Essential tremor is a movement disorder that causes involuntary and rhythmic shaking, usually in the hands but sometimes involving the head, voice, legs or trunk. It tends to occur during movements or when trying to maintain postures and worsens with intentional movements. Essential tremor is one of the most common movement disorders, affecting up to 1% of the general population. While not life-threatening, it can interfere with daily activities and cause embarrassment or social isolation. Medications can help reduce tremors in some people, but they are not effective for everyone. Making dietary changes to avoid potential tremor-inducing foods and drinks may help lessen tremors. Here are some suggestions for dietary modifications that may help manage essential tremor symptoms.
Avoid caffeine
Caffeine is a stimulant found in coffee, tea, soft drinks, chocolate and some medications. Caffeine triggers the release of catecholamines, which are chemicals that can increase tremor amplitude and temporarily worsen essential tremor symptoms in those predisposed to the condition. Studies suggest that caffeine intake is associated with enhanced tremors in patients with essential tremor. It is recommended to avoid or limit caffeine consumption. Try switching to decaffeinated coffee and herbal teas instead of regular coffee and black tea.
Limit alcohol
Alcohol acts as a nervous system depressant initially but can ultimately stimulate brain activity. This rollercoaster effect can disrupt the neurotransmitters that influence essential tremor. Alcohol may help dampen tremors briefly but can make them worse as the alcohol wears off. It is best to avoid drinking alcohol or only drink in careful moderation if you have essential tremor. Limit yourself to one standard alcoholic drink per day if you choose to drink.
Be cautious with carbonated sodas
The bubbles and stimulant ingredients in carbonated sodas may exacerbate hand tremors in those with essential tremor. Drink water, fruit-infused water or decaffeinated iced tea instead of soda. If you do drink soda, have it very well chilled, avoid caffeine/stimulant-containing varieties and sip it very slowly through a straw to minimize the impact of the carbonation.
Avoid foods high in glutamate
Glutamate is an excitatory neurotransmitter that is found naturally in certain foods. There is some limited evidence that ingesting foods and additives high in glutamate may worsen tremors by overstimulating nerve cells. Foods naturally high in glutamate include soy sauce, Parmesan cheese, tomatoes, mushrooms and processed meats like sausage, hot dogs and ham. Avoiding soy sauce and MSG (monosodium glutamate) seasoning may help reduce tremors triggered by glutamate.
| Food | Glutamate Level |
|---|---|
| Soy sauce | 1222mg/100g |
| Parmesan cheese | 1200mg/100g |
| Tomatoes | 242mg/100g |
| Mushrooms | 45mg/100g |
| Sausage | 38mg/100g |
Limit refined carbohydrates and sugars
Eating large amounts of refined or simple carbohydrates and sugars causes rapid spikes and drops in blood glucose levels. These fluctuations may alter neurotransmitter levels and lead to increased tremors. Limit foods like white bread, pasta, pastries and candy and instead choose whole grain options that are absorbed more slowly. However, not all studies have found a clear link between tremor severity and carbohydrate intake. More research is still needed.
Avoid heavy meals and hunger
Consuming very large, heavy meals taxes the body’s energy as it works hard to digest. This may exacerbate tremors temporarily. Low blood sugar from hunger can also make tremors worse. Eat smaller, more frequent meals and don’t let yourself get overly hungry. Light nutritious snacks between meals can help maintain steady blood sugar.
Increase selenium intake
Some research indicates that increased dietary selenium intake may improve essential tremor, while selenium deficiency may worsen tremors. Good sources of selenium include Brazil nuts, tuna, eggs, sunflower seeds, crimini mushrooms and spinach. Aim for 55 micrograms of selenium per day.
| Food | Selenium per 100 grams |
|---|---|
| Brazil nuts | 1917 mcg |
| Tuna | 92 mcg |
| Eggs | 56 mcg |
| Sunflower seeds | 53 mcg |
| Mushrooms | 29 mcg |
| Spinach | 27 mcg |
Omega-3 fatty acids
Omega-3 polyunsaturated fatty acids have anti-inflammatory effects in the body that may help stabilize nerve cell membranes and reduce tremors. Good food sources include fatty fish like salmon, mackerel, trout and sardines, chia seeds, flaxseeds, walnuts and soybeans. If using supplements, take no more than 3 grams of combined EPA/DHA omega-3s per day.
Magnesium rich foods
Magnesium plays a role in muscle and nerve function. Low magnesium levels have been associated with enhanced tremors in some studies. Getting adequate magnesium from whole food sources may help reduce tremor severity. Magnesium-rich foods include dark leafy greens, avocado, nuts, seeds, bananas, beans, lentils, whole grains and yogurt.
Avoid food triggers
For some individuals certain foods seem to trigger or worsen essential tremor symptoms. Common food triggers include caffeinated drinks, alcohol, carbonated beverages, monosodium glutamate (MSG), refined sugars, artificial sweeteners and ice cream. Keep a food diary to identify any problematic foods that correlate with increased shaking for you. Then try eliminating those foods for a period to see if it reduces tremor intensity and frequency. Reintroduce one at a time to confirm.
Stay hydrated
Dehydration can cause electrolyte imbalances that may worsen essential tremor. Drink plenty of water throughout the day and limit diuretics like caffeine and alcohol that can lead to dehydration. Herbal teas, fruit-infused water, coconut water and diluted fruit juices are healthy ways to add fluids. Aim for about 2-3 liters of total fluid intake daily.
Vitamin D
There is some evidence linking vitamin D deficiency with enhanced tremors in those with essential tremor. Vitamin D helps regulate calcium balance and nerve conduction. Get your vitamin D level tested and supplement as needed to reach a sufficient level, around 50 ng/mL. Good food sources include fatty fish, cod liver oil, mushrooms and fortified milk and yogurt. Spend 10-15 minutes in midday sun 2-3 times per week for natural vitamin D as well.
Conclusion
While no specific diet has been proven to cure essential tremor, making smart dietary modifications may help reduce symptoms. Limit or avoid tremor-inducing foods and drinks like caffeine, alcohol, carbonation, glutamate and refined carbs. Stay hydrated, eat frequent small meals and include foods rich in selenium, magnesium, omega-3s and vitamin D. Identify and eliminate any personal food triggers that seem to make tremors worse. Making thoughtful changes to your diet is a proactive way to self-manage essential tremor. Consult a doctor or nutritionist for personalized dietary advice.