What Causes Shaky Hands,wrinkled Fingers,low BP,muscle Weakness, Irritability And Appetite Loss?

Posted on Tue, 21 Jan 2014

Question: I have shaky hands, wrinkled fingers, low blood pressure 108/67, pulse 58 to 75, muscle weakness, irritability,no appetite,dizziness, confusion,feel faint, some loss of balance.Any idea about what could cause these symptoms? XXXXXXX E-mail: YYYY@YYYY

Answered by Dr. Hardik Thakker (32 minutes later)

Brief Answer: Multifactorial, please read the detailed reply. Detailed Answer: Dear patient. Greetings from health care magic!!! I am Dr Thakker and shall be answering your question. I have gone through your symptoms and the past medical history.I wish to know if you are taking any medications especially for control of blood pressure. they are known to cause dizziness. I also wish to know if the tremors occur at rest or on action. if the tremors persist in sleep. Given your symptoms we could thing of the following causes: A) For tremors: 1) Essential tremors:Usually they are familial and occur at rest. 2) Parkinsonian tremors: Pill rolling tremors at rest, occur with stiffness of joints and difficulty in walking. 3) Hypothermia: we need to know your core body temperature measured with a thermometer. 4) Hyperthyroidism: They are fine tremors which occur at rest accompanied by palpitaitons, insomnia. We need to do a thyroid hormone study to rule this out. B) For low blood pressure, dizziness, fainting, weakness: 1) Orthostatic hypotension: With aging the blood control mechanisms do not work efficiently. This leads to a drop in the blood pressure when one gets up from sleeping position. 2) Excessive antihypertensive meds: If you are taking drugs which slow the heart rate in a higher dose, it can cause the above. e.g. beta blockers. 3) Hypothyroidism: This can be ruled out by thyroid hormone study. 4) Heart block. I would recommend you to get a 12 lead electrocardiogram and send it to me for analysis. It may show second or third degree heart blocks which need urgent attention. 5) Sensory ataxia/ peripheral neuropathy: This can occur due to vitamin b12 deficiency. We can perform a vitamin b12 level in your blood to rule this out. 6) Stroke: A particular type of stroke affecting the balancing apparatus in the brain and the cerebellum can cause these symptoms. We need an MRI brain to rule this out. I hope this helps you out. If you have any more questions, please do not hesitate to write back to me. Yours sincerely, Dr Thakker

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Hardik Thakker (1 hour later)

My temp is 97.6. Hands are very cold, especially the finger tips. I do not take meds other than Aleve, prn for joint pain. Also shaking hands effects my writing, letters are shaky. Thank you for your response.

Answered by Dr. Hardik Thakker (32 minutes later)

Brief Answer: Please read the reply. Detailed Answer: Dear patient, Thanks for your follow up question. Your temperature of 97.6 is less than the normal range. I would recommend the following for you: 1) T3,T4,TSH levels in blood 2) Electrocardiogram. 3) Clinical examination by a neurology expert to rule out essential tremors, parkinsonism. 4) Vitamin b12 levels in blood. 5) MRI brain. You can then send me these reports as a direct question addressed to me. We could discuss about the treatment options for you. I hope this helps you out. If you have any more questions, please do not hesitate to write back to me. Yours sincerely, Dr Thakker

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Above answer was peer-reviewed by : Dr. Yogesh D