Why am I shaking?

Isn’t this an interesting question? What sort of shakes are there?

Temporary shakes

Anxiety, fear, feeling generally unwell and fever can all make your feel shaky or it can make you tremble. Of course, feeling shaky without knowing what’s causing it can make you feel anxious – which can lead again to shaking.

Tremor – what could be the cause?

If you feel shaky as a one-off, it’s likely that there is a temporary cause like fever, fear or stress. If you have recurrent or persistent episodes there are a lot of possible causes. An essential tremor is not related to a serious underlying medical problem. This is the most likely explanation for tremor if you feel otherwise well.

Causes of tremor are:

• Anxiety – feeling anxious, this is often accompanied by palpitations (fast heart beat), shortness of breath, dry mouth and sometimes chest pain
• Low blood sugar – most common if you have diabetes.
• Caffeine – large quantities of caffeine can lead to tremor and palpitations
• Medications – some examples: salbutamol (used to relieve asthma symptoms); lithium carbonate (usually used in bipolar disorder) some cancer treatments. Some antidepressants can also make you feel shaky, when you first start them.
• Recreational drugs
• Alcohol withdrawal – can lead to severe symptoms including shaking, anxiety, confusion, sweating, palpitations and even seizures
• Parkinson’s disease– tremor tends to be worse when you’re not moving
• Overactive thyroid
• Multiple sclerosis – tremor is unlikely to be the only symptom you get

Essential tremor or a benign tremor does not cause any harm, but it can affect simple daily activities and people’s self-esteem.

It tends to start in one arm, gradually spreading to the other. It often stops there, but can affect your head and occasionally your legs. Stress, tiredness, heat and hunger can all make it worse.

If you have mild symptoms you do not need treatment. Just keep anxiety to a minimum and avoid tiredness and excess caffeine may be enough.

If you do need treatment, the mainstays for essential tremor are:

• the beta blocker propanolol and
• Primidone, a tablet originally developed to treat epilepsy.

Some people find that a tremor becomes less with drinking alcohol. You will however create bigger problems by drinking large amounts of alcohol regularly. My advice is to discuss any concerns with your trusted medical practitioner.