Essential Tremor and Diet

Image Credit: Gennaro D’Orio / Flickr. This image has been modified.

Do Dietary Toxins Contribute to Hand Tremors?

Essential tremor, affecting 1 in 25 adults over 40 and up to 1 in 5 of those in their 90s, is one of the most common neurological diseases. In addition to the potentially debilitating hand tremor, there can be other neuropsychiatric manifestations, including difficulty walking and various levels of cognitive impairment.

Might beta-carboline neurotoxins play a role in essential tremor? Harmane is one of the most potent of the tremor-producing neurotoxins. Expose people to harmane, and they develop tremors; take it away, and the tremors disappear. What if we’re exposed long-term? A recent study at Columbia University, highlighted in my video, Essential Tremor and Diet, found that those with essential tremor have much higher levels of this toxin in their bloodstream compared to those without tremor. Furthermore, the higher the harmane levels, the worse the tremor. The highest levels are found in those who have both essential tremor and cancer, suggesting harmane may be playing a role in both diseases.

How did folks get exposed to these chemicals? Primarily through meat: beef, pork, fish, and especially chicken. So, if this potent, tremor-producing neurotoxin is concentrated in cooked muscle foods, is meat consumption associated with a higher risk of essential tremor? Another Columbia University study found that men who ate the most meat had 21 times the odds of essential tremor. To put that in context, if we go back to the original studies on smoking and lung cancer, we see that smoking was only linked to about 14 times the odds, not 21.

Blood levels of this neurotoxin may shoot up within five minutes of eating meat. Five minutes? It’s not even digested by then. This rapid uptake is indicative of significant absorption directly through the mouth straight into the bloodstream, bypassing the stomach and, most importantly, bypassing the detoxifying enzymes of the liver. This may lead to higher exposure levels in peripheral organs, like the brain.

Due to its high fat solubility, harmane accumulates in brain tissue, and, using a fancy brain scan called “proton magnetic resonance spectroscopic imaging,” higher harmane levels have been linked to greater metabolic dysfunction in the brains of essential tremor sufferers.

Harmane is also found in certain heated plants, like tobacco. A broiled chicken breast has about 13 micrograms of harmane, and cigarettes average about one microgram, so a half pack of cigarettes could expose us to almost as much of this neurotoxin as a serving of chicken. Harman is created when tobacco is burned, and also when coffee beans are roasted. However, coffee intake has not been tied to increased risk (and neither has tobacco for that matter), so it may be something else in meat that’s to blame for the 2,000 percent increase in odds for this disabling brain disease.

I also have a few videos about the other major tremor condition, Parkinson’s Disease: Preventing Parkinson’s Disease with Diet and Treating Parkinson’s Disease with Diet

Other compounds created in cooked meats may also have implications for cancer risk:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of DeathMore Than an Apple a DayFrom Table to Able, and Food as Medicine.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

40 responses to “Do Dietary Toxins Contribute to Hand Tremors?

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  1. So this toxin is found in “cooked muscle foods”, as you have stated above. Would this imply that raw meats, raw sushi, etc. do not contain this toxin? Heat/cooking is what is creating the problem, no? And yes, even raw meat and raw fish contain their own host of pollutants, problems, but right now I am just interested in this science with the harmane in cooked flesh.

    1. Good question. Yes, that is what I am reading. “Harmane, one of the heterocyclic amines (HCAs), is a potent neurotoxin linked to human diseases. Dietary exposure, especially in cooked meats, is the major source of exogenous exposure for humans.”

      1. Interesting, no mention of eggs or dairy. And I assume the cooked aspect of these meats is why animals in nature that eat raw meat (as well as some humans and pets) escape this toxin highlighted in today’s video.

    1. I have not read them all. You are of course free (and encouraged) to read more! You can find them by clicking on the hyperlinks.

      From what i see, no, the studies do not mention treating the tremor by avoiding meat. They refer to the increased risk/odds of developing essential tremor for those eating more meat.

