Menier's Disease, benign positional vertigo
Vertigo is very similar to Meniere's disease.
Description - This is a distressing condition with 3 clinical features - Episodic vertigo (spinning sensation that has an onset and offset), some hearing loss and tinnitus (ringing in the ears). This is usually a clinical diagnosis and there are no specific tests to diagnose it. Occasionally these symptoms, particularly if they are constant can be due to other conditions (including benign tumours of the ear nerve) - so it is important to have the condition checked out by your doctor who may wish to organise some special scans to exclude these.
We do not know what causes meniere's, but it is believed that there is some abnormality of fluid (endolymph) movement in the semi circular canals ( which we use for balance) in the ears. It is more common in families and the cause could be of immune cause, virus or perhaps narrowing of the arteries - but no one knows.
What Doctors can do
Because we do not know the cause, there is no definite treatment, and to some extent trial and error can be used to see if there is some success, especially with drugs.
Acute attacks -
- Tranquilisers ( valium, librium) can be used to lower the sensitivity of the nerves and may reduce the symptoms.
- Antihistamines may help
- Nausea and vomiting is helped by drugs such as promethazine and stemetil
- Rest until it stops.
- Consider the Eplet maneuver - see below
Preventive therapy -
- Diet - try to avoid foods or activities which may precipitate attacks.
- Diuretic drugs which remove some fluid from the body may also help the fluid movement in the canals.
- Betahistine is a drug which reputed to improve blood circulation to the area.
- Steroid drugs - if the disease is caused by an immune response then steroid drugs like prednisone may help
- Other drugs have been suggested - antiviral drugs ( acyclovir), immunosuppressive drugs like methotrexate have also been tried, without much success, and the latter can have very serious side effects and I would not recommend its use.
What you can do
Avoid triggers - many people find that their Meniere's are triggered by some action in the previous day or so. these include high salt intake, alcohol, nicotine, stress, fatigue, MSG, or caffeine. If these can be recognised, then by far the best therapy is to avoid them.
- Salt restriction - it is recommended that most meniere's patients should try to restrict salt for a few months. This may affect the production and thickness of the fluid in the canals.
- Caffeine may be a two edged sword. In some people it may cause Meniere's, but in others regular caffeine intake may help.
- When you have an attack, lying or sitting still minimises the symptoms.
- The Eplet manoevre - this simple manoevre moves the fluid round the semicircular canals and can stop an attack.
Discuss with your doctor first before trying this on yourself, but if done gently there is little risk. It is well described in this video.
Nutritional supplements - These may help, and should be tried in most cases before resorting to drugs, especially the more toxic ones. It may take some time before they become effective.
- It seems logical for everyone to have optimal nutritional status with a good multivitamin and mineral
- Calcium and especially magnesium may help by their effects on the nerves - 500-800mg of each per day
- Fish oils - 1-2 grams per day may affect the lymph fluid thickness and be beneficial.
- Bioflavanoids which can reduce inflammation may help.
- Vitamins C and D can have anti inflammatory and antiviral actions, and I would recommend that anyone with Meniere's take 2-4 grams of vitamin c and 5-8,000iu of vitamin D for a few months and see if this helps.
- Ginkgo biloba may improve the blood supply in smaller arteries. it may help patients with Meniere's but then again this may make them worse. But is worth a try.
- Niacin (vitamin B3) also dilates the arteries, and may similarly help pr make it worse.
- CoEnzyme Q10 - this improves energy production and activities within the cells making the function better. There is no data on the use of this with Meniere's but it may help.
The Nutritional supplements I use and recommend to my patients
For my patients with Meniere's diseases I recommend -
USANA - Cellsentials *, Biomega, Active Calcium plus,Vitamin D, Proflavanol C, Coquinone, -
Other therapiesThere are a number of other therapies which you might like to look at. They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help. They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner. My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.
Nutritional supplementsI believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.