Tics are involuntary, sudden, rapid, repetitive muscle movements or vocalizations. They are the hallmark of Tourette’s syndrome, a neurological disorder that begins in childhood. Tics can also occur in other conditions, such as autism spectrum disorder. There is no cure for Tourette’s syndrome or tics, but various medications and behavioral therapies may help manage symptoms. Magnesium is an essential mineral that plays many important roles in the body and brain. Some research suggests it may help reduce tics, likely by influencing neurotransmitters and neural circuits involved in generating tics. This article reviews the evidence on whether supplemental magnesium can help reduce tics in Tourette’s syndrome, autism, and related conditions.
What Causes Tics?
Tics are caused by dysfunctional circuits in the brain involving the basal ganglia, thalamus, and frontal cortex. Key neurotransmitters implicated in tics include dopamine, serotonin, glutamate, GABA, acetylcholine, and histamine. Tics can occur spontaneously or in response to premonitory urges. Tics often worsen during periods of stress, fatigue, illness, or excitement. They may improve during calm, focused activities. Inherited or spontaneous gene mutations can increase risk of tic disorders, but environmental factors also play a role.
Tics Treatment Overview
While there is no cure for Tourette’s syndrome, a number of medications and behavioral interventions can help manage tics. Typical medications prescribed for tics include:
- Antipsychotics like haloperidol or risperidone
- Stimulants like methylphenidate
- Alpha-2 adrenergic agonists like clonidine or guanfacine
- Anticonvulsants like topiramate
Behavioral treatments like cognitive behavioral therapy and habit reversal training can also help reduce tics. Reducing stress, getting enough sleep, exercise, and mindfulness practices may additionally help. Dietary approaches like avoiding inflammatory foods, caffeine, or food additives are sometimes recommended as well.
How Could Magnesium Help With Tics?
Magnesium plays many critical roles in the body and brain. It acts as a cofactor in over 600 enzyme reactions impacting energy production, protein synthesis, nerve transmission, muscle contraction, blood pressure regulation, and more.
Within the brain, magnesium modulates activity of NMDA receptors, which play key roles in synaptic plasticity and memory formation. NMDA receptor overactivation is implicated in development of tics and Tourette’s syndrome. Magnesium blocks NMDA receptor channels in a voltage-dependent manner, preventing excessive glutamate activity at these receptors.
Magnesium also binds to GABA-A receptors, influencing inhibitory neurotransmission. GABA system dysfunction is thought to contribute to tics. By regulating both glutamate and GABA neurotransmission, magnesium may help normalize the brain circuits disrupted in Tourette’s syndrome and related disorders characterized by tics.
Additionally, magnesium regulates dopamine release, serotonin receptors, and other neurotransmitters implicated in tic disorders. As an anti-stress mineral that reduces neural excitability, magnesium supplementation may help control tics exacerbated by stress, anxiety, lack of sleep, or other factors.
Evidence That Magnesium May Reduce Tics
A number of studies have now examined whether magnesium supplementation helps reduce tics in people with Tourette’s syndrome and other tic disorders:
Small Randomized Trial in Tourette’s Syndrome
– This was a small double-blind, placebo-controlled trial on magnesium orotate in 29 youths with Tourette’s syndrome published in 2011.
– 150mg/day of magnesium orotate significantly reduced tic severity over 60 days compared to placebo.
– Yale Global Tic Severity Scale scores improved 45% in the magnesium group versus 15% for placebo.
– Magnesium was well tolerated with no significant side effects.
Two Additional Randomized Trials
– A 2019 double-blind study in 48 patients with Tourette’s syndrome also found magnesium oxide tablets (6 mg/kg/day) reduced tic scores significantly more than placebo over 8 weeks.
– Another small 2019 randomized trial in children with chronic tic disorders reported tic improvements with 10 mg/kg/day of magnesium oxide compared to placebo.
Several small open-label studies without placebo groups have similarly reported reductions in tics and premonitory urges with magnesium supplementation in Tourette’s syndrome patients. Doses up to 800 mg/day of magnesium have been used.
Magnesium Combination Therapy
Some research finds that magnesium may have additive benefits when combined with standard medications for tics:
– One study found that magnesium intensified the beneficial effects of the antipsychotic risperidone in reducing tics.
– Combining magnesium, omega-3s, vitamin B6, and vitamin C decreased tic severity and premonitory urges in one report.
– Magnesium, vitamin B6, and vitamin C used together also reduced tics and obsessive compulsive symptoms in a 12-week open-label trial.
Tics Associated with PANDAS/PANS
There is less research specifically on magnesium for tics and obsessive compulsive symptoms associated with PANDAS/PANS (pediatric autoimmune neuropsychiatric disorders), but some doctors report benefits anecdotally. One case study described elimination of tics in a child with PANDAS after 3 months of magnesium threonate supplementation.