    2. I have seen no studies on patients demonstrating reversal. The correlational studies are clear. I did have one patient who had a mild essential tremor that disappeared after 1 1/2 years on plant based diet. He has been tremor free for the last 8 years. I imagine like many chronic conditions that there will be a variable response from individual to individual. That said, there is no downsides that I can think of. The problem is there no way to know how bad it would have been if you continued to eat products with harmane. I was unable to find the half life of harmane in the human body. Regardless of how fast it is excreted the effects can take time to reverse if it will happen. Seems to this clinician that patients with tremors should eliminate exposure and make sure they have adequate Vitamin B-12 intake.

      1. Some of the other commenters here, such as Skeptic and SeedyCharacter, have said that coffee makes their ET flare up. Skeptic wrote, “I generally avoid harmane as much as possible, though it essentially occurs in any food that is browned, like bread crust. Browning also occurs at a microscopic level when cooking many foods, so it might even be beneficial to cook fruits and veggies as lightly as possible to reduce or eliminate HCA formation.” Is it true, in fact, that harmane levels increase in a food when it is browned or cooked? Could the coffee be the culprit of their flare-ups, considering that “coffee intake has not been tied to increased risk (and neither has tobacco for that matter)”?

    3. I have serious ET and have followed the studies for years. I’ve also been entirely whole food, plant based for a decade. I’ve never seen a documented case of someone reversing ET. I have NOT been able to reverse the tremors, though they are somewhat diminished, and I appear to be fully or mostly stable, that is not “progressing” as happens to most people. I always recommend a whole food, plant based diet to ET people because it makes you as healthy as possible to cope with the condition, and may prevent the ET (or slow it) from getting worse.

    1. Sorry to hear about your neighbor. I hope he doesn’t drive you many places ;) (joking). Funny story, my 95 year old grandmother still has a valid driver’s license yet the amazing lady has been dead for 6 years! What is the world coming to?

      Anyway, thanks for the link. I agree the microbiome is a great focus and populating the correct bacteria and maintaining gut health may drastically improve and maintain wellness. These “prebiotics” are fundamental for establishing a healthy gut.

      1. My 85 yr old Ma is still driving. She doesn’t have enough grip strength to remove the gas cap for a fill-up so she keeps a pair of pliers in the car for extra leverage…:)

      2. I know you were joking about Gary’s neighbor driving but I thought I’d say that I have tremor (mostly in one hand) that does affect my writing and my ability to hold a mug without shaking. But I have strong grip strength and can drive just fine–and lift weights. It only affects fine hand movements for me and others I know with benign essential tremor.

      3. I understand that in Florida, many deceased folks are still actively voting. As Ponce de León taught us, it’s the land of the fountain of youth.

    2. Driving is much easier than signing, because the steering wheel anchors your hands and the seat and belt anchor your body. Writing is much harder with ET than driving. ET is NOT on the list of conditions that prevent driver licensing. I even drove a commercial truck with advanced ET, even though my writing was largely illegible. I can also easily bowl over 200. ET affects VERY fine motor movements usually involving light weight items. Heavy objects or anchored things are not nearly as difficult for us.

  2. I was 40 when I was diagnosed with Essential Tremors and I have cognitive impairment, although that has gone undiagnosed. In your research and your opinion do you think it’s at all possible for this to reverse itself if a person doesn’t eat meat ever again? I haven’t tried coming off of my medication (Propranolol) lately but I’m willing to give it a shot with doctor’s supervision of course.

    1. I have had benign essential tremor for the past decade. I haven’t eaten meat in several decades and I’ve never smoked. Caffeine makes it flare up for a few hours, so I’ve given up caffeine containing beverages. I wonder if I’m being exposed to harmane in some other way?

      1. Same thing happens to me, even with decaf coffee. I generally avoid harmane as much as possible, though it essentially occurs in any food that is browned, like bread crust. Browning also occurs at a microscopic level when cooking many foods, so it might even be beneficial to cook fruits and veggies as lightly as possible to reduce or eliminate HCA formation. I ate entirely raw for 2 years and the tremor decreased, but it was still very significant.

