It’s four o’clock in the morning and I’ve been walking in a tight circle in my bedroom, on and off, for three hours.

The feeling I’m battling is hard to describe: an uncomfortable, shuddering, electric almost-pain that is shooting through my legs. But if you’re struggling to sleep in the heatwave, you might already be familiar with what I mean. 

Heat is a surprisingly common trigger for my affliction: restless legs syndrome (RLS). The UK going through its hottest June on record is bad news for many sufferers. 

Not long ago I was going up and down the stairs, which proved most relieving for my calves. Before this I was doing yoga poses. Even though my body is driving me on, I’m so tired I can barely open my eyes.

When things calm down, I return to bed for a few seconds until the feeling starts again. And the only way to relieve it is to move. I step out of bed, and begin again.

I’m pregnant – and have developed restless legs syndrome, a common disorder described by the NHS as an overwhelming urge to move your legs to stop an uncomfortable sensation.

That’s not the half of it. People affected describe it as like fizzy water in their veins; insects crawling beneath the skin; a burning, itching, tingling, or internal pins and needles.

RLS, also known as Willis-Ekbom disease, affects feet, calves and thighs in particular – but can affect your arms and torso, too.

Up to 10 per cent of people in the UK will experience it. It is a common condition but many won’t have heard of it, suggests Dr Julian Spinks, a GP and chairman of RLS-UK.

India Sturgis developed Restless Leg Syndrome while pregnant. The disease affects feet, calves and thighs in particular

Symptoms tend to be worse at night and are linked to tiredness, yet it can prevent sleep, leading to a vicious cycle. As such, RLS is considered a sleep disorder and can cause insomnia and trigger anxiety and depression.

According to Dr Spinks, it’s hard to say exactly what causes it, as it’s ‘so under-researched’.

‘We used to think it was mostly due to low dopamine, the neurotransmitter chemical that sends signals between brain cells and is related to muscle movement, as the drugs that were most effective at treating RLS were dopamine agonists, which effectively mimic dopamine,’ he explains. ‘Now we know this isn’t the whole picture.’

In fact, he says, taking these drugs for too long – ‘sometimes from three years but commonly after five years’ – can make symptoms worse.

Now it’s thought that the most likely cause of RLS is insufficient iron in some parts of the brain. ‘This affects brain function, including dopamine pathways, causing RLS sensations via the central nervous system, although how, why and the mechanism of action remains a mystery,’ says Dr Spinks.

There may be a genetic predisposition to it. It can also accompany other conditions, such as kidney disease, deficiencies in magnesium and calcium, arthritis, Parkinson’s disease and hormonal changes.

That it’s worse at night could be a clue as to why it happens. ‘We have got a sleep-wake brain cycle,’ says Dr Spinks. ‘So it may be that the changes that happen in the brain when you go to sleep start to bring this on.’

Likewise, some medication can trigger symptoms – including some antidepressants, antihistamines (often taken for hay fever and allergies), as well as blood pressure drugs such as calcium-channel blockers, and lithium. 

RLS is a common disorder described by the NHS as an overwhelming urge to move your legs to stop an uncomfortable sensation

‘A lot of these have brain effects and make you feel sleepy, which many believe might bring on symptoms,’ he adds. Women are twice as likely to develop RLS as men, possibly because of hormonal fluctuations – especially during pregnancy or the menopause – but also due to lower iron reserves from losing blood through menstruation. It usually develops in middle age (from 40 to 45).

RLS is a bare-faced mystery. As a result, the internet is awash with theories on how to cure it.

Two of the more bizarre ones, which I tried, included putting a rubber band around the middle of each foot (the pressure is said to disrupt the uncomfortable internal signals) and drinking tonic water (which contains quinine, a compound that used to be used to treat leg cramps). Neither worked.

Having never experienced RLS before, including during a previous pregnancy (my first child is now six), it hit like a freight train, aged 37. When it began, at eight weeks pregnant, whenever I tried to sleep or nap, I dismissed it as yet another weird symptom of growing a small human.

But soon, even just lying in a darkened room reading to my six-year-old felt like torture, so I’d read The Magic Faraway Tree with my legs in the air, ankles circling, bending and flexing, my daughter laughing and telling me that I’m crazy. I felt crazy. 

