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Violent shaking

I am a young 74 yr old lady with essential tremor for a few years now. This past year has began occasional uncontrollable Violent Shaking. The happens a lot first thing in the morning. When this occurs my blood pressure spikes very high as high as 244/124. I have been to the ER four different times and sent home with no answers.
Does anyone know what could be causing this I have seen every specialist and still no answer or cure?  Getting desperate for some help, this is effecting my everyday life.
Best Answer
1081992 tn?1389903637
"...simply because i asked if you were a Dr?"
People ask me that all the time. I don't know where you get the idea that that is some sort of problem.
Not a problem just asking if you were an authority on theses medical questions. ..So can you still try to help with my  problems unsolved  by my doctors?
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1081992 tn?1389903637
Hi, first of all have the docs considered the very rare 'paradoxical hypertension' from the beta blocker drugs (especially propranolol) that are usually prescribed for essential tremors?

Here's an example case report:

"...she had severe hypertensive episodes with SBP up to 250 mmHg...

Betablockers should not be used in patients with uncontrolled hypertension in the absence of specific cardiological indication, until phaeochromocytoma/paraganglioma is ruled out."

(Those are 2 types of rare, benign tumors.)

BP episodes that high are an emergency and can cause a stroke. Did any doc give you nitroglycerin to take before going to the ER? Do you know the signs, such as disturbed vision?

"I am a young 74 yr old lady"
Great attitude :)
Helpful - 2
Not taking betablocker, not ever given Nitro
1081992 tn?1389903637
We'd also consider that if the BB drug is causing adrenalin release from a pheochromocytoma or a paraganglioma, that could possibly worsen the tremors. So you'd have more shaking plus the hypertension crises at the same time - which you do, right?

Do the attacks happen not long after taking the BB?

I'd also wonder if you are taking a lot of calcium supplements, especially with vit D.

Helpful - 1
Not taking  BB, no calcium , no vit D
Have never taken a BB
1756321 tn?1547095325
My 77 year old mum is having these symptoms and more due to metabolic acidosis.  Her kidneys aren’t as good at removing acid due to her age anyway but in her case it’s the serious dehydration from toxic mould inflammation that is causing excess acid in her body. So anything that raises acid sets off these terrible attacks.

She has had tremors and facial spasms for years from higher acid levels but now the attacks have shown up. Rapid breathing (last ditch effort to remove acid via the lungs to keep blood pH stable), uncontrollable facial spasms, uncontrollable body movements, tremors, head pressure, severe hypertensive crises (too high for the blood pressure monitor to measure..errors out)…. It’s so bad she should have been in hospital but she refuses to go.

She has to breath into bags to increase carbon dioxide to help with symptoms during an attack. She is in such a state it’s really bad. Thankfully I figured this out what was going on after she had numerous attacks drinking a lot of orange juice.

Triggers of her attacks: Acidic foods under 5 pH (one rasher of bacon - 3 pH set of an attack for instance), high potassium foods, fasting (includes sleeping all night), stress.  Metabolic acidosis raises potassium but high potassium triggers metabolic acidosis too.  I believe the severe hypertension is due to sudden spikes in potassium as acid levels rise.

I now have mum on an anti inflammatory drink daily, lower acidic foods (over 5 pH), low potassium foods, eating as soon as she wakes up, avoiding stress.  This is the answer until we can leave this toxic house!
Helpful - 0
I had a look online as I wasn’t too sure about potassium and high blood pressure and as potassium is shown to lower blood pressure it has to be due to the high acid levels.  I did found this online “Chronic Metabolic Acidosis Elicits Hypertension via Upregulation of Intrarenal Angiotensin II and Induction of Oxidative Stress.” Hmm there you go.,
Update: I now realise Mum’s metabolic acidosis is causing respiratory alkalosis.

“Respiratory alkalosis results from hyperventilation as the primary disturbance. Hyperventilation also forms the respiratory compensation of metabolic acidosis.”

The respiratory alkalosis are the attacks. So this explains why eating a punnet of strawberries (alkaline) on the verge of an alkaline attack caused numerous attacks. Not to mention alkalosis lowers potassium. It’s fluctuating pH levels. It’s so unstable and based on how bad the mould/inflammation/dehydration is. I have had to tweak the diet based on symptoms.  So today she has eaten more acidic foods on the verge of an alkaline attack and this is preventing an attack. It’s a bit difficult to do this all night. Just hoping the detox supplements and anti inflammatories work ASAP.
Strawberries are acidic actually so she needs to be careful when to eat them! Still learning lol. She must of still been too acidic when eating that punnet of strawberries! I’ll have to check each food pH!  I have just bought pH strips from Temu as well.
Hi, Red. It turns out that it's not the pH of the foods that matters. If a food contains potassium or magnesium, those are used as 'mineral buffers' which alkalize the body. E.g., lemons and limes are acidic but have an alkalizing effect on the body once the minerals are absorbed, though they are acidic in the mouth and stomach.

