Heavy alcohol consumption can lead to essential tremor

tremorDrinking three or four alcoholic drinks a day can double the risk of developing essential tremor – or ‘the shakes’ – in old age, suggest new findings from a Spanish research group.  In a report published earlier this year, the same researchers found that individuals with essential tremor were four times more likely to develop Parkinson’s disease than people without the shakes.

Essential tremor is a progressive neurological disorder characterised by uncontrollable shaking of the hands or, in some cases, the head, jaw, face, feet or tongue.  An estimated 650,000 people in the UK and five million in the US over the age of 60 are affected by this disorder.

Scientists don’t really know what causes essential tremor.  They do know, however, that people with this disorder have damage in the cerebellum part of their brain, including loss of neurons called Purkinje cells.  Given that alcohol is known to be toxic to the cerebellum, Louis and colleagues investigated whether alcohol consumption had an effect on the development of essential tremor.

This study assessed lifetime alcohol consumption and neurological symptoms in more than 3,000 people aged 65 years or older.  At initial assessment, more than half (1,838 people; 56%) of the participants were found to have had at least one alcoholic drink per day over their lifetime.  During the subsequent 3 years, 76 people developed essential tremor.

Individuals who drank 3-4 alcoholic drinks each day were twice as likely to develop essential tremor than those who drank less.  In fact, just one or two drinks a day increased the risk by 30%.

The authors suggest that ethanol, a known cerebellar toxin, lowers the threshold for developing ET – a disorder involving the cerebellum.  It is also possible that individuals who develop essential tremor use alcohol to self medicate, thus making their shaking worse.

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Louis E et al. (2009) Population-based study of baseline ethanol consumption and risk of incident essential tremor. Journal of Neurology, Neurosurgery & Psychiatry 80 (5): 494-497 DOI: 10.1136/jnnp.2008.162701

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26 Comments

  1. Dear Ms Jaques, I think you should be ashamed of supporting research which clearly is based on inadequate research and has been taken in a completely unconstructive direction. While I would never argue that excessive alcohol consumption can cause damage to the cerebellum and thus create a situation where ET may ensue, this is entirely incidental to the whole issue of ET which exists, in the majority of cases, without the influence of alcohol. How much better would it be to concentrate research on the many people (my father, myself and my two brothers) who have had this disorder for many years. I do not drink – I never have. My brothers, like many people with ET, find that a drink in the evening can help their ET, but obviously do not drink in the morning and carry out fully functioning careers in engineering and architecture, finding ways around their ET. PLEASE, please do not load your website with small, selective sections of research which concentrate on the negative when people like me have had to fight all our lives because people assume that our symptoms are the result of alcohol abuse. Instead, why don’t you encourage research scientists to speak to people like the many who have posted on your website – they live every day with this disorder and could give a much better insight into it that you clearly can who appear to have taken this at face value. I think you should be ashamed of adding your weight to the already common perception of sufferers.

  2. I had never heard of ET until my 3 year old was diagnosed with it. I thought she was having seizers when she was a baby. Let me just say that I have heard of an adult “shaking” from withdrawls of many drinks and drugs. But this does not even come close to explaining why my 3 year old shakes. Money for research could be better spent. I’m not a research expert but I would not give a dollar to find that drinking can make people shake. Hope to see more information that will help my child and the many across the globe that are looking for help. Thank you for your time.

  3. My biological father drank alcohol heavily for many,many years–became an alcoholic. After he gave up alcohol, he was steady as a rock.

    My mother develped tremors in her hands when she was in her sixties–she vey seldom drank alcohol.

    I’m 75, my full body E T started at my age of 8-9. Of course I did NOT drink alcohol at the time.

  4. I have had ET since at least age 12. I am now 51. I am a heavy drinker, probably an alcoholic BUT I didn’t start drinking until my late teens and at that time only at social gatherings (because it helped to control my tremor – which I found so embarrassing). I inhereted ET from my mother – she has never drank alcohol. My son and my nephew also have ET. They began displaying symptoms as earlier as five years old. They definitely had never had alcohol at that age!

