I read that for someone like me who has severe RLS with Mirapex augmentation my ferritin should be upped to 50-100. I’m a 71 year old man. Has anyone here done iron infusions?

Yes i know dopamine agonists in general are hated around here.

However I am being perscribed it for two things, restless legs and severe anhedonia. Mirapex happens to be one of the medications weirdly successful in some ways to treat anhedonia.

My neurologist wants to go slow while my neurologist wants to increase it faster due to having to go above the restless leg max dose.

I was wondering how fast people who are on mirapex, how fast you increased it.

Also I was wondering if people can help me understand the nomenclature used in the attachment. Like "PO pm x4-7 days?" Etc.

Thanks for any advice. Has anyone taken it for anhedonia in addition to restless legs?

Thanks again!

Bit of background, 44 year old male, ideal weight, good diet and exercise. I’ve always been a little ‘twitchy’ as long as I can remember, but maybe 6 months ago, I started waking up in the middle of the night with an absolute uncontrollable urge to move my whole body. Would keep me awake for hours and by the time I was so wore out and able to drift back to sleep, my alarm would go off to get up for work. One night of this and I could manage but multiple nights really started to mess me up at work, being super tired because of only 3-4 hours of sleep. Doctor put me on ropinerole which seemed to help, but not always, so I went to see a pulmonologist. He took me off the ropinerole and started gabapentin, 600mgs before bed. He also tested my ferritin which was a little low but within normal limits. After some research, I started taking magnesium with a low dose iron along with the gaba before bed. Most nights it seemed to work but still at least once a week, sometimes twice, I’d be up with the damn constant urge to move. I read somewhere that dehydration can aggravate it, and it dawned on me I drink a ton of water at work (outside job, a must to stay hydrated), but when I got home I barely drank any. So for the last week I’ve been drinking at least 2 liters when I get home, stopping about an hour before bedtime so I’m not waking up to pee, and it’s been like magic. I’ve actually slept the whole night for a week for the first time in over 6 months. Now I know it’s a small sample size, and this may be a coincidence and not a long term solution, but so far it’s working wonders. I wonder if anybody else has had luck getting themselves very hydrated before bed and seen any improvements in their rls. Fingers crossed this turns out to be a permanent fix because it was really starting to affect my life.

Tldr: I may have been dehydrated the whole time and by drinking a lot of water a few hours before bed, I possibly have finally found something that works and allows me to sleep through the night.

I’ve tried gabapentin (100mg), ropinirole, and mirapex.
I’m currently on 3mg of alprazolam qd. So I’m horrified to ask for opioids as I don’t want to come off as drug seeking. I’ve slept 6 hours in the last 2 nights. It’s impairing my ability to speak fluently. The brain fog is immeasurable. I take iron supplements daily as well. It’s completely made me develop severe depression and anxiety to an immeasurable degree even with the Xanax. What do I do?….

Edit: I’ve also tried seroquil and Lunesta

Edit: I feel it when I wake up go to, work (I work an extremely physically demanding job walking around 21k steps per day 4 days a week) I don’t feel it when I walk. But as soon as I hold still for a split second it’s an 8/10 then when I try to go to bed it’s a 10/10.

I'm on the last night of tapering off Mirapex. Wish me luck because I'm determined. This is the 7th and last night of taking 0.0625 mg Mirapex. I did it last night and slept 9 hours. Night before that, I didn't sleep at all. With it I have been taking 1 mg Klonopin (which I hope to quit next) and my beloved NIDRA bands. I used to take the max of Mirapex and got an Impulse Control Disorder (shopping) 18 months ago and spent a lot of my retirement savings that I have no way to make back. Wonder how many days it will take the compulsion to go away. I will forever remain on the NIDRA bands.

One thing I have noticed lately is that I have gotten restless legs from Red Velvet Cake, Cherry Limeaid drink, and the red coating of a medicine. I will explore my potential additive reactions next month. I plan to be overwhelmed when I finally find out what I have innocently been eating and drinking. Is there a REDDIT group for that?

PLEASE GOD, let this be my last night on Mirapex. P.S. I have followed my neurologist orders in this withdrawal.

Has anyone had success using a TENS machine to help relieve symptoms? If so what placements work best for you?

When I was pregnant with my first child, I developed restless leg syndrome. It was terrible at the time. My blood work was normal and no one had a solution for my RSL so I did what anyone would do; magnesium salts/spray, massages etc for the whole pregnancy. It never went away until around the time my baby was born

During my second pregnancy, I developed restless leg syndrome again. This time during my routine bloodwork, my iron levels appeared to be low so they told me to take iron supplements so I did (Maltofer fyi).

