 |  | Translated by Marta Campbell |
 |
14.04.2026 08:00 Uhr |
Patients with RLS can also be recognised by their inability to describe the typical abnormal sensations in their legs precisely. The language seems to lack the appropriate words. If, on the other hand, people describe pain, then it is generally not RLS, according to Brandt. Polyneuropathy can resemble RLS in its symptoms and must diagnostically be ruled out.
How is RLS treated? Whilst many GPs are aware that iron deficiency can play a decisive role in the aetiology, what may be new is that cerebral iron metabolism is of particular importance. The expert explained: ‘The availability of iron in the brain is crucial for dopamine synthesis’. Therefore, one of the first steps for the doctor is to assess iron metabolism. To do this, they measure ferritin, transferrin, transferrin saturation and iron. According to Brandt, a ferritin level below 75 micrograms per litre and a transferrin saturation below 20 per cent indicate a relative iron deficiency. These values should be above these levels whenever possible.
In cases of mild RLS and relative iron deficiency, iron is administered orally, specifically 80 to 100 mg of iron plus 100 mg of vitamin C twice daily over a period of twelve weeks. In cases of severe RLS or intolerance to oral administration, patients are usually given whilst in hospital either a single 1000 mg dose of ferrocarboxylmaltose intravenously or two 500 mg doses. A check-up is carried out after twelve weeks.
Anaemia does not always manifest itself; an iron deficiency may nevertheless be present and is particularly significant in the case of RLS. In this so-called functional iron deficiency in the central nervous system, iron, being a key factor for adequate dopamine synthesis, is lacking precisely there. Important: Treatment with iron for RLS should not be undertaken on one’s own initiative, but always based on a medical diagnosis.
If the iron metabolism is normal, doctors use dopamine agonists such as pramipexole, ropinirole or rotigotine as the first-line treatment. Off-label, gabapentinoids are used, namely gabapentin and pregabalin. The second-line treatment is oxycodone/naloxone.
| German | English |
|---|---|
| Aufwachreaktion | arousal reaction |
| Beine | legs |
| Beinbewegung | leg movement |
| Bewegungsdrang | urge to move |
| Depressionen | depression |
| Dopaminsynthese | dopamine synthesis |
| Eisen | iron |
| Eisenmangel | iron deficiency |
| Eisenstoffwechsel | iron metabolism |
| Familienanamnese | family history |
| Missempfindungen | abnormal sensations |
| Niereninsuffizienz | renal insufficiency |
| Polyneuropathie | polyneuropathy |
| Schlaflabor | sleep laboratory |
| Schlaflosigkeit | insomnia |
| Schmerzen | pain |
| Schwangerschaft | pregnancy |
| Unruhe | restlessness |
| Zentrales Nervensystem | central nervous system |
| Zirkadianer Rhythmus | circadian rhythm |
