Unusual Causes for Muscle Twitching

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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 3 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. In fact, you might be able to figure out what the cause is before it even goes away! That’s because there are easily traceable causes for benign fasciculations, but they may last a few days, sometimes a week or two. If it persists of course, you do need to see a qualified medical practitioner to help you tease out what’s really going on. 

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

Hypercalcemia or High Calcium.
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. 

Elevated Vitamin D.

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

If you breathe very fast, you will hyperventilate. This happens more on occasion to someone who suddenly receives stressful news, or experiences a panic attack or state of phobia. When you hyperventilate (sometimes termed “over-breathing”) during a panic attack or while exercising very hard, then you could start twitching too. Hyperventilating can occur as a side effect of certain medications, as well as with asthma or emphysema. It can trigger the twitch.

Too much coffee will do it! Excessive caffeine from Red Bull drinks and espressos (or whatever!) tends to amp up the 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. It could last for a while until your body breaks down the catecholamines.

Medications for ADHD or Antidepressants.

Some medications are associated with muscle twitching due to their stimulating nature. They 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. 

Small Fiber Neuropathy.

I recently wrote an informative blog entitled, Small Fiber Neuropathy Causes and Treatment and I’ve continued to research this topic because I believe it is underdiagnosed, and too many people are suffering with it. Several studies have shown that about half of people with fibromyalgia have reductions in their epidermal nerve fiber density (ENFD as detected by skin biopsy) and it’s consistent with SFN! I also came across an ARTICLE that connects muscle twitching (aka benign fasciculations) to rheumatological disorders and small fiber problems. Here’s the STUDY about twitching and small fiber neuropathy.

Recent Viral Infection

People who get a cold or flu will often take antihistamines or decongestants that contain pseudoephedrine. Albuterol is the most popular inhaler that people use to open their airways. This medicine belongs to the “beta-agonist” drug category and those can cause muscle twitches. Medications like the three I’ve listed above are associated with muscle twitching that is temporary. Keep yourself well hydrated and take the proper dose of prescribed antihistamines, decongestants and beta-agonists.

There is a lesser known reason for twitching, and it’s the virus itself, not the medication that treats the virus. So for the sake of completeness, I will tell you that even COVID or HIV have the possibility to cause temporary muscle twitching. 

B12 Deficiency.
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. 


The use of MRI contrasts that are gadolinium-based has been associated with a chronic twitch as in benign fasciculation syndrome. This dye may also cause the sensation of ‘electrified skin’ in some people and other neurological abnormalities. If you’d like to read my article about this topic, CLICK HERE.

Hyperhomocysteinemia (HHcy).

The influence of high homocysteine is well known in the heart, it can even increase the risk of a heart attack. But for muscles, it is not always considered in the differential diagnosis of chronic muscle twitching. If you have constant, never-ending twitching, have your blood levels checked for homocysteine, and if they are high, you might need B12. Low B12 and folate are sometimes the cause for HHcy. 

Pinched Nerve in Spine.

This may lead to muscle twitching too. 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. I get this sometimes too if I overdo it at Zumba. It happens because lactic acid accumulates in the muscle cells used during exercise, but it doesn’t last long.  As the lactic acid is cleared, the twitches stop. These are frequently felt in the forearms, calves, thighs, tummy and back. 

If you have muscle twitches that persist and you are worried about them, please see a qualified physician for a proper medical workup. They will have to do electrolyte panels, a urine test, and possibly some imaging. A nutrient profile is important to determine if the twitching has to do with a nutrient deficiency. The OATS test (Organic Acids) is a good test to take if you want to do a thorough test and see lots of biomarkers. I love the OATS test as a basic test for people anyway, and it’s particularly helpful for this type of symptom. You can buy it directly by clicking on the left side of their WEBSITE on the words “Order a Test,” or alternatively you can ask a physician to get it for you on your next visit.