Low calcium and magnesium levels in RLS

Thank you.

I've spent a lot of time looking at sleep. My sleep patterns are good and I out the hours in.  I do have mild sleep apnea, for which a CPAP machine helps, putting me within the machine's acceptable limits (I use an app called Sleepyhead) and overnight oximetery gives OK results.

I can find no link between Modafinil and Cortisol, other than indirectly through high Cortisol's being often associated with depression. I had the fatigue before I started Modafinil, I always leave plenty of time between taking and sleep, and on days when I don't take it, primarily as I'm concerned over building up tolereance, I see no effect on the next night's sleep.

I exercise and eat healthily (a balanced diet with plenty of fruit & veg).

The fatigue and depression prevent me from working. The fatigue affects me socially because it makes going out and maintaining interaction difficult, particularly in the evening when most opportunities are; the depression makes little or no difference. Although the effort often drains me, I do something social every day, even if it's just going to a coffee shop and talking to people I see there; I doubt anyone I meet has any inkling of how I'm struggling behind my behaviour and public image.   

It was just that someone in another forum thought "in stressful situations [Modafinil] reduces the level of cortisol but increase[s] the level of cortisol when you're not stressed". However, indeed I can't find any scientific/medical confirmation of this idea.

Like I expect a lot of people, some mornings I can't imagine making it through the day without starting with a few mugs of coffee. Other than that, and knowing that ME/CFS is medically recognized, I suppose like other non-sufferers, I wonder whether you are not just trying to do things that you are not needed to do, or shouldn't be needed to do. Maybe a good social psychologist could make a realistic assessment, but expecting that from the NHS in the UK currently is perhaps unrealistic.

I probably don't doubt psychological states can affect vitamin and mineral levels, but I guess it would be as well to investigate possible physiological causes.

Thanks. I have a GP's appointment tomorrow morning so will know his thoughts soon. Strangely, I just came upon a footpath bench dedicated to a woman who died after my GP's surgery failed to diagnose Addison's disease.

At the risk of straying well outside this RLS section, I'm trying everything I can, although my fatigue does make that a difficult and long process.

I limit my caffeine intake as one cup of Costa's finest can give me the shakes and I'm wary of the come-down afterwards.  I avoid drinks like Red Bull as I fear the come-down and longer-term effects would overshadow any short-term energy gain.

Several studies show that in short-term sleep deprivation for healthy individuals Modafinil has no noticeable effect of Cortisone levels. However, extrapolating the results to the very-different conditions of long-term CFS sufferers is pretty dangerous.

I have no chance of seeing a psychologist, of any variety let alone a social one, on the NHS.  I've not paid for one yet as I've been resistant to talking cures before, albeit with less qualified 'counsellors', its expensive, I struggle for the effort, and getting books is easier and more efficient for me. 

I'm currently pacing myself and doing very little beyond what i have to do.  I've not had the application for house & garden maintenance and a car project I started; even a simple bicycle puncture repair takes 2 hours and knocks me out for the rest of the day.

I'm not too sure how healthy my coffee-drinking habit is. There seems to be some evidence that it's neuro-protective but against that are the adverse effects of the raised cortisol level (not to mention a tooth-staining problem).

Research has found that richer people with higher social status and greater social support have a higher density of dopamine receptors (and presumably, therefore, less RLS). It would seem to me that psychologists could help a lot in this direction. However, society currently seems to think strongly in terms of the individual, but it seems to me that even CBT must work to some extent by altering the influence those receiving it have on other people.

Strangely, I'm currently renovating what is in fact a top quality teak park/garden bench that the council left in the close I live in and which was totally grey and encrusted with years of grunge accumulated while standing out in all conditions. In a way, I'm glad of the rainy days when I can't work on it for the respite – but then I'm not a carpenter/joiner and I don't see working full time day in day out on such things is what my life is about.

Do divulge your doctor's thoughts!