ZocdocAnswersWhat kind of doctor should I see if I feel shaky and weak?

Question

What kind of doctor should I see if I feel shaky and weak?

I'm 26 and for the past year I've been feeling shakiness with movements. I've also noticed that if I hold my hands out and try to keep them still they shake a little. I went to my GP who referred me to a neurologist. He ordered blood tests and my iron, B12, and thyroid hormone levels were normal, but my thryoid stimulating hormone was high. He said this may be a problem down the road but was not the cause of my shaking. He also performed an EMG on my entire left side including neck and back which he said looked normal. I just finished a 8-session run of acupuncture which made no difference. At this point, I just want to know what my next step is. Should I see a nutritionist? A endocrinologist? I really want to find out what is wrong so I can fix this!

Answer

I'm sorry that this has been such an persistent issue for you and that you haven't found a clear answer for your symptoms. It does sound like you have had a pretty thorough work up, most of which has come back completely normal. Investigating for the common nutritional causes of neurological problems (like iron and B12 deficiency) was a great idea, as was ruling out hyperthyroidism with the TSH test. After all of this, the next move to go see the neurologist was also appropriate, and the appropriate testing was performed, since the EMG/nerve conduction studies would have ruled out all the major serious additional neurological or muscular problems. Therefore, at this point, you may unfortunately be dealing with an essential or idiopathic tremor, meaning that no clear cause is identified. These are actually pretty common. I wouldn't continue to pursue additional specialists just yet, as those are probably not going to turn up much more at this point. It seems like the best bet would be to sit down with the primary doctor and the neurologist that you already know and get their opinion on how best to treat this tremor and whether they feel additional testing is needed.

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