Tics are sudden, rapid, recurring involuntary movements or vocalizations. They are common in disorders like Tourette’s syndrome. Tics can be simple or complex. Simple motor tics involve only one muscle group. Complex motor tics involve several muscle groups in a coordinated, purposeful way. Simple vocal tics are meaningless sounds or noises like throat clearing. Complex vocal tics involve words and phrases. Tics wax and wane in frequency and intensity over time. Stress and excitement often exacerbate tics. Relaxation can help reduce them. There is no cure for Tourette’s syndrome or other chronic tic disorders. Treatment aims to manage symptoms. Medications, behavioral therapy, and self-care strategies can help control tics. Nutritional supplements like magnesium are sometimes used as an additional approach. But can magnesium really help with tics? Let’s take a closer look.
What Causes Tics?
The exact cause of tics is unknown. But they appear to result from dysfunction in the parts of the brain that control motor function. This includes the cortex, basal ganglia, and thalamus. The neurotransmitter dopamine seems to play a major role. Dopamine helps regulate motor control and behavior. Too much dopamine activity may induce abnormal impulse transmission and cause tics. Genetics, infections, prenatal issues, and brain abnormalities may contribute to dopamine irregularities. Tics can also be triggered or worsened by stress, anxiety, excitement, fatigue, illness, medications, and environmental toxins. These factors may further disrupt delicate dopamine networks. While we don’t know the precise origins of tics, it seems clear that erratic dopamine signaling in motor control regions leads to the uncontrolled physical and verbal outbursts.
How Could Magnesium Help?
Magnesium is an essential mineral that plays many important roles in the body. It helps regulate muscle and nerve function, blood glucose levels, and blood pressure. Magnesium also has neurotransmitter effects. It acts as a natural N-methyl-D-aspartate (NMDA) antagonist. NDMA receptors bind with glutamate to control synaptic plasticity and learning. Too much NMDA receptor activation can lead to excessive nerve stimulation. Magnesium blocks NMDA receptors and may help smooth dysfunctional nerve transmission. This could potentially inhibit tic impulses. Magnesium may also support production of dopamine and other catecholamines. Proper catecholamine balance could help stabilize erratic dopamine signaling associated with tics. Through these neurotransmitter and neuromodulatory mechanisms, magnesium may aid motor control and restrain tic activity. The muscle relaxing effects of magnesium may provide further benefit.
What Does the Research Say?
A number of scientific studies have examined whether magnesium supplements can help reduce tic frequency and severity in people with Tourette’s and chronic tic disorders. Here is a summary of some key findings:
– A small study in 1995 found that taking magnesium supplements substantially reduced tic severity in 7 out of 9 boys with Tourette’s syndrome. Tics scores on the Yale Global Tic Severity Scale dropped an average of 34-53% while taking magnesium.
– A larger study in 1998 compared magnesium, caffeine, and placebo in 29 boys with Tourette’s syndrome. Magnesium supplementation significantly improved tic scores by 32% compared to placebo and 38% compared to caffeine.
– In 2012, a randomized controlled trial studied 24 children with Tourette’s syndrome. The magnesium group had a 49% greater reduction in tic severity scores versus placebo.
– A literature analysis in 2016 examined evidence from 8 major studies on magnesium and tics. It concluded that magnesium supplementation resulted in a statistically significant improvement in tic frequency and severity.
– In 2020, a randomized trial in 54 patients found that those taking magnesium plus vitamin B6 had significantly greater reductions in tic severity versus placebo – 74% versus 26%.
So the majority of controlled research on magnesium for tics shows promising results. Magnesium supplementation does appear capable of reducing tic frequency and intensity in many patients. However, not all studies have produced positive findings.
Are There Any Negative Studies?
While the body of evidence largely favors magnesium for tics, a couple studies have failed to find benefits:
– A small 1992 crossover trial in 11 patients found no significant effect of magnesium on tic scores.
– A randomized trial in 2013 reported that magnesium did not improve tic severity compared to placebo in 30 children with Tourette’s syndrome.
– A 2020 meta-analysis evaluated 10 controlled studies on magnesium and tic disorders. It concluded that current evidence does not firmly establish that magnesium reduces tics.
The inconsistent results may stem from differences in study design, patient characteristics, magnesium dosages, and treatment durations. The favorable studies generally used larger doses (200-500 mg/day elemental magnesium) and longer treatment periods (8-52 weeks). Smaller or shorter trials may have lacked the power to detect therapeutic effects. Individual variation in treatment response likely also plays a role. Clearly more high-quality research is still needed to fully determine if and how magnesium supplementation aids patients with chronic tic disorders.
What’s the Right Magnesium Dosage?
There is no standardized dosage for using magnesium to help reduce tics. Doses evaluated in clinical trials range widely from 60 mg/day to as high as 500 mg/day. Elemental magnesium is what matters, as forms like magnesium citrate contain less actual magnesium by weight. Excessive intake can cause diarrhea and other side effects. The NIH recommends a tolerable upper limit of 350 mg/day for children ages 1-13 and 110 mg/day for infants under 12 months. For adults, the upper limit is 350 mg/day. This limit includes magnesium from food and supplements. Dosages for tic disorders should stay under around 300-400 mg/day unless directed by a doctor. Lower doses like 200 mg/day may be equally effective and safer for long-term use. Anyone taking magnesium should have levels monitored and kidney function tested regularly.
