Do trembling hands always have something to do with Parkinson’s? The so-called tremor has many different causes – experts explain the background and know when you should see a doctor.

When we tremble, the muscles contract and relax in rapid succession—it’s beyond our control. It is normal for nervousness to make us tremble – for example, when we have to give a speech in front of a large number of people. The cold also makes us shiver.

What if your hands suddenly tremble for no apparent reason? In such a situation, many people are concerned at first. Especially when that involuntary tremor keeps coming back.

Those affected then fear that they have Parkinson’s disease. But that is by no means always the case. A tremor – that’s what medicine means for shaking – can also have other causes.

“Trembling is often accompanied by an overactive thyroid gland,” says Prof. Andrés Ceballos-Baumann. He is the chief physician of the Parkinson’s specialist clinic at the Schön Klinik in Munich, Schwabing.

Certain medications can also cause a tremor. Examples of this are psychotropic drugs, but also asthma or epilepsy drugs.

Other possible causes of tremors are a nerve disorder due to diabetes mellitus or kidney disease. If the body is not sufficiently supplied with vitamin B12 or calcium, a tremor can also occur.

“Trembling is also often a symptom of many cerebellar disorders, such as those caused by long-term alcohol abuse,” says Prof. Lars Timmermann, Director of the Department of Neurology at the University Hospital Gießen and Marburg.

By the way: The tremor can not only affect hands, but also legs or voice. Or the head: “There is a so-called yes tremor and a no tremor,” says Lars Timmermann. The first resembles a nod, the second a shake of the head. A head tremor often occurs in old age.

What to do if the trembling becomes a burden and you even avoid certain situations because a tremor could then occur? Then you should contact your family doctor to get to the bottom of the cause.

Once this has been found, an important step has been taken. “The tremor often disappears with a change in medication or with the treatment of a newly occurring disease, such as hyperthyroidism,” says Andrés Ceballos-Baumann.

However, it is not always immediately clear what is behind the tremor. Then a look at the details is helpful. “It is ideal if patients can then describe as precisely as possible the situations in which the tremor occurs and film this or have it filmed using a smartphone,” says Lars Timmermann.

There are several types of tremors. Essential tremor is the most common. Disorders in the nervous system, for example, make your hands tremble when you write or hold a cup. When relaxed, however, they do not tremble.

The situation is different with the resting tremor: It is present when the respective part of the body trembles in a relaxed state – for example a hand that is placed on the table. According to Andrés Ceballos-Baumann, the suspicion of Parkinson’s is confirmed by a resting tremor.

Whether Parkinson’s or not: Once the diagnosis has been made, medication and exercise are central components of therapy.

However, it is also possible that there is no disease behind the tremor. It is then related to age or develops when excited or stressed. “In such cases, relaxation techniques can be effective, especially when the level of suffering is high,” advises Lars Timmermann.

Anyone who only trembles in certain situations, such as an artist before her performances, can take medication such as beta blockers beforehand. However, you should definitely discuss this with your doctor.

Some drink alcohol when they tremble – with the effect that the symptoms improve for a short time. However, the effect is not permanent. On the contrary, warns Andrés Ceballos-Baumann: “The tremor intensifies as soon as the alcohol has been broken down in the liver.” His recommendation: it is best to avoid alcohol.