Hand tremors & prednisolone

[Minushabens]

Hi all - I hope you're all coping in the lousy weather.

My consultant has been increasing my medication a lot lately, which has run alongside my GP increasing my blood pressure medication (I spend my days singing 'John Is Falling Apart Again to the old Joy Division tune).

Anyway, although I don't know exactly what's behind it, I have started to experience far worse hand tremors than ever before. He put me on a high dose of pred just after Xmas, which has been tapered down to 10mg/day, but he says I should prepare for the possibility of that being very long-term. He also moved me from Symbicort 200/6 to 400/12 plus a 50% increase in itraconazole (for ABPA).

It's worse some days than others, but I pretty much suspect the increase in steroids is to blame for the tremors. I wondered if anyone has developed any strategies or techniques for managing it? I'm finding, for example, that I often need both hands to hold a drink still & my shirt gets more of my food than I do.

I've started to wonder if there are exercises or anything similar that might just help manage it? All suggestions gratefully received!

[M-D-F]

I think you should that it is not something worse than asthma, or maybe you are worried that your beloved football teams run of luck will come to an end

[Minushabens in reply to M-D-F]

Haha...HTFC have been wrecking my mental health since at least the early 1970s, so probably no surprise they'd do it to my physical health as well - having a Fitbit has been a real eye-opener what they do to my heart-rate during matches!

[emmasue]

I am on higher steroids and my hands are shaking at the moment. It could be the steroids or it could be that I am ill. Hope you feel better soon. x

[Erin001]

Hiya, I've had tremors for a long time and they guess it's due to asthma meds

I haven't really figured a way to deal with them I just prefer to breathe than have still hands

I find a lot of things a challenge with them eg writing near enough impossible and not legible and I get pain in my hand when I write and at random points which I have guessed is due to tremors

Holding things like you said drinks is a challenge

I'm also a 17 year old college student who wants to be a nurse which with my tremors I'm limited on my options on career cos I won't be able to use needles won't be able to be a theatre nurse cos I need steady hands

My tremors are never the same one day I won't notice them at all the next they are going crazy

With the meds I'm on I still struggle to breathe and my tremors are just something I rather put up with than asthma

And btw salbutamol can cause tremors too because whenever I've had loads of it or a nebuliser I'm extremely shaky as in I can hardly use my hands

I'm sorry about this it is a thing you might just need to put up with I have for several years and as a 17 year old student it's something I've had to put up with alone because no one my age really has tremors I think I've met one person my age with tremors

I'm sorry I hope your ok and someone can suggest something to help

[Minushabens in reply to Erin001]

I've had minor tremors for many a long year - you're right I always tend to put it down to my inhalers which until maybe a couple of years ago were bog standard blue/brown or then seretide. It's just got significantly worse with these last few weeks with the increased steroids.

Cheers for the reply anyway & I hope that you are successful in your aspirations & that it doesn't interfere too much. One of the kids (he's 6 or 7 I think, but a bit of a rogue) at school asked me why I was scared the other day when I was only eating my dinner!

[emmasue in reply to Minushabens]

Ha, that's funny! Yesterday, my daughter (9) brought me a blanket because she thought I was cold. I didn't have the heart to tell her that I was actually warm. 😝

[anjyil]

Ever since I started meds, I have shakes off and on depending on how high my dosage is, how bad my asthma is, etc. I would say definitely the meds as I never had hand-shakiness prior. Take care! I have found that doing exercises in penmanship, calligraphy and line-work in art to be very helpful in helping me manage and learn to work through it.

[Minushabens in reply to anjyil]

It's funny you should say that as I've always had an inkling that I'd like to learn to draw (I'm currently trying to perfect stick men). I keep telling my wife I'm going to enrol somewhere when I retire, which given the state of play with pensions here will be around my 103rd birthday.

[anjyil in reply to Minushabens]

There are a lot of nice, free stuff online ^_^ It really did help me with learning to work through shaky hands, so I really recommend it. Either line work (like stickmen!) or calligraphy is great--makes you focus and gets you used to using your hand in a new form.

[strongmouse]

I first noticed hand shaking after taking symbiocort. Changed to Fostair and use it with a spacer. Still get some shaking but less than on the symbicort. I call it the sugar shakes as when I go to put sugar on my cereal it goes everywhere! Reluctant to ask to change as Fostair does work well for the asthma.

The most difficult symptom I have currectly is cramps in the legs, feet and groin at night. It can be very painful. Trying to see if taking a magnesium supplemment helps (with the night cramps).

[Lysistrata Administrator Community Ambassador]

I also wonder if it's the Symbicort not the oral steroids. I used to be on 400/12 above licensed dose and had very noticeable tremors - I'd get well-meaning but annoying comments that everything would be fine and why was I anxious? Also very noticeable and annoying palpitations. This seemed to be the case though a bit less even when my cons reduced the dosage of Symbicort and added in Pulmicort to keep the steroid the same but reduce the LABA.

My new cons said this would be a great idea if it were 1995 and immediately switched me to Fostair Nexthaler 200/6 2x twice daily. Fine particle so apparently gives same effective dose with less steroid. Same LABA (formoterol) as Symbicort and same dose as I was on more recently but way less issue with tremors and palpitations - perhaps the budesonide is somehow worse for that? I feel like it works better for my asthma too, though this is partly the delivery - I was having to take so many puffs on the old regime and when struggling couldn't generate the inhalation force I needed. Nexthaler and other newer devices are much easier to inhale and it's one of the reasons my cons prefers it.

Is your cons particularly attached to Symbicort and does it work well for you? I wonder if you could bring this up and ask about trying a different combination inhaler like one of the fine particle ones, with an equivalent doseto what you're on - Fostair Nexthaler is one, there are a few others out now. I'd never thought of Symbicort being especially tremor-inducing until I wasn't on it.

[Minushabens in reply to Lysistrata]

Thanks for the reply & apologies for the slow reply - the consultant isn't particularly attached to Symbicort I don't think, as he's said that he's thinking of replacing it, although that's not specifically for the tremors. I think he's waiting to see what happens generally across my symptoms with the current treatment plan.