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Back to Serum Iron Studies (Addition of Restless Leg Syndrome as a Covered Indication)

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Serum Iron Studies (Addition of Restless Leg Syndrome as a Covered Indication)

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Total Comments: 5

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Jones, Christopher	Title: University Hospital Sleep-Wake Center Organization: University of Utah Date: 08/23/2006 Comment: I am the medical director of the University of Utah Sleep Cneter. Iron supplementation has been of great benefit to my patients with RLS but only when the ferritin is below about 20-30 or the transferrin binding is below about 20%. Inadequate iron stores for purposes of treating RLS is farily common in the elderly but most of the population has normal stores and some have occult iron overload (e.g. hemochromatosis). Unfortunately, empiric "blind" oral iron supplementation in amounts necessary for benefit are contraindicated in people who have normal markers of iron stores because iron overload is harmful. Therefore, it is not ethical to offer an empiric trial of iron supplementation to see if that saves the cost of higher doses of prescription medications for RLS. This ruling will have a significant NEGATIVE impact on my ability to help people with RLS. Less I am the medical director of the University of Utah Sleep Cneter. Iron supplementation has been of great benefit to my patients with RLS but only when the ferritin is below about 20-30 or the transferrin binding is below about 20%. Inadequate iron stores for purposes of treating RLS is farily common in the elderly but most of the population has normal stores and some have occult iron overload (e.g. hemochromatosis). Unfortunately, empiric "blind" oral iron supplementation More
Manthena, Prasanth	Date: 08/22/2006 Comment: I strongly feel this is the wrong decision to make in terms of RLS and iron studies. As a sleep specialist who sees and has a large population of RLS patients, testing for ferritin and iron levels is routine in my and every other sleep clinic that I know. It guides treatment decisions now in terms of whether to look for other disorders and to go ahead with iron therapy and will likely do so into the future with the possible use of IV iron as a therapy for refractory RLS
Schriner, Robert	Organization: Baptist Sleep Disorders Center Date: 08/18/2006 Comment: Extensive review of the literature. Why did you not poll at least a group of sleep specialists to provide "expert opinion"?
Gladen, Herbert	Date: 08/17/2006 Comment: The consensus of expert opinion is that iron studies will benefit a substantial number of patients with RLS. Since there is a substantial relationship, RLS can identify occult anemia, even if iron supplementation has not yet been shown in controlled trials to improve symptoms.
Thompson, Lowery	Title: Physician Organization: Neurology Consultants Date: 08/17/2006 Comment: I treat patients with restless leg syndrome as part of my practice as a Neurologist and Sleep Medicine Physician. I am board certified in both specialities. Iron studies, specifically serum ferritin levels, will sometimes identify patients who can be treated with iron replacement therapy, avoiding the use of more expensive and risky medications. Since there is some risk of hemachromatosis with iron replacement, I would not be able to recommend iron withou an initial evaluation of ferritin status. I order ferritin studies from an independent lab and receive no direct compensation for their performance. Thank you for your time and consideration. Less I treat patients with restless leg syndrome as part of my practice as a Neurologist and Sleep Medicine Physician. I am board certified in both specialities. Iron studies, specifically serum ferritin levels, will sometimes identify patients who can be treated with iron replacement therapy, avoiding the use of more expensive and risky medications. Since there is some risk of hemachromatosis with iron replacement, I would not be able to recommend iron withou an initial evaluation of More

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