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Restless Legs is a Warning Sign - Not a Sleep Problem (Do this to fix it) — Transcript

by Thomas DeLauer · 2,891 words · 421 segments · language en · Watch on YouTube

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0:00restless legs. The crawling, the
0:02twitching urge to move your legs shows
0:04up as soon as you lie down or usually a
0:06couple hours into it. Turns out it's not
0:08really a sleep problem. It's your legs
0:10reporting an issue with supply,
0:12reporting an issue with actually
0:14receiving what they need. You see,
0:16restless leg syndrome gets treated like
0:18this quirk that you manage with maybe
0:20stretching or a little magnesium or a
0:22sleep aid, but the sensation is actually
0:25coming from three things that your body
0:27is struggling with at the exact same
0:28time. It comes from an iron delivery
0:30problem. It comes from oxygenation of
0:33tissue. And it actually comes from blood
0:35sugar control. Yet, everyone just says
0:37it's magnesium or it's a sleep issue.
0:39Every single one of these things that I
0:40mentioned is measurable years before it
0:43turns into an actual problem. So, if
0:44you've had your iron checked for this
0:46and it came back normal, that normal
0:48result is the problem. And I'll explain
0:50why. Because it's not just about getting
0:52some blood work done and seeing that
0:54you're low or high iron. And maybe a
0:55doctor's told you that it's a dopamine
0:57issue. Like they tell you that you
0:58twitch, you move at night because you
1:00have a dopamine hit that's kind of like
1:02trying to hit at night. They'll tell you
1:04that it's about scrolling on the phone.
1:06Stay with me because the whole brain
1:07thing is really important here. Okay, we
1:09do need to actually pay attention to
1:11that. So, in this video, I'm going to
1:12explain why your brain can be short of
1:15iron and why that affects your restless
1:18leg. Then, I'm going to show you what
1:20the tissue in your legs is actually
1:22doing during an episode of restless
1:24legs. Researchers have actually measured
1:25oxygen through the skin of patients legs
1:28while they sat still and it showed them
1:30a lot about restless leg syndrome. Then
1:32thirdly, I'll come back to the whole
1:34dopamine thing. I want to show you why
1:36they saw in studies that certain
1:38dopamine compounds actually improves
1:41restless legs and some of them made it
1:43worse. It just teaches us a lot. And
1:45then fourth, I'll cover the blood sugar
1:46piece and why restless legs shows up in
1:49a lot of times people with diabetes.
1:50Before we get into the restless leg
1:52science, we also need to understand some
1:54of the mineral piece. A lot of restless
1:56legs can be a signal thing. Calcium, it
1:58can be magnesium, it can be sodium. It's
2:00a firing thing, a dopamine thing, a
2:02brain thing. I put a link down below for
2:04the electrolytes that I use. Our body is
2:06an electrical system. I can't say that
2:08it's going to solve restless legs.
2:10That's not the point. The point is that
2:11we do need to pay attention to our
2:13body's electrical system. And if you're
2:14sweating or if you're depleted or you're
2:16stressed, electrolytes can be out of
2:18whack. element is very cool because it's
2:20focused on sodium first, then potassium,
2:22then magnesium. So, it's helping with
2:24sending those signals and hydrating the
2:26tissue the way that it should be
2:27hydrated so that our brain can actually
2:28send the messages. It's a unique
2:30approach to dealing with some of these
2:31metabolic issues. It's a unique approach
2:33to even dealing with sleep. It's helped
2:34me immensely. So, this is my personal
2:36anecdote that paying attention to my
2:38electrolytes, paying attention to my
2:39minerals was the best thing that I could
2:41have done for my sleep, but also how I
2:42feel in the morning. So that link down
2:44below gets you a free sample variety
2:46pack of element electrolytes with any
2:48purchase. So they have these cans that
2:49have 500 milligrams of sodium. Then they
2:51have their larger cans that have a
2:52thousand. They have their stick packs.