Five years ago this was made official when I was diagnosed with chronic insomnia and generalised anxiety disorder (GAD), which I recovered from, but a return of anxiety and insomnia, however fleeting, is something I was keen to avoid.

As my pregnancy progressed, the sensation became more intense – and was happening perhaps 50 or more times a day. I tried everything: yoga, baths with Epsom salts (magnesium sulphate is thought to help relax muscles), massage (a battery-powered massage gun was fairly effective), rubbing Vicks on to my legs (not sure why, but I was willing to try it), and cutting out sugar (there’s anecdotal evidence this might feed into symptoms for some), caffeine and alcohol (likewise).

I went to the GP, discussed it with five midwives, two consultants, a psychiatrist and a neurologist, but no one knew what to suggest other than a hot bath and wait in the hope it would ease off once I had my baby.

The drugs usually prescribed – dopamine receptor agonists such as pramipexole or ropinirole, or alpha-2-delta ligands such as pregabalin or gabapentin – are not considered safe to take in pregnancy. I was told by a neurologist I could try clonazepam to sleep – a tranquilliser – but this should be a last resort as there are risks including reduced foetal growth and preterm birth.

My options were, then, a hot bath or a benzodiazepine. With 100 days left of pregnancy I was starting to dread night-time – and I was getting dizzy spells during the day due to being awake for whole nights.

Thank God for Googling in the early hours – I found an article by Professor Guy Leschziner for the BMJ about RLS.

Professor Leschziner is a neurologist specialising in sleep disorders and someone I’ve actually interviewed for a book I’m writing about anxiety.

I emailed him and he came straight back with a few sentences that changed everything – but could be boiled down to one word: codeine.

Codeine is a painkilling opioid that’s considered safe in pregnancy, but as it can cause dependency it is not recommended long-term. It works on the central nervous system and brain, blocking pain signals, as well as RLS sensations.

‘I wouldn’t recommend it widely, but it can be helpful for some people,’ says Professor Leschziner. ‘I prescribe it for individuals who have very intermittent RLS or when a situation would be unmanageable for them, such as during pregnancy or a long-haul flight or car journey.’

I returned to my GP and requested it: codeine is listed as a recommended RLS treatment in the National Institute for Health and Care Excellence (NICE) guidelines. I started taking 15mg.

That first night I slept better – the feeling was still there, but dramatically reduced. The next day my head felt my own again and I could see a way out. In days, as my sleep banks rebuilt, the feeling receded further.

I wish someone had suggested it earlier but, according to Dr Spinks, ‘it’s a degree of luck whether your GP knows much about RLS’, he says, as it’s not on their training curriculum.

Professor Leschziner says while 10 to 15 per cent of RLS patients require medication, the majority manage the condition by testing for low iron and taking supplements or having iron infusions, removing medication that exacerbates symptoms, and using exercise and massage for flare-ups.

Why might massage and exercise help? ‘It’s possible that by getting other sensory input from running or having your legs rubbed you’re creating other sensory neural signals that disrupt the transmission of RLS discomfort or pain.’

As my due date approached, I upped the codeine to 30mg as the symptoms progressed, but I kept sleeping and remained sane. After my baby – a very happy boy – was born in June, I came off the codeine and the RLS disappeared after three weeks.

If I meet it again in life – a risk once you experience it in pregnancy, studies show – I will now be far better equipped, no rubber bands required.

Do I really need…

This week: Smartbud, £29,99, thesmartbud.com

The idea is you attach this pen-size otoscope – a device that allows you to see inside the ear – to your phone: this then relays images from your inner ear on to the screen. You can use the light, camera and a choice of two differently shaped flexible silicone heads to remove wax from the ear canal. 

Expert verdict: ‘You should not insert anything into your ear yourself – poking around in it risks pushing anything further down the ear canal, potentially causing damage and introducing an infection,’ says Maddie Maliszewska, an audiologist with Boots Hearingcare.

‘Even just inserting this probe into the ear to see what is happening comes with these risks.

