DEAR DR. DONOHUE: Is it possible to get Parkinson’s disease at 35? My hands shake. It started about two years ago and seems to be getting worse. I can’t thread a needle anymore, and I have a hard time getting food into my mouth. It’s most embarrassing to eat out. Several of my friends say it is Parkinson’s. What are your thoughts? — E.B.

ANSWER: The more likely condition is essential tremor. Ten million Americans have it, but many of them don’t realize what the problem is. It can come on at any age, and it tends to worsen with age. Parkinson’s usually appears at older ages. The tremor of Parkinson’s appears when the hands aren’t active. It’s most prominent when they’re resting in the lap. Essential tremor comes on with action — threading a needle, eating, writing or trying to put a contact lens on the eye. Parkinson’s tremor is most often a one-sided tremor. Essential tremor affects both the right and left hands. Essential tremor tends to run in families. That’s why another name for it is familial tremor. Caffeine worsens essential tremor. Alcohol abolishes it for a short time.

Essential tremor also can involve the head. It might bob in a no-no or yes-yes motion. The voice can be affected. It takes on a trembling quality.

When the tremulousness is truly bothersome, medicines can control it. Propranolol (Inderal) and Mysoline (primidone) are two drugs often chosen. There are others. Should the tremor completely disrupt a person’s life, as it can, or when the tremor isn’t responding to medicines, deep-brain stimulation often subdues it. An electric current, supplied by a generator about the size of a pacemaker and placed under the chest skin like a pacemaker, sends signals to electrodes located in the movement center of the brain to suppress the trembling.

Thanks to the International Tremor Foundation, Congress has designated March as National Essential Tremor Awareness Month to spread the word about this condition. Contact the foundation at www.essentialtremor.org or via toll-free phone call at 888-387-3667. The foundation will supply you with the latest information on this condition and its treatment.

DEAR DR. DONOHUE: Will you inform me of a blood pressure medicine that serves as an alternative to metoprolol? I take one 50-mg tablet of it a day, as well as tablets of lisinopril. Since taking the metoprolol, I have experienced dizzy spells, especially when getting up quickly, but often for no reason at all. The pharmacy’s printout says metoprolol can cause dizziness. — M.N.

ANSWER: Your problem might be too much blood pressure medicine. Your pressure drops too low, especially with a change in position. Metoprolol (Lopressor) comes in a lower dose, 25 mg. Or your doctor might have to cut back on your lisinopril (Prinivil, Zestril). Or the doctor might make a change in your medicines. I could name all the blood pressure medicines available, but the list is so long it would fill an entire page of print.

Which is best? The medicine or combination of medicines that lowers your pressure safely with the fewest side effects and for the least amount of money is the best one for you. Finding the right one takes experimenting.

Your problem is easily solved by a phone call to your doctor.

DEAR DR. DONOHUE: I have Meniere’s disease. I have yet to see in your column a medicine prescribed by my ENT doctor. It’s called Serc (betahistine) and is hard to get in the U.S. I get it through a Canadian pharmacy.

Since I started Serc six months ago, when I feel an attack coming on and take it, the attack never materializes. — J.R.

ANSWER: For readers, Meniere’s disease consists of attacks of dizziness, ear-ringing and lessened ability to hear. As time passes, the attacks can come more frequently, and the signs become more or less permanent.

About 40 years ago Serc was widely available in the United States. The Food and Drug Administration withdrew its approval because the agency deemed there was a lack of evidence to support the drug’s effectiveness.

As a citizen, feel free to voice your opinion to the FDA. I don’t know if you’ll sway the drug reviewers to change their minds.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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