In an X post shared by Dr Sudhir Kumar, neurologist, Apollo Hospitals, Hyderabad, highlighted the importance of routine tests in fixing one of the health issues that was neglected for years. He explained the significance of iron in our bodies and how it can impact overall health.
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What was the case?
Dr Kumar stated that for nearly a decade, a 77-year-old man lived with a strange nightly torment. Every evening, as he tried to rest, an uncomfortable sensation would creep into both his legs. It was difficult to describe, neither pain nor cramps. It felt like an internal irritation, an urge to move, a deep restlessness that worsened at night and robbed him of sleep. Walking around for a few minutes would help temporarily, but the discomfort always returned.
Over the years, he consulted several doctors. He was prescribed “nerve vitamins” and nutritional supplements repeatedly. None of them made any meaningful difference. Eventually, he stopped expecting improvement. His blood pressure was under good control. Routine blood tests were largely normal. There was no obvious neurological weakness, no swelling, no severe back pain, and importantly, no anemia.
Like many elderly patients with long-standing symptoms, he had quietly accepted that this was simply part of aging. But when encouraged by a family member, he decided to seek one more opinion. This time, the most important step was not an advanced scan or expensive investigation. It was listening carefully to the story. The pattern of symptoms immediately raised suspicion for a condition called Restless Legs Syndrome (RLS), a common but frequently overlooked neurological disorder. People with RLS experience an irresistible urge to move their legs, especially during periods of rest or at night. The condition can severely disrupt sleep and quality of life. One blood test was ordered: serum ferritin. The result came back strikingly low: 8.9 ng/mL.
What changed after the blood test?
Dr Kumar said, “That number changed the entire story. Ferritin is a marker of the body’s iron stores. Many people assume iron deficiency exists only when hemoglobin levels are low and anemia develops.” He highlighted that iron deficiency can affect the brain and nervous system long before anemia appears. In fact, low ferritin is one of the most important reversible causes of restless legs syndrome. He was started on appropriate medications, including iron supplements. We expect a good recovery in his symptoms and quality of life.
Significance of iron
According to Dr Kumar, iron plays a crucial role in dopamine function within the brain, particularly in pathways involved in movement and sensory regulation. When iron stores fall, these pathways may malfunction, triggering the classic symptoms of RLS.
“Importantly, ferritin deficiency is not limited to women. Although more common in menstruating women, elderly men can also develop low iron stores due to poor dietary intake, reduced absorption from the intestines, chronic use of acid-suppressing medications, hidden gastrointestinal blood loss, or other medical conditions,” said Dr Kumar. In older adults, especially men, finding low ferritin should prompt further evaluation to identify the underlying cause.
With appropriate treatment, including iron replacement and medications commonly used for restless legs syndrome, many patients experience substantial improvement in sleep and quality of life.
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