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Restless leg syndrome: iron important.

Mr. J is a 55-year-old man who presents with a 6-month history of progressive fatigue and a 3-month history of “legs that hop all over the place when I am sitting in the evening or trying to get to sleep.” He was last seen by another primary care provider about 2 years ago and was told he was in good health. His daily medications include a multivitamin and a fullstrength aspirin. Currently, he denies any new life stress other than sleep disturbance. A review of his systems is noncontributory with the exception of intermittent upper gastrointestinal upset, or “heartburn” he attributes largely to dietary indiscretion. He denies the presence of melena or frank blood in stool. He does not smoke and drinks one to two beers on two occasions in an average week. He is not physically active and works as an accountant. On physical examination, findings show his body mass index at 34 kg/m and blood pressure at 152/98. The rest of his physical examination is within normal limits. Using a validated scale, Mr. J’s report of involuntary leg movement meets diagnostic criteria for restless leg syndrome (RLS).