Friday, July 15, 2016

Carbon monoxide and restless legs syndrome (RLS)

As part of the research I've been doing in nutrition, I have come across studies and information giving rise to a theory in a very different area. Here's the theory:

Restless legs syndrome (RLS) appears to possibly be caused by carbon monoxide buildup in leg muscles. Here's why I think that could be the case:

1) Everyone's body makes endogenous carbon monoxide in small amounts. The endogenous carbon monoxide is a product of the breakdown of heme, a cofactor containing iron that is found primarily in animal products.
2) There appears to be a weak association between a heme oxygenase (which produces carbon monoxide) gene and RLS.
3) When we rest in a horizontal position, we are lowering arterial O2 (oxygen) pressure in the legs, which can cause more carbon monoxide to move from blood to the muscles. This effect should be even more pronounced during pregnancy due to the temporarily increased weight on the legs when standing; pregnancy is associated with increased risk of RLS. Compression stockings would help keep arterial pressure high; many RLS sufferers find that using compression stockings lessens their symptoms.
4) Carbon monoxide binds to myoglobin--"The oxygen carrying and storage protein of muscle, resembling hemoglobin but containing only one subunit and one heme as part of the molecule (rather than the four of hemoglobin), and with a molecular weight approximately one quarter that of hemoglobin," per an online medical dictionary--in the muscles. Thus, those who are already deficient in iron would tend to suffer more from higher levels of carbon monoxide interfering with myoglobin in the muscles. RLS has long been found associated with low stores of iron in the body.
5) The primary (and almost only) treatment for carbon monoxide poisoning is oxygen therapy. Peripheral hypoxia in the legs is associated and correlated in degree with RLS.
6) The most well-known symptom related to RLS is involuntary movement of the leg muscles. This movement could be the body trying to get more oxygen to the leg muscles in order to alleviate carbon monoxide buildup in the legs. Moving muscles take in more oxygen than resting ones.
7) Severe RLS and ischemic stroke are correlated. Carbon monoxide poisoning also correlates with an increased risk of ischemic stroke. This is a point in support of the hypothesis that endogenous carbon monoxide poisoning is behind RLS.
8) Dopamine agonists lessen RLS symptoms. Dopamine is also used to increase arterial pressure in patients with hypotension (low blood pressure). This is another point in support of the hypothesis, for increasing arterial pressure can be expected to help prevent the movement of carbon monoxide from blood into muscles.

Does my theory point to ways to treat RLS? I see a few, many of which have already been studied and shown positive effects:

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