taken on an empty stomach. There is recent evidence that RLS and hereditary hemochromatosis can coexist (Shaughnessy et al 2005), and ferritin and transferrin saturation levels should be monitored while taking iron. Potential benefits from intravenous iron therapy, even in those without systemic iron deficiency, were suggested by a study in the 1950s (Nordlander 1953) and is currently the subject of investigations. Randomized trials have demonstrated the efficacy of levodopa (Trenkwalder et al 1995), pergolide (Pieta et al 1998), ropinirole (Pellecchia et al 2004) and gabapentin (Thorp et al 2001) in uremic patients or in those undergoing hemodialysis. Such patients are also reported to benefit from intravenous iron therapy and from successful transplantation (Sloand et al 2004). The treatment of RLS in pregnancy is complicated by the unsuitability of most of the available medications and nonpharmacological methods should be encouraged. Treatment of iron deficiency seems reasonable, but has never been evaluated. Lower folate levels are associated with RLS during pregnancy (Lee et al 2001). Folate supplementation is now standard advice for those planning pregnancy; compliance with this advice should be checked, and folate levels assessed if necessary. Treatment summary In patients with regular, troublesome RLS symptoms, a dopamine agonist is the current treatment of choice, although it should be noted that there have been few satisfactory studies comparing different treatment modalities for RLS. If dopamine agoints are poorly tolerated or ineffective, gabapentin or oxycodone should be considered. . Levodopa is an excellent option for those with intermittent symptoms, such as during a long trip or meeting. It takes only 15 to 20 minutes to become effective, and augmentation is not a risk with infrequent use. 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