2:54They have one that has a little
2:55caffeine. Their tea, their lemon iced
2:57tea, lemonade iced tea. It tastes like
2:58an Arnold Palmer. These guys are rolling
3:00out so many cool new flavors and
3:02products. It makes hydration and
3:03electrolytes actually fun and
3:05entertaining. So I put that link down
3:06below for Element. You can go to
3:08drinklnt.com/toomas
3:11to check them out and see if that's
3:12something that can help you out. a lot
3:13with how you feel in the morning. So now
3:14let's get into the science. I want to
3:16start with the brain when we talk about
3:17restless legs first. So in the region of
3:19the brain that's most involved in
3:20restless legs. We have iron and feritin
3:22which is the protein that your body
3:23stores iron in and they were both
3:25reduced while the machinery that
3:27transports iron was turned up. So that
3:29is like the structural signature of a
3:32region asking for iron but not getting
3:34it. Transporters are turned up but
3:35actual iron was low. So it all comes
3:37down to delivery. People that had
3:39restless legs had bad iron delivery in
3:41the brain. Iron has to be carried across
3:43the bloodb brain barrier by transport
3:45proteins and that handoff seems to be
3:47the bottleneck. Your body has the iron,
3:49so eating more iron is not going to help
3:50you. Getting it across the barrier is
3:52what's failing and triggering restless
3:54legs. So, you need a bigger surplus
3:56outside the barrier to push a normal
3:58amount across it. That's why the fluid
4:00around the brain can actually be low in
4:02feritin while a standard blood panel
4:04calls your iron levels fine. Like, you
4:06didn't think I was going to go to iron
4:07on this, right? When it comes to
4:08restless legs, a big part of it is iron.
4:10And iron isn't just like a raw material
4:12that the brain uses for random things.
4:14It sits inside the electron transport
4:16chain, which is the assembly line that
4:18every single cell in your body, in your
4:19brain, uses to turn oxygen into usable
4:22energy. So, a brain that is short of
4:24iron. It's short of what it needs to
4:27build the neurotransmitters and to
4:28produce energy at the same time. So,
4:30restless legs has very little to do with
4:31your legs. It has a lot to do with
4:33signaling and stuff that's happening in
4:34your brain. If you've got the symptoms
4:36of restless leg and your doctor's
4:37checked all your blood panel and says,
4:39"Well, your iron's fine." You can't take
4:40that as the allclear. You need to ask
4:42yourself like where you could be losing
4:44iron in the first place because if
4:45something is draining it, taking more
4:47iron isn't going to fix the issue. And
4:49we're going to talk about the
4:50neurotransmitters here in just a second.
4:52But first, I want to pivot over to the
4:53legs for a minute because obviously
4:55restless legs deals with the legs. It
4:57was just important that we talked about
4:58the brain for a minute first. There was
4:59a study in neurology that took 15
5:01patients with restless legs and 14
5:03people without restless leg syndrome.
5:05They ran a suggested immobilization test
5:07where they completely sit still and the
5:09stillness itself brings on the symptoms.
5:11So they also did this while measuring
5:13oxygen pressure through the skin at the
5:15legs and the chest. So they basically
5:17had them sit still to trigger their
5:18restless legs and they measured their
5:19oxygen like what was happening in the
5:21tissues. During immobilization, oxygen
5:23pressure in the patient's legs dropped
5:26to 5.54 kilopascals. That's against 7.19
5:30in the controls. So basically they had
5:32like a 20% more than a 20% drop in their
5:34overall oxygenation, their oxygen
5:37pressure and the chest readings barely
5:39moved. So what we see here is that there
5:41is less oxygen getting to the legs but
5:44not to other parts of the body. That's
5:46starting to make some sense. When
5:47patients took specific dopamine
5:49medications, the leg oxygen came back up
5:52and the discomfort actually eased too.
5:54So they basically gave these compounds
5:56to balance dopamine, which we'll talk a
5:57little bit more about in a minute, and
5:58it sort of like fixed the issue. So
6:00again, we're finding iron in the brain,
6:02energy in the brain, dopamine in the
6:04brain, all having to do with that
6:06crawling feeling, which is truly
6:08appearing to come from tissue that is
6:10actually short of oxygen and not just
6:12from a little misfire in the brain. And
6:14because iron sits inside the electron
6:16transport chain, if you short the iron
6:18and the cell can't use efficiently, then
6:20that's going to be a problem. So, even
6:22though this is a relatively small study,
6:23it shows us a lot of what's going on.
