Ask the Pharmacist: Causes of muscle twitching

Suzy Cohen
Studies conducted so far do not establish a definitive link between caffeine and muscle cramps, but some research shows a possible connection. Stimulants can cause any muscle in the body to twitch, and coffee is a stimulant.

Do you ever get a little twitch near your eye, or on your ankle or calf? How about your finger or near your elbow? Almost everyone gets an occasional twitch and you feel it for a microsecond, then it goes away. This is normal.

Muscle twitches are almost always benign issues and not based in serious neurological disorders. If you’ve ever had an eyelid twitch for three days straight, you know it’s more annoying than anything else. The medical term for this symptom is called “benign fasciculation.” 

The typical eye fluttering you get, or thigh twitch is rarely a cause for concern.

Here are some of the most common causes for muscle twitching: 


This means you have excess calcium in your blood and that will cause your muscles to contract and twitch. It can be from excessive calcium supplementation, overdoing vitamin D or magnesium supplements, or from elevated parathyroid hormone (PTH). 

There are other causes for hypercalcemia too. A deficiency of calcium will most often feel like a cramp, not a twitch. 


This causes more calcium to go inside the cells, causing hypercalcemia, then the twitching begins.


If you breathe very fast, you will hyperventilate. This occurs during a panic attack or while exercising very hard and could trigger twitching too. Hyperventilating can occur as a side effect of certain medications, as well as with asthma or emphysema.


Too much coffee will do it! It causes production of catecholamines in your nervous system – think of dopamine and adrenaline- and these guys cause your skin to flutter and twitch like crazy, if you’re sensitive.


Some medications excite the nervous system and trigger the twitch. Usually a dosage reduction or discontinuation is necessary to stop this type of twitch. 


If you smoke tobacco, you are apt to occasionally twitch due to the stimulant you’re smoking. 


You can take a blood test to determine B12 levels and if they’re low, just supplement. A B12 deficiency can also lead to high homocysteine levels. 


This can become very pronounced in bed, as you’re trying to sleep but you keep twitching. Anxiety twitching stops while you’re sleeping and has to do with stress. It shouldn’t recur each night unless you’re constantly stressed and you’re dealing with insomnia. 


If you have constant, never-ending twitching, have your blood levels checked for homocysteine, and if they are high, you might need B12.


A gentle chiropractor or massage therapist or acupuncturist may be able to help tease this one out. 


Occasional muscle twitches will occur sometimes after doing a lot of physical activity or working out. These are frequently felt in the forearms, calves, thighs, tummy and back. 

More:Ask the Pharmacist: Causes and solutions for dysphagia

And:Ask the Pharmacist: Calcium channel blockers and cancer risk

Also:Ask the Pharmacist: Two steps to making thyroid hormone

If you have muscle twitches that don’t go away after a few days and you are worried about them, please see a qualified physician for a proper medical work up to tease out what’s really going on. 

Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Visit