If you’re living with systemic lupus erythematosus (SLE), you may experience a wide variety of symptoms, from joint pain to muscle weakness. But can lupus cause tremors too? The short answer is yes — hand tremors, or involuntary shaking of the hands, can happen with lupus.

These tremors can range from barely noticeable to severely affecting daily activities. They may be related to lupus itself, certain lupus medications, or something else entirely.

If your hands or other parts of the body are shaking, it can affect your quality of life in unexpected ways. Here’s what you should know about lupus and hand tremors.

What Do Hand Tremors Feel Like?

Several MyLupusTeam members have shared their experiences with tremors. For some, hand tremors were among their first lupus symptoms. “My first symptom was a right-hand tremor, which eventually became a right-and-left hand tremor. It was my only symptom for a while.”

Another member said their hand tremors “are definitely worse” during a flare-up.

Hand tremors can be severe. One member shared, “I don’t drink coffee. The tremors in my hands shake like I’ve drunk 10 cups.”

These types of tremors can interfere with daily life in a number of ways. For example, they can make it difficult to hold onto objects. As one member explained, “My hand tremors are the worst they’ve been. I have to use two hands to hold something.”

Having shaky hands can also make you drop things. One member said, “I call what I have ‘the dropsies.’ No matter what I pick up, everything drops.”

Another shared, “My hand will tremble, then just lose grip on whatever I have, and then it breaks.”

Hand tremors can affect your overall sense of well-being. One member put it this way: “I’ve definitely experienced bad hand tremors, especially during my worst flare-ups. I struggled so hard one day just trying to drink water out of my Yeti cup. I couldn’t. … I felt so helpless.”

Why Does Lupus Cause Shaky Hands?

There are several possible reasons for hand tremors in people with lupus. They could be related to the lupus itself, to medications used to treat it, or to unrelated factors.

Neurological Symptoms of Lupus

Lupus can sometimes affect the nervous system, leading to neurological symptoms. The most common ones include seizures (sudden episodes of abnormal brain activity that can cause convulsions or loss of awareness) and psychosis (a serious mental state that may involve hallucinations or delusional thinking).

Other neurological symptoms may include:

• Headaches
• Dizziness
• Mild cognitive problems (such as trouble with thinking, reasoning, or memory)

Tremors aren’t a common neurological symptom of lupus.

Chorea

Chorea is a movement disorder that causes sudden, repetitive, and uncontrolled movements. While chorea isn’t the same as a tremor, the two can feel similar — especially if multiple chorea movements happen close together. In one study of 83 children with SLE, 6 percent experienced chorea. Scientists aren’t entirely sure exactly how lupus leads to chorea.

Thyroid Problems

People with lupus are at higher risk for thyroid disease. The thyroid, a gland in your neck, produces hormones that help regulate vital functions such as blood pressure, body temperature, and metabolism (how your body uses energy).

According to the Johns Hopkins Lupus Center, about 6 percent of people with lupus have hypothyroidism (underactive thyroid), while about 1 percent have hyperthyroidism (overactive thyroid).

Tremors, including hand tremors, can be a symptom of hyperthyroidism. If you’ve been diagnosed with lupus and your hands start shaking, it may be worth asking your doctor to check your thyroid function. This is especially important if the shaking is accompanied by symptoms like unintentional weight loss or heart palpitations (feelings of a fast, fluttering, or pounding heartbeat).

Lupus Medications

Tremors can also be a side effect of certain lupus medications. Not everyone who takes these medications will develop tremors, but it’s important to pay attention if you notice new or worsening symptoms.

Talk to your doctor if your tremors started after beginning a new medication, changing your dose, or switching treatments.

Some medications used to treat lupus that can cause tremors are:

• Corticosteroids
• Cyclosporine
• Hydroxychloroquine (Plaquenil)
• Mycophenolate mofetil (CellCept)

It’s hard to estimate exactly how many people experience tremors from these medications. In one study of people on long-term cyclosporine, 7 percent reported having tremors. Tremors are considered a less common side effect of mycophenolate mofetil.

Other Causes

Tremors aren’t always related to lupus. Sometimes, they may be caused by other health conditions, including:

• Physiological tremor — A common type linked to factors such as excess caffeine, alcohol withdrawal, or hypoglycemia (low blood sugar)
• Essential tremor — A neurological condition that causes parts of your body — most often the hands — to rhythmically shaking involuntarily
• Parkinson’s disease or other movement disorders
• Stroke
• Tumors
• Alcohol withdrawal

Since there are many factors that can cause tremors, it’s important to work with your doctor to determine the underlying reason. Testing is the only way to know what’s causing your hands or other parts of your body to shake.

Managing Hand Tremors With Lupus

Although tremors can be frustrating, there are steps you can take to reduce their impact on your daily life.

Treat Lupus Effectively

If your tremors tend to appear during lupus flares, keeping your condition under control with the right treatment plan may help. You may need to try several treatment options or combine a few to figure out what works for you.

Weigh the Pros and Cons of Changing Medications

If you and your doctor suspect that your tremors are medication-related, it’s important to consider the pros and cons of switching to a different medicine.

If your tremors are mild or don’t interfere with your daily life, you may want to stay on your current treatment — especially if the medication is working well for you.

On the other hand, if tremors are severe and keep you from doing everyday tasks or caring for yourself, it may be worth exploring other treatment options with your doctor.

Experiment With Avoiding Caffeine

Caffeine can sometimes make tremors worse. Steroids, commonly used to treat lupus, can also interact poorly with excess sugar, which can affect motor control. You might want to try reducing or eliminating caffeine and sugary foods to see if your tremors improve. If cutting back makes a difference, you can continue avoiding them. If not, you can return to your usual habits without worry.

Add Weight to Your Hand

Wearing something heavy on your wrist, like a weighted bracelet or a heavier watch, may help reduce tremors. The extra weight provides sensory feedback that can sometimes signal the brain to stop or calm the trembling. This trick doesn’t work for everyone who experiences tremors, but it’s a simple and low-risk option to try.

Talk to Your Doctor

If you experience new or worsening tremors, or if your tremors seem to signal a lupus flare-up, talk to your healthcare provider. They can help you identify the cause and work with you on a treatment plan, which may include lifestyle adjustments, changes in medication, or additional therapies.

Join the Conversation

On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

Do your hands shake while living with lupus? Let others know in the comments below.