Bicarb alkalizes, but too much has a laxative effect - as does too much Mg.

Hi, thanks for the info. I actually knew that about citrus the hard way lol. I had kidney failure from magnesium supplements of all things. Low dose magnesium too. My kidneys are not too happy from chronic insulin resistance it seems. My metabolic acidosis internal tremors improved drinking orange juice.

I decided this morning to stop all magnesium.  All the magnesium mum is having in her magnesium supplements, anti inflammatory drink with raw cacao, powerade ion4 is probably too much for her kidneys to handle and causing the very condition I’m treating. Oh boy.  This mould brain is a pain lol.
1081992 tn?1389903637
"Also check if you have already had the test for metanephrines."
Especially at ER visits for hypertensive crises --- which should also then include testing for adrenalines, since you were right in the middle of the severe hypertension.

Also tests for hyperthyroid at ER visits. That's not likely to have been high but you never know. They must have tested that.

Helpful - 0
1081992 tn?1389903637
I just checked and discount sites like walkinlab have the metanephrines test for ~$200. So a doc should not be really hesitant, it's not super expensive. Or else a doc should have a *strong* reason why not.

Btw, it'd also be very helpful to reply ASAP. To strike while the iron is hot. And everything is fresh in memory.

Also, do you take in lots of caffeine, nicotine or stimulant herbs?
Helpful - 0
1081992 tn?1389903637
Well, you have to be more forthcoming with specific information. Such as what *specific* meds you are taking.

Also check if you have already had the test for metanephrines. If not, I'd think the docs were less than thorough.

Also, we should know why you are not on propranolol and an anticonvulsant - for the tremors. Those are standard. Maybe there is some medical reason that you can't tolerate those drugs. If not, then that's very odd. Too odd, unless the tremors were very mild before this recent period.

Also, think back to what happened before you worsened. Immense stress? Life changes? Was it more sudden or more of gradual worsening?

Do you see the approach here? It's using logic to figure the why. You've already been through the standard approach, which is based on pattern matching, and based on the average patient. But people who are atypical will have a hard time under the standard approach.

Helpful - 0
1081992 tn?1389903637
No, I'm not a doctor. But I do have more than a little experience in how to approach mystery cases where the patient saw various specialists over years with no benefit.

If you are mainly interested in what doctor to see, that would be an Internist or other GP who practices "Functional Medicine". They try to figure out the *why*, rather than only going by the book as most specialists do. Specialists only see their own specialty, but a good Internist wouldn't be limited like that. Good luck.
Helpful - 0
I guess by you saying "Good Luck" you are refusing to discuss this case anymore simply because i asked if you were a Dr?
1081992 tn?1389903637
What do you take instead of a beta blocker? Just an anticonvulsant? A beta blocker (and maybe also an alpha blocker) might do you quite well. There's something odd going on here.
Helpful - 0
Is your blood pressure already too low for a beta blocker?
I don not take any anticonvulsant,nor do i  ever fast. My blood pressure is high sometimes up ino the high 200's i do take a blood pressure meds.    Are you a Doctor?
1081992 tn?1389903637
Do you do fasting? That can provoke adrenaline release.

What drugs do you take?
Helpful - 0
1081992 tn?1389903637
Okay, no BB drug. But we still have a plausible mechanism which is excess adrenaline causing both the hypertensive crises and the worsened tremors at the same time. We need to somehow adjust the theory as to the underlying cause of the adrenaline. E.g., there can still be a pheochromocytoma or paraganglioma.

Btw, adrenaline is usually naturally highest "first thing in the morning". Quite a coincidence.

You should ask for the metanephrine test, blood or urine. That measures breakdown products of adrenaline. Adrenaline breaks down quickly, so it's not advisable to measure adrenaline quickly. But the breakdown products remain much longer. You have nothing else to go on at this point.

It would be IDEAL to have that test soon after an episode. A doctor can write a standing order for a test, which you use when needed.

If you metanephrine is normal, then we'd look at excess serotonin. Possibly from a carcinoid tumor.
Helpful - 0
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