hi and welcome gp!
ms patients are known to have quite a few nutrition problems linked to energy levels and muscle function.
one of the first things you could do would be to make sure that nutrients are in no way contributing to your fatigue and muscle twitching issues.
may i ask what your diet is like, and if you are female? also, would you say your consumption of alcohol is linked in any way to helping with sleep or anxiety issues?
i'd like to draw a couple of essential nutrients to your attention:
the single most common nutrition problem anywhere is with iron. low iron means low oxygen delivery to cells and that means fatigue. young women are at particular risk.
Nutrition of Women and Adolescent Girls: Why It Mattershttp://www.prb.org/Publications/Article ... tters.aspx
"Although malnutrition's effects on this group have been recognized for decades, there has been little measurable progress in addressing the specific nutritional problems of women and adolescent girls. Ignorance about the symptoms of malnutrition, such as the lethargy and depression caused by iron deficiency, may be dismissed as "normal" or unimportant, further exacerbating the problem.1"http://kidshealth.org/parent/growth/feeding/iron.html
-Adolescent boys should be getting 11 milligrams of iron a day and adolescent girls should be getting 15 milligrams. (Adolescence is a time of rapid growth and teen girls need additional iron to replace what they lose monthly when they begin menstruating.)
-Young athletes who regularly engage in intense exercise tend to lose more iron and may require extra iron in their diets.
you can compare what you eat iron-wise to the daily targets given above, by checking the food chart here: http://www.whfoods.com/genpage.php?tnam ... #foodchart
another commonly neglected nutrient is magnesium. low magnesium status also results in fatigue, as well as muscle twitches and anxiety (not to mention that magnesium can help with PMS pain and mood issues).http://ods.od.nih.gov/factsheets/Magnes ... kFacts/#h5
"The diets of most people in the United States provide less than the recommended amounts of magnesium. Men older than 70 and teenage girls are most likely to have low intakes of magnesium."
compare this chart to your diet to see if you are getting at LEAST 400mg magnesium per day http://www.whfoods.com/genpage.php?tnam ... #foodchart
alcohol consumption depletes a wide array of nutrients across the board. magnesium is a significant one, and so is zinc.
low levels of these minerals affect your ability to absorb and/or utilize other nutrients such as b12.http://healthyeating.sfgate.com/zinc-teens-4589.html
"teen boys between the ages of 14 and 18 should consume 11 milligrams of zinc daily. Teen girls of the same ages require 9 milligrams of zinc each day." https://wrightnewsletter.com/2005/05/30 ... eficiency/
"In this country, teenagers are at the highest risk of zinc deficiency, since zinc is used at higher rates by the body during times of intense cell growth and division."
here's the food chart for zinc - make sure you are getting enough! http://www.whfoods.com/genpage.php?tnam ... #foodchart
you'll notice some overlap between the food lists and that's great - it means you can be working towards multiple targets with each food serving.
do focus on unprocessed food as much as possible to address your need for these various essential nutrients. you'll get far more out of whole healthy foods than just these single essential nutrients on their own. if you just can't get there with healthy food, at least try to get part way and only use a supplement to top up where necessary.
note that in addition to the detrimental effects of alcohol, that high consumption of wheat bread can also make it challenging for your body to absorb nutrients. it's all about balance
looking forward to hearing more about your diet, so we can help you figure this out!
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com