Shaky Hands: Common Causes and When to See a GP (UK)

Last updated: October 2026

Shaky hands are usually harmless. Everyone has a slight tremor, and it becomes more noticeable with too much caffeine, anxiety, tiredness, hunger, alcohol, smoking or being cold. Some medicines and conditions such as essential tremor or an overactive thyroid can also cause it. See a GP if shaking is new, getting worse or affecting daily life.

Below: everyday causes, a “cause, clues, what helps” table, whether it’s anxiety, medicines and medical causes, what helps and when to get help.

Quick check: if your hands shake after a few coffees, before a big meeting or when you’re running on no sleep, and it settles once the trigger passes, that is very likely a normal tremor made louder. Shaking that is new, keeps getting worse, affects one side or comes with other symptoms is worth a GP visit.

Is it normal for your hands to shake?

Yes, a little. The NHS says it’s normal to have a slight tremor: if you hold your arms out in front of you, your hands won’t be completely still. Doctors call this physiological tremor. Everyone has it, but most of the time it’s too small to notice.

A review for family doctors explains that anxiety, caffeine, tiredness and some medicines can turn this everyday tremor up, and that this is one of the most common tremors GPs see. The NHS adds that it often becomes more noticeable as you get older.

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Common harmless causes of shaky hands

Too much caffeine. Coffee, tea, cola and energy drinks all count. In a small lab study, a single dose of caffeine at about 3mg per kg of body weight (roughly 210mg for a 70kg adult) measurably increased arm tremor, while a lower dose did not. EFSA says up to 400mg a day, and single doses up to 200mg, raise no safety concerns for most healthy adults, but you can feel jittery well below that if you’re sensitive. See how long caffeine lasts.
Anxiety, stress and adrenaline. When you feel under threat your body releases adrenaline, which can make your hands tremble. See the fight or flight response.
Tiredness. The NHS lists being tired as a common reason a tremor becomes more noticeable. Tired muscles after a hard workout can shake too.
Going too long without food. Shaking, sweating and feeling hungry or irritable are classic symptoms of low blood sugar. The NHS says true low blood sugar is rare if you don’t have diabetes, so see a GP if you get these symptoms and you aren’t diabetic.
Alcohol and hangovers. The NHS includes drinking alcohol among the things that make a tremor more noticeable. Many people feel shaky and on edge the morning after. See hangxiety.
Smoking and nicotine. The NHS names smoking as another common trigger.
Being cold (or very hot). The NHS says a tremor can be more noticeable at either extreme.

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Shaky hands: cause, clues, what helps

Cause	Clues	What helps
Too much caffeine	Soon after coffee, tea or energy drinks; racing heart, jitters	Cut down gradually; no caffeine after early afternoon
Anxiety or stress	Happens before or during stressful moments; racing heart, sweating, butterflies	Slow breathing, movement, tackling the cause; talking therapy if it’s ongoing
Tiredness	Worse after a poor night or a long day	Regular sleep and wake times
Hunger	Long gap since eating; sweaty, irritable, hungry	Regular meals and snacks; see a GP if it keeps happening and you don’t have diabetes
Alcohol or a hangover	The morning after drinking	Water, food, rest; drink less
Smoking or nicotine	Shortly after a cigarette or vape	Cutting down or stopping; free NHS stop smoking support
Cold	Shivering, cold hands	Warm up; layers and gloves
A medicine	Started after a new medicine or dose change	Speak to your GP or pharmacist; don’t stop it yourself
Essential tremor	Hands and arms, worse when holding a cup or writing; often runs in families	See a GP; treatment can help if it affects daily life
Overactive thyroid	Weight loss, fast heartbeat, feeling hot, nervous energy	See a GP for a blood test
Parkinson’s disease	Usually starts on one side, when the hand is resting; slowness, stiffness	See a GP

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Is it anxiety?

It often is. The NHS lists trembling and shaky limbs among the physical symptoms of a panic attack, alongside a racing heartbeat and sweating. Anxiety-related shaking tends to come with other signs: a pounding heart, tight chest, butterflies, dizziness or feeling on edge. It usually eases as the anxious moment passes.

Clues it’s anxiety: it appears in stressful situations (presentations, social events, arguments) and is gone when you’re relaxed. Caffeine can add to it. See does caffeine cause anxiety?, anxiety symptoms and how to stop a panic attack.

If anxiety is behind your shaky hands most days, it’s worth speaking to a GP. Adults in England can also refer themselves to NHS Talking Therapies without seeing a GP first.

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Medicines that can cause shaky hands

The NHS says some medicines can cause a tremor, and a review of drug-induced tremor lists several common ones. Examples include:

Reliever inhalers for asthma and COPD (salbutamol). The NHS says feeling shaky is a common side effect, affecting more than 1 in 100 people, and that it wears off after a short time.
Lithium. The NHS lists slight shaking of the hands as a common side effect. Shaking with muscle weakness, twitches or jerks can be a sign of lithium toxicity, which is an emergency.
Antidepressants. The NHS lists feeling agitated, shaky or anxious among their common side effects.
Others named in the research include some heart rhythm medicines (amiodarone) and epilepsy or mood medicines (valproate).

