You should be investigated for anemia which can explain all;restless leg, tiredness and tinnitus.
The most common causes of tiredness or fatigue are;
Connective tissue diseases
Chronic infections like Epstein Barr virus
Endocrine diseases (Addison disease).
Chronic fatigue syndrome
You would need following investigations:
Complete blood count (CBC)
Liver function tests
Thyroid function tests
Erythrocyte sedimentation rate (ESR)
Serum electrolyte level measurement
Immunoglobulin M (IgM)/immunoglobulin G (IgG) coxsackievirus B titer
IgM/IgG human herpesvirus 6 (HHV-6) titer
IgM/IgG C pneumoniae titer
Rest Leg Syndrome can develop as a result of certain conditions, particularly iron deficiency and peripheral neuropathy. Other causes of RLS are folate or magnesium deficiency, amyloidosis, diabetes mellitus, lumbosacral radiculopathy, or vitamin B-12 deficiency. Following investigations are advised;
1) A complete iron panel including iron levels, ferritin, transferrin saturation, and total iron binding capacity.
5) thyroid-stimulating hormone (TSH),
6) vitamin B-12, and folate.
These investigation results will help to treat the primary problem so symptoms are benefited.
Following measures usually are helpful;
1) Avoidance of caffeine, alcohol, or nicotine (if one takes them).
2) Exercise before the bed time
a) Pramipexole (Pexola)
b) Ropinirole hydrochloride (Requip); which you are already taking.
Following treatment approaches are recommended, if Pexola is not helping (called as refractory RLS):
1) Change to gabapentin
2) Adding a second medicine like gabapentin, a benzodiazepines, or an opioid
3) Change to a high potency opioid or tramadol
In addition to above non pharmacologic therapy comprises of the following components:
1) Iron replacement therapy
2) Mental alerting activities such as video games or crossword puzzles, may reduce symptoms at times of boredom.
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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