‘If you’re concerned that your ears are blocked, you have a possible ear infection or you’re experiencing ear-related symptoms, this needs to be investigated by a trained health professional.’

Getting hooked up to a NAD+ drip or taking it as a supplement has become one of the most fashionable anti-ageing trends in wellness.

Hailey Bieber was filmed receiving an NAD drip on an episode of The Kardashians, joking: ‘I’m going to NAD for the rest of my life, and I’m never going to age.’

Gwyneth Paltrow has spoken publicly about her enthusiasm for IV wellness treatments, while Jennifer Aniston has been reported to use NAD+ IV drips, helping fuel the treatment’s celebrity cachet.

Now NAD+ has become one of the hottest buzzwords in wellness, sold in forms ranging from IV drips and at-home injection kits to pills, powders and stick-on patches.

Clinics and supplement brands claim it can boost energy, sharpen the brain, strengthen immunity and even help slow ageing.

But experts are divided. Some warn the booming market has raced ahead of the science, with products that may be useless, poorly regulated or potentially risky. Others insist they have seen real improvements in patients, particularly those suffering from fatigue, brain fog and poor sleep.

NAD+, short for nicotinamide adenine dinucleotide, is a molecule found in every living cell. It plays a crucial role in helping the body convert food into energy and is also involved in DNA repair and other vital cellular processes.

Dr Michael Sagner, a clinical adviser at King’s College London who specialises in longevity and preventative medicine, told the Daily Mail: ‘It’s an essential component of how a living cell produces energy – obviously without energy it would die. And as we age, it has been shown that NAD levels decline.’

NAD+ has become a lucrative longevity trend – but does the science match the claims?

That age-related fall has helped turn NAD+ into a lucrative longevity trend. Supporters claim topping up levels may help tackle tiredness, brain fog and signs of ageing by improving how cells function and repair themselves.

Dr Sagner said: ‘The assumption was that if we stop this decline, or if we somehow managed to increase energy levels, that we could slow down ageing.’

A booming market has followed. NAD+ IV drips can cost hundreds of pounds a session, with some clinics charging up to around £400 for an hour-long treatment and more for longer courses. At-home injection kits can cost about £350 for a month-long course, while pills, powders and patches are sold for anything from £20 to £80 or more.

Market estimates vary widely, depending on whether analysts are counting NAD+, NAD precursors, supplements, skincare or wider longevity products. But the broader NAD+ and NAD-precursor sector is now valued from the hundreds of millions into the billions, with forecasts predicting sharp growth over the coming years.

While the marketing has become increasingly glamorous, Dr Sagner argues the evidence in healthy humans remains limited and any claims that NAD+ products can extend life or reverse ageing are largely unproven and are based mainly on animal studies.

‘It’s extremely difficult to do these trials because you’d have to have thousands of patients, and make sure they take it every day,’ he said. ‘And what will we actually measure?

‘In animal models where you have a life expectancy of a year, two years, three years, it’s a lot easier to measure these things. In humans it’s basically impossible. It hasn’t been done for any substance that increases NAD levels.’

He said there are some ‘promising’ disease-specific studies, including in Parkinson’s and cardiovascular disease, but added that this is very different from proving that NAD+ can keep healthy people young.

Dr Enayat claims his patients have seen positive results after taking NAD+

‘It’s very difficult to measure ageing,’ he said. ‘It’s more about being disease-free for as long as possible as you get older.’

His biggest concern is the popularity of NAD+ IV drips, which deliver the compound directly into the bloodstream.

Dr Sagner described parts of the NAD+ drip industry as ‘murky’ and a ‘very grey market’.

He said: ‘A lot of stuff that happens in these underground drip clinics in London and elsewhere are very hush-hush.

‘Some of them have apparently removed the NAD+, and just tell the patients it’s NAD+ and charge them for it. They infuse a little bit of vitamin C or something else because they are afraid of the side effects, but they still want to make money.’

He added: ‘You can’t really take NAD+, or you shouldn’t, especially intravenously. Those drip clinics that offer it are very dangerous.

Do you want to lose a stone in six weeks?

 

Hi, I’m Emma Bardwell, a nutritionist with more than 15 years’ experience helping people improve their health and lose weight.

