Laboratory Testing for Essential Tremor Diagnosis

Essential Laboratory Panel

The American Academy of Neurology recommends a complete metabolic panel, including electrolytes, renal function, liver function tests, calcium, and glucose, to screen for metabolic disturbances that can cause or exacerbate tremor 1, 2
A complete blood count (CBC) with differential is recommended to assess for systemic conditions 1
Thyroid-stimulating hormone (TSH) is recommended to exclude hyperthyroidism or hypothyroidism, both of which can cause tremor 1, 2
Vitamin B12 level is recommended to identify deficiency that may contribute to neurological symptoms 1
Hemoglobin A1c is recommended to screen for diabetes, particularly given the patient's age 2, 3, 4

Thyroid dysfunction is a common and treatable cause of tremor in elderly patients, making TSH screening essential 1, 2
Metabolic derangements, including electrolyte abnormalities, renal dysfunction, and hepatic dysfunction, can all produce or worsen tremor 1, 2
Vitamin B12 deficiency can cause neurological symptoms that may be confused with or coexist with essential tremor 1
Diabetes screening is appropriate given the patient's age and the association between metabolic conditions and neurological symptoms 2, 3, 4

Lyme serology is recommended only with relevant exposure history or other neurological signs 3, 4
Erythrocyte sedimentation rate (ESR) or C-reactive protein is recommended only if giant cell arteritis or inflammatory condition is suspected 3, 4