        1. Thanks, Skeptic! I do love toast in the morning. I’ll work on reducing my toasting time and shifting towards minimal cooking of other foods.

          1. I eat a lot of raw fruit and steam fried leafy veggies like spinach and crucifers, and a small amount of raw nuts like walnuts. Steamed fried roots like sweet potatoes and onions and garlic seem to work well too! The same strategies that help optimize general plant based nutrition seem to help manage ET, I also find high anti-oxidant foods like berries and herbs and spices helpful.

            1. Thanks again, Skeptic. I’m aiming for your degree of healthiness. I don’t eat junk. I eat mostly fruits and veggies and whole grains. I make big pots of veg soup and stews with plenty of beans, garlic & onions.

  3. I’ve had serious ET for nearly 40 years. I adopted a fully plant based diet 10 years ago in a effort to prevent or reverse it. The very low fat, whole food plant diet I rigorously follow has not reversed the ET but appears to have reduced it’s intensity maybe 20%. Most people with ET also get worse over time. I appear to have been stable (or nearly stable) for the ten years I’ve followed the diet. In my extensive experience with ET and diet, I suspect diet can prevent most or all progression but has little effect reversing existing damage.

  4. I appreciate Dr Gerger’s dedication to vegan eating. I also hope readers concerned with essential tremors are made aware that harmanes are present in many common non-animal foods too:
    “A number of tremorogenic β-carboline alkaloids such as harmane, harmine, harmaline, and ibogaine have been found in common plant-derived foodstuffs (wheat, rice, corn, barley, soybeans, rye, grapes, mushrooms, vinegar). plant -derived beverages (wine. beer. whisky. brandy, sake) and plant-derived inhaled substances (tobacco). These substances are also endogenous to animal tissue and have been isolated in beef and sardines. ( from )
    Zheng W, Wang S, Barnes LF, Guan Y, Louis ED. Determination of Harmane and Harmine in Human Blood Using Reversed-Phased High-Performance Liquid Chromatography and Fluorescence Detection. Analytical biochemistry. 2000;279(2):125-129. doi:10.1006/abio.1999.4456.

    1. I believe the concentrations of alkaloids are much higher in cooked and blackened foods (particularly meats) though, than naturally otherwise occur. Alkaloids are pretty touugh to complete eliminate from the diet, but they can probably be greatly reduced by focusing on the principal sources-grilled or roasted meat and obviously browned foods like many baked goods.

  5. is the problem caused by meat suppliers feeding the animals chemicals that cause the problem/? are these cancer causing chemicals found in free range venison ?

  6. My friend is a vegan, and has developed essential tremor. It is scary to me how many of my vegan or vegetarian friends have developed neurological problems (ALS, Fibromyalgia, Essential Tremor, and MS). All meat is not the same. Factory farmed meat, eggs, and milk are completely different, and should never be compared to grass-fed and organic meat, eggs, and milk.

  7. My mother has ET, I have it, and our identical twins have it at 30. As an artist I can paint the mast of a ship first thing in the am but if I use large motor movements the only thing I can paint is the quick blotches of Impressionism. We control the balance of caffeine, sugar and protein which helps a lot, as does a glass of milk. Will try to become a pescatarian as a first step. Thanks for your guidance and help!

    1. I also have ET and have for over 30 years. I went pescatarian years ago and that made no difference in my tremor. If you’re ready for it, I’d suggest going completely vegan.

  8. I have Essential Tremor and have had it for over 30 years. I’ve recently switched to a WFPB diet and my ET is much better. My hand tremor has all but disappeared. My question is has harmane been linked to tremor in other body parts? I have a tremor in my hands, head, torso and slightly in the legs. This condition has progressed for me over 30 years spreading to other body parts. I also have a genetic component in my ET. Can I expect the tremor in my head, torso and legs to improve on a WFPB diet?

