2 Vitamin Studies Shed Light on Essential Tremor and Nutrition

“Let food be thy medicine and medicine be thy food.” This quote, attributed to the ancient Greek physician Hippocrates, seems like forgotten advice in an age when drugs are heavily marketed to consumers as the pathway to health.

This promised pathway is a big disappointment for individuals with essential tremor (ET). ET is the most common movement disorder, affecting individuals of all ages, though most new cases occur from middle age onward. We know a lot about how it is relayed from the brain to the shaky body part, but we still don’t know why. Since we lack both a way to prevent it as well as a cure, medication is aimed at quieting brain activity that transmits tremors.

The two types of medication most frequently prescribed are beta blockers (e.g. propranolol) and anti-seizure medications (primidone). The disappointment is the fact that for roughly 50% of those with ET, the drugs don’t work. Or, they start out working, but as tremors progress, so do the doses—until undesirable side effects lead to discontinued use.

Vitamins – a natural alternative?

Two published papers report case studies in which vitamins, with or without other supplements, appeared to control ET. It is interesting that both of these papers are from European countries. In 2001, a Scottish author, David Reilly, observed that in Europe, the demand for complementary and alternative medicine – which includes nutrition – “is in part a search for a broader range of therapies, but is also a call for a different approach to care, with less emphasis on drugs, and a more whole-person approach.”1

The first describes the situation of a 13-year old Croatian boy whose dream of being a guitar player was short-circuited by two years of tremors severe enough for him to give up his music. His medical work-up was unremarkable. There was no history of exposure to toxins, no family history of ET, brain and spine imaging with MRI was normal, as were his blood test results. He was not overweight, but every day he consumed foods and snacks high in refined sugar. Both he and his parents were opposed to pharmaceutical treatment for fear of side effects. Here’s how his case was managed:

… he was prescribed a sugar-free, Mediterranean-style diet rich in whole grains as a carbohydrate source and rich in vegetables, fruit, olive oil, and fish. He was also prescribed two nutritional supplements: 150 mg Triptobel (www.triptobel.eu, Croatia) supplement three times daily (8 am, 1 pm, and 6 pm) and gamma-aminobutyric acid (GABA) 750 mg twice daily (10 am and 4 pm) (www.puritan.com, USA). Triptobel capsules contain L-tryptophan, thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), vitamin B6, folic acid (vitamin B9), and cyanocobalamin (vitamin B12).2

As remarkable as it might seem, by day 14 of embarking on a new diet and specific supplements high in B vitamins and other nutrients, his tremors had significantly subsided. Even more astonishing, by two months they had completely disappeared! The author writes, “The patient continues on long-term therapy and has resumed playing his guitar to pursue his chosen career.”

The second case report, out of Italy, describes the novel treatment of two nursing home patients in their 70s who had poor quality of life due to aggravated hand tremors. Researchers treated them with super-strength doses of vitamin B1 (thiamine). The vitamin as delivered as intramuscular injections at about 100 times the normal recommended dose. The author of the published paper wrote, “The treatment … has led to a rapid, remarkable and persistent improvement of the symptoms In two patients with essential tremor. This result suggests the possibility that high doses of intramuscular thiamine may be an affordable alternative, highly effective and long-lasting medical treatment that has shown no relevant side effect.”3

“Don’t try this at home”

If you or a loved one has ET, it may be appealing to think, “Hey, why don’t I just go pick up some vitamins and see if they work?” First of all, you can’t just run to your local pharmacy and pick up high-dose thiamine and hypodermic needles – so the Italian approach is simply not an option.

As for the Croatian study, remember that the supplements prescribed for the teenager were administered under a doctor’s supervision, and in conjunction with a switch to the Mediterranean diet. Therefore, speak with your neurologist before deciding if you want to pursue such a course of action. It is especially important that your doctor be involved to objectively monitor your use and track any changes that may occur.

Keep in mind that these papers present anecdotal evidence with three individuals. This is considered a very low level of evidence and does not constitute “proof.” That said, I encourage a wellness lifestyle that includes heart-healthy nutrition, regular exercise, and stress management.

Here’s to your health!

1 Reilly D. Comments on complementary and alternative medicine in Europe. J Altern Complement Med. 2001;7 Suppl 1:@23-31.
2Novak, MR. Treatment of essential tremor with multi-modal nutritional therapy in a teenage patient. J Neurol Stroke 2017, 7(3): 00242. https://pdfs.semanticscholar.org/7ecc/e830274e6a7e68a144f9fb6c9e146b9df9f9.pdf
3 Costatini A. High-dose thiamine and essential tremor. BMJ Case Rep. 2018 Mar 30;2018. https://www.ncbi.nlm.nih.gov/pubmed/29602891

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.