I’ve been there. I was overweight, unhappy with my skin and stuck in a rut. Then I changed the way I eat. You can now do the same with my tried-and-tested healthy eating plan. And for DailyMail+ subscribers, it’s completely free. 

Click here to sign up and start your journey

‘We have seen a lot of adverse side effects such as inflammation, allergic reactions, and so on.

‘After the drip, people can have headaches and dizziness.’

Dr Sagner said he had heard reports of serious complications following NAD+ infusions, although such cases can be difficult to verify publicly.

He also questioned whether many of the products being sold actually increase NAD+ in a meaningful way. According to him, the body is designed to make NAD+ inside cells from precursor compounds, rather than receive NAD+ directly through the bloodstream.

He said: ‘Your body doesn’t want it in the bloodstream. The only thing that makes sense is taking NR orally, if someone wanted to increase their NAD+ levels.

‘It’s a small molecule, but it does not enter the cell. Which means your body has to break it down, which partly explains why people who take any of it intravenously by a drip get this inflammatory response, because you should not have a high amount of NAD, or probably any NAD, in your bloodstream. It belongs in the cell.

‘Your body uses precursors, little components, building blocks, and then makes it inside the cell.’

The two best-known NAD+ precursors are NR, or nicotinamide riboside, and NMN, or nicotinamide mononucleotide. These are sold as supplements and are designed to give the body the raw materials to make NAD+ itself.

Dr Sagner said that, if someone is determined to try to raise their NAD+ levels, oral NR is the most sensible option.

‘NR is the gold standard if someone wants to increase their NAD levels,’ he said.

However, he warned consumers to be careful about where they buy supplements from because quality and regulation vary widely.

In the UK, NAD+ supplements sold without medicinal claims are generally regulated as food supplements rather than medicines, meaning they are not assessed by the MHRA for efficacy in the same way as licensed drugs.

Dr Sagner said some products are made by suppliers that adhere to recognised quality standards, but added that many IV drips, powders, patches and at-home kits are not properly tested.

‘You never know where that’s actually coming from,’ he said.

He was particularly sceptical of NAD+ patches, saying they ‘make no sense’.

There is also a more controversial concern: whether artificially boosting NAD+ could have unintended consequences.

Dr Sagner said: ‘We don’t want to boost NAD levels endlessly. There is the risk of increasing your cancer risk.’

NAD+ supplements have not been proven to cause cancer in humans. But some scientists have raised theoretical concerns because NAD+ is involved in cellular energy production and DNA repair, processes that are also important in cancer cell survival and growth.

There may also be another downside to trying to make cells more metabolically active. Dr Sagner said that boosting the pathways involved in energy production could also increase the amount of biological ‘waste’ produced by cells.

‘Whenever you boost something or increase something that actually increases possible energy production, you also increase the amount of waste product,’ he said.

In other words, the concern is that driving cells to produce more energy may also create more by-products that the body has to process and clear.

Dr Sagner added that many long-lived animals tend to have slower metabolisms rather than faster ones.

‘And we know that animals that live a very long life actually have a very slow metabolism. Turtles, elephants, and so on.’

The point, he said, is that ageing biology is more complicated than simply trying to make cells run faster.

But not all doctors are so sceptical about NAD+.

Dr Enayat, a GP and founder of the longevity clinic HUM2N, argues that it can be beneficial for some patients and says he has seen improvements in symptoms such as brain fog, low energy and poor sleep.

And in his opinion, whether NAD+ enters the cell directly or is simply introduced to the blood is less important to him than the clinical improvements he sees in practice.

‘I’m not a scientist, I’m a doctor,’ he said. ‘I see my patients improve, clinically – and that’s where I build my confidence with them. Whether the NAD+ is extracellular or intracellular to me, is by the by.’

He added: ‘In theory, scientists say it has to be intracellular to provide any noticeable benefit, but I would argue and say that if that’s the case then why do my patients feel better energetically? How do they report better motivation?’

Dr Enayat said around 75 per cent of his patients report symptom improvements, including better energy, sleep and mental clarity.

However, he also warned that NAD+ is being oversold.

