As an Internist practicing for 35 years I have seen most common and many very uncommon illnesses. Little research is available, but there is some evidence that CBD may help treat restless legs syndrome (RLS). Here’s what to know before using CBD for RLS. Restless legs syndrome (RLS) is a chronic sensorimotor disorder characterized by an urge to move the legs. This urge is often accompanied by pain or other uncomfortable and unpleasant sensations, it either occurs or worsens during rest, particularly in the evening and/or at night, and temporarily im …
RESTLESS LEGS SYNDROME AND CANNABIDIOL (CBD)
As an Internist practicing for 35 years I have seen most common and many very uncommon illnesses.
Restless Legs Syndrome (RLS) is real and there are millions of Americans who suffer from some form of RLS.
RLS is characterized by leg discomfort or pain that is only partially relieved by moving ones legs; hence the restless legs.
RLS is an illness often difficult to treat with traditional allopathic meds, so I was interested in seeing what happening when I began seeing patients with RLS in my cannabis medicine practice.
Well, now I have seen five patients with RLS. Three of the patients have had nearly complete cessation of their symptoms and the the two had marked improvement.
The dose seems to be fine taken just before sleep. In the unlikely situation that the patient awakens in the AM and has any troublesome psycho activity, they can simply take 4-6 mg CBD sublingually and will be much clearer very soon.
It is critical to remember, as I have written in many, many blogs, hemp based CBD has minimal effects.Hemp works very poorly because it is missing most of the other cannabinoids, terpenes and flavonoids. It is never just a “one molecule deal”. It is the entourage effect of all of natures medicine working together, not just CBD. Always look for whole plant CBD, not hemp
Allan Frankel, MD Dr Allan Frankel is one of the few physicians in the US who truly understands Cannabis as a medicine. All treatments suggested have been well studied. Every patient seen by Dr Frankel is given a personally created Treatment Plan created with the patient’s specific issues defined. Plant medicine requires “tuning” of the dosing. Dr Frankel works with his patients thru a messaging portal. The use of this portal, allows quick and simple follow up contact with Dr Frankel. Patients are not charged for these messages, as this is how Dr Frankel has learned what he has learned. Follow up appointments in person or by phone/video are also available when needed
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Can CBD Help With Restless Legs Syndrome?
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Restless legs syndrome (RLS) causes unpleasant sensations in the legs, along with an overwhelming urge to move them.
Symptoms tend to be strongest in the evening, when you’re least active. They can also flare up when you lie down in bed. RLS can make it difficult to get a good night’s sleep, which can become a serious quality-of-life issue.
Some anecdotal evidence suggests that cannabidiol (CBD) may help ease symptoms of RLS. However, there haven’t been many studies focusing on CBD for RLS.
This article will cover the research, potential benefits, and side effects of using CBD for RLS, along with information about dosage and the types of CBD products that are available.
Atsushi Yamada / Taxi Japan / Getty Images
What Is CBD?
CBD is a cannabinoid, a naturally occurring compound found in the cannabis plant.
It’s not the same as medical marijuana. Marijuana contains a significant amount of another cannabinoid called tetrahydrocannabinol (THC). THC is the substance that produces psychoactive effects that make you feel “high.”
CBD is extracted from hemp. The difference between marijuana and hemp is the amount of THC. Hemp contains less than 0.3% THC, which isn’t enough to get you high.
THC vs. CBD
Cannabis is a plant of the Cannabaceae family. Cannabis products come from its leaves, stems, seeds, and flowering tops. Cannabis contains more than 120 naturally occurring substances called cannabinoids. THC and CBD are two of the main cannabinoids. THC is the substance that produces a high. CBD is a nonintoxicating substance that may have therapeutic effects.
Research Around CBD and RLS
There hasn’t been much research to assess the effectiveness of CBD in the treatment of RLS.
It does appear, however, that some people are using it for that purpose. In a small 2021 survey based primarily in the United Kingdom, more than 42% of respondents said they used CBD to improve sleep or for insomnia, while another 5% reported using CBD for RLS.