6:25Let's look at what it says about the
6:27urge to move, right? Because movement
6:29drives blood flow. Blood flow raises
6:31tissue oxygen and the relief is
6:33immediate when you're moving and comes
6:35back within minutes of stopping. So,
6:36it's like you feel like you need to
6:38move. Well, yeah, because you're picking
6:39up on the fact that you need oxygenation
6:41to the legs. So, when the urge hits in
6:43the evening, yeah, you should move
6:45because it's literally telling you to
6:47get oxygen to the legs. It's just a pain
6:49in the butt when you're actually
6:50sleeping cuz you don't want to get up
6:52and walk in the middle of the night. So,
6:53the whole idea is like you're actually
6:55just pushing oxygen back into the
6:56tissue. It's not a need to fidget. It's
6:58a need to get oxygen there. So, don't
7:00fight it. There was a review that put
7:02the iron and dopamine evidence side by
7:04side. And in brain tissue from people
7:07with restless legs, tyrrosine
7:09hydroxilase, which is the enzyme that
7:11sets the speed of dopamine production,
7:13was running really high. Okay? And I'll
7:15explain what that means in a second. At
7:16the same time, the density of dopamine
7:19D2 receptors was reduced. So what that
7:21means in human terms is that more
7:23dopamine is being made and the receiving
7:25end has turned itself down to cope. So
7:28restless legs is not a dopamine
7:31shortage. Dopamine falls to its lowest
7:33point at night. So if the receptors have
7:35already downregulated to handle high
7:37daytime output, that normal nighttime
7:40dip lands on a brain with no reserve
7:43left, which is why the symptoms hit so
7:45hard in the evening because it's when
7:47your dopamine is already low and then
7:49you have less receptors for it. So then
7:51you have a serious dopamine issue where
7:53you feel the need to move, right? It
7:55also explains like the biggest problem
7:56in restless legs treatment which is
7:58augmentation. So a lot of times they'll
8:00prescribe these like dopamine agonist
8:02drugs. So dopamine agonist drugs work at
8:04first, but then over months the symptoms
8:06tend to creep back and they creep
8:08earlier into the day and they'll get
8:09more intense and sometimes it'll even
8:11spread to the arm. So you feel the need
8:12to move the arm. If you push more
8:14dopamine into a brain that's already
8:16overproducing and the receptors
8:18downregulate further. See what's going
8:20on here? So tyrrosine gets recommended
8:22online a lot because it's the amino acid
8:24that your body builds dopamine from. But
8:26the enzyme that converts it is already
8:29running hard. Now, a lot of times people
8:31will see tyrrosine as a decent
8:33supplement. They'll see, you know, see
8:34it online talked about. It's the amino
8:36acid that your body builds dopamine
8:37from, but the enzyme that converts it is
8:40already like running pretty hot. So, it
8:42doesn't hurt to take tyrrosine, but
8:43taking tyrrosine in combination with
8:45these dopamine compounds, these dopamine
8:48drugs that are prescribed for restless
8:49legs can be a little bit of an issue.
8:51So, here's a little bit of a quick win
8:52on this. Skip the tyrroscine unless you
8:54want to spend the money on it. Okay? And
8:55if you're offered a dopamine agonist,
8:57ask specifically about augmentation and
9:00about non-dopamine options first.
9:02Because if you start adding more
9:04dopamine agonists, like more dopamine to
9:07the system, it absolutely can make it
9:09worse. But if the brain is making more
9:11dopamine than it needs, it's
9:12compensating for something. So this is
9:14where we get to like the root issue.
9:16Blood sugar turns out to be a very big
9:18part of this. So if we look at the blood
9:20sugar connection here, there is a
9:21poolled analysis in e-clinical medicine
9:23looked at 42 observational studies with
9:25over 800,000 participants total.
9:27Restless legs showed up in 25% of people
9:30with diabetes against roughly 5 to 10%
9:32in the general population. So it's close
9:34to double the odds. Insulin resistance
9:36and high glucose damage the small blood
9:38vessels and they damage the peripheral
9:40nerves. Okay. So then what ends up
9:41happening is you have a chronic
9:43inflammatory response that raises this
9:45thing called hepetin which is the
9:47hormone that locks iron away in storage
9:49and it blocks absorption from the gut.
