Are hand tremors anxiety-related or sign of illness?

Question

Hello doctor,

I am 27 years old. I have suffered from gastroesophageal reflux disease (GERD) for a couple of years along with anxiety and depression, which some think is related to GERD or the opposite way round. I have taken Citalopram for about three years on and off. Seven months ago, I decided myself and finally did stop for good. Citalopram 10 mg was the dose, and I have been feeling great since. Three days ago, I got a call from the hospital, and they have scheduled me for a Nissen fundoplication surgery after a year of test and conservative treatment. Two days after I found that they had put a date to my surgery which is next week. I did sit before the computer and took a pen. I saw my left hand shaking; shaking like a tremor or Parkinson symptom. I have never seen this before, and I did get a shower, and the hand did not shake the same after. When I searched on the internet, and of course, I can only see negative things like essential tremor and Parkinson disease. I feel nervous and shaky since then, like restless arms, legs and fatigue. I am apprehensive about this. Can this only be a symptom of anxiety inside my body as I fear for the surgery? The symptoms are not noticeable to others, but only myself and I still feel restless.Is this anything serious or will this subside when things are getting closer or after surgery? It seems like I have been working so hard on getting the help I need for my GERD and when I finally got the call from the doctor about they want to give me this surgery; everything turned around. I am feeling restless. I have a hair thinning problem and slight beard alopecia areata. I have attached the photos of medicine I am taking for hair thinning problem and vitamin supplement) I am also on probiotics to help with constipation, sometimes it occurs due to indigestion and GERD.

Answer 1

Hi,

Welcome to icliniq.com. I have read your query in detail and noted the issues. My opinion is that the tremors which you are feeling are just because of anxiety and it is not a neurological disease. If had it been essential tremors or Parkinson's, ethe symptoms profile would have been entirely different. I have also checked the contents of your different medicines (attachment removed to protect patient identity), and none seems to be a cause for tremors. I would request you try not to do any analysis of your symptoms with the help of the internet as it is counterproductive at times. With reference to so many serious diseases, the partial knowledge increases your anxiety. Anxiety will exacerbate the GERD (gastroesophageal reflux disease) and also the tremors. Your symptom profile is quite suggestive of chronic underlying anxiety. Regular meditation and moderate physical exercises will help you get rid of anxiety. Another very effective and non-pharmacological way of treating anxiety is cognitive behavior therapy. It is about changing the thinking process. I would even say that if you follow all these regularly to bring down the anxiety, even your GERD will improve. You can relax and go ahead with fundoplication, but even after the surgery, I would suggest you follow my advise to reduce anxiety as that would be beneficial to you in the long run.