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Restless Leg Syndrome could be due to Celiac Disease

I wrote an article a while ago about the connection between gluten and sleep disturbance, including restless leg syndrome. A new study published this month in the medical journal Sleep Medicine confirms the connection between restless leg syndrome and celiac disease.

What is restless leg syndrome?

Here is an explanation from the RLS Foundation:

“Restless legs syndrome (RLS) is a neurological condition that is characterized by the irresistible urge to move the legs. While the name may sound funny, it is a very real disorder. In order for you to be officially diagnosed with RLS, you must meet the criteria described in the four bullets below:

RLS can also cause difficulty in falling or staying asleep which can be one of the chief complaints of the syndrome. A substantial number of people who have RLS also have periodic limb movements of sleep (PLMS). These are jerks that occur every 20 to 30 seconds on and off throughout the night. This can cause partial awakenings that disrupt sleep. Sleep deprivation can seriously impact your work, relationships, and health.”

What is the connection between restless leg syndrome and celiac disease?

Celiac disease can cause iron deficiency, and iron deficiency can cause restless leg syndrome.

In the journal study, people with restless leg syndrome had iron deficiency caused by celiac disease. There were only 4 cases in the study but all 4 reported that the symptoms of restless leg syndrome improved on a gluten-free diet. Many people with restless leg syndrome are given medication to treat it, but it is clear that gluten could be the cause and that celiac testing and a gluten-free diet should be the first course of action.

Here is the abstract of the study:

Celiac disease as a possible cause for low serum ferritin in patients with restless legs syndrome


To describe celiac disease (CD) as a possible cause for low serum ferritin in patients with restless legs syndrome (RLS).


Low iron stores have been found to be a risk factor for RLS with serum ferritin levels less than 45–50 ng/mL associated with increased severity of RLS. It has become routine clinical practice to test serum ferritin in the initial assessment of RLS. CD is a common genetic disorder that can cause iron deficiency.


Consecutive case series of four patients with RLS and serum ferritin below 25 ng/mL, who had positive screening tests for celiac disease.


We report four patients who had serum ferritin <12 ng/mL and positive screening tests for CD. All had CD 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.


In patients with RLS and low serum ferritin who do not have an obvious cause for iron deficiency, we suggest looking for CD by simple, inexpensive serologic testing. Diagnosis and treatment of CD is likely to improve the outcome for RLS, as well as identify individuals who are at risk for the significant long-term complications of CD.

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