The doctors and scientists that are interested in RLS have read the same scientific reports as I have. We have that in common.
The big difference is that THEY have read the reports through the eyes of a scientist - dissecting the information with a brilliant and logical mind that understands how the complex processes of the body work and all the terminology that goes with it.
In other words, they completely understand what's being presented to them.
Therefore, it is not likely that I'm seeing something OBVIOUS that they are NOT seeing.
It would be clear to them that:
1. forty-one INFLAMMATORY diseases and conditions show a HIGHER prevalence of RLS
2. two demographics, pregnant women and the elderly, both have a HIGHER presence of inflammation and both have a HIGHER prevalence of RLS
3. the most notable triggers of RLS are ALL inflammatory
4. inflammation has a NEGATIVE effect on dopamine levels
5. inflammaton has a negative effect on iron levels
6. inflammatory cytokines cause the brain to release HIGHER levels of glutamate
7. the most recommended solutions for RLS such as iron, potassium and magnesium ALL have anti-inflammatory properties
It would certainly be obvious to any doctor reading the Restless Legs studies, that without a doubt, inflammation is a primary factor.
These doctors would also be fully aware that there are currently no medical solutions for this problem.
They know that there are NO Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in existence that don't have SEVERE side-effects with prolonged use. So, an anti-inflammatory drug is NOT an option for dealing with any inflammation-based ailment.
The doctors, scientists and pharmaceutical company's hands are tied. They have no answer for inflammation. They can only watch helplessly as endless studies pour in that identify inflammation as a MAJOR PLAYER in hundreds of diseases and conditions.
Pharmaceutical executives must be salivating at the thought of being the first to develop a cure. A safe way to get rid of all that inflammation.
They know that if their company WAS able to produce a potent anti-inflammatory, that could heal inflammation without any dangerous side-effects, it would be applied to HUNDREDS of diseases and ailments!
Such a drug would be a UNIVERSAL PANACEA such as the world has never seen. It would not only wipe out RLS, it would be a MAJOR HEALER for hundreds of conditions, including cancer, Parkinson's, ALS, depression, ADHD, all the "itis" conditions such as arthritis ... and many more.
Just think how much they would make from arthritis alone.
It wouldn't be a billion dollar drug for that company, it would be a TRILLION dollar drug.
Below you'll find substantial proof that NSAIDs CANNOT be taken over a LONG period of time They are therefore NOT a viable solution for the MANY inflammatory diseases and conditions that are now known to exist. This includes Restless Legs Syndrome / Willis-Ekbom Disease.
from "Recent Considerations in Nonsteroidal Anti-Inflammatory Drug Gastropathy."
Singh Gurkirpal, MD. The American Journal of Medicine, July 27, 1998, p. 31S
"Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone."
from the Washington Post "Consumer Reports: Overuse of pain relievers can be hazardous." July 18, 2011
How do NSAIDs work?
They fight pain by targeting one or both of two enzymes: COX-1 and COX-2. These enzymes are crucial for the production of hormones called prostaglandins, which trigger inflammation, which in turn sends pain signals to the brain. At high enough doses, NSAIDs can inhibit inflammation and thus thwart pain.
But blocking COX-1 also leaves the stomach vulnerable to ulcers and bleeding, since prostaglandins help protect the lining of the stomach from acid. In fact, 5 to 10 percent of NSAID users experience ulcers or bleeding in a given year.
from R. Morgan Griffin on WebMD
"There is no question that the risks of NSAIDs can be serious, even life-threatening.
According to the American Gastroenterological Association (AGA), each year the side effects of NSAIDs hospitalize over 100,000 people and kill 16,500 in the U.S., mostly due to bleeding stomach ulcers.
Cox-2 inhibitors are a newer form of prescription NSAID. Two of them - Bextra and Vioxx - are no longer sold because of concerns about their side effects. The third, Celebrex, is still available.
How Anti-Inflammatory Pain Relievers Work
While the details are different, all of these medicines work in more or less the same way. They block the effects of chemicals that increase the feeling of pain. Unlike many other painkillers, they also help by reducing swelling, which can further reduce pain. Sometimes swelling is a key cause of pain.
But the problem with NSAIDs -- or any systemic drug -- is that they can affect the entire body, not just the part that hurts.