  5. I do think Helen’s report on the research is significant however . It is logical to anyone from a medical background that alcohol which is already known to cause damage to brain cells and neuronal connections is very likely to be asscociated with an “increased risk or tendancy to develop neurological disorders such as essential tremors , thpoug I suspect it probably neds to also be combined with a predispoistion in the first place , maybe like most neurobiological disorders often involving genetic loading, where certain triggers may add to the chance of developing it. Alcohol rarely helped improve anyones health , and in particular if they aleady have a neurological condition. It has long been established through exytensive research and observation that if it used regularly or in more than small amounts , alcohol will naturally continue to cause further deterioration of any neurological condition and likely development of other health problems, due to further loss of brain cells so it does not take much to deduce how it does “most certainly” worsen the progression of this very distressing and socially debilitating condition. Naturalky small amounts do temporarily alleviate the symptoms for a very logical simple reason. Alcohol causes muscle relaxation and E T works on the neurological pathways that overstimulate the muscles, so yes it will ,therefore, temporarily reduce symptoms by relaxing the muscles , that is all it does, but I would not say that it really “helps” the individual in the long run as it does most certainly cause worsening, rebound worsening of the symptoms often the next day or so, nothing to do with alcohol having worn off. This is often misunderstood as to be due to a kind of alcohol withdrawal shake if using alcohol to manage symptoms, but in the small to modertae quantities “some ” not all have used to manage the symptoms, this would not be sufficient to cause alcohol withdrawal shakes. There is misunderstanding here of the mentioned association with “alcohol and the shakes”. Offence is often taken unnecessarily when this subject is mentioned in association with alcohol and ET. The medics and researchers are not talking about alcoholic withdrawal shakes at all, just a worsening of neurological symptoms caused by effetcs of alcohol on the neurones in NON alcoholics and often NON heavy drinkers but just regular use of relatively small to moderate amo andunts which does seem to make the condition worse. I totally agree and have witnessed this in my own family member who developed ET 2 years ago and it has progressed intermitte distresses him tremendously as well as making it not onlky dificult to maiantian social engamenst or plan activities but has increased his reluctance to want to go out or attend meetings, church, clubs etc for fear of it coming on, so it can be very disabling if one lets this happen. But I have noticed it stays away for longer when he is not using moderate alcohol to try to alleviate the symptoms. Likewise , it can come on out of the blue when he has not had a drink for a week. This is not alcohol withdrawal or anything to do with it as that would come on immediatey the next day in heavy drinkers if someoen had reached tha level of dependence. Alcohol withdrawal shakes are quite different and involve sweating and often nausea too and loss of appetite and acute anxiety though they may be misread by the odd few who are ignorant of how they present. e We are not talking about that kind of shaking though there is always the risk of course that if someone does start to find that alcohol in small amounts seems to relax the muscle jerks and tremors as you would expect it to do as a muscle relaxant , and they feel more relaxed in heir mind socially too as sometimes the stress of it starting in a social situation can add to the trigger, anything that would normally make anyone shake, such as caffeine or worry can exacerbate symptoms in those with essential tremore in a more noticeable way, and that they could run the risk of increasing their drinking over time almost without noticing it in an attempt to manage the condition, especially as the small benefits will be less helpful as their tolerance increases as they drink more regularly, so dependencecould then develop as a secondary problem alongside the ET, which is then just another problem to deal with which will make matters worse all round and cause furthe health problems. For some but my no means all or not even most , of course alcohol is not linked with the development of the condistion. From all accounts it can come on at any age, any time, any sex with any health history, but for some , I agree alcohol is certainly a “precipitating factor” that when relied upon as a treatment can only add to further distress and isolation from society which does not help anyone. I can totally sympathize with all the above comments and have heard all the arguments for and against and as daughter of someone with essential tremor I can fully apreciate the impact on the sufferer and the family in desperately trying to find reasons and cures and above all hope. I would say in my father’s case though there most certainly is a link with alcohol precipitation and worsening the condition and it worries me very much as my father certainly does use alcohol as a treatment and in doing so has put himself at other risks and caused me a great deal of additional worry too. Nevertheless I can understand how frightening it is for him when these uncontrollable shakes and jerks come on but sadly the first thing he will always turn to at the time is drink , because it does temporarily work on the muscle movements. Unfortunately short term measures though are never the solution to a progressive problem and I am afraid we will be dealing with a dual diagnosis here which complicates everything. He always had a tendancy to like to drink moderate ( not small ) amounts regularly, 2-4 units a day, more on odd occasions infrequently, up to 10 / 12 units in 24 hours, and ofcourse probably more when younger long before he developed this and it came on after a collapse. He never had it before. That is not to say that alcohol was the cause though, that I can see it is making it worse now after each episode and seems to prolong he episode or cause it to return with avengeance when it had been subsiding . 1-2 units have been found to give temporary relief for a period of about 4 hours or in some cases longer, but this should not really be used as a regular treatement, but I see no harm if carefully self monitored in having the occasional small drink just like anyone else socially to relax or with a nice meal, but never regularly with this condition, I think it is best avoided. It is probably also worth keeping an honest eye on whether it worsens over subsequent days or becmes more frequent just to see if any pattern emerges. If anyone notices their alcohol consumption has increased in response to trying to manage symptoms believs they are using alcohol to deal with the psychological impact of living with ET, then it is probably time to be honest with yourself and seek help. It is hard eneough to cope with and manage ET without having 2 illnesses to deal with . There are treatments available that caan be discussed with your doctor to see what might help .They may not all be suitable for everyone depending on other health and other medications they are taking but it is well worth discusing them depending on the severity , progression and duration of symptoms and the individual mpact it is having on your and your family’s life. For some medication can help considerably if they want to have this, but other smay prefer to consider Sugery under local anaestetic, or DBS. I think with the advance in treatments and huge amounts of research i neurosciences in the past 10 years there is great hope for ET sufferes in the future, but I also feel than any link however small should always be researched and that the scientists would be doing us a great disservice if they did not share their knowledge and findings with us, even if some do not wnat to accept it or feel it does not apply in their case. For some, this will be a life saver and they may choose to to make healthier lifestyle adjustments which could in some individual cases make all the difference to their over all quality of life. I see no harm in Helen’s report and am grateful that research is taking place. Those who may have taken offence clearly need to look at the bigger picture and may have missed a useful point which could help others. What they choose t do with the research is of course up to them but it is man’s way to dismiss what he does not want to believe or hear. Those who may have felt judged or wrongly or cruelly labelled alcoholic, I am very sorry to hear that as this can be deeply hurtful and embarrassing, but perhaps if we are honest, we have probably all at some time jumped to the same conclusion even fleetingly, especially if not a medical person. We could too be making the assumption about how others are veiwing us when we feel slef conscious at times. Those who may have taken offence at the research Perhaps may need to examine their own judgements before having esential tremor if we saw someone shaking , as this illness challenges us all. Instead of staying at home and avoiding “potential ” judgements and hurts , would it not be more helpful to remain as socially active as possible and use the symptoms as a way of educating others and thereby reduce ignorance and stigma. Just like raising awareness of mental health issues, negative experiences from onlookers or friends, family or the public can be used in a positive way and it is wasted energy to take offence and become hermits. That way the illness wins ! I know I have a 50 % chance of developing the same inheritted cobdition and a 50 % chance of not developing it so I I intend tp start spreading the word in the hopes that people will be kinder. Most people want to. It is just ignoranc and we can do alot about this by helping ourselves and others. Sometimes people only make remarks because they too are embarrased and don’t know how to help so perhaps let them know how they can help and they too will educate others. I welcome any research that comes our way and have confidence that better help will be found soon. I hope everyone is enjoying the autumn colours in whatever way they can. Martin

