Tremors or ‘the shakes’ can usually be controlled. Sometimes, they are the signs and symptoms of hypoglycemia. Blood glucose levels should be checked within 15 minutes, using the finger-stick glucose test. If the blood glucose level isn’t normal or near normal, repeat the carbohydrate dosage. If hypoglycemia persists, or symptoms become more severe, seek immediate emergency medical care.
We all have natural, physiological tremor. It’s caused by continuous ‘traffic’ down the nerves from our brains to the muscles that control bending and stretching each joint. We’re not usually aware of this traffic, unless it becomes exaggerated for example, by the adrenaline surge we get when we’re anxious or angry.
Hangovers/alcohol withdrawal can also cause temporary shakiness (a sign that you’ve overdone it). Many medical conditions can cause tremors, which can be embarrassing, inconvenient or occasionally disabling, so it’s important to find out the cause.
Essential Tremors (ET)
ET can run in families and becomes more common with age, affecting one in 25 older people. It doesn’t usually occur until you try to use the affected part, but may fluctuate, depending on what you’re doing, or get worse with time. Initially, it tends to affect one hand or arm (rattling teacups is a common complaint) but can spread to the other arm, the legs, or even the head, mouth and/or voice. It only causes a tremor, doesn’t occur during sleep and doesn’t progress to other neurological symptoms.
Other Causes of Tremors
An overactive thyroid and some medicines used in asthma and depression can cause shaking at rest, which improves once your thyroid is treated or the drugs are changed/reduced.
However, if you have additional neurological symptoms, such as weakness, stiffness, numbness, pins and needles, or problems with coordination and balance, your GP will need to consider Parkinson’s, MS, tumours, stroke and other neurological conditions. More rarely, chemical imbalances, or tumours that produce adrenaline, toxins or vitamin deficiencies may be to blame.
Tests and Treatment
Your GP may be able to diagnose ET simply by examining you, but you may need to stop or change your medication, or see a neurologist to rule out other conditions, using blood tests, brain scans, and/or nerve signal checks.
Treatment depends on the cause. ET often improves with self-help but may require drug treatment with beta-blockers (used in heart disease) when required or regular primidone/other drugs used for epilepsy.
If your symptoms are disabling, you may be offered Botox injections or neurosurgery. Thalamic deep brain stimulation and thalamotomy use an electrical probe, ultrasound or radiation to target the brain area responsible for sending out nerve signals.
Ways to help Essential Tremors
- Identify and reduce your triggers for example, fatigue, caffeine; or temperature extremes. Don’t stop suspect medication without speaking to your GP.
- Stress can make ET worse. Try relaxation techniques, such as mindfulness or complementary therapies.
- An alcoholic drink can calm the tremor in social situations (however, frequent or heavy use is not recommended).
- Contact your National Tremor Foundation for more information and guidance.
E371 – Tremors, An Occasionally Everyday – diabetic.today