He said: ‘There is a lot of misselling of NAD+, with people upselling that this is going to be some kind of transformation for anyone and everything at the same time. And I don’t believe it’s that, I think you need it when you’re depleted.’

That view is not entirely at odds with Dr Sagner’s more cautious advice. He said the most sensible approach is not to chase NAD+ blindly, but to check whether levels are actually low.

‘A smart idea would just be to measure it,’ he said. ‘If you think you have low NAD levels, there are labs, they can measure it.

‘And if your levels are low, why not just take NR for a while, measure again, treat it like a deficiency instead of injecting yourself, or taking something randomly.’

He said oral supplements may be able to raise NAD+ levels within one or two weeks, adding: ‘If you’re forty plus, maybe just get some high-quality NR and take it for three weeks and see how you feel – if it improves energy levels.’

But he stressed there is still no proof that doing so will deliver long-term anti-ageing benefits.

When contacted for comment regarding NAD+ supplements, a representative for the MHRA said: ‘In the absence of medicinal claims, NAD+ supplements are not medicinal products and they do not fall under the remit of MHRA; we cannot advise on their efficacy or safety.’

For now, experts say anyone considering NAD+ injections or IV drips should be cautious, particularly if they have existing health problems, are taking medication or have a history of cancer.

And while the celebrity wellness world may be selling NAD+ as the latest shortcut to youth, the more measured advice from both sides is less glamorous: avoid overblown claims, be wary of unregulated providers and do not assume that more is always better.

By EMMA GRITT, ASSOCIATE HEALTH EDITOR

Published: 11:43 BST, 27 June 2026 | Updated: 11:47 BST, 27 June 2026

[noscript_1]

It seems almost everything comes with ‘extra added protein’ these days, from bread and breakfast cereal to chocolate mousse.

But protein is not just a marketing buzzword, it is an undeniably important nutrient, used every day to repair tissue, maintain strength, support the immune system and keep organs, skin, hair and nails healthy.

As we get older, protein becomes especially important for helping preserve muscle mass, strength and mobility, all of which play a role in staying independent and well.

It can also help us feel fuller for longer, because protein tends to be more satisfying than many refined carbohydrates and takes more work for the body to break down.

Unlike fat and carbohydrate, protein is not mainly stored by the body as a reserve fuel.

That means we need a regular supply from food – and that does not mean chomping down on a steak every day.

Some assume meat is the only reliable option, while others worry plant-based diets cannot provide enough.

In reality, the picture is more nuanced, and the quality, variety and spread of protein across the day can all make a difference.

Protein comes in many forms – not just steak 

Protein is naturally present in scores of different foods, from eggs, yoghurt, fish and chicken to beans, lentils, tofu, nuts and seeds.

There are also countless protein bars, shakes and powders aimed at people looking to build muscle, cut calories or simply boost their daily intake.

Protein is also one of the key pillars of nutritionist Emma Bardwell’s The 30g Plan, a practical eating style built around four goals: 30g of protein with each meal, 30g of fibre a day, 30 different plant foods each week, and a small calorie deficit if weight loss is the aim.

Last month saw the release of The 30g Plan Cookbook, which we are exclusively serialising for Mail+ members.

Over the course of six weeks, the plan guides readers through a realistic, sustainable approach to healthy eating, with the aim of supporting weight loss, better energy, improved digestion and overall wellbeing.

There’s also a weekly weight loss group to meet other people on the plan, to get support and swap tips for making the plan work for you. 

Yet when it comes to protein, many people are unsure how much they actually need – or which foods provide the best sources.

So how much do you really know about protein – where to find it, how your body uses it, and whether you are getting enough? Take our quiz to find out.

Do you want to lose a stone in six weeks?

 

Hi, I’m Emma Bardwell, a nutritionist with more than 15 years’ experience helping people improve their health and lose weight.

I’ve been there. I was overweight, unhappy with my skin and stuck in a rut. Then I changed the way I eat. You can now do the same with my tried-and-tested healthy eating plan. And for DailyMail+ subscribers, it’s completely free. 

Click here to sign up and start your journey

What foods are good for blood pressure?

Why is high blood pressure dangerous?

Other foods that are good for specific health conditions