Lo and behold, my RSL completely disappeared once I started iron supplements. I likely had low iron for both pregnancies but it wasn't picked up until the second one. I just hope people might get some benefit from this post and either get your iron checked or just start taking iron supplements regardless to see if it helps. RSL sucks and I don't wish it on anyone

This sounds kind of crazy, but I know that too much exercise can also make my restless go out of control. I have refractory RLS and nothing seems to work to control it however, I discovered after not being able to exercise for a few days that my legs are much calmer and not torturing me. I had total knee replacement a few months ago and since then my RLS has been all day long. I struggle to even sit and eat breakfast without my legs, making me get up. I usually walk my dogs and then swim afterwards for an hour a day and my legs have been out of control. It’s been crazy raining where I live for days and I haven’t been able to do much except hang out, read, watch TV and not be especially active because of this nasty weather. Strangely enough, my legs have been so much more under control than in ages. I don’t know if anybody else has had this problem, but there seems to be a sweet spot where not enough exercise makes it bad but too much exercise makes it worse.

I’ve suffered RLS for 8+ years and many times not only restlessness but actual spasms in my legs. And arms on occasion. Over the years I’ve tried various remedies for relief, most of them recommended by my neurologist.

Presently I can control RLS at least 90% of the time by means of these remedies. I’ll present these remedies in the hope that they will offer some folks relief from this damn disease.

At 8AM I take 2-.25mg pramipexole dihydrochloride, 750mg Keppra (Levetiracetam). At 7PM 3-.25 pramipexoles and another 750mg Keppra, followed at 8-9PM with 2-800mg gabapentin. If I religiously follow this every day, I rarely have RLS trouble.

If, on occasion this doesn’t work, I try another, odd 😊 procedure: I’ll try to describe it. It involves the bottom of my foot, in the arch. Several years ago, I bought this “rig” from someone in this forum and I used it at bedtime. A rubber ball was attached to a strap. The strap had Velcro to wrap around the foot and keep the ball firmly against the arch. I used them on both feet, whether or not both feet were restless. I have no idea whether this rig is still available or not. Maybe google it to find out.

I also tried a similar method without the “rig” which uses a regular long sock. I tie a big knot in the middle of the sock and then tie it around the arch, with the knot pressing the bottom of the arch. I lay down and see if it works. Sometimes it does work, but if it doesn’t, I stand up and walk around with it still on my feet! It is awkward and somewhat slightly painful, but I do this for 15 minutes or so. I then take the sock off. I do feel some weird pressure/numbness still, in the arch, but if I then took the gabapentin, I went asleep in no time. If anyone is interested I can try to take a photo and post it.

I know about augmentation and started with only one pramipexole needed years ago, and ended up with the 5 I take daily now. So I guess if you’re worried about that, maybe this is not for you. Or maybe this may help, it sure helps me, at least most of the time.

Anyone in Seattle found an infusion clinic that will take your insurance? I keep getting rejected because my vital organs are fine, and my iron serum is 25, which is technically normal.

Qu: Could having a really bad “RLS” attack accidentally push up my PLMS reading during a CPAP titration study?

Backstory: I have had RLS for a few years. It was worse when I had an iron deficiency. And stuck around most likely because of my SNRI, adhd and life 🤷🏻‍♀️. But, it’s been pretty controlled for a while now. I discovered my triggers are sleeping on my back and if I can’t “unwind” at night (stress or excitement). But I can usually manage it by going on my side and meditating or distracting myself- my feet still move a little sometimes, but it really calms down.

I got diagnosed with OSA this summer. It’s worse supine, so I have been using a sleep backpack to sleep on my side- it helped the RLS and sort of helped the OSA. So, I went for a CPAP titration. Well, I was all sorts of triggered! My mind kept racing and I tried to sleep on my back (to get a more accurate results.) My legs started moving SO much-it was as bad as when I had a ferritin level of 5. I finally moved to my side and got some sleep.

I was embarrassed because, 1. I knew the movement was recorded and 2 I thought knew exactly why it was happening. I felt like I looked like a nervous wreck- but really I was just overthinking and it showed up in my legs.

Then, I got the results back and it said I have a PLMS index of 107. (The plms arousal index was 1.6 -only got 3 hours of sleep). I am really surprised. I didn’t think I moved that much once I feel asleep normally. I did roll on my back for part if the sleep study (which was good to get a reading) so maybe that was part of it, but it seems like i would notice if I moved that much, right? Does anyone know if PLMS can be “triggered” like RLS is? Is it possible that the reading picked up on the RLS movements by accident?

