Body Tremors: 8 Causes & When to See a Doctor

Updated in June 2023

Body tremors are most commonly caused by cold environments, which trigger the muscles to contract rapidly to warm up the body. 

However, there are other reasons that can also cause body tremors, like moments of anxiety, consuming stimulating substances, or neurological or muscular illnesses. Parkinson‘s disease, for example, is a disease that is associated with body tremors and shaking. 

The main areas of the body where tremors tends to be felt are in the hands, arms, head, chin or face. There are also many types of tremors that can occur, like tremors at rest or tremors when moving, as well as unilateral (one-sided) or bilateral tremors. Body tremors may also be associated with other symptoms, like imbalance, slow movements, and muscle rigidity. 

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Main causes

The main causes of body tremors include:

1. Anxiety attacks

When you feel anxious, stressed or fearful, the nervous system is activated so that the body can react to a potentially dangerous situation. This is also known as the fight-or-flight response, and is associated with a sudden release of hormones, like adrenaline in the blood. These hormones cause muscle contractions as a way of preparing the body to any type of response. These muscle contractions can trigger many different sensations, like pain, tremors, spasms and cramps.

Learn more about how to recognize an anxiety attack and the symptoms associated with one.

What to do: To reduce body tremors and other symptoms of anxiety, it is necessary to relax. You can take deep breaths, try to meditate and remove yourself from the stressful situation. If this is impossible, or if the reaction is very intense, medical interventions may be required. A doctor can prescribe anxiety medications, like clonazepam. Anxiety attacks that occur frequently should be assessed by a psychotherapist so that better coping strategies can be initiated to manage symptoms like body tremors. 

Mild anxiety can be treated with natural remedies - read more about herbs for anxiety that can be use to prepare soothing and relaxing teas at home. 

2. Low blood sugar

Low blood sugar, or hypoglycemia, can occur in diabetic and non-diabetic patients. The main cause of low blood sugar in diabetics is administering the wrong dose of insulin or a prolonged fasting. Those without diabetes can experience low levels following long periods without eating or after consuming large amounts of alcohol. Hypoglycemia can cause other symptoms in addition to body tremors, such as weakness, palpitations, blurry vision and seizures.

What to do: You should eat or drink a sugary food or beverage that is quickly digested, like orange juice or a hard candy. Drops in blood sugar should be avoided, however, and can be prevented by eating every 3 hours. You should avoid eating high carb foods that are quickly digested, and opt for food with a low glycemic index. 

3. Excessive intake of energy drinks

Consuming stimulating drinks (like coffee and tea with caffeine, or energy drinks with taurine, glucuronolactone or theobromine) can activate the nervous system. These substances mimic adrenaline and can cause many reactions, including body tremors. 

What to do: You should reduce your intake of energy drinks, particularly in your day to day diet. These drinks can increase blood pressure and heart rate, and therefore you should opt for natural options to boost energy and reduce drowsiness.

4. Use of antidepressants and other medications

Some medications can cause tremors in various different forms. The most common tremors are due to nervous system activation, which is most frequently associated with antidepressants, anticonvulsants or bronchodilators for asthma. 

Other types of medications, like haloperidol and risperidone, can cause body tremors due to the effects these medications cause on the parts of the brain that regulate movements. These medications can induce a condition similar to Parkinson‘s, in that it causes tremors, muscle rigidity and imbalance. 

What to do: If you notice body tremors after taking a medication, you should inform your prescriber, so that these effects and the possibility of an alternative can be evaluated. 

Diseases that cause body tremors

When tremors are not triggered by any of the above situations, or if the tremors are persistent and intense, they can be a sign of a neurologic disease. In these cases, seeking a medical assessment is essential for treating them. The most common diseases that cause body tremors are: 

1. Enhanced physiologic tremor 

A physiologic tremor can occur in anyone, but they tend to go unnoticed. In some people, these tremors appear in a more exaggerated way, and are referred to as enhanced physiologic tremors. These are more noticeable during specific movements, like writing, sewing or eating.

People with enhanced physiologic tremors may have worsening when feeling anxious or tired, or after consuming certain substances, like coffee or alcohol. 

What to do: As long as these do not interfere with activities of daily living, these tremors do not need any treatment and do not pose as a health risk. Severe symptoms can be managed with beta-blockers like propranol. Treatment will be more effective if symptoms and triggers are tracked.

2. Essential tremors

These types of tremors are very common, particularly in the arms and hands. They can also affect the face, voice, tongue and legs. They are noted during movement or after staying in the same position for too long (such as holding a heavy object for a long time). 

Essential tremors are known to be related to genetics, although the underlying cause of them is not fully understood. It can affect people at any age, but is most commonly seen in older adults. Symptoms can worsen in times of stress, anxiety or after consuming stimulating substances, like alcohol, 

What to do: Mild cases do not require treatment, however tremors that interfere with activities like eating and writing should be treated with prescription medications, like propranol and primidone. Serious cases, or cases that do not improve with medications, can be managed with botox injections or cerebral stimulators in the brain. 

3. Parkinson's disease

Parkinson's disease is a degenerative brain condition that is characterized by body tremors at rest that resolve or become better with movement. Body tremors can be accompanied by other symptoms, like muscle rigidity, slow movement and imbalance. Their underlying cause are . These tremors tend to become better with movement. Other common symptoms include muscle stiffness, slow movements and imbalance. Although the underlying cause is not totally known, it is associated with a breakdown in the areas of the brain responsible for dopamine production.

What to do: The main medication prescribed to treat Parkinson's is levodopa, although the doctor may also prescribe biperidene, amantadine, selegiline, bromocriptin and pramipexole. Physiotherapy and occupational therapy can also help to relieve symptoms and improve quality of life. 

4. Other diseases

Other diseases that stimulate the nervous system and cause body tremors include hyperthyroidism, heavy metal poisoning (from lead and aluminum for example) and restless leg syndrome. The latter is a sleep disorder associated with involuntary movements of the legs and feet.

There are other rare brain diseases that cause brain tremors or other movement abnormalities which some people may confuse with Parkinson's. These include Lewy body disease, Wilson's disease, and multiple organ dysfunction. 

When to see a doctor

You should consult a doctor when the body tremors are intense enough to interrupt day-to-day activities, or if the tremors are persistent and gradually worsen with time.

In these cases, it is important to book a consult with a family doctor, neurologist or geriatric specialist. The doctor will assess the presenting symptoms and complete a full body exam, as well as order further testing as needed (such as blood work or a brain MRI).

It is important to inform your doctor about your health history and any medications you are on. A diabetic, for example, that presents with body tremors may be administering the wrong dose of insulin.