannabis plants also contain another cannabinoid, called THC, which is the cannabinoid that’s associated with the psychoactive effects of marijuana and responsible for getting you “high”. And recreational THC use is still illegal in most of the United States. CBD oil, on the other hand, is legal. So long as it has a chemical makeup that’s less than 0.3% of THC. In fact, CBD was not made legal until the 2018 Farm Act which aimed to remove industrial hemp from the controlled substance list. This also brings about the important topic of verifying CBD suppliers. Not every supplier properly vets their products which could become problematic if their product is not sourced from the correct plants or contains a higher level of THC than allowed.

So just remember: when we’re talking about using CBD to address restless leg symptoms, we’re only talking about hemp-derived extracts. If you use marijuana-derived CBD, you’ll have to worry about issues of legality, as well as psychoactive side effects.

How Does CBD Work in the Body?

As we briefly mentioned earlier, your endocannabinoid system is a highly sophisticated internal system charged with regulating many physiological processes. We still have lots to learn about its workings, but we know it can affect your learning, mood, memory, pain, sleep, neurological health, appetite, digestion, inflammation, and stress, among others.

The endocannabinoid system consists of a wide variety of receptors, classified as CB1 or CB2s. They are spread throughout your body and work closely with enzymes that synthesize and degrade cannabinoids in order to trigger responses meant to preserve balance in your body (homeostasis).

When you are stressed, in a bad mood, or simply hurting, your endocannabinoid system moves to restore homeostasis. This process is not always successful, however, which is where cannabinoids may come in handy, helping stimulate your endocannabinoid system to work as hard as it needs to in order to achieve homeostasis.

Origins of Restless Leg Syndrome

Current evidence suggests that restless leg syndrome is tied to the way your brain functions. This is why there is no exact diagnosis procedure. All doctors can do is try to assess your trigger conditions, in order to rule out any condition other than restless leg syndrome.

CBD may be very effective at targeting restless leg syndrome since it stimulates your own endocannabinoid system to restore balance. But, aside from that, CBD may effectively target specific restless leg symptoms. In some cases, doctors prescribed opioids and anti-seizure medications to treat restless leg syndrome. And, today, we know that CBD has anti-seizure properties: that’s why the FDA approved Epidiolex, a CBD-based medication that treats certain forms of pediatric epilepsy.

Additionally, many CBD users report improved sleep. So, in combination, CBD’s restful properties and seizure-fighting abilities may prove effective at managing the symptoms of restless leg syndrome.

How to Use CBD for Restless Leg Syndrome

The increase in popularity over recent years has provided many options in the CBD market. Delivery methods vary from oral options, like an oil or tincture, which offers fast effects, to CBD capsules, which make it very easy to measure your exact dose and offer maximum convenience. But another CBD delivery method, topical cannabidiol, may be best for restless leg sufferers.

Why is that the case? Topical CBD offers targeted effects. So if you experience discomfort in one spot on your leg, applying a CBD salve or lotion right on that spot could alleviate your urge to move and provide the desired relief.

What Is the Right CBD Dosage for Restless Leg Syndrome?

Just as it is with any supplement, proper dosing is crucial. Since CBD can affect various bodily functions, you should talk to your doctor before adding this cannabinoid to your routine. Once you’ve got the medical go-ahead, we always suggest beginning with a low dose of CBD. This will let you see how your body reacts to the cannabinoids.

Your doctor can help you determine what a low dose means for you, and from there, you can gradually increase your intake until you achieve the desired relief. Keep in mind, people with severe symptoms will typically need to take a higher dosage than someone with mild symptoms.

If you’re suffering from restless leg syndrome, ask your doctor whether Tanasi’s full-spectrum CBD oil products could help you manage your symptoms. We also invite you to contact us with any questions about delivery methods or dosing, so you can get the most out of your CBD experience!

Restless leg syndrome affects about 10% of the American population and new evidence suggests that CBD may help offer some relief.

Dr Ginevra Liptan

By Ginevra Liptan, MD
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The throbbing, pulling or creeping sensations of Restless Legs Syndrome (RLS) can be miserable—and affect at least one third of all women with fibromyalgia. These uncomfortable feelings and urge to move the legs are often triggered by trying to relax or sleep, making it hard to fall and stay asleep. And it is not just the legs, some people experience the restless sensations in their arms or over their whole body! Since sleep is already a huge issue in fibromyalgia, it is really important to be look for and treat any condition that is making sleep worse.

If you answer yes to any of these questions, you may have Restless Legs Syndrome:
o Do you often get a strong urge to move your legs to relieve unpleasant sensations?
o Are the symptoms worse when you’re sitting still or lying down and resting?
o Do you get temporary relief from moving your legs or walking?
o Do the symptoms start or get worse in the evening or at night?

