A 28 year old female with a history of hypothyroidism, and w…

Questions

A 28 yeаr оld femаle with а histоry оf hypothyroidism, and who is a probation officer, presents to the office with a several month history of "shaking in my hands especially the right one".  She tells the NP she is concerned because she carries a weapon and is worried her target skills will be affected which can affect her job. She also relates her brother "has the shakes too" but he never went to see a health care provider about it. She is taking levothyroxine 50 micrograms daily. The last TSH 3 months ago was 2.1 and B12 = 600 pg/mL. The most likely diagnosis is:

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