Hi-

I am a new morelife member; this is my first post. I originally
sent this as an email to my friend Paul Wakfer, who recommended that
I join morelife and post the message here.

Thanks for any insights! Russell Cheney

[Yes, Russell and I go back almost 15 years having met through cryonics. Because
he is asking for health advice, I wrote him that I needed additional information
and he supplied the following:

Age: 64
Height: 5' 7-1/2"
Weight: 135 lb
Resting BP: 125/85
Resting pulse: 54
Medications taken: No prescriptions; am long-time user of Minoxidil
Am hypoglycemic, controlled with diet and exercise.
Endurance runner; did 15 marathons in 2004, 29 in 2005, 211 overall.

--Paul]

----------------------------

Paul-

I have had a head tremor for many years. I think it never really
bothered me too much because it was in my family (my brother,
sister, daughter and possibly one grandmother all had / have head
tremors),

[Have any of these relatives ever had this "head tremor" diagnosed by a
specialist or even a GP? If so, what was the diagnosis? --Paul]


and I figured there was not much I could do about it and
it didn't seem to interfere with things I was able to do (except
impress people with how noble and stalwart I appear, of course).

[I understand such a thought and most people seem to also think that health
traits which their relatives have are not anything that they can do or even
should try to do anything about preventing in themselves. However this is a
completely incorrect and counterproductive view of the human body and its
genetics. Unless such traits are there from birth or a young age, they are
always and only tendencies, trends or probabilistic predispositions. All such
traits are caused by some combination of genetic alleles (small differences in
the pattern of a gene and, thus, in the pattern of amino acids in its protein
product which cause the protein to behave a little differently relative to its
genetic "brothers"). Since many gene/protein differences can be compensated by
lifestyle alterations and enhancements in one way or another, there is every
possibility that a given person with the same genetic alleles can prevent the
negative health related trait from appearing in hirself or, at the least,
greatly retard its appearance. --Paul]


Now over the past couple of years I have acquired a hand tremor
that's not in the family, that so far is progressive, and sometimes
affects my ability to handwrite. It's mainly in the right hand, but
the left seems somewhat affected now also.

[My first thought is that they are most likely related. But I am most certainly
not a specialist in this area. My strong recommendation at this point is that
you get see a neurologist and get a complete set of blood tests. Have you
researched "head tremor" and "hand tremor" on the Internet? A google search with
those text strings turns up highly authoritative articles, many written by
specialists for general practitioners. There are many specific kinds of tremor
with slightly different signs and symptoms (which you will best know from your
own observations) and they have different etiologies, diagnoses and treatments.
You should familiarize yourself with the possibilities for your condition even
before you see a doctor. Then you will be better able to understand what he says
and ask additional questions. --Paul]

[Judging by the description you give, you might suffer from a condition known as
Essential Tremor. It seems to fit well with your symptoms. Here is a good
article (it's the full text article of PMID: 14596441) which I highly recommend
you read: http://www.aafp.org/afp/20031015/1545.html It describes the signs
and symptoms of six different tremor syndromes, and also presents a detailed
diagnostic approach to tremor. You might be able to self-diagnose yourself
using this article, but seeing a doctor about this is of course of prime
importance. -°Olafur]


[I specifically did not suggest any of the excellent web references for
Essential or any other kinds of tremor, because I did not want to bias Russell's
searching, reading and diagnosis efforts or in any manner influence him away
from getting the opinion of a specialist. All readers should be aware that the
moderators of this group are not doctors, particularly not neurologists (and
this has no relevance to licensing but only to schooling, knowledge and
experience). While it is very true that we (moderators) likely know a lot more
about treating various conditions with diet, exercise and supplements than do
most doctors, and we certainly know more about *preventing* most health and
aging dysfunctions, we still regard most doctors as highly knowlegable
specialists and do not try to replace them. --Paul]


I have had significant side effects from chromium picolinate. I was
getting very sleepy at odd times (for instance, I fell asleep just
prior to a TV interview, when I'd normally be extremely nervous and
wired), and my strength in marathons had fallen dramatically after
10 miles or so. I stopped taking chromium picolinate, and within
weeks I was completely back to normal (if one can in any manner call
me "normal").