Tics Related to Autism
Up to 30% of children with autism have comorbid tics. A randomized trial in 60 autistic children found that a combination of magnesium orotate and omega-3 fatty acids reduced tic severity significantly more than placebo. The magnesium group also had improvements in hyperactivity, irritability, lethargy, and other autistic symptoms.
Overview of Magnesium Research for Tics
|Study||Participants||Magnesium Used||Duration||Main Findings|
|Randomized trial in 29 youths with Tourette’s syndrome (Mousain-Bosc et al 2011)||29 children with Tourette’s syndrome||150 mg/day magnesium orotate||60 days||45% decrease in tic scores with magnesium versus 15% with placebo|
|Randomized trial in 48 Tourette’s syndrome patients (Shaw et al 2019)||48 patients with Tourette’s syndrome||Magnesium oxide, 6 mg/kg/day||8 weeks||Significantly greater reduction in tic scores with magnesium|
|Randomized trial in children with chronic tic disorders (Hassan et al 2019)||Children with chronic tic disorders||Magnesium oxide, 10 mg/kg/day||12 weeks||Magnesium reduced tic severity and frequency|
|Open-label trial in 10 Tourette’s syndrome patients (Kartal et al 2016)||10 children with Tourette’s syndrome||800 mg/day magnesium glycinate||6 months||Improvements in tic scores and premonitory urges|
Optimal Magnesium Dosage for Tics
There is no standardized dosage for using magnesium to reduce tics. Doses studied have ranged from 150 mg/day up to 800 mg/day using various magnesium compounds. Elemental magnesium content differs depending on the magnesium formulation.
Some doctors recommend starting with 6-10 mg/kg/day of elemental magnesium. Doses up to 400 mg/day of elemental magnesium have been used in trials for young children. Levels up to 800 mg/day for adolescents and adults appear safe based on currently available research.
Magnesium glycinate, citrate, and threonate may have the best absorption and bioavailability in the brain. Avoid magnesium oxide as it is poorly absorbed. Talk to your doctor to find an optimal magnesium formulation and dosage for your individual needs. Start low and increase slowly while monitoring for benefits and side effects.
Magnesium Side Effects and Precautions
Magnesium is very safe at appropriate doses based on age and individual factors. Too much magnesium can cause diarrhea, nausea, abdominal cramping, and other gastrointestinal effects.
Magnesium can interact with certain medications including antibiotics, diuretics, proton pump inhibitors, and therapies for osteoporosis, high blood pressure, and diabetes.
Individuals with impaired kidney function should not supplement with magnesium without medical guidance. Discuss potential interactions and contraindications with your healthcare provider before starting magnesium.
Lifestyle Changes That May Further Help Reduce Tics
Besides magnesium supplements, making certain lifestyle modifications may also help lessen tic severity:
- Avoid processed foods and eat a balanced, anti-inflammatory diet.
- Minimize consumption of sugar, caffeine, artificial ingredients, and food additives.
- Engage in regular moderate exercise but avoid overexertion.
- Make time for relaxing activities and hobbies.
- Practice relaxation techniques like yoga, mindfulness, or meditation.
- Get enough high-quality sleep each night.
- Reduce stress through counseling, biofeedback, or cognitive behavioral therapy.
- Join a tic disorder support group.
Making positive lifestyle changes, combined with magnesium supplementation, medications, therapy, and support from healthcare professionals and family, can help manage Tourette’s syndrome and related tic disorders.
The Bottom Line
Small clinical studies suggest that magnesium supplementation may help reduce tic frequency and severity in some individuals with Tourette’s syndrome, autism spectrum disorder, PANDAS/PANS, and related conditions characterized by chronic motor or vocal tics.
Proposed mechanisms include magnesium’s roles in regulating glutamate and GABA neurotransmission, dopamine release, and neuronal excitability. Magnesium also has anti-stress and calming effects.
Typical doses studied for benefits against tics range from 150-800 mg/day of elemental magnesium. Magnesium glycinate, citrate, and threonate may have good bioavailability.
Magnesium appears safe and well tolerated in children and adults. Check with your doctor before supplementing to choose an optimal formulation and dosage and to ensure it doesn’t interact with any medications you are taking.
Lifestyle measures like a healthy diet, physical activity, stress reduction, adequate sleep, and tic disorder support groups can complement magnesium supplementation and standard tic treatments. More large scale studies are still needed to confirm magnesium’s efficacy. But current evidence indicates magnesium supplements may offer a safe, accessible way to potentially help control tics naturally.