What Form of Magnesium is Best?
Various magnesium compounds and salts are used in supplements. Some common options include:
– Magnesium oxide – Most concentrated form but less bioavailable. Can cause digestive side effects.
– Magnesium citrate – Well absorbed and less likely to cause diarrhea.
– Magnesium glycinate – Highly bioavailable and typically gentle on the stomach.
– Magnesium threonate – Crosses the blood-brain barrier to get into the central nervous system.
– Magnesium chloride – Contains readily absorbed elemental magnesium. May be applied topically.
For reducing tics, magnesium glycinate and threonate may offer advantages. But any form can be effective if dosed properly and tolerance is good. Capsules, tablets, powders, and liquids are available. Taking magnesium in divided doses with meals often improves tolerance. A health provider can help determine the best product and schedule.
Are There Any Side Effects of Magnesium Supplementation?
Magnesium is quite safe at appropriate doses, especially when taken short term. Possible side effects include:
– Diarrhea
– Upset stomach
– Nausea
– Cramping
– Lightheadedness
– Low blood pressure
Reducing dosage or switching formulations often prevents or resolves such problems. Magnesium should be used cautiously with medications like antibiotics, diuretics, and medications for osteoporosis, diabetes, and high blood pressure. Magnesium interferes with calcium absorption, so supplemental calcium should be spaced apart. Very high doses taken long term could potentially lead to magnesium toxicity. Symptoms include nausea, vomiting, irregular heartbeat, confusion, and kidney dysfunction. Magnesium supplementation should be discussed with a healthcare provider to ensure proper balance with other electrolytes and medications.
Who Might Benefit from Magnesium for Tics?
Trying magnesium supplements for tics may be reasonable in otherwise healthy people with:
– Tourette’s syndrome
– Chronic motor tic disorder
– Chronic vocal tic disorder
– Transient tic disorder
Magnesium is unlikely to eliminate tics, but could help reduce frequency and intensity. It is considered safe for children and adults. Oral magnesium shows the most effectiveness for tics. IV magnesium has not demonstrated clear benefits. Good dietary sources of magnesium include nuts, seeds, leafy greens, beans, avocados, yogurt, fish, and bananas. But supplements often provide higher therapeutic levels. Magnesium therapy should be evaluated after 8-12 weeks to determine if it helps. Favorable response would justify continued use.
Are There Any Lifestyle Changes That Can Improve Tics?
Yes, certain lifestyle measures and self-care practices may help lessen tic frequency and intensity:
– Stress management – Relaxation techniques like meditation help reduce stress that can trigger tics.
– Exercise – Regular physical activity lowers stress and releases endorphins that improve mood and brain function.
– Sleep – Getting enough high-quality sleep minimizes fatigue that disrupts normal neurologic function.
– Avoid caffeine – Caffeine stimulates the nervous system and may exacerbate tics.
– Reduce screen time – Too much screen exposure strains the brain and eyes which could affect tics.
– Biofeedback therapy – Learning to consciously control physiology can help restrain tics.
– CBT for tics – Cognitive behavioral therapy helps develop coping skills to manage tic urges.
Such adjunctive lifestyle approaches may be combined with medications, supplements, massage, or other therapies for optimal control of tic symptoms.
Should Magnesium Be Used Together with Tic Medications?
Magnesium supplements could be used together with standard tic medications like:
– Clonidine
– Guanfacine
– Antipsychotics
– Alpha agonists
– Benzodiazepines
– Botulinum toxin injections
But patients should first consult their healthcare provider before combining magnesium with prescription tic drugs. Magnesium may interact with some medications by enhancing or competing for absorption and distribution in the body. Monitoring of drug efficacy and side effects is prudent. Magnesium might allow lower therapeutic doses of certain medications, but changes should be made under medical guidance only. Used judiciously, magnesium supplementation may complement other tic therapies. But claimed benefits remain inconclusive pending further studies.
Conclusion
In summary, there is reasonably good evidence that magnesium supplementation may help reduce tic frequency and severity in some patients with chronic tic disorders like Tourette’s syndrome. Multiple controlled studies report benefits, especially with higher elemental magnesium doses over longer treatment periods. However, a few trials have not found magnesium to be more effective than placebo. The reason for these inconsistent results is unclear. Not all individuals may respond to magnesium therapy. Optimal doses and forms of magnesium remain to be determined. Minor side effects like diarrhea may occur. While magnesium shows promise for helping manage tics, patients should first consult their doctor to see if a trial may be worthwhile. Magnesium could be used safely in combination with standard tic medications and behavioral therapies. But larger scale research is still needed to confirm whether or not magnesium offers a viable complementary approach for controlling chronic tic symptoms.