9:51So a blood sugar problem ends up feeding
9:54straight to the brain iron problem that
9:56I talked about earlier in this video.
9:57Now again it's observational data but
9:59it's very powerful. Either way if you've
10:01got restless legs there's a decent
10:02chance that your iron, your oxygen
10:04delivery and your blood sugar are all
10:05being pushed at the same time. And the
10:08person that should be paying the most
10:09attention is the one with restless legs
10:11and no diagnosed metabolic problem
10:12because all that shows up on a blood
10:14test before it ever turns into a
10:16diagnosis. So it's like if you are
10:17dealing with metabolic issues, you don't
10:19realize it. Sometimes restless legs is
10:22actually a very early sign for you and
10:24it could actually help you because it's
10:26something that could be potentially
10:27easier to fix. So if you get restless
10:28legs and nobody's ever talked to you
10:30about blood sugar issues, check it
10:32because this could be the issue. Or do
10:34some of the things I talk about on this
10:35channel to modulate blood sugar right
10:37now. If you go to the doctor and you get
10:38some blood work done, ask specifically
10:40for ferotin and transferin saturation,
10:42not just a regular CBC. A normal
10:44hemoglobin tells you nothing about the
10:46iron problem behind restless legs. Okay,
10:48here's what the feritin number tells
10:50you. There's a meta analysis from Baylor
10:52University. Okay, they pulled 12
10:53randomized control trials at 500 people.
10:55In this case, they were comparing iron
10:57supplementation against placebo and they
10:58found that iron produced a statistically
11:00significant improvement in restless leg
11:02syndrome. In fact, intravenous iron was
11:04the strongest performer. And then oral
11:06iron was also potentially effective in
11:08people who had like pretty low like
11:10maybe 75 micrograms per liter feritin.
11:12But that 75 number is very important
11:14because the standard lab cut off for
11:16iron deficiency is around 30. So your
11:18test flagged nothing because you came in
11:21nowhere near 30 and yet you can sit well
11:24above 30 and still at or below 75, right
11:27inside the range where treating iron
11:29relieves restless legs. Essentially, a
11:31little extra iron from some red meat or
11:33something like that could actually help
11:34you. A normal feritin result can
11:36absolutely still be too low for your
11:38brain and the dopamine signaling. Now,
11:39we need to look at a few things, right,
11:40with iron timing. In one of the poolled
11:43introvenous iron trials, there was no
11:44significant benefit at 4 weeks, but a
11:47clear one at 12. So, first off, you have
11:49to give any iron intervention a couple
11:51of months before deciding if it works or
11:52not. I recommend going the food route
11:54first. absolutely increase your hem iron
11:57with a little bit of red meat intake,
11:58maybe a little bit of liver, things like
12:00that. Iron supplements might only help
12:01you if you're truly low. And even then,
12:04there's a lot of different nuance with
12:06iron. So, I don't recommend people just
12:07go take a bunch of iron supplements. I
12:09would much rather you take in some
12:10tyrrosine, manage your blood sugar, and
12:12eat more actual iron. The bottom line is
12:14that if you've been answering restless
12:16leg issues with more sleep aids, you
12:18actually can be counteracting the whole
12:20thing, okay? Because you're just messing
12:21with dopamine even more in many cases.
12:23We need to be able to get the iron to
12:25the brain so the dopamine signals can
12:27work properly so that oxygenation can
12:29get to the legs. And if glucose is out
12:31of whack, that's going to be something
12:32that messes you up. So, it's one of
12:34those things where if we just simply
12:35reduce the carbohydrate intake at night
12:36a little bit, so we don't have this
12:38blood sugar issue, we might stop having
12:40the restless leg issues. And also things
12:42like scrolling, things that are causing
12:43dopamine spikes that are making the
12:45crashes even worse at night absolutely
12:47can be part of this. Okay, restless legs
12:48are only part of the problem. We need to
12:50look at the whole picture. I did a video
12:51talks about glycine. This could be
12:53something that's really powerful that
12:54helps people sleep through the night
12:55because it does have a calming and
12:56cooling effect on the extremities which
12:58can definitely impact restless legs. So,
13:00I popped the link for that video.

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