[40F] Experiencing intermittent shaking and headaches

Patient Description

A 40-year-old female reports intermittent and random episodes of noticeable shaking in the hands, left arm, and thighs over the past few weeks, with no identified triggers or relief methods. The patient also experiences headaches, primarily in the forehead area, and long-standing dizziness. The patient has been on anxiety medication for 6 months, including bupropion and escitalopram, and takes Mary Ruth's liquid complete vitamin. There is a noted allergy to codeine and a past unusual reaction to amoxicillin. No other symptoms, medical conditions, or medications were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Essential Tremor: This is a neurological disorder that causes rhythmic shaking. It can affect almost any part of your body, but the trembling occurs most often in your hands. It's usually not a dangerous condition, but it can progressively worsen over time and significantly impact your quality of life.

    • Treatment typically involves medications to reduce the severity of the tremor, such as beta blockers or anti-seizure drugs. In severe cases, surgery may be considered.
  • Anxiety Disorder: Given your history of anxiety and the fact that you're on medication for it, it's possible that your symptoms are related to this condition. Anxiety can cause a variety of physical symptoms, including shaking and headaches.

    • Treatment typically involves a combination of medication and cognitive-behavioral therapy.
  • Thyroid Disease: You mentioned that you're taking levothyroxine, which is a medication used to treat hypothyroidism. If your thyroid hormone levels are not well-controlled, it could potentially cause symptoms such as shaking and headaches.

    • Treatment involves adjusting the dose of your thyroid medication under the guidance of your doctor.
  • Medication Side Effects: Both bupropion and escitalopram can cause side effects such as tremors and headaches. It's possible that your symptoms are related to these medications.

    • If this is the case, your doctor may adjust your medication regimen.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with your healthcare provider for an accurate diagnosis.

What you can do

Here are some steps you can take:

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to adjust your medication regimen or order tests to rule out other potential causes.

  2. Keep a symptom diary. Note when your symptoms occur, what you're doing at the time, and any potential triggers. This can help your healthcare provider identify patterns and make a diagnosis.

  3. Practice good sleep hygiene, eat a balanced diet, and engage in regular physical activity. These lifestyle factors can have a big impact on your overall health and well-being.

  4. If your symptoms are causing you distress, consider seeking support from a mental health professional. They can provide strategies to help you manage your symptoms and cope with any anxiety or stress you may be experiencing.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • A sudden increase in the severity of your symptoms
  • New symptoms such as severe headache, chest pain, shortness of breath, or sudden weakness on one side of your body
  • Symptoms that interfere with your ability to perform daily activities

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with your healthcare provider for accurate information.

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1 yr ago

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People Also Ask


What is essential tremor and how is it treated?

Essential tremor is a neurological disorder that causes rhythmic shaking, most often in the hands. It is not usually dangerous but can worsen over time. Treatment may include medications like beta blockers or anti-seizure drugs, and in severe cases, surgery might be considered.


Can anxiety cause physical symptoms like shaking and headaches?

Yes, anxiety can cause a variety of physical symptoms, including shaking and headaches. These symptoms are often a result of the body's stress response. Treatment typically involves medication and cognitive-behavioral therapy to manage anxiety.


How can thyroid disease affect my body if not well-controlled?

If thyroid hormone levels are not well-controlled, it can lead to symptoms such as shaking, headaches, and other issues like fatigue or weight changes. Treatment involves adjusting the dose of thyroid medication under a doctor's guidance.


What are the potential side effects of bupropion and escitalopram?

Bupropion and escitalopram can cause side effects such as tremors and headaches. If these symptoms occur, a doctor may need to adjust the medication regimen to alleviate the side effects.


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