RLS from low iron in celiac disease responds to a gluten-free diet
Low iron levels have been associated with increased severity of restless leg syndrome. The following medical case report discusses four patients with low iron and restless leg syndrome who were tested positive for celiac disease and placed on a gluten free diet. All four had improvement on the gluten free diet.
“Celiac disease as a Possible Cause for Low Serum Ferritin in Patients with Restless Legs Syndrome.”
Manchanda S, Davies CR, Picchietti D.
University of Illinois at Urbana-Champaign, College of Medicine, 506 S. Mathews Avenue, Suite 190, Urbana, IL 61801, USA.
OBJECTIVE: To describe celiac disease as a possible cause for low serum ferritin in patients with restless legs syndrome (RLS). BACKGROUND: Low iron stores have been found to be a risk factor for RLS with serum ferritin levels less than 45-50ng/mL associated with increased severity of RLS. It has become routine clinical practice to test serum ferritin in the initial assessment of RLS. Celiac disease is a common genetic disorder that can cause iron deficiency.
METHODS: Consecutive case series of four patients with RLS and serum ferritin below 25ng/mL, who had positive screening tests for celiac disease. RESULTS: We report four patients who had serum ferritin <12ng/mL and positive screening tests for celiac disease. All had celiac disease confirmed by duodenal biopsy and response to a gluten-free diet. RLS symptoms improved in all four, with two able to discontinue RLS medication and two responding without medication.
CONCLUSIONS: In patients with RLS and low serum ferritin who do not have an obvious cause for iron deficiency, we suggest looking for celiac disease by simple, inexpensive serologic testing. Diagnosis and treatment of celiac disease is likely to improve the outcome for RLS, as well as identify individuals who are at risk for the significant long-term complications of celiac disease.
Source: Sleep Med. 2009 Jan 10. [Epub ahead of print]