Restless legs syndrome (RLS) is classified as a neurological disorder that can affect anyone of any age. It becomes the most severe and painful as a person grows old. Sometimes RLS is referred to as Willis-Ekbom disease or Wittmaack-Ekbom syndrome. Both names come from, among others, one of the first physicians who discovered and identified RLS in 1943, Dr. Karl-Axel Ekbom.

        In order to qualify as RLS, a patient must meet five specific criteria. First, she has to feel a strong urge to move her legs, usually accompanied by an unpleasant sensation of creeping under the skin. Second, the urge to move the leg must increase during periods of prolonged rest or inactivity. Third, the movement of the legs must alleviate at least some of the unpleasant sensations. Fourth, RLS has to happen most often at night. Fifthly, the need to move the legs cannot be explained by any other medical or psychological condition.

     As you can see, RLS is more than an irritation for the patient. It usually leads to trouble sleeping, making the body more prone to disease, irritable moods, and lowered mental function. It is a condition that can impair a patient’s quality of life, causing not only daytime sleepiness and decreased immune function, but also greater stress and overall health decline.

     Despite this long list of conditions that must be met, RLS is unfortunately quite common. This disorder affects approximately ten percent of the world’s population. It can start early in life for unknown reasons, or it can develop later, caused by factors such as poor diet (not enough magnesium or iron), exercise deficiency, and even as a side effect of certain medications.

     Most cases of RLS occur for no apparent reason. It can be genetic when doctors find it in many family members who have symptoms before the age of 40 (such cases are called idiopathic or primary RLS). In other situations, doctors blame inadequate dopamine and glutamate levels in the body. Finally, RLS appears as a symptom of an undiagnosed medical condition such as iron deficiency anemia or kidney failure. In these cases, doctors call the disease secondary RLS, which is just as common in pregnant women and disappears shortly after birth.

        What symptoms do people with RLS experience most? These are: painful muscle spasms in the legs, generally in the calves, a nagging feeling of worms crawling up the legs, tingling, itching, burning or throbbing in the legs, feeling as if the blood vessels in the legs are full of carbonated water, an overwhelming need to move the feet and legs. The effects of these symptoms can be mild or completely unbearable. 80-90% of RLS patients who show these symptoms also suffer from PLMS, i.e. periodic limb movements during sleep.

     Since there is no cure for Restless Legs Syndrome, specialists focus on treating or relieving symptoms. Many prescribed medications have their own unpleasant side effects. Opioids, benzodiazepines, and antiepileptic drugs reduce the feeling of crawling, but they can be dangerous or lose their effects when taken for long periods. Doctors also prescribe dopamine or medications that increase iron levels to induce a feeling of relief in the patient. Fortunately, drugs that eliminate dopamine and glutamate imbalances are quite effective, but some experience troublesome side effects, for example, about 20% of patients develop impulse control disorders.

     New findings recently published in the journal Sleep Medicine indicate that cannabis use has made it easier for people with severe restless leg syndrome (RLS) to improve their condition.

     To start with, research shows that CBD oil acts as a powerful sleep inducer that allows people with chronic pain to get a full sleep. Patients with severely disturbed glutamate levels often complain of a lack of sleep. CBD oil can actually aid glutamate signaling to reduce RLS symptoms. In addition, due to difficulty sleeping, RLS patients may develop other problems such as anxiety, depression, decreased mental functioning, and wear and tear of the body’s immune system. Fortunately, CBD contains natural anxiolytic and antidepressant properties. This cannabinoid can also provide the body with antioxidants that can help improve the immune system.

     CBD oil also affects dopamine by increasing the amount of neurotransmitters in patients’ brains. Stabilizing dopamine levels seems to minimize involuntary movements in people with any movement disorder.

     Since CBD oil can directly affect the body’s nervous system, it can also relieve symptoms of many different neurological disorders, such as RLS, Parkinson’s disease, and more. It does this through the body’s endocannabinoid system. Cannabinoids act like neuronal construction workers, re-paving the main pathways of the brain so that neurons and glial cells can work better together. Rather than simply holding dopamine in the brain as dopamine agonists do, cannabis appears to improve the health of neural networks involved in cognition, emotions, eating, motor control, and more. Better infrastructure leads to better results. Some argue that cannabinoids are better than dopamine agonists.

     One 2017 study found that inhaled medicinal cannabis reduced symptoms of RLS. Five of the six subjects said they experienced complete remission of symptoms after consuming cannabis. After the cannabis treatment was completed, all participants experienced an improvement in sleep. Another study found that Sativex (a cannabis-based sublingual spray that contains CBD and THC, officially adopted as a pharmaceutical drug in most European countries) helped 40-50% of RLS patients with their sleep problems.

    Hemp contains many different chemicals, so it’s not clear which of them benefit from RLS, but CBD is suspected to be a key ingredient in cannabis in RLS. Why? Well, CBD has powerful muscle relaxant and nerve-calming effects that can really ease the discomfort of restless legs. Also, just like iron and magnesium, CBD can be taken orally or topically on the legs.

     So far, there is no clinical research on the therapeutic properties of cannabis in RLS. There is currently one company trying to develop a type of gum that may be able to treat RLS. AXIM Biotechnologies, Inc., a world leader in cannabinoid research and development, recently announced that it had entered into a service contract with the Israeli CRO to begin a clinical trial supporting the concept of combining cannabidiol and gabapentin in chewing gum as a way to treat restless syndrome. legs in patients.

     We’re already familiar with CBD, but what is the other drug in gum? Gabapentin is often used along with other medications to reduce seizures. It can also be valuable in reducing nerve pain when it is a symptom of herpes zoster. In some cases, gabapentin causes drowsiness, dizziness, loss of coordination, fatigue, blurred / double vision, unusual eye movement, tremors, and / or swelling in the hands and feet. AXIM chewing gum uses a combination of CBD and gabapentin and is currently the second phase of this single-center, double-blind, randomized trial in which its effectiveness will be tested in approximately 30 participants with RLS.

     According to Dr. Stuart Titus, president of Medical Marijuana, Inc., a major investor in AXIM Biotechnologies, Inc .: “Research shows that RLS can be associated with abnormalities in the nervous system … We believe that advances in cannabinoid clinical research can be instrumental in helping people to experience symptom relief from difficult and debilitating neurological disorders. ‘

    Like many breakthroughs in cannabis and cannabinoid research, the one about cannabis use for RLS began after doctors noticed that patients were using cannabis and getting results. Maybe the revolution will not finally be about better cannabis-based research. Maybe a new practice of listening to patients and treating them seriously will come into force before our very eyes?


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