Drug-induced tremor usually settles when the medicine is changed or stopped, but that is a decision for your doctor. Don’t stop a prescribed medicine without speaking to your GP or pharmacist first.

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Medical causes to know about

These need a doctor to diagnose. The list is here so you know what to mention, not to self-diagnose.

Essential tremor

The most common type of abnormal tremor. A 2021 review of 42 population studies estimated it affects about 1.3% of people overall and nearly 6% of those aged 65 and over. The National Tremor Foundation describes a rhythmic shake, most often in the hands and arms, that can make writing, drinking from a cup or eating harder, and says it is usually inherited. It is not the same as Parkinson’s.

Overactive thyroid

The NHS lists twitching or trembling among the symptoms, along with nervousness, a fast or irregular heartbeat and weight loss despite a bigger appetite. It is about 10 times more common in women than men. A simple blood test can check. (Feeling cold and sluggish is more typical of the opposite problem; see underactive thyroid symptoms.)

Parkinson’s disease

The NHS says the tremor usually begins in a hand or arm and is more likely when the limb is relaxed and resting. It typically comes with slowness of movement and muscle stiffness. Most shaky hands are not Parkinson’s, but a resting tremor on one side is worth getting checked.

Alcohol withdrawal

If someone who drinks heavily cuts down or stops, the NHS says withdrawal symptoms can start within 6 to 12 hours and include a racing heartbeat, sweating and shaking. Stopping suddenly can be dangerous if you’re dependent on alcohol, so get medical help before you stop.

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How to stop your hands shaking

For a normal tremor that’s been turned up, tackling the trigger is what works:

Cut back on caffeine, slowly rather than all at once, to avoid headaches. See caffeine withdrawal and coffee alternatives.
Calm your body. Slow breathing such as box breathing can help you feel calmer. See how to calm down fast.
Eat regularly and don’t rely on coffee in place of breakfast.
Protect your sleep. If you feel exhausted but can’t switch off, see tired but wired.
Drink less alcohol and stop smoking if you smoke.
Keep warm in cold weather.
Make tasks easier while it settles: use both hands for a full mug, or rest your elbows on a table.

The NHS says a mild tremor that isn’t caused by another condition doesn’t usually need treatment. If a tremor is affecting your life, a GP may offer medicine, which won’t cure it but often reduces the shaking.

If you’re swapping an evening coffee for something caffeine-free, our Magnesium Glycinate Sleep Complex is a berry-flavoured bedtime drink. Magnesium contributes to normal functioning of the nervous system and to normal muscle function. It isn’t a treatment for tremor, and shaky hands aren’t a sign you need a supplement.

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When to see a GP about shaky hands

The NHS says to see a GP if a tremor is getting worse over time or affecting your daily activities. It’s also worth booking an appointment if:

the shaking is new and you can’t link it to caffeine, stress, tiredness or another obvious trigger
it affects one side only, or happens mostly when your hand is resting
it comes with other symptoms, such as weight loss, a fast heartbeat, slowness, stiffness or problems with walking
it started after a new medicine
you get shaking, sweating and confusion and you don’t have diabetes

Your GP will ask about other symptoms, your medicines and whether tremor runs in your family.

Call 999 if: shaking comes on suddenly with confusion, slurred speech, a drooping face or weakness in one arm or side (possible stroke); someone with diabetes has a hypo and isn’t responding normally; or someone has severe alcohol withdrawal, such as shaking visibly, confusion, seeing things or a seizure. If you have diabetes and feel shaky, check your blood sugar and treat a hypo straight away with a sugary drink or glucose tablets, as your diabetes team advised.

Other symptoms that can feel similar are covered in eye twitching and heart palpitations at night.

If your hands tingle as well as shake, read our guide to pins and needles in your hands.

Small flickers under the skin are a different thing from a tremor; see muscle twitching: causes and when to see a GP.

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FAQs

Why are my hands shaking for no reason?

Usually there is a reason you haven’t spotted yet: caffeine, stress, poor sleep, hunger, alcohol the night before or being cold. Some medicines can also cause it. If it’s new, getting worse or affecting daily life, see a GP.

Can anxiety cause shaky hands?

Yes. Adrenaline released when you’re anxious can make your hands tremble, and the NHS lists trembling as a symptom of panic attacks. It usually settles as the anxiety passes.

Can caffeine make your hands shake?

Yes. Caffeine makes the normal tremor everyone has more noticeable, especially at higher doses or if you’re sensitive. Cutting back gradually usually helps.

Are shaky hands a sign of Parkinson’s?

Usually not. A Parkinson’s tremor typically starts on one side, happens when the hand is resting and comes with slowness or stiffness. See a GP if that sounds familiar.

How do I stop my hands shaking?

Cut back on caffeine, eat regularly, get enough sleep, use slow breathing when anxious, drink less alcohol and keep warm. If a tremor affects your daily life, a GP can offer treatment.

When should I worry about shaky hands?

See a GP if shaking is new, getting worse, one-sided or comes with other symptoms. Call 999 if it starts suddenly with confusion, slurred speech or weakness on one side.

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