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Type 2 Mystery Tremor:

Erin

Well-Known Member
Messages
748
Location
Canada
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
mean people, corrupt politicians, poverty, happy pharmaceutical ads;
Dear fellow diabetics:

This may be a complicated question as the symptom of inner tremor sensation (tingling, quivering, increase upon physical exertion, stronger upon awakening) occurred during a two-month period of unfortunate occurrences:

1. Abrupt lithium discontinuation after 35 years by my doctor: Cause: symptoms of brain damage and lithium toxicity - dose 900mg (1.9): staggering, inability to walk, or talk, memory damage, severe headache. After 2 months all these have improved but a tremor has remained. Dr. says she does not know what it is. After the discontinuation I can only say that I feel as if there has been a rebirth of

-more social and happy personality
-less anxiety, phobias
-more hair growth
-weight loss
-GFR improvement (from 40 to 50)
-general sense of well being

Everything improved. However, there is some doubt in my dr.'s mind that this improvement may be transient and mania or depression may return according to the initial diagnosis of bipolar. I am optimistic that it will not.

The lithium toxicity of 35 years may have become worse during the past 10 years at which time diabetes began.

2. About 2 days after lithium I had the worst flu ever in my life. It was generally reported to be a bad one throughout Canada and other countries. Some people died of it.

3. My mother died of cardiac arrest at age 92. She also had the flu about the same time I did. Tremor had begun before this tragedy. Stress made my tremor worse after all the consequences and responsibilities after her death. But as I said the tremor began before her unexpected death.

4. I asked my dr. for Xanax to palliate the tremor and it helps the consciousness of it, but not the tremor itself. Physical exertion makes it worse.

Bottom line: I am wondering what the cause of this may be - my blood sugar has been 7-16 for the past year on 80mg glyclazide and 3 metformins. When I asked for an increase in glyclazide dose, y dr. said my A1H[?] is 6.8 which is not bad for my age and weight. Possibly the lows are more dangerous than the highs. I can count the 4's on10 fingers in the past year; most other numbers are 7-11 or 16.

I hope I am not overwhelming everyone with this long tirade. I am trying to be as precise as possible in case anyone can help me with the tremor business. My guess: myelin sheath damage due to flu, but I am not a doctor- only on the internet.:-)

Thank you for any suggestions.

Erin
 
Hi @Erin,
As a health care consumer (patient) I am looking at various articles on lithium to try to make some sense of your dilemma.
Of course what I have to report needs to be discussed with your doctor as I am not able to offer professional advice or opinion.
AND one has only to look at causes of tremour to appreciate the wide variety of causes !!
Taking lithium seems to associated with tremour as a side-effect (mhc.,cpnp.org Lithium and valproate-induced tremours. Canning.J Jun 2012 vol no. 7)
Whilst there has been articles stating there is, and others stating there is not, a lithium withdrawal syndrome, Side-effects.info /lithium side-effects does report tremour as a side-effect of lithium withdrawal but does not state for how long such a side-effect lasts or why..
Lithium apparently can affect the thyroid gland's functioning: "How should lithium-induced thyroid dysfunction be managed in bipolar patients" Journal of Psychiatry and Neuroscience 2002 Sept27(5)p392 AND some thyroid problems can cause a tremour (endocrineweb.com Hyperthyroidism Overview).
And cessation of lithium does cause changes in various body measures such as thyroid function (onlinelibrary.wiley.com Clinical and laboratory effects of discontinuation of lithium prophylaxis. Acta Psychiatrica Scandinavia Goodnick J. June 1985.
So at the vey least if your doctor has not tested for thyroid problems (like overactive thyroid)such tests might at least rule that out as a cause. Best Wishes for now and the future. I defer to a medical equivalent of Sherlock Holmes for further elucidation.
 
Some people get tremor for no known reason but it can occur as a result of specific conditions (e.g. hyperthyroidism or peripheral neuropathy) which need to be ruled out. It can also occur as a result of some treatments and also as a result of treatment withdrawal.

There is some useful information about essential tremor here:-
https://www.nhs.uk/conditions/Tremor-(essential)/Pages/Introduction.aspx

There is some more detailed information here but it is aimed at medical professionals so may be harder to understand:-
https://patient.info/doctor/tremor-pro
 
Dear kitedoc and Dark Horse,

Thank you so much for going into the trouble to find some of thes relevant articles. I have infact seen some of them. Like you, I suspect hyperthyroidism because of the symptoms: more energy, shortened sleep cycle, soft skin, fast weight loss, greater appetite, hair growth on legs, etc., dyspnea at times, and pulse from 60 to 70.
However, my dr. did take blood tests and found all lithium-related possible changes to be normal, including TSH (but did not test T4). BTW, I never had the common hand tremor that some people get on lithium, except for the final week when I went toxic. Perhaps if this disappears with time, then I can rule out hyperthyroidism. Synthroid is still being taken at 0.112 initially prescribed for the effect lithium has on the thyroid, but never reduced since the lithium was discontinued.

I thank you both for your very kind efforts to cite these articles, and I will be happy to read them.

Erin
 
Dear helpers,

I have good news for my part: My dr. agreed to lower my Synthroid dose and increase my glyclazide one. I see some improvement, esp. Synthroid. Both meds may take a while for stabilization (pharma research needed). The tremor though is still there: could be post flu, abrupt withdrawal from antihypertensives or lithium, or diabetic neuropathy. If any of you have diabetic neuropathy, I would appreciate any feedback on your symptoms. Also, what is your opinion on hypertensive treatment? Thank you so much for your help.
 
Hi @Erin, my understanding from having a daughter on Thyroxine is that is takes about 3 weeks for thyroid levels to stabilise after a change in dose. Whether it takes that long for possible effects like tremor (if tremor is in fact due to say an excessive dose and the cause of your tremor) to settle , I am not sure. Best Wishes.
 
Hi @Erin, my understanding from having a daughter on Thyroxine is that is takes about 3 weeks for thyroid levels to stabilise after a change in dose. Whether it takes that long for possible effects like tremor (if tremor is in fact due to say an excessive dose and the cause of your tremor) to settle , I am not sure. Best Wishes.[/QUO

Dear "kitedoc",

Thank you for your prompt reply. Time will tell, even though I don't think time heals all wounds." :-)
 
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