"If you use a drug to ease one problem, like an achy joint. It's likely to cause a different reaction somewhere else too." says cardiologist Nieca Goldberg, MD, a spokesperson for the American Heart Association and Chief of Women's Cardiac Care at Lennox Hill Hospital, New York City.
Anti-Inflammatory Pain Relievers: The Risks
"For most people, taking an over-the-counter NSAID for the occasional headache or backache is very safe. "The bigger risks are for people who have chronic pain and take NSAIDs in the long-term," says Goldberg.
The most common side effect from all NSAIDs is damage to the gastrointestinal tract, which includes your esophagus, stomach, and small intestine. More than half of all bleeding ulcers are caused by NSAIDs, says gastroenterologist Byron Cryer, MD, a spokesperson for the American Gastroenterological Association.
"Gastrointestinal bleeding is a serious issue," says Cryer. "But we've seen in many surveys that people really underestimate this risk." Most ulcers caused by NSAIDs will heal once you stop taking the drug, according to the American College of Gastroenterology.
"Researchers developed Cox-2 inhibitors -- like Celebrex, Vioxx and Bextra -- to get around this problem. Contrary to common belief, Cox-2 inhibitors are not more powerful painkillers than standard NSAIDs. Their advantage is they are much less likely to cause gastrointestinal problems." says rheumatologist John Klippel, MD, President and CEO of the Arthritis Foundation, Atlanta, GA.
"However, after their introduction in 1999, further study revealed that the Cox-2 inhibitors had a real downside: an increased the risk of heart attacks and strokes. The heart risks of two Cox-2 inhibitors, Bextra and Vioxx, were considered significant enough to pull them from the market. Bextra also posed a risk of serious skin reactions. Celebrex is still for sale, but it now bears a strong FDA warning about the risks of heart attacks and strokes.
These heart risks may also be common to many over-the-counter NSAIDs when used long-term, although probably to a lesser extent. Except for aspirin, all over-the-counter NSAIDs now must carry a warning about the risks of heart attack and stroke along with other side effects." Klippel told WebMD.
NSAIDs have other dangers, too. They can cause high blood pressure and kidney damage in some people. They can also cause potentially severe allergic reactions. Both prescription and over-the-counter NSAIDs now carry warnings about skin reactions as well.
Scott Zashin, author of "Arthritis without Pain" and Clinical Assistant Professor at the University of Texas Southwestern Medical School, suggests that people explore other ways of relieving pain.
"Patients should also look for techniques to reduce pain that don't rely on medication," he tells WebMD, "like biofeedback, acupuncture, hypnosis, and yoga." Depending on your condition, physical therapy, exercise and weight loss -- if you're overweight -- can also improve your symptoms."
from The New York Times "Experts Warn Against Long-Term Use of Common Pain Pills." by Roni Caryn Rabin, May 6, 2009
Last week, an expert panel of American Geriatrics Society pretty much bumped all non-steroidal anti-inflammatory drugs, or NSAIDs, off the list of medicines recommended for adults ages 75 and older with chronic, persistent pain. Long-term use of drugs like ibuprofen, naproxen and high-dose aspirin is so dangerous, the panelists said, that elderly people who can't get relief from alternatives like acetaminophen may be better off taking opiates, like codeine or even morphine.
The risks from chronic use of NSAIDs are myriad. They can cause life-threatening ulcers and gastrointestinal bleeding, a side effect that occurs more frequently and with greater severity as people age. Some NSAIDs may increase the risk for heart attacks or strokes, and they don't interact well with drugs used to treat heart failure. They can make high blood pressure worse, even uncontrollable, and impair kidney function. And the list of potentially hazardous interactions with other drugs is a long one, experts say.
"Physiological changes in the elderly affect the way drugs are absorbed and secreted and how the body responds to them," said Dr. Keela Herr, a professor at the University of Iowa College of Nursing in Iowa City who researches pain management in the elderly and was involved in drafting the new guidelines. "Younger people can use this class of medicine with limited risks. In older persons, it's a different story. Physical changes make them more sensitive."
