Hi, and thanks for your medical question on eHealth\'s Ask a Doctor forum.
You should ideally get the blood levels of the following checked if they have not already been checked: potassium, calcium, sodium, vitamin B complex, or vitamins B1, B3, or B6 and Vitamin D. Generally deficiencies of any of the above can cause muscle twitching and spasms in localized or generalized areas of the body.
Get your kidney function, parathyroid gland function and adrenal function tests done because these affect the electrolyte balance in the body. Stress, alcohol, caffeine and fatigue all cause similar symptoms.
Since a confirmed diagnosis cannot be given on net please discuss these possibilities with your doctor once. Hope this helps. Take care!
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