Restless Leg Syndrome and IBS

December 4, 2022

Why is it important to get to the ROOT of a problem, rather than simply treat the symptoms?Treating the symptoms is like putting a piece of tape to cover the warning light in your car. While getting to the root is actually fixing your car.

Today we will look at 2 conditions that are:

  • Seemingly unrelated
  • Very common
  • Significant problems
  • Yet often occur together

The critical importance of getting to the root of the problem is why we choose to utilize both Traditional Chinese Medicine and Functional Medicine in our practice.They both focus and specialize in getting to the root cause of illness.

For example, there appears to be a direct correlation between restless leg syndrome (RLS) and irritable bowel syndrome (IBS).What is restless leg syndrome?

RLS is a disorder in which a person experiences uncomfortable and nearly irresistible urges to move their legs (... and drive their partner crazy).

Symptoms typically occur during times of rest or inactivity, particularly in the evening and into the night and may contribute to insomnia.

These bothersome urges are often relieved with movement.

It is estimated that RLS affects approximately 7-10% of the populationWhat Causes RLS?

Researchers have identified the following as possible contributors to the problem:

  • Genetic predisposition
  • Problems with the neurotransmitter dopamine
  • Problems with the metabolism of iron
  • Problems with nervous system motor pathways

Clinical studies are showing that some people who have certain gastrointestinal disorders, including:

  • Celiac disease
  • Crohn's disease
  • IBS

Have a higher rate of Restless Leg Syndrome

Studies estimate that approximately one-fourth to one-third of IBS patients may also have RLS.

One might wander how an irritable bowel disorder could be related to leg movement?

The specific gut issue associated with RLS is a condition called Small Intestine Bacterial Overgrowth (SIBO).

Although SIBO is a new diagnostic criteria in western medicine, it has been effectively treated in over 2000 years with Chinese medicine

The bacteria present in SIBO often over-produce high amounts of methane and hydrogen, leading to significant discomfort and illness.

Why does SIBO cause restless legs?

Chronic inflammation caused by SIBO, or gut dysbiosis [when there's an unhealthy balance of types of gut bacteria] in the colon may release additional hepcidin.

Hepcidin is a hormone that can decrease iron availability in the brain and contribute to RLS and other conditions.  

Low brain iron availability can be a significant contributor for mental/ emotional conditions such as ADHD (Attention Deficit Hyperactivity Disorder)

Findings of a a Stanford research study suggest that treating a person's SIBO may help resolve the brain iron deficiency that contributes to RLS.

Promising Treatment

In one study, 13 IBS patients who tested positive for SIBO using breath testing were treated with the antibiotic rifaximin for a period of 10 days.

Following treatment, according to the study, 10 of these patients experienced "at least 80% improvement" in their RLS symptoms.

At a later follow-up date, half of these patients reported complete relief from their RLS.

While 50% is significant, other studies show that a higher success can be achieved using other methods.

The discovery that the gut barrier plays a key role in immune health fueled the search to strengthen it.

Research has shown that the binding capabilities of IgG (immunoglobulins) have a positive effect on gut barrier function.

IgG helps to maintain a healthy intestinal immune system by binding a broad range of microbes and toxins within the gut lumen. As these unwanted triggers are removed, it resets healthy immune tolerance and builds a stronger barrier to the external environment in the gut.

Colostrum is the "pre-milk" that mammals produce to prime the gut immune system of their babies.It has been collected and used as a supplement for many years to improve barrier function and health.

However Serum-derived bovine immunoglobulins have the highest IgG concentration available for GI and immune challenges where allergens are a significant concern.These serum-derived bovine immunoglobulins have only been available as a supplement for a short period of time.

Probiotics have also been extensively studied and are characterized as having broad GI and immune benefits, including:

  • Increasing the population of healthy bacteria following microflora imbalance.
  • Supporting healthy bowel function.
  • increases the production of short-chain fatty acids, (which provide energy to the cells of the intestinal lining)
  • Strengthening the gut-immune barrier by promoting a healthy gut mucosa.
  • Aiding in the digestion of compounds like lactose and casein.
  • Enhancing detoxification of harmful compounds.

The bacteria, Bacillus coagulans, has been shown to increase the commensal GI microbiota.

  • Supplementation of 1 billion CFU daily for 28 days with B. coagulans significantly increased levels of the commensal microbe F. prausnitzii from baseline compared to placebo, as well as increased Bacillus spp. in fecal samples of adults over 65.
  • Bacillus coagulans has also been shown to relieve GI discomfort and improve stool consistency.
  • Bacillus coagulans given once a day for eight weeks showed reduced daily bowel movements and GI symptoms.
  • B. coagulans also significantly improved bowel movements in healthy adults with occasional constipation, as well as decreased abdominal discomfort.

The bacteria, Bacillus clausii, is commonly used as:

  • A probiotic to promote microbiome balance
  • Has specifically shown promising results in treating SIBO.
  • B. clausii has demonstrated significant effectiveness in adults with acute diarrhea.
  • B. clausii has also been shown to significantly reduce duration of occasional diarrhea and decreased stool frequency in children.

The bacteria, Bacillus subtilis has been shown to:

  • Relieve GI distress in patients.
  • Bacillus subtilis supplementation of 1-3 billion CFU, alongside motility stimulating agents, was shown effective for relief of GI symptoms at four weeks.

When treating SIBO, studies have shown that combining probiotics WITH the binding capabilities of immunoglobulins have a positive effect on gut barrier function in vitro.

All brands of probiotics are not the same. Different gut conditions require different species and amounts of probiotics. Unfortunately many, maybe most, probiotics do not deliver a high enough concentration strain of bacteria to successfully re-populate the gut.

For example, at Alameda Acupuncture we use 6 different types and dosages for various conditions.

This combination of probiotics, IgG, binding and elimination decreases microbe and toxin encounters by the immune system and resets immune tolerance.

Conclusion

There is hope for patients suffering with IBS (SIBO) and RLS.Treatment to eradicate SIBO could in fact be effective in treatment of gut, movement disorders, and numerous mental and emotional conditions and problems.

In addition to pharmaceuticals, herbs and supplements have also been shown to relieve SIBO symptoms. Talk to your acupuncturist/ functional medicine practitioner to find out more.

Compliments from Functional Medicine Universitywww.FunctionalMedicineUniversity.com

Writen by Dr. John Nieters, DAOM, L.Ac, M.Sc. CFMP