The geriatrics society's new guidelines say NSAIDs should be considered "rarely" in the population of frail elderly people, and used "with extreme caution" and then only in "highly selected individuals." For those patients with moderate to severe pain that diminishes the quality of life, opiates may be considered, the guidelines suggest, after both the patient and caregiver are screened for prior substance abuse.
from the Chicago Tribune "Patients in pain keep popping pills despite FDA warning." by Bruce Japsen, April 11, 2005
Despite sweeping new warnings that the nation's most popular painkillers can harm hearts, stomachs and skin, many Americans are going to go right on taking them, saying the relief is worth the risk.
The popular arthritis drug Bextra last week became the second Cox-2 painkiller pulled from the market, while the Food and Drug Administration pinned its highest warnings on Celebrex and nearly 20 other common prescription-strength drugs such as Mobic, Motrin, Naprosyn and ibuprofen.
from Consumer Reports "The Nonsteroidal Anti-Inflammatory Drugs: Treating Osteoarthritis and Pain."
Studies show that NSAIDs are effective pain relievers, but they have serious risks. When used at high doses for long periods, most increase the risk of heart attacks and strokes. NSAIDs also have other risks, such as increasing blood pressure, causing fluid retention, and reducing kidney function.
It is well known that oral NSAIDs can cause life-threatening gastrointestinal bleeding, usually from the stomach. The risk increases with age, which is important to note because the majority of people who take NSAIDs for long periods are 60 years or older.
from "About.com 9 Ways to Reduce Your Risk of Bleeding Ulcers from NSAID Use." by Carol Eustice, August 26, 2008
Bleeding ulcers are one of the most serious problems associated with NSAID (nonsteroidal anti-inflammatory) use. While there are many potential side effects that can occur from longterm use of NSAIDs, bleeding ulcers can be life-threatening and must be taken seriously.
Bleeding typically occurs from the duodenum or stomach, but may also develop from the large intestine. While warning signs often occur, such as stomach discomfort or bloody/black stools, some patients -- especially the elderly -- may have no warning before they develop serious bleeding.
"Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain."
Maroon JC, Bost JW. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
The use of NSAID medications is a well-established effective therapy for both acute and chronic nonspecific neck and back pain. Extreme complications, including gastric ulcers, bleeding, myocardial infarction, and even deaths, are associated with their use.
from PureHealthMD "NSAIDs"
The most concerning category of side effects for many NSAID users involves the gastrointestinal tract. NSAIDs pose a high risk for upset stomach and indigestion [Source: Jones]. The formation of an ulcer is a potential concern for anyone regularly using NSAIDs. These pain meds can cause this by thinning the protective layer of the stomach and blocking the secretion of bicarbonate which helps balance the pH level of the gut [Source: Jones]. This can put the body at great risk for a gastrointestinal bleed. This bleeding occurs along any part of the GI tract, which can happen directly at the site of an ulcer. These side effects can create a tremendous financial cost. Up to 30 percent of the cost for treating arthritis with NSAID use is related to the intestinal problems these medications cause [Source: Laine]. Up to 60 percent of patients using NSAIDs daily experience heartburn and 20 percent or more obtain an ulcer [Source: Jones]. The risk for GI bleed appears to be worse for those taking an NSAID with a type of antidepressant from the SSRI class [Source: Loke]. SSRIs (selective serotonin reuptake inhibitors) include Prozac, Celexa, Paxil, Zoloft and Lexapro. These are commonly prescribed medications, and it is very reasonable to think that some SSRI users could also be regularly using NSAIDs.
NSAIDs are related to other serious problems as well. Patients with a history of kidney disease have to be very careful about using NSAIDs, possibly avoiding them completely. Congestive heart failure is one of the most common reasons why people over the age of 65 are admitted to the hospital [Source: Page]. NSAID use is known to pose risk for congestive heart failure and increase chances for admission [Source: Page]. This is a concern since someone could easily take an ibuprofen for a bad headache without realizing that it could seriously upset their fluid balance. NSAIDS can increase the risks associated with blood pressure as well [Source: Jones]. Complications from increased blood pressure and kidney problems are especially pronounced in the elderly [Source: Petrone]. The heart problems caused by a special class of these medications called COX-2 inhibitors (Vioxx, Bextra) were so significant that these medications were pulled off the market [Source: Bresalier].
from "Pain Relievers and the Risk of Hearing Loss." by Sharon G. Curhan, MD, MSc
Many of the harmful effects of NSAIDs are related to their primary mechanism of action, through the inhibition of prostaglandins. They can cause gastrointestinal problems such as dyspepsia, ulcers and bleeding, be toxic to the kidneys, increase the risk of bleeding, have adverse nervous system and cardiovascular effects, and interfere with the cardioprotective benefits of aspirin. Too much acetaminophen can cause serious liver damage and can be particularly harmful in combination with alcohol. NSAIDs and acetaminophen can increase the risk of high blood pressure and interact adversely with other medications.