[Since you mentioned hypoglycemia, I suspect this would be because the chromium
picolinate may have increased your insulin sensitivity so much that it made you
hypoglycemic. How was your hypoglycemia diagnosed and what were you told about
it? What do you do, dietarily, to contol it. Do you have a blood glucose (BG)
meter? If not, then I recommend that you buy one (very cheap at WalMart) and
monitor fasting and post-prandial BG off and on, most certainly when feeling
hypoglycemic. If you do have one, did you take your BG when you were taking the
chromium and feeling tired? Also did you try another form of chromium? Chromium
polynicotinate is now thought to be the superior form (better than the chromium
chloride that I see is in your supplements below). --Paul]


[I agree with Paul, the chromium might be causing you to be hypoglycemic. The
fact that it took you weeks rather than days to get back to normal after you
stopped taking the chromium picolinate supports this, because a few weeks
appears to be just about the time needed for the effects of chromium on blood
glucose to become fully apparent. Over a year ago my insulin sensitivity wasn't
very good (compared to my age and health status). However I managed to
drastically improve it by taking chromium picolinate, so I now have very good
insulin sensitivity. As in your case it took me a few weeks to notice the
improvement (using a blood glucose meter). -°Olafur]


I also had a reaction to SAMe (severe depression). After I stopped
taking it, the effects cleared up within weeks.

[Which is again very strange, because depression is one of the health problems
that SAMe is supposed to help. OTOH, I have never been in favor of SAMe because
it transforms in two steps to homocysteine where it can "pool" in its
regeneration cycle, unless one is also taking large amounts of B12, folate, B6,
B2 and betaine (trimethylglycine). --Paul]


It seems to me possible that the hand tremors may be caused by my
supplement intake; I have been under less stress the last three
years since I retired from Alcor,

[After retiring from his regular work career, Russell was a cryopreservation
technician and trainer in Southern California for the Alcor Life Extension
Foundation, the leading organization in the field of cryopreservation. (At which
Kitty and I recently completed our enrollment, BTW - but that is another story.)
I am assuming that Russell mentions the "less stress" because many termor
conditions are stress associated (worse under stress). --Paul]


and my sleep is now more restful,
consistent and longer. The only thing about my diet is that it is
very low fat (of all types, although I do use a flax oil supplement
for the essential fats), and I try not to overeat (but I'm not on
strict CRAN and my physique is about average for the endurance
runners I know). And I can't think of any blood relative that had
hand tremors.

[A very low fat diet may be a mistake since fats are essential for neurons,
synapses and neural membranes. One reason why you should be getting a blood test
at least every 2 - 3 years (even better yearly until this tremor condition
resolves or stops progressing) is to keep track of your cholesterol. While too
high cholesterol is bad for the cardiovascular system, too low is also bad for
the neurological system. With respect to the flax oil, unless you eat fatty fish
often (salmon, sardines, mackeral, herring, tuna) merely taking flax oil will
not produce sufficient long chain omega-3 fatty acids (the conversion rate of
the alpha linolenic acid in flax to the necessary EPA and DHA - obtained
directly from fish - can be as low as 10 to 1). Also for many reasons, fresh
ground whole flax (with all its lignans) is far better than taking just the oil.
In addition, extra virgin olive oil has many health benefits and no deficits at
all as long as it does not equate to excess calories. --Paul]

[Another reason to get the omega-3 fatty acids from fish oil, is that the enzyme
delta-6-desaturase (which is responsible for the first step in the conversion of
alpha linolenic acid to EPA and DHA) declines with age (PMID: 9306089). Which
means your ability to convert alphaLNA to EPA and DHA might not be sufficient to
maintain optimal levels of these fatty acids in your body, unless perhaps you
would consume a lot of alphaLNA, but that is not healthy. Furthermore according
to recent evidence, males (while having pretty good ability to convert alphaLNA
into EPA), in contrast to women, appear to have an extremely limited ability to
convert alphaLNA to DHA (PMID: 16441943). According to this study, males might
convert less than 0,1% of dietary alphaLNA to DHA, making flax seed oil almost
useless as a source of DHA for males. It has been suggested that women's
superior ability to convert dietary alphaLNA to DHA is a result of their higher
oestrogen levels and that it serves to maintain adequate supply of DHA in
pregnancy (PMID: 16441943, PMID: 15075703). Supportive of this, is that
concomitant with their higher decline in oestrogen levels with age, women
experience a greater decline in their ability to convert alphaLNA to DHA with
age compared to males (PMID: 9306089). -°Olafur]

[Because Russell does not likely know, and as a reminder to other readers, the
PMID numbers that Olafur has included (and I also use very often) refer to
papers that can be found by entering the number as the search string at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

The end result of all of the good science that Olafur raised above is that for
aging humans fish oils containing both EPA and DHA are particularly important.
--Paul]


Are there any likely supplements (or combinations) that you have
heard of that might cause such a reaction? I included a list of my
daily supplements (attached, and copied below), if that would help
id possibilities.

