Most tremor is not serious. Worry more when it affects only one side, comes with slowness or stiffness, appears suddenly, involves the head or voice, or interferes with eating, writing and handling objects. Medications and an overactive thyroid are frequent and reversible causes, so a complete medication list and a simple blood test are worth doing early.
Most tremor is not serious. Worry more when it affects only one side, comes with slowness or stiffness, appears suddenly, involves the head or voice, or interferes with eating, writing and handling objects. Medications and an overactive thyroid are frequent and reversible causes, so a complete medication list and a simple blood test are worth doing early.
A tremor clearly worse on one side, particularly with slowness, stiffness or reduced arm swing, points towards Parkinson's disease and warrants assessment. Sudden onset over hours or days is different from something appearing gradually and needs prompter evaluation. Tremor accompanied by weakness, coordination problems, unsteadiness, speech change or double vision needs assessment for a different reason. Any tremor that interferes with eating, writing or work is worth reviewing regardless of cause.
A fine tremor of both hands that appears during activity, has been present for years, may run in the family, and is not accompanied by slowness or stiffness is most likely essential tremor, which is common and manageable. Tremor that is clearly worse with caffeine, tiredness, anxiety or being observed, and settles otherwise, is usually physiological and not a disease. Neither is a reason for alarm, though both can be treated if function is affected.
An overactive thyroid causes tremor and is a simple blood test. Medications and substances are a frequent and reversible cause: some asthma inhalers, certain antidepressants, lithium, excess thyroid replacement and too much caffeine all produce it, as do alcohol excess and alcohol withdrawal. Bringing a complete list including over-the-counter items matters, because identifying a drug-induced tremor turns a worrying symptom into a reversible one.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: National Institute of Neurological Disorders and Stroke; MedlinePlus: Parkinson's disease; MedlinePlus, National Library of Medicine.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.