What Is the Relation Between These Analgesics and Hearing Loss?
For a long time, it has been known that very high doses of aspirin can lead to temporary hearing loss and tinnitus (ringing in the ears). Usually, these symptoms are reversible and improve when aspirin use is discontinued. However, little was known about the relation between moderate doses of aspirin, NSAIDs or acetaminophen and the risk of hearing loss, particularly when taken frequently.
Analgesics have been associated with harm to the kidneys, and many medications that are toxic to the kidneys (nephrotoxic) are also toxic to the ears (ototoxic). We previously found that men who regularly used NSAIDs, acetaminophen or aspirin had an increased risk of developing hearing loss. Women use these analgesics even more frequently than men, therefore, we performed a study that specifically examined this relation in women.
from "Harmful effects of NSAIDs among patients with hypertension and coronary artery disease."
Bavry AA, Khaliq A, Gong Y, Handberg EM, Cooper-Dehoff RM, Pepine CJ. Department of Medicine, College of Medicine, University of Florida, Gainesville. Am J Med. 2011 Jul;124(7):614-20. doi: 10.1016/j.amjmed.2011.02.025. Epub 2011 May 18.
Among hypertensive patients with coronary artery disease, chronic self-reported use of NSAIDs was associated with an increased risk of adverse events during long-term follow-up.
from theheart.org "More evidence that NSAIDs are harmful to heart-failure patients." by Sue Hughes, January 29, 2009
Further evidence that even commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) are harmful to heart-failure patients has come from a new study.
The study, published in the January 26, 2009 issue of the Archives of Internal Medicine, shows dose-related increases in risk of death and rehospitalization for heart failure or MI with all COX-2 inhibitors or other NSAIDs.
Lead author Dr Gunnar Gislason (Gentofte University Hospital, Hellerup, Denmark), commented to heartwire: "Although our study is observational, and you can never exclude all confounding factors, we have very consistent results estimated using two different statistical methods. And these results are similar to many other previous studies. In addition, we see a strong dose-related response. I think the data are very convincing."
And it is not just the COX-2 inhibitors that are the problem, as diclofenac showed a similar risk. "This is very disturbing, as this drug is so widely used and is available off prescription in many countries," Gislason noted.
He described the effect as "quite considerable." For example, for rofecoxib (Vioxx, Merck), the number of patients needed to treat for one year to cause one death was just nine, and the corresponding number for celecoxib (Celebrex, Pfizer) was 14 and diclofenac. "These numbers are very low," Gislason said, noting that for antihypertensive drugs, the number needed to treat for one year to save one life is in the range of 50 to 100. "Everyone agrees that it is worth treating hypertension. So the harmful effect of some NSAIDs is much greater than the beneficial effect of antihypertensive treatment."
Even naproxen risky at high dose
"Our results suggest that all NSAIDs have harmful effects in heart-failure patients, even naproxen at high doses. Naproxen is probably the best of the bunch, but it still increases fluid retention, which is bad news for heart-failure patients," Gislason added.
But he points out that these drugs are still being used in this population. "I don't think doctors are aware of this problem. We need to raise awareness. I think the main culprits are primary-care doctors, as these drugs are so widely prescribed in general practice," he commented. "The fact that some of these drugs are available over the counter makes the situation much worse, as anyone can buy them without advice from a doctor. All NSAIDs should be prescription-only drugs. Making them available in petrol stations and supermarkets gives the impression that they are not harmful. Many heart-disease patients will not be aware that they shouldn't take them."
In the current study, Gislason and colleagues used Danish national records of hospitalizations and pharmacy drug dispensing to identify 107 092 patients surviving their first hospitalization due to heart failure between 1995 and 2004 and their subsequent use of NSAIDs.
They found that 36 354 patients (33.9%) claimed at least one prescription of an NSAID after discharge; 60 974 patients (56.9%) died, and 8970 (8.4%) and 39 984 (37.5%) were rehospitalized with MI or heart failure.