A small 2019 study on the efficacy of smoking cannabis for RLS suggests that regular use of cannabis may reduce symptoms of RLS. A notable limitation is that study participants smoked cannabis containing THC. It’s possible that results are distorted by THC’s psychoactive and antianxiety properties.
More large-scale studies on CBD and RLS are needed.
Types of CBD Products
The three main types of CBD products are:
- CBD isolate: This type is also called “pure CBD” because all other cannabinoids have been removed.
- Broad spectrum: This type contains three or more other cannabinoids. It may have terpenes and flavonoids, which provide aromas, flavors, and colors. It does not contain THC. : Also known as “whole flower CBD,” it’s almost the same as broad spectrum. However, it can contain up to 0.3% THC.
These products are available in many forms, including:
- Oral tablets and capsules
- Chewables and gummies
- Tinctures, oils, and extracts
- Patches, creams, and lotions
What to Look for in CBD Products for RLS
Once you decide on the type of CBD product, it’s important to look for a reputable source.
According to the Food and Drug Administration (FDA), some CBD products are marketed with unproven medical claims and are of unknown quality. The agency hasn’t approved any nonprescription CBD products.
CBD products sold in dispensaries must have a label that lists exactly how much CBD it contains. It should also state whether it contains THC.
If you don’t have access to a dispensary, another good option is a trusted pharmacy. You can also buy CBD products online, but be careful about the source. One study of online CBD products found that:
- 31% were accurately labeled.
- 43% had more CBD than labeled.
- 26% had less CBD than labeled.
No matter where you get CBD, always ask for a certificate of analysis (COA). This document provides information such as:
- The date of the report, so you know it’s recent
- The name of the third-party lab that performed the testing, along with its license number
- The potency of a variety of cannabinoids, including CBD and THC
- Whether the product passed safety tests for contaminants
Things to avoid:
- Illegally sold synthetic CBD products, including those marketed as “bath salts” or “spice,” which can cause a psychotic reaction in some people
- CBD added to food or labeled as a dietary supplement, which is illegal
- Products that claim to prevent or cure a health condition
- Products that list only “total cannabinoids” rather than breaking them down separately
- Products without a COA
CBD Dosage for RLS
The FDA has approved prescription CBD products for the treatment of certain seizure disorders. The agency hasn’t granted approval for any other use. And because research on CBD for RLS is limited, there’s no standardized dose.
It’s best to start with a low dose and build up slowly, if needed. Discuss dosing with a healthcare provider or pharmacist and ask about possible interactions with any medicines or supplements you take.
Benefits of CBD for RLS
People from all walks of life are using CBD for specific health conditions, including RLS and sleep problems. Many say CBD helps in the absence of conventional medicine alternatives and with few troublesome side effects.
Since research specific to CBD for RLS is scarce, the benefits are unclear. If you try CBD for RLS, it may be helpful to keep a journal of the CBD product, dose, and your response. Over time, this may clarify whether it’s beneficial for you.
Side Effects of CBD for RLS
CBD is a naturally derived product, but natural products can cause side effects. Side effects of CBD can include:
- Decreased appetite
- Upset stomach
Due to limited controlled studies, there’s not enough information to properly assess risks such as:
- Cumulative effects
- Food interactions
- Effects on older populations, children, and adolescents
- Effects during pregnancy or while breastfeeding
- Interactions with common medications
There may be an increased risk of liver damage in people who take medicines that affect the liver. There may be interactions between CBD and immunosuppressive drugs used for organ transplants, as well as with chemotherapy or Coumadin or Jantoven (warfarin).
Other Treatment Options
There’s no cure for RLS, though it’s possible to minimize symptoms and improve sleep. You may not need treatment if your symptoms are mild.
- Avoid or cut back on alcohol and tobacco.
- Set up a regular sleep schedule, going to bed at the same time each night and getting up at the same time each morning.
- Perform leg-stretching exercises and massage your legs as needed.
- Take a warm bath before bed.
- Apply an ice pack or heating pad to your legs.
