Dr Bernadette offers health advice for people with restless legs

Q. I am a woman in my early 40s and recently I have had an uncomfortable feeling in my legs, particularly when I go to bed. I have to keep moving my legs and my sleep pattern is affected. 

I am a woman in my early 40s and recently I have had an uncomfortable feeling in my legs, particularly when I go to bed. I have to keep moving my legs and my sleep pattern is affected. I’ve read about a condition associated with restless legs, could this be what I am suffering from?

A. Restless legs syndrome (RLS) is a condition where because of unpleasant feeling in your legs (feet, calves, and thighs) you have an urge move them. Some people may experience this in their arms. The feeling has been described variously as a crawling or creeping sensation, though some people experience pain or tingling. The symptoms tend to occur when you are resting become more pronounced in the evening or at night, as you have experienced, this typically happens in bed. This can lead to difficulties in trying to get to sleep and interfere with sleep. The severity and frequency of the symptoms varies — it can be some evenings/nights or every evening/night. It is estimated that one in 10 people will experience RLS at some point in their lives with women affected more than men.

In most cases there is no obvious reason for RLS. However, in some cases there may be an underlying cause such as iron deficiency, anaemia or diabetes. There may also be a link between RLS and some prescribed medications.

I would advise you to make an appointment with your GP. He/she can examine you, discuss your symptoms and family history, and may arrange blood tests to rule out any underlying conditions.

Some people find that massaging their legs helps to ease RLS and lifestyle changes may help ease symptoms. While you are waiting for your appointment, here are some general suggestions:

* Avoid drinking caffeine and alcohol in the evening;

* If you smoke, stop;

* Exercise daily;

* Lose weight;

* Have a regular sleeping pattern. Go to bed at the same time every night; take time to wind down by having a hot bath and reading.

I am sure your GP will be able to reassure you. It would be helpful to him/her if you have a note of how long this has been happening and the frequency. You should also bring a list of any medications you may be taking, both prescribed and over the counter.

Q. My 19-year-old daughter has recently moved out to share a flat but comes home most weekends. She told me last weekend that she has had a couple of mouth ulcers for the last few weeks. I suspect she is not eating properly and wonder if this could be a vitamin deficiency?

A. Mouth ulcers can be very painful and are a common condition, occurring normally in 20% of the population. This must be distressing for your daughter as they can be painful. The ulcers will usually go away without any treatment in 10-14 days. For some people, mouthwashes, lozenges, or gels can ease the pain. Aphthous mouth ulcers are the most common and can be either minor or major. Minor aphthous ulcers are less than 10mm across, not usually painful and can be swollen and red. They usually heal withinseven to 10 days without leaving a scar. Major aphthous ulcers tend to be larger (10mm or greater), last from two weeks to several months, and can be very painful. They take longer to heal and may leave a scar. Women are affected more than men.

The cause of mouth ulcers is unknown but it is possible they may be related to other factors such as:

* An injury, possibly from a toothbrush;

* Stress or anxiety;

* Rarely, a food allergy may be the cause.

It is also possible that the mouth ulcers could be caused by a lack of iron or vitamins such as B12 and folic acid. Vitamin B12 is needed to make new cells in the body, including red blood cells. This vitamin is found in meat, fish, eggs, and milk and a balanced diet should contain enough of the vitamin. Some foods are fortified with vitamin B12 and you could encourage your daughter to look for breakfast cereals and breads that include the vitamin. It might be a good idea to talk to her in general about making time to cook and eat healthily.

As your daughter has had the mouth ulcers for a few weeks, I would advise that she makes an appointment with her GP. He/she can examine and establish a reason for the mouth ulcers and determine if any investigation is needed. I am sure that he/she will be able to reassure your daughter.


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