Shaky hands aren’t always cause for alarm, but they could signal a health issue worth addressing. Know what’s normal—and what needs a closer look.

Essential Tremor

This nerve disorder is the most common reason your coffee cup won't stay still while you hold it. It kicks in while your hands are doing something, but goes away when they're not. There's no clear cause, but it's sometimes traced to a change in a gene. If your symptoms are mild, you may not need treatment. If they get in the way of everyday tasks or your job, you may need medicine, occupational therapy, or surgery.

Parkinson's Disease

When you have this condition, your hand shakes because brain cells that tell your muscles to move get damaged. The shaking usually starts on one hand, but over time may spread to the other. You may also move more slowly, have trouble with balance, or find that your arms and legs stiffen up. The main treatment for Parkinson's tremors is medication and sometimes surgery for better muscle control.

Multiple Sclerosis (MS)

This condition damages a coating on your nerves called myelin. When this happens, you may get symptoms that include shaking in your hands or other parts of your body. Medicine is the most common way to treat it. A physical or occupational therapist can help you learn ways to manage your symptoms.

Overactive Thyroid (Hyperthyroidism)

Have you had your thyroid hormone levels checked lately? Shaky hands may be a sign of hyperthyroidism. This means your thyroid gland is working too hard and kicking your heart rate into high gear. You may also notice that you lose weight without trying, are sensitive to light, get a fast heartbeat, and have trouble sleeping. A simple blood test will help you and your doctor figure out what's going on.

Too Much Caffeine

Can't do without your morning coffee? Have a cup or two, then cut yourself off. Caffeine is a stimulant, so the same natural chemical that helps you wake up will also make your hands shake if you have too much. Coffee isn't the only culprit. You can also find caffeine in over-the-counter headache medicine, chocolate, and some sodas.

Alcohol Withdrawal

If you have an addiction to alcohol, you could get symptoms that include shaky hands when you quit. It starts as soon as 10 hours after your last drink and can last a few weeks. Some detox programs use medication to help you manage withdrawal symptoms.

Lack of Sleep

You can't expect a car to run if you don't give it gas. And you can't expect your brain to send messages to all the right places without sleep. When you don't get enough shut-eye, it can cause your brain to mistakenly tell your hands to tremble. Luckily, you can snooze your way back to steady hands.

Low Blood Sugar

Your nerves and muscles are powered by blood sugar. When they don't get enough, they tell your hands to shake. Low blood sugar can be caused by diabetes, certain medications, too much alcohol, or not enough food. A doctor can help you narrow down what's happening and why.

Stress

When something stresses you out, like giving a speech or watching a scary movie, your nerves kick into overdrive. Your hands shake and your heart beats fast. The shakiness will go away when the stress does. Try stress relief techniques like deep breathing or meditation.

Certain Medications

Twitchy hands are a common side effect of many different types of prescription drugs. Among the most common are medicines for your mood, seizures, migraine, neuropathy, and asthma. Some antihistamines cause this problem, too.

Smoking

Though some people do it because they hope it will ease stress, smoking can cause anxiety. Nicotine, the addictive drug in tobacco, gets into your bloodstream and makes your heart beat faster. This can make you feel anxious and cause your hands to shake. Talk to your doctor to get ideas on how to quit tobacco.

Lack of Vitamin B12

B12 plays big role in keeping your nervous system healthy. If you don't eat meat or eggs, don’t drink milk, or if you take certain medications, you might have lower-than-normal levels of this vitamin. This can cause your hands to shake or make your arms and legs feel numb and tingly. Your doctor can tell you if you need to take supplements.

Pheochromocytoma

This is a long word for a rare tumor that grows in your adrenal gland. Though the tumor is usually benign, it makes your blood pressure go way up. It could make you shake as well as cause heavy sweating, shortness of breath, and headache. The tumor can also lead to heart disease and stroke, so it's best to remove it with surgery.

Liver Disorders

Shaking is a symptom of a few liver disorders, like Wilson's disease. In this genetic condition, a buildup of copper in your body damages your liver and brain. You'll also feel tired and get jaundice -- a yellow tint to your eyes and skin. Doctors treat Wilson's disease with medication and diet changes.

Brain Disorders

If you've had a stroke or a traumatic brain injury, the muscles in your hands may have a mind of their own. Ask your doctor about medication or occupational therapy to manage shakiness. And steer clear of caffeine, nicotine, or anything else that makes the symptoms worse.

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