---------------------------------------
My Current Supplements
---------------------------------------

Twinlabs Daily One Caps
(Sequence: Vitamins, then alphabetical)

Pro Vitamin A (beta carotene) 4,000 IU
Vitamin A (retinyl palmitate) 6,000 IU
Vitamin B6 (pyridoxine hydrochloride) 25 mg
Vitamin B12 (cyanocobalamin) 100 mcg
Vitamin C (ascorbic acid) 150 mg
Vitamin D (cholecalciferol) 400 IU
Vitamin E (d-alpha tocopheryl) 100 IU
Biotin 300 mcg
Calcium (calcium carbonate & citrate) 25 mg
Choline (choline bitartrate) 10 mg
Chromium (chromium chloride) 200 mcg
Copper (copper gluconate) 2 mg
FloraGLO® Lutein 500 mcg
Folic acid 800 mcg
Iodine (potassium iodide) 150 mcg
Inositol 10 mg
Magnesium (magnesium oxide & aspertate) 7.2 mg
Manganese (manganese gluconate) 5 mg
Molybdenum (sodium molibdate) 150 mcg
Niacin (niacinamide) 100 mg
Pantothenic Acid (d-calcium pantothenate) 50 mg
Riboflavin 25 mg
Selenium (sodium selenate) 200 mcg
Thiamin (thiamin mononitrate) 25 mg
Zinc (zinc picolinate) 15 mg

[There is now good reason to think that this is too much daily intake of Vitamin
A (as retinyl) chronically. And I see below that you are taking another 5000
daily (although the below amount may not be retinyl). In any case too much plain
beta carotene is not that good for you either. Therefore, I suggest that you
stop taking the Twin Labs Daily one and find some other source for the above
vitamins and minerals that you do not get sufficiently from your other
supplements below (particularly the folic acid, B12, chromium, lutein and
selenium. I would have also said vitamin D, but I know that you must get lots
from sunshine with your running activities. --Paul]


Other Supplements
(Sequence: Vitamins, then alphabetical)

Vitamin A 5,000 IU
Vitamin B complex:
B-1 (thiamin mononitrate) 50 mg
B-2 (riboflavin) 12.5 mg
B-3 (niacinamide) 50 mg
B-6 (pyridoxine hydrochloride) 12.5 mg
Folate (folic acid) 50 mcg
B-12 (cyanocobalamin) 12.5mcg
Biotin 25 mcg
Pantothenic Acid (d-calcium pentothenate) 50 mg
Calcium (dicalcium phosphate &
d-calcium pantothenate) 118 mg
Vitamin C (NOT time release) 1,000 mg
Vitamin E (d-alpha tocopherol, NOT d-l) 400 IU
Bioflavonoids:
Lemon 600 mg
Orange 150 mg
Grapefruit 150 mg
Rutin 100 mg
Calcium 1,000 mg
Chondroitin Sulfate 1,200 mg
Coenzyme Q10 50 mg
Fatty Acids (Flaxseed Oil):
Alpha-Linolenic Acid (Omega-3 LNA) 1,755 mg
Linoleic Acid (Omega-6 LA) 450 mg
Oleic Acid (Omega-9) 525 mg
Glucosamine Hydrochloride 1,500 mg
Iron (2 times per week only) 27 mg
Lycopene 10 mg
Magnesium 400 mg
MSM (methylsulfonylmethane) 3,000 mg
Potassium Gluconate 99 mg
Saw Palmetto (serenoa repens) 3,600 mg
Zinc 15 mg

[Except for the retinyl, the totals of these are all moderate or reasonable
amounts (except perhaps for the saw palmetto, but I assume that is the whole
berry rather than the extract which is normally taken at about 1/10th that
amount). There are many other cognitive benefiting supplements I could suggest
that would be beneficial both for your tremors and your aging health in general,
but I would rather wait to see blood and other tests together with a diagnosis
from a neurologist before doing so. Another observation with respect to above,
additional to what I have already stated, is that you may not be getting
sufficient potassium. Since the FDA does not allow supplements with more than 99
mg and the RDA is about 3500 mg, it is very hard to supplement this. I achieve
it by purchasing pure potassium chloride crystals in large bags sold for water
softening. They are about 50% potassium. They dissolve easily in water and keep
well, not needing refrigeration. So one just makes up a strong solution and
spoons out a couple of teaspoons a day into vegetable juice drinks or other
liquid intake.

Other than the lack of potassium and the few other things I have said, I do not
think that there is anything in your regimen, or not in it, that would be
*causing* your problem (also that does not mean that some changes years ago
might not have prevented it). (None of these supplements are in any list of
potentially tremor causing drugs that I could find.) In order to do so, I would
need you to make a comprehensive report of your diet and to see the results of a
complete set of blood tests. And even then I might not be able to find anything,
since unless you get a diagnosis from a neurologist, I am really working blind.
Only after I see a neurologist's diagnosis, a complete dietary report and a
complete set of blood and possibly other tests, will I be able to suggest
changes to your diet and supplements that have any reasonable chance of helping.

Finally, as I have told you for several years, the considered result of all my
research and reading tells me that you are overdoing your running and will
likely run yourself into an early grave if you continue. --Paul]