  9. The closest evidence is the fact that people that smoke have lower rates of Parkinson’s disease, most likely due to nicotine that should be obtained from eating WFPB, not smoking. Dr. G covers that here:

    To my knowledge there is no peer-reviewed published evidence on your specific disease. It comes down to risk vs. benefit. WFPB lifestyle risk is low and the potential benefits are high. Keep on it and keep us posted as we’re all very happy that you’re feeling better!

    Dr. Ben

  10. People with Benign Essential Tremor tend to grasp cups with both hands, eat soups out of cups instead of using a spoon or just use straws for liquids. Herbal Treatment of Benign Essential Tremor can help manage the symptoms effectively and lead a quality life. “Betneton” herbal supplements that can provide relief from the symptom of benign essential tremor while preventing its further progress.

  11. I don’t know what kind of tremors I had, but I know my hands always shook when I tried to hold still. I remember being frustrated I couldn’t draw or cut straight as a toddler because of shaking and it continues throughout childhood. I was always a good athlete however. If I did anything that made me nervous I’d also get facial ticks and eye ticks and speak vibrato. Because of severe allergies and sinusitis that never ends and my knowledge of health as a recipient of the Adventist health message, I stopped dairy at 22 and beef at 23. I gave up chicken at 26 when my joints swelled up for a couple of years after getting a flu vaccination (I usually only swell a few weeks). I have some milk occasionally now and fish once or twice a year.

    Anyways, I just realized suddenly in my late 30s that I rarely had any shake at all, and I could generally choose not to shake when I concentrated on being in relaxed control, which is the opposite of what used to happen when I concentrated on holding still. It seems miraculous to me to now be in my 40s and able to function like a young surgeon, remembering how frustrated I was with my shaking hands growing up.

    Side note: I toured a microchip manufacturing plant in Asia around the turn of the century, and with labor so cheap there virtually everything was done by hand working in microscopes in clean rooms. The thing that stuck out was all of the solderers and assemblers were women. The owner of the plant told me that they only hire and train women because men shake too much.

  12. The article says, “Might beta-carboline neurotoxins play a role in essential tremor? Harmane is one of the most potent of the tremor-producing neurotoxins. Expose people to harmane, and they develop tremors; take it away, and the tremors disappear.”

    Are other beta-carbolines, such as harmine and harmaline, similarly tremorigenic? Also, if a person’s essential tremor is caused by beta-carbolines, would it go away if they stopped consuming meat that contains them? Or do they cause permanent brain damage, making the condition permanent?

  13. Hi, Laura Henry! Beta-carbolines, including harmane and harmaline, are heterocyclic amines generated, at least in part, by Maillard reactions. They appear to have brain effects in addition to causing tremors, including impairment of executive functioning. I don’t know whether or not these effects are reversible, but eliminating dietary exposure to beta-carbolines seems likely to slow or possibly stop progression. I hope that helps!

    1. Hi Christine, thank you so much for getting back to me! I’m trying to figure out whether beta-carbolines are something I want to try to avoid or not. I’m confused because some studies suggest they cause neurological disease, and others suggest they may actually be neuroprotective.

      For instance, this one suggests that MAOIs could be neuroprotective beyond their MAOI activity, and beta-carbolines are MAOIs. This study seems to be suggesting that because MAOIs inhibit MAO, they could lower oxidative stress, therefore inhibiting the development of Parkinson’s and Alzheimer’s.

      According to this review, beta-carbolines harman and norharman “exhibited a wide spectrum of biological and pharmacological effects, including antioxidant, neuroprotective, and anti-inflammatory effects” and that coffee, being rich in beta-carbolines, might reduce risk of neurodegenerative diseases. Later, the article even says “β-carbolines are described as having good antioxidant, anti-inflammatory, and neuroprotective effects, while also inhibiting the initiation of apoptosis, preventing structural changes to neurons, and even contributing to the recovery of neurons.”

      Is there a consensus on whether beta-carbolines help or hurt, whether they should be utilized as a protectant or avoided?

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