Editing Openai/69585660-954c-8011-b9ec-bc5c70cfea17 (section)

=== Assistant: Ferritin is strongly linked to restless legs syndrome RLS, and the threshold for symptoms is much higher than the lab’s… ===
Ferritin is strongly linked to restless legs syndrome (RLS), and the threshold for symptoms is much higher than the lab’s “normal” lower limit.

==== Ferritin levels associated with RLS ====

===== Key clinical cutoffs used by sleep medicine & neurology specialists =====

| Ferritin level | RLS risk                                     |
| -------------- | -------------------------------------------- |
| < 20 ng/mL     | Very high risk – RLS common and often severe |
| 20–50 ng/mL    | High risk – symptoms frequent                |
| < 75 ng/mL     | Treatment usually recommended if RLS present |
| 75–100 ng/mL   | Target range for symptom improvement         |
| > 100 ng/mL    | Optimal for most RLS patients                |

===== Critical point (often missed) =====

: RLS can occur even when ferritin is “normal” by lab standards.
: Labs may list 15–20 ng/mL as normal, but that is NOT sufficient for RLS.

==== Why ferritin matters in RLS ====
* Ferritin reflects iron stores, not just circulating iron
* RLS is linked to low iron availability in the brain, especially in dopamine pathways
* Brain iron deficiency can exist even when hemoglobin is normal

==== Treatment guidance commonly used ====
* Ferritin < 75 ng/mL with RLS symptoms → iron supplementation is usually advised
* Ferritin 75–100 ng/mL → may still benefit if symptoms persist
* Oral iron may take 8–12 weeks to raise ferritin
* IV iron is sometimes used if: - Oral iron fails - Ferritin remains <75 - RLS is severe or refractory

==== Important modifiers ====

Iron treatment decisions also consider:
* Transferrin saturation (TSAT) - TSAT < 20% supports iron deficiency
* Inflammation markers (CRP) - Ferritin can be falsely high in inflammation
* Medications (SSRIs, antihistamines, dopamine blockers can worsen RLS)

==== Bottom line ====
* Ferritin < 75 ng/mL can trigger or worsen RLS
* Goal ferritin for RLS: ≥ 75–100 ng/mL
* “Normal” ferritin does not rule out iron-related RLS

If you want, you can tell me:
* Your ferritin value
* Transferrin saturation (if available)
* Whether symptoms are night-only, daily, or severe

and I’ll give you a more tailored interpretation.