After adjustment for age, sex, calendar year, comorbidity, medical treatment, and severity of disease, the authors found a clear dose-related increase in risk with the drugs.
from The Medical Observer "Least harmful NSAID for cardiovascular patients identified." by Kirrilly Burto, 17th Jan 2011
THE safety of NSAIDs is back in the news, following a meta-analysis showing little evidence they are safe for patients at high cardiovascular risk.
However, the researchers said that of the seven NSAIDs examined, naproxen appeared the least harmful.
"In general, naproxen seems to be the safest analgesic for patients with osteoarthritis in cardiovascular terms," the authors wrote.
However, naproxen's relative benefits should be weighed against the drug's gastrointestinal toxicity and the need for concomitant use of proton pump inhibitors, they warned.
Celecoxib 400 mg prescribed once daily may be considered an alternative, they said.
A meta-analysis of 31 randomised trials, in more than 116,000 patients with osteoarthritis and rheumatoid arthritis, found little evidence any of the commonly used NSAIDs for pain management were safe in cardiovascular terms compared with placebo.
The drugs analysed were naproxen (Naprosyn), ibuprofen (Nurofen), diclofenac (Voltaren), celecoxib (Celebrex), etoricoxib (Arcoxia), rofecoxib (Vioxx) and lumiracoxib (Prexige).
Patients taking rofecoxib and lumiracoxib had twice the risk of myocardial infarction compared to people taking placebo.
The meta-analysis follows the 2004 manufacturer's withdrawal of the COX-2 selective inhibitor, rofecoxib, due to an increased risk of myocardial infarction and stroke.
"Our study confirms previous notions of regulatory bodies, mainly based on observational evidence, that all non-steroidal anti-inflammatory drugs are associated with an increased risk of cardiovascular adverse effects," the authors said.
Ibuprofen was associated with the highest risk of stroke, accounting for a threefold risk of having a stroke.
Both etoricoxib and diclofenac were associated with the highest risk of cardiovascular death, with around a fourfold risk.
from "Acetabular bone destruction related to non-steroidal anti-inflammatory drugs."
Newman NM, Ling RS. Lancet. 1985 Jul 6;2(8445):11-4.
In a retrospective investigation of the relation between use of non-steroidal anti-inflammatory drugs (NSAIDs) and acetabular destruction in primary osteoarthritis of the hip, 70 hips were studied in 64 patients. Cranial acetabular migration, a measure of acetabular destruction, was present in 37 hips and absent in 33. Migrators and non-migrators did not differ in age, sex, hip pain score, walking ability score, femoral neck-shaft angle, or distribution of atrophic and hypertrophic types of osteoarthritis. Regular intake of NSAIDs was noted for 31 of the 37 migrating hips and irregular intake for a further 3. Among the 33 non-migrating hips, the corresponding numbers were 7 and 5, respectively. This highly significant association between NSAID use and acetabular destruction gives cause for concern, not least because of the difficulty in achieving satisfactory hip replacements in patients with severely damaged acetabula.
from The Guardian "Ibuprofen warning to pregnant women." Tuesday 6 September 2011
Women who take even a small dose of painkillers such as ibuprofen early in their pregnancy more than double their risk of suffering a miscarriage, research shows.
The findings prompted medical experts to advise mothers-to-be to avoid taking the drug and instead to use paracetamol for pain relief. Taking any painkillers from the class of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs) - such as ibuprofen, naproxen and Diclofenac - in the first 20 weeks after conception increases the risk of miscarriage by 2.4 times, the study found. The paper, published in the Canadian Medical Association Journal, found that pregnant women taking any type of NSAID, and any dose of one, ran that scale of extra risk of spontaneous abortion.
Chronic inflammation is the result of a particular lifestyle choice or environmental situation. It's not something a pill can fix.
There's no drug that's ever going to clean up the mess of 20 years of hard drinking, or a lifetime's worth of eating potato chips.
The damage created from the inflammation needs to be attended to, but more importantly, the SOURCE of that inflammation needs to be ALTERED.
Otherwise, you're only going to continue feeding the fire, and increase the amount of inflammation that is burning inside of you. And with that comes a more intense twitching.
What you need to ask yourself is HOW did this inflammation come into existence?
Once you figure that out, you can then work on moving away from the source(s).