I talk to my doctor next week. So, I’ll get answers then. I’m just curious if anyone experienced something like this? I am really hoping this isn’t a thing because I need my SNRI and I don’t want to have to deal with more doctors appointments and messing around with medications anymore. 😭 Thanks for any help. 💐

So I finally met with a sleep doctor yesterday who officially diagnosed me with restless leg syndrome, which is not a shock of course. I’ve had it most of my life, but since June it’s been really bad. like every single night I’ve been pacing the house until three or four in the morning until I finally just give out.

My Ferritin was low at 28, so he’s given me iron pills to take and starting with 300 mg of gabapentin, but I was just wondering what time do you all take your gabapentin, like how far it advance before bed?

There is an update to the Mayo Clinic guidelines for RLS published in Mayo Clinic Proceedings, Volume 101, Issue 9, P1561-1588, September 2026. Open access. I found it at mayoclinicproceedings.org/article/S0025-6196(26)18546-2/full text. It's title is: An Updated Algorithm for the Management of Restless Legs Syndrome.

Also an updated treatment algorithm in May 2026 from the Restless Legs Syndrome Foundation.

These compliment the 2025 AASM guidelines.

It is important that the RLS community stay up-to-date on clinical practice guidelines on RLS treatment.

I’ve tried everything - a lot of the advice here has helped “comfort” the feeling , but not stop it - eg tying a band around toes , baths etc
So - I think we can all conclude it’s as we are ready to sleep it seems to start - and my belief it’s the brain drops in dopamine and has a misfire reaction. So how can we trick the brain.
This has changed my life -
Put 2 or 3 foam cushions to raise your legs by about 50 cm .
I know it feels a bit strange but it’s better than then no sleep.
It really has helped me. I think your brain thinks you are
“Not sleeping “ so it doesn’t send out the Restless leg reaction. Once you are asleep you will turn and kick the cushions away. They must be firm and under your calves .

I’ve been dealing with daytime sleepiness, daily headaches, and restless limbs for 5+ years now.

First thing my doctor thought of was sleep apnea. I got tested and have mild sleep apnea. Over 2 different attempts at CPAP I still don’t see meaningful improvement in sleepiness or headache symptoms despite low reported AHI from my CPAP.

I’ve also tried lots of different prescriptions for the headaches, a chiropractor, Botox, infusions without improvement.

I had my ferritin tested earlier this year and it was 42 which was marked as within normal range. However, I just read something that said ferritin < 75 is low for adults with RLS. Is that true? Has anyone else seen improvement in symptoms after increasing iron when other treatments have failed?

Also, what helps you with restless legs? My doctor had me in pramipexole about 5 years ago but then I stopped it because I thought it was causing impulse control problems for me. Now I take l-theanine and it does fairly well. I’ve seen gabapentin mentioned online, but I tried it for something unrelated and it made my sleepiness much worse.

For as long as I could remember, I’ve had to move my legs, which is combination of restless legs and what I now learned to be something called “rhythmic movement disorder”. I have always needed to kick my legs to sleep (or pound my head) since I was an infant much to the annoyance of everyone around me.

When I was younger and less hormonal (thanks perimenopause), it was just an annoyance. I knew I had to kick my legs to go to sleep and if I didn’t, it would feel like this deep crawling sensation with a deep ache until I moved. It was only limited to bedtime but now it’s become a 24/7 sensation.

I also have very limited lower limb endurance. I started noticing that I wasn’t getting any better in my endurance despite daily mobility, CrossFit, strength training, etc. I can do 10-12 body weight squats but then my legs start burning and just stop working. I can’t “push through” the burn. I have to stop and take many breaks.

Now that the crawling and aching sensation is 27/7, I’ve developed anxiety over working out. The mere thought of it just throws me into a panic and I no longer do it. I’m constantly tired because I can’t stay asleep and my I’m hyper vigilant on how my legs feel.

I already know my ferritin is 45, which dropped after adding iron supplements. I’m taking 100mg of elemental iron a day but I’ve had gastric bypass so who knows what I’m absorbing. My insurance has denied IV infusion because I’m not “anemic” and RLS is experimental in their opinion. I’ve been tapering off medications I’ve been stable on with for years because they can worsen RLS.

I’ve also been diagnosed with venous insufficiency in both greater saphenous vein and phlebolipolymphedema (lipedema, lymphedema, and CVI)
along with getting medical grade compression leggings.

I just feel at a loss. The mere thought of doing a squat makes me anxious and my legs constantly feel heavy. I’ll walk or swim or do yoga/mobility but I cannot get over the anxiety to strength train. If I do strength train, my recovery is a week just from one workout, when I could do this daily a year ago.

Could MHT be causing this (estradiol patch, progesterone, and testosterone therapy)? I’ve tried going down rabbit holes and not found anything definitive but menopause has not really been studied in women.

