Caring Medical and Rehabilitation Services
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Robert Filice, M.D.
 

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Dr. Robert Filice's E-Newsletter
Natural Medicine Management of
Benign Essential Tremor

One of our patients (61 year-old-man) called us today and described the recent onset of tremor in both hands. His mother suffered from the same condition, so a genetic component is implied. This is not an uncommon problem. Usually one would think of Parkinson’s disease first in such a case, but Benign Essential Tremor (BET) is twenty times more common than Parkinson’s. When he comes in, I will perform a neurologic exam that will help differentiate Parkinson’s from BET.

The tremor in Parkinson’s is more pronounced when the patient is at rest, looks like “pill rolling”, and the patient may have a loss of facial expression, rigidity of the muscles, drooling, and loss of the arm swing associated with a normal gait. It results from free radical damage to a specific part of the brain known as the Substantia Nigra. The BET diagnosis is a “wastebasket” type, and no doubt includes tremor (more noticeable on movement of the hand) resulting from neuron damage from a variety of causes. For the sake of “redundancy”, neurons in the central nervous system perform their function in bundles rather than individually. Thus some loss of neurons can be compensated for, and function maintained. However, there comes a point in the disease or toxicity process when so many neurons of a bundle are damaged that its output is no longer adequate to maintain functionality. It is at this point that neurologic symptoms such as tremor may be seen. Some neuron loss occurs “normally” with age, but free radical damage and neurotransmitter depletion may be accelerated by improper nutrition, smoking, chemical toxins, pharmaceuticals (especially appetite suppressants, stimulants, and psychiatric drugs), drugs of abuse (especially amphetamines and ecstasy), and heavy metal toxicity (especially lead, cadmium, and mercury).

The workup for this patient will include a neurologic exam, a survey of life style and drug use habits (including the use of caffeine which can obviously aggravate tremor), nutritional status, and neurotransmitter and hormone levels. We may also perform some vitamin levels and essential fatty acid analyses to define whether the neuronal lipid cell membrane may be suffering from loss of integrity, and most definitely will perform urine testing after an IV chelating agent to assess the possibility of heavy metal toxicity.

Orthodox practitioners say they do not know the cause of of BET. Logically, there can be only one root cause with numerous possible contributing factors: damage to neuron bundles resulting in inadequate electrical output from loss of neurons or inadequate neurotransmitter levels. Orthodox physicians use Inderal, a beta adrenergic blocker, to suppress the symptoms of BET. Sometimes it helps and sometimes it doesn’t. It can cause fatigue and depression, and, as is so often the case with pharmaceuticals, it fails to address the cause of the problem.

Natural medicine treatment would depend on the results of testing, but in general, I expect to use specific amino acids to help increase neurotransmitter in the remaining neurons of the damaged bundles which may well compensate for the loss of neurons or neurotransmitter deficiency and restore adequate electrical output. I will aggressively chelate out any heavy metals that are found, and will probably use IV glutathione, a powerful intracellular antioxidant to protect neurons from further damage.

I would normally recommend high dose B12 and folic acid therapy even when levels come back normal. These two vitamins are crucial to nervous system function. The amino acids which replentish neurotransmitter levels may have to be used the rest of this man’s life to compensate for existing damage,  but at least the underlying causes will have been addressed and no side effects are to be expected.

Natural medicine offers better ways to treat common illnesses.
 

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