There are definitely medications that can help ease these symptoms, but many of them have significant side effects. Some very effective natural treatments for Restless Legs Syndrome to consider are iron, magnesium and cannabidiol (CBD).

Iron for Restless Legs
We know that restless legs is caused by low levels of the brain chemical dopamine, and many of the prescription treatments for RLS act to increase dopamine levels. Iron is a key player in the production of dopamine, so low iron levels in the brain may lead to low dopamine levels and restless legs symptoms. There has long been a suspected connection between low iron levels and RLS, and people with iron deficiency anemia often experience restless legs symptoms. However people with normal iron blood levels can still experience RLS, and it appears that it is the level of iron that reaches your brain that matters, not the amount floating in your bloodstream. One of my patients with severe RLS and normal blood iron levels had her symptoms eliminated after a series of intravenous (IV) iron infusions, which is the most effective way to get iron into the brain. One study found that IV iron infusions showed significant improvement of RLS symptoms in 76% of the subjects without any major side effects.

For patients with RLS I aim to get their ferritin levels (a blood test for iron) around 70 to maximize how much iron is getting into their brain. Typically any ferritin above 10 is considered “normal”, but if you have RLS it is worth a try to get your ferritin levels up into “optimal” range and see if symptoms improve. In my clinical experience, the results can be pretty dramatic, but be sure to talk with your health care provider before starting iron supplementation as your levels will need to be monitored to ensure they don’t get too high as that can be harmful. You want to find the amount of iron supplementation that keeps your ferritin around that optimal level of 70.

Some forms of iron can be hard on the stomach and cause nausea and constipation. I have found iron bisglycinate to be the best tolerated, my favorite is Opti-feren C by Pure Encapsulations. To optimize iron intake make sure to take it away coffee, tea, and calcium supplements as these can interfere with iron absorption. I often recommend taking any iron with dinner as most of us are not drinking coffee with dinner!

An alternative approach for those that don’t tolerate or absorb oral iron is to apply it transdermally. Yes, we can absorb some iron through our skin! Compounding pharmacies can make a prescription iron cream, although a few of my patients found it discolored their skin. For topical iron I prefer the PatchMD Iron Plus Topical Patch as it is less messy, cheaper, and has no skin discoloration issues.

In addition to getting ferritin levels up to optimal range, for those with severe RLS I will often add some specific nutrients that increase the ability of the body to utilize iron, like the active forms of B-6, B-12, and folate, found in MethylGuard by Thorne Research. For this purpose I have patients just add one capsule of MethylGuard per day.

Magnesium for Restless Legs
Magnesium is another beneficial mineral that can help RLS. Clinically I see this all the time and this study found it was effective for mild to moderate symptoms. Magnesium promotes muscle relaxation and soothes irritable nerve endings. The best form of magnesium for this purpose is magnesium glycinate 240mg to 480mg at bedtime. Magnesium glycinate is the type least likely to cause loose stool, one common and undesirable side effect of magnesium supplementation. Just like iron, we can absorb magnesium through our skin, so you can also apply magnesium oils and lotions directly to your legs. Remember that magnesium is a salt, so some oils can be irritating to the skin. My goal with Frida Botanicals magnesium cream was to make a potent cream that was still gentle and moisturizing. Some of my patients have found that a combination of oral and topical magnesium is the ticket to ease their restless legs symptoms while limiting the laxative effect.

Cannabidiol (CBD) for Restless Legs
Many patients have reported that cannabis (marijuana) eases their restless leg symptoms. This small study found 6 patients reported complete remission of their RLS with cannabis. Cannabis contains lots of different chemicals, so it is unclear which are specifically giving benefit for RLS, but CBD (cannabidiol), is suspected to be the key component of cannabis for RLS. In fact an Israeli company is currently studying CBD as a treatment for Restless Legs Syndrome.

CBD has strong muscle relaxant and nerve calming effects which can really ease the discomfort of restless legs. And just like iron and magnesium, CBD can be taken orally or applied topically to the legs. I have seen patients get improvement from CBD applied topically or a CBD tincture under the tongue before bed. And unlike cannabis, CBD does not have any psychoactive or mind-altering effects and if it is derived from hemp it is legal and accessible in all 50 states. If you want to learn more about CBD safety, effectiveness and dosing check out my other blogs here and here and my videos below.

The throbbing, pulling or creeping sensations of Restless Legs Syndrome (RLS) can be miserable—and affect at least one third of all women with fibromyalgia. Learn how iron, magnesium and CBD can help.