Determine if there is significant reduction in tic severity with combined iron and magnesium supplementation.

Tic disorders (TD) are the most common movement disorder seen in children.  Older children admit to feeling an “urge” described as an impulse, tension, pressure, itch, burning, or tingle that is felt before a motor or vocal tic occurs.

Another common neurologic sensorimotor disorder affecting children is restless legs syndrome (RLS) characterized by complaint of an irresistible urge to move the legs.  RLS patients are often identified to be iron deficient with low ferritin levels.  Iron deficiency is considered a primary cause of RLS and patients often have symptom reduction when treated with iron supplementation.

Studies have found that children with tics had lower ferritin levels compared to those without tics.  One study suggested improvement in tic severity among patients with low ferritin levels when treated with ferrous sulfate. There are few studies investigating the efficacy of magnesium in TD or TS patients, and more research is needed as most publications indicating magnesium as a remedy are anecdotal.

Retrospective study reviewing medical records of patients seen in the pediatric movement disorders clinic between 2020-2025 with diagnoses of tic disorder (TD), chronic motor tic disorder, vocal tic disorder, Tourette Syndrome (TS) and iron deficiency to compile the following data points:

• Tic diagnosis
• Ferritin levels (pre- and post-treatment)
• Duration of treatment with iron and magnesium supplements
• Patient-reported tic severity level (pre- and post-treatment)

Families reported a 50-80% reduction in perceived tic severity after a minimum of 3 months of daily iron and magnesium supplementation compared to patients taking only iron or only magnesium supplementation.  Those who experienced reduction in tic severity were found to have improved ferritin levels.