  6. My son just turned eight and the tremors got so bad I took him to the Dr and found out he has E.T., now I know he does not drink.

  7. Mark you are so right Alcohol does not cause Essential Tremor no more than it makes it worse.

    The cause as you explain your wife has had it since childhood, therefore is it not right to consider it is something that happend earlier than the first time the symptom was recognised/seen/experienced.

    I have written a paper on Essential Tremor you may well care to read, it is on my website http://www.talkingcures.co.uk which explains in more detail your comments and concerns.

    The paper contains an invitation to comment or critise, however harshly via email and if better information comes to hand than included within the website paper, I will include it with author rights expressed to the writer/contributor.

    Peter

  8. My GP said recently that my shaking hands were caused by ET. Mine manifests itself just in the hands, the spoon and cup may rattle in the saucer if I’m carrying it to the table but nothing stronger. I do sometimes tend to fall backwards but I control that quite easily. I had previously laughingly told friends and family that it was due to all the medication I was having. Could this be true of some cases? I – like many of your bloggers – hardly drink alcohol, a glass of sherry maybe once in a few weeks and a glass of white wine when I am out to a meal with family or friends. I hadn’t noticed if that improves the condition.
    Is it possible that the tremor which is not very troublesome is not E but, as I suggested, due to medication. I take somewhere in the region of 20 tablets a day and I am diabetic, type 2.
    Geoff Hunt

  9. i am 51 and in my early 30’s started having my right arm to tremble usually when drinking from a cup. sometimes slight shaking and others so bad almost pouring it on me. it comes and goes mostly happening when i’m very tired or working hard. i saw an article in my local paper last week about essential tremor, first time i ever heard of it. i now have a name for it, i am not a drinker and after learning that someone is tring to prove thats what causes this,i doubt if i’ll talk to anyone about it. i’ll just wait and see how bad it gets. and then if anyone asks i might have to talk about it. i would hate for my family and friends to think i’m an alcoholic. but whats worse is if i pass this on to my children.

  10. Thanks for all the comments guys.

    Perhaps the title of this blog post should have instead been “Heavy alcohol consumption is associated with a risk of essential tremor.” The authors of this longitudinal cohort study found that a history of drinking was associated with a higher risk of incident essential tremor, not that alcohol was the cause. As such this doesn’t mean that all heavy drinkers with get essential tremor, or, more importantly, that people with essential tremor have a history of drinking. Just that there is a link between the two things.

    Also, having had another look at this research I notice exactly how “marginal” this association is – it only just reaches statistical significance – and that the findings are in people aged 65 years or older, so probably don’t apply to people outside this age group.

    I apologise if these points weren’t clear in my original blog post. What this study definitely does not prove is that alcohol causes essential tremor or, by extension, that people with essential tremor developed the disorder because of their drinking habits.

    This is just one study in one population and certainly doesn’t apply to all people with essential tremor or even many individuals. Studies like this are important though because they add bits and pieces to what we know about how essential tremor develops – knowledge that might eventually help find a cure.

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