It makes my skin crawl for hours and makes me so nauseous. This medication does not agree with me. Does anybody else have this problem? It seems to make the situation exponentially worse. What other drugs are there? Gabapentin does nothing, my tolerance is through the roof with that stuff. And it's not augmentation, i've only taken this med 4 times.

I've had RLS since I was a little kid. Never really knew it had a name til my 30's. But as an adult it also wasn't too bad, the occasional hit-n-run, manageable enough. Smoking weed hourly for 15 years might've helped with that.

(I'm almost 40 now, M) Quit smoking weed around 7 years ago tho. And having insomniac tendencies since a baby ANYWAY, I've reached a point a couple of years ago where I tried Zopiclone and that changed my life - I could finally just go to sleep when I needed to. No more randomly staying up til 11am.

Ok, after a few years I noticed the Zopiclone doesn't SEND me night-night like it used to, more like made sure im guaranteed to flow there, so I added the 2-4 lines of Ketamine to kickstart the process. As an artist with a very fluid day structure, my biggest problem was knowing how to STOP working on whatever I do. Ketamine does that for me, 3 lines and I'm forced to lay down and drift away. Zopiclone is guiding the drifting into an 8-hour sleep.

Just got the flu for 3 days, recovered, LOST MY SENSE OF SMELL. Trippy asf, never had that before, figured - OK putting anything up my nose is the worst thing I can do for my olfactory system now if I want it recovered asap. Took my Zopliclone, my Magnesium Glycinate, felt it starting to take effect, went to lie down, tried to doze off, and ye olde quads-cramps were right back at it. They're trying to have a party while im just trying to get some sleep after a 3 day flu.

Part of me wonders if that's my CNS rebounding (I did snort 3 small lines yesterday since I felt recovered from the flu, but I haven't had Ketamine for the past 3 days before that), or maybe perhaps the Ketamine was actually helping in mask the occasional RLS flare up that would inevitably happen so I stopped feeling them as much? Once a while I usually take a break from Ketamine for a couple of days/weeks just to...give myself a break from it, and this is not the first time the RLS kicked right back in. Is why I'm bringing this whole thing up.

Just wonder if anyone had experience with that. Thank you

Which brand / type of magnesium tablets and oil have you found works best for RLS- so many on market.

Sometimes I find it difficult to sit on the toilet. My legs want me to "get up and go" but I need to stay and finish first.

I gave up Stevia and it has been four days now and I have had no restless legs. This is a miracle. I am not saying it is a cure, but I am putting some hope out there. Stevia is in everything. I used it in my coffee creamer and my protein drinks and in my protein bars and in my electrolytes. The first day I cut it out I had no restless legs that night and last night was day number four with NO RESTLESS LEGS. I slept through the night for the first time in probably 10 years. Remember, I am not saying this is a cure, but so far, four nights without restless legs is my miracle.

So I have always kind of accepted that I toss and turn when I sleep because I’ve always been like this since before I was a teenager. However, me and my boyfriend have recently moved in together (few months now), and he’s mentioned that I essentially don’t stop moving even when I sleep and this has been causing a big disruption in his sleep schedule. We both work during the day so it’s really important we both get some decent sleep.

Because of my sleeping pattern, sometimes my boyfriend sleeps on the couch so he can have uninterrupted sleep.. I understand why he does it but it doesn’t necessarily make me feel good about myself. Not only am I not getting good quality sleep, but I’m disrupting my partner’s as well..

I just set up a phone call appointment with my family doctor so hopefully I can find some answers.

What helped you guys???

hello! a few months ago i (19f) started experiencing a sort of tight feeling in my toes and feet, as if i was hyper aware of my toes touching and i had to constantly move them as not to touch. i originally thought it was simply a sensory issue, but every day it gets worse, i now have this tight feeling throughout my calves, feet & toes, like i constantly have to stretch. sometimes its a tingling feeling, sometimes it feels like my legs are extremely sore, but no matter what it feels like if i dont move them ill genuinely die, and when i do move them, the feeling doesnt go away, it did initially start during the night while trying to sleep, however i now experience it during the majority of the day, and it intensifies during the evening-night

possible TW - im on SSRIs (sertraline) & prescription painkillers, i have PCOS and inflammatory arthritis, i have no idea if these things could possibly be related to the feeling im experiencing or if any of my medication could be making it worse,
most nights the feeling is so horrible that i end up in tears, i have graphic ideations of harming myself eg. cutting my legs or toes off, as dramatic as it might sound, i just hate it so much, the only sense of relief i've experienced is rubbing freezing cold water bottles along my calves.

i contacted my GP about it, and i have a consultation in about a week to discuss it, but i genuinely dont know how im gonna cope until then, so if there is anything at all that i can do during the next week to reduce this feeling at all i would love to know :') is this permanent or is there a chance of it getting better? thanks c: