The most commonly associated medical condition with RLS is iron deficiency so a doctor or healthcare professional will check the ferritin (an iron storage protein) levels in the blood. If there is a deficiency (levels should be at least 50mcg for those with RLS), an iron supplement should be taken. For some people increasing the ferritin levels will eliminate or reduce the RLS symptoms.
A neurological examination will also establish whether inflammation of the nerves in the legs is causing the movement and uncomfortable sensations.
In some cases the patient may be observed in a sleep laboratory.
Some Parkinson's medications can make RLS worse so any Parkinson’s drugs the patient is taking should also be considered when planning treatment. For example, some people who take levodopa complain that RLS symptoms occur during the day, as well as evenings, and may also involve the arms. Moreover, the symptoms worsen late in the night as the medication wears off. It is therefore often preferable to use dopamine agonists (a Parkinson's medication that works by increasing the level the low of dopamine that is thought to be the main cause of RLS) instead of levodopa when treating Parkinson’s and RLS.
However, if dopamine agonists are already being taken to manage Parkinson's and RLS symptoms are still present, then other medications can also be useful such as carbamazepine, gabapentin, strong painkillers, and benzondiazepines (however, these medicines do not have a license to treat RLS in the UK, but some specialists may recommend using them if other treatments have proved unsuccessful) – speak to your doctor or specialist. In severe cases, an apomorphine infusion can be given at specialist centres during the night.
