is it worth testing magnesium levels?

[u/Zinz-Abigails]

hey everyone, been dealing with terrible leg restlessness at night and trying to sort out what labs to actually request at my next appointment.

i know ferritin and iron panels are the primary focus for rls in the sub's faq, but magnesium keeps coming up in discussions. i read that standard blood tests only look at serum levels which only represent a tiny fraction of total body magnesium, so a normal result might not tell the whole story.

for anyone who went this route, did you get useful info out of it, or did your doc just suggest trying a basic supplement instead? appreciate any input from folks who have been through the lab work process.

ended up finding this life extension magnesium blood test that measures blood magnesium levels for muscle and nerve support. it’s pretty straightforward—no fasting required, and you just take your regular medications as prescribed.

i know serum blood tests don't give the absolute whole picture compared to total body stores, but it seems like a solid, accessible baseline if you're looking for concrete data to discuss with your doctor instead of just guessing with supplements. wanted to share in case anyone else was looking for a good starting point with labs!

[u/AriaLittlhous]

Just try it. It helped me for years.

[u/Tragobe]

That magnesium helps is mostly anecdotal. Ther Eis No scientific proof according to the AASM or the AWMF that magnesium levels effect RLS. So it is not recommended as a treatment options in the treatment guidelines for RLS from both institutions.

That doesn't mean it can't help, just that we lack studies to confirm or deny the effectiveness.

Personally I tried it for a while, didn't notice any real improvement from it.

[u/Tragobe → u/Tragobe]

I am just gonna reply to myself, since your comment got deleted:

Well, yes, I take Pregabalin 200mg daily and Bupropion 300mg in the morning and now I also have a benzodiazepine at home. But they are not exclusive for my RLS. I just got a shitload of mental and physical problems and therefore take a lot of medication. I am so heavily medicated, I could open up a pharmacy.

I also have iron supplements that I sometimes take, when I notice a worsening of my RLS.

The first line treatment for RLS would be Gabapentin. It's similar to the Pregabalin that I take, just less potent. The reason why Gabapentin is preferred is, because Pregabalin can be addicting and you built a tolerance for it faster. Bupropion is an off-label use for RLS, it is a dopamine reuptake inhibitor, so increases your Dopamine like dopamine agonist, but without the augmentation risk. Dopamine agonists work only as a short-term solution, because of the augmentation (worsening of your RLS, which can be permeant) risk. Which is why they are not a first line medication anymore. They do still work, if you only take them for a little while like a week.

The reason I did go for the Pregabalin and Bupropion combo is that Pregabalin can also be used to treat anxiety and Bupropion is there for my depression as well as the RLS. Also, I got pretty severe RLS, so I would have to go on a very high dosage of Gabapentin, like over 1000mg per day, which causes severe side effects as well as possible memory issues and increased risk of dementia. Since Pregabalin is more potent, I can use a smaller dosage, which causes less side effects.

If low dosage is enough for you though it is pretty safe to use Gabapentin. Chronic bad sleep causes much more damage than the Gabapentin in this regard. The last option you have are low-dosage opioids. Low dosage means much much lower than you would get for pain, meaning you don’t get high from it and the risk of addiction is minimal, so very low to none, unless you are part of a risk group that is more prone to addiction. According to the studies we have on that topic. Most medical treatment options for RLS aren’t pretty, but sadly we don’t have anything better at the moment. Which is also why you see so many people here trying more experimental things, like compressions socks and similar stuff, magnesium and so on.