- Try a compression foot wrap or a pad that delivers vibration to the back of your legs.
Medications to treat RLS include drugs that affect dopamine levels, such as:
- Requip (ropinirole)
- Mirapex (pramipexole)
- Neupro (rotigotine)
Sometimes, anti-seizure drugs can help with symptoms of RLS. These include:
or gabapentin enacarbil
If those medications don’t work, opioids may be an option. These may include:
Benzodiazepines such as clonazepam and lorazepam may help improve sleep.
Each of these drugs can produce serious side effects. It’s important to discuss the potential benefits and side effects with your healthcare provider.
Is Medical Marijuana Effective for RLS?
Research on the use of medical marijuana for RLS is limited. There are reports of total remission, suggesting that more scientific research, including controlled trials, is warranted. Marijuana contains THC, which can get you high. It also contains other substances that produce different side effects than CBD does.
RLS causes uncomfortable sensations in the legs along with a powerful urge to move them. Symptoms usually occur in the evening, when you’re at rest or in bed.
RLS can make it very difficult to fall asleep and stay asleep, which can have a negative effect on your quality of life. There are medicines to treat RLS, but they don’t help everyone.
CBD is one of hundreds of cannabinoids in cannabis plants. Unlike THC, it doesn’t produce a high. CBD is available in many forms, including chewables, tinctures, and sprays.
It appears that many people have used CBD for symptoms of RLS. And many report that it helps without causing serious side effects.
Unfortunately, CBD for RLS is not well studied. There’s a lack of information regarding proper dosing and the effects of long-term use.
A Word From Verywell
Living with RLS can be challenging, especially if lifestyle changes or medicines aren’t helping. If you’re considering trying CBD, it’s a good idea to speak with a healthcare provider first. Be sure to mention other health conditions you have, as well as any medications and supplements you’re taking.
A healthcare provider or pharmacist can help you decide if CBD is right for you and possibly suggest a starting dose. All CBD products are not alike. If you’re purchasing CBD online, make sure it’s a reliable source and you have access to a COA. And, of course, stay away from products that claim to prevent or cure RLS.
Frequently Asked Questions
It varies a lot from person to person. It could be several hours to a full day. Factors such as metabolism, dose, method of administration, and how often you use it all play a role.
While there are anecdotal reports of improvement and even some of total remission, there’s not enough scientific data to put a number on it.
It appears that most people are able to tolerate CBD with minimal side effects. But it’s important to remember that research on dosing, administration, and cumulative effects is in its infancy.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Ann Pietrangelo
Ann Pietrangelo is a freelance writer, health reporter, and author of two books about her personal health experiences.
Cannabis for Restless Legs Syndrome
Restless legs syndrome (RLS) is a chronic sensorimotor disorder characterized by an urge to move the legs. This urge is often accompanied by pain or other uncomfortable and unpleasant sensations, it either occurs or worsens during rest, particularly in the evening and/or at night, and temporarily improves with activity. Affecting nearly 3% of the North American and European populations in its moderate-to-severe form, RLS has a considerable negative impact on the quality of life, and sleep and is associated with significant morbidity. Although new developments have deepened our understanding of the disorder, yet, the corresponding pathophysiologic features that underlie the sensorimotor presentation are still not fully understood. Usually, symptoms respond well to dopamine agonists (DA), anticonvulsants, or opiates, used either alone or in any combination, but still, a subset of patients remains refractory to medical therapy and serious side effects such as augmentation and impulse control disorder may occur in patients with RLS under DA. Convincing treatment alternative are lacking but recently patients’ spontaneous reports of a remarkable and total remission of RLS symptoms following cannabis use has been reported. The antinociceptive effect of marijuana has been documented in many painful neurological conditions and the potential benefit of cannabis use in patients with refractory RLS should, therefore, be questioned by robust clinical trials. Here, we review basic knowledge of RLS and the putative mechanisms by which cannabis may exert its analgesic effects.
Keywords: Cannabis; Restless legs syndrome; Treatment.
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