Benign essential tremor syndrome

Do fava beans have a place in the treatment of tremors?

Benign essential tremor syndrome causes uncontrollable shaking; it's usually not serious, hence the name. Typically it begins in mid age, and gradually worsens, occasionally becoming severe. Unlike that of Parkinson's disease which occurs at rest, this is an 'action' tremor.

It does not occur when the hands are at rest, but when you reach out for something, or holding an article such as a sheet of paper which begins to shake uncontrollably, and often embarrassingly; the so-called postural tremor. It's worse when you're under stress, for example having to introduce someone whose name you have forgotten.

It typically begins in one hand, and may move to the other, and the rest of the body. Since it gets worse with movement of a body part, it's also known as an 'intention tremor.' The classic neurological test is ask the patient to touch his or her nose; this becomes increasingly difficult as the finger approaches the face. If the finger in unable to stop, so-called 'past pointing', cerebellar disease is suspected. 

The word benign is often dropped nowadays as an essential tremor is now thought to cause other symptoms.

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Let's get one thing straight; since I'm a chiropractor, not a neurologist, but with a deep interest in the subject as all of our profession should have, look elsewhere too for confirmation of these facts.

There are two other reasons that I have personally studied this condition. I myself suffer from benign essential tremor syndrome. It began some twenty-five years ago, and has not worsened. In fact, recently it has improved dramatically after an astonishing discovery; more about that lower down.

There was no known cause and an investigation by a neurologist shed no light on my condition.

So, you have two types of tremors, those which occur when an intentional movement is initiated, and those which occur at rest.

A resting tremor is quite different; typical is the pill-rolling tremor of Parkinson's disease which is anything but benign.

Parkinson's disease

The tremor of Parkinson's disease is quite different to that of a benign essential tremor syndrome. It occurs when the body part is at rest. For example, the lower jaw is often affected, not when speaking or chewing - it's not related to intention - but continuously.

Parkinson's disease is far more likely to affect seriously other parts of the body. Speech may become slurred, and walking tends to be a shuffling yet strangely hurried gait; those suffering from it seem almost to run; it's known medically as festination. 

Parkinson's disease is caused by the death of a nucleus in the brain known as the Substantia Nigra; normally it should produce a neurotransmitter called dopamine that sends messages to other cells, mediating many different functions in the body.

Benign essential tremor syndrome

Benign essential tremor syndrome most often affects the hands, for example when holding up a book, but can affect any part of the body. The involuntary shaking or trembling varies from hardly noticeable to really quite dramatic. It typically worsens very slowly with age.

Blood sugar plays a role so that those who are insulin resistant with wild swings of glucose are more affected, especially should it become particularly low. The early part of a long fast may for example increase the tremor until the body moves from using glucose to ketones for energy. It may be worse in the early morning when blood sugar is at its lowest.

A simple test is to draw a spiral which may be very shaky.

Holding a sheet of paper or book in front of one with arms outstretched; as when singing in a choir.

What causes essential tremor syndrome?

The cause of benign essential tremor syndrome is unknown, but it sometimes has a genetic basis. Complicating this supposition is the fact that children inherit not only their parents' genes but also their lifestyles and frequently diet.

It may also be a side-effect of many medicines; more complex is that the tendency to turn to medication for the treatment of poor health is also familial, muddying the water by suggesting a genetic predisposition.

Alcohol abuse, diseases such as multiple sclerosis, thyroid, kidney and liver failure have all been implicated as causes of tremors.

Treatment of tremors with fava beans

It has long been known that the resting tremor of Parkinson's disease is caused by a deficiency of the neurotransmitter dopamine after the death of a nucleus in the brain known as the Substantia Nigra.

Medically the condition is treated with drugs that supply dopamine, but Parkinson's patients will tell you that often all is not well. Certain legumes, in particular fava beans and mucuna pruriens, can supply a steady supply of L-dopa, the precursor, which has a longer lasting effect without the extremes of the medication. 

Fava beans are difficult to procure, but a concentrate from mucuna pruriens is available in tablet form; it has long been used in ayurvedic medicine.

There is nothing in the literature to suggest that these beans can assist in the treatment of benign essential tremor syndrome, but only Parkinson's which is dopamine mediated. However, a substantial proportion of patients with an essential tremor eventually develop full blown Parkinson's disease.

Eggs Hilton

Fava beans for the benign essential tremor syndrome may not be to everyone's liking, little grey ticks but we have two ways to get round this visual abhorrence. Firstly only enjoy them young and freshly picked, and secondly slice up the young fruit, pod and all, and you won't be visualising the little blood suckers.

The pods of young fava beans have even more L-dopa than the beans.

Most often we enjoy them as Eggs Hilton, based on the great Florentine breakfast.

If you have a tremor syndrome, and abhor pills, then you should really have the favas - we call them broad beans - twice a day. Half a cup of the sliced very young fruit for breakfast and dinner; and if you don't like them, think of it as medicine, which it is; never tastes good, but this medication you will enjoy if you can find, or better still grow, a source of young pods.

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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