There may be a relationship between proton pump inhibitors (PPIs) and iron 
absorption. PPIs may decrease the amount of iron absorbed gastrointestinally 
specifically due to alteration of the pH in the duodenum. Restless legs syndrome 
(RLS) is a sensorimotor disorder that includes an urge to move legs, accompanied 
or caused by uncomfortable and unpleasant sensations in the legs; the urge to 
move begins or worsens during periods of rest or inactivity, the urge to move is 
partially or totally relieved by movement, and the urge is worse or only occurs 
at night. In the majority of the restless leg syndrome population, the sensation 
is deep seated, often described as being in the shin bones, and most commonly 
felt between the knee and ankle. It may be described as a creepy, shock-like, 
tense, electric, buzzing, itchy, or even numb sensation. A subpopulation of this 
restless leg syndrome patient population experiences restless leg syndrome 
associated pain (RLSAP) that has been described as a deep "achy pain." This pain 
has not been found to be relieved by many of the typical over the counter 
analgesics. Often, constant movement of the legs appears to be the only remedy, 
as these sensations usually appear during periods of rest. Furthermore, there 
appears to be an association between iron deficiency and those suffering from 
Restless Leg Syndrome (RLS). The authors theorize that there may be a possible 
correlation between PPIs and the symptoms (e.g. pain) associated with RLS. The 
authors propose that PPIs, such as omeprazole, may interfere with iron 
absorption in certain patients and that a subpopulation of patients who develop 
significant iron deficiency characterized by low serum ferritin levels while on 
PPIs may also develop RLS-like symptoms (including RLSAP). While there is no 
robust direct evidence to support any associations of PPIs and iron deficiency 
or PPIs associated with RLS-like symptoms (including RLSAP), it is hoped that 
this manuscript may spark research efforts on this issue.