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What is Meniere’s disease?
Meniere’s disease is a disorder of the inner ear that causes severe
dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a
feeling of fullness or congestion in the ear. Meniere’s disease usually
affects only one ear.
Attacks of dizziness may come on suddenly or after a short period of
tinnitus or muffled hearing. Some people will have single attacks of
dizziness separated by long periods of time. Others may experience many
attacks closer together over a number of days. Some people with Meniere’s disease
have vertigo so extreme that they lose their balance and fall. These
episodes are called “drop attacks.”
Meniere’s disease can develop at any age, but it is more likely to
happen to adults between 40 and 60 years of age. The National Institute on
Deafness and Other Communication Disorders (NIDCD) estimates that
approximately 615,000 individuals in the United States are currently
diagnosed with Meniere’s disease and that 45,500 cases are newly
diagnosed each year.
What causes the symptoms of Meniere’s disease?
The labyrinth is composed of the semicircular
canals, the otolithic organs (i.e., utricle and
saccule), and the cochlea. Inside their walls (bony
labyrinth) are thin, pliable tubes and sacs
(membranous labyrinth) filled with endolymph.
Credit: NIH Medical Arts
The symptoms of Meniere’s disease are caused by the buildup of fluid
in the compartments of the inner ear, called the labyrinth. The labyrinth
contains the organs of balance (the semicircular canals and otolithic
organs) and of hearing (the cochlea). It has two sections: the bony
labyrinth and the membranous labyrinth. The membranous labyrinth is filled
with a fluid called endolymph that, in the balance organs, stimulates
receptors as the body moves. The receptors then send signals to the brain
about the body’s position and movement. In the cochlea, fluid is
compressed in response to sound vibrations, which stimulates sensory cells
that send signals to the brain.
In Meniere’s disease, the endolymph buildup in the labyrinth
interferes with the normal balance and hearing signals between the inner
ear and the brain. This abnormality causes vertigo and other symptoms of Meniere’s disease.
Why do people get Meniere’s disease?
Many theories exist about what happens to cause Meniere’s disease,
but no definite answers are available. Some researchers think that Meniere’s disease
is the result of constrictions in blood vessels similar to those that
cause migraine headaches. Others think Meniere’s disease could be a
consequence of viral infections, allergies, or autoimmune reactions.
Because Meniere’s disease appears to run in families, it could also be
the result of genetic variations that cause abnormalities in the volume or
regulation of endolymph fluid.
How does a doctor diagnose Meniere’s disease?
Meniere’s disease is most often diagnosed and treated by an
otolaryngologist (commonly called an ear, nose, and throat doctor, or ENT).
However, there is no definitive test or single symptom that a doctor can
use to make the diagnosis. Diagnosis is based upon your medical history
and the presence of:
- Two or more episodes of vertigo lasting at least 20 minutes each
- Temporary hearing loss
- A feeling of fullness in the ear
Some doctors will perform a hearing test to establish the extent of
hearing loss caused by Meniere’s disease. To rule out other diseases, a
doctor also might request magnetic resonance imaging (MRI) or computed
tomography (CT) scans of the brain.
How is Meniere’s disease treated?
Meniere’s disease does not have a cure yet, but your doctor might
recommend some of the treatments below to help you cope with the
- Medications. The most disabling symptom of an
attack of Meniere’s disease is dizziness. Prescription drugs such as
meclizine, diazepam, glycopyrrolate, and lorazepam can help relieve
dizziness and shorten the attack.
- Salt restriction and diuretics. Limiting dietary
salt and taking diuretics (water pills) help some people control
dizziness by reducing the amount of fluid the body retains, which may
help lower fluid volume and pressure in the inner ear.
- Other dietary and behavioral changes. Some people
claim that caffeine, chocolate, and alcohol make their symptoms worse
and either avoid or limit them in their diet. Not smoking also may
help lessen the symptoms.
- Cognitive therapy. Cognitive therapy is a type of
talk therapy that helps people focus on how they interpret and react
to life experiences. Some people find that cognitive therapy helps
them cope better with the unexpected nature of attacks and reduces
their anxiety about future attacks.
- Injections. Injecting the antibiotic gentamicin
into the middle ear helps control vertigo but significantly raises the
risk of hearing loss because gentamicin can damage the microscopic
hair cells in the inner ear that help us hear. Some doctors inject a
corticosteroid instead, which often helps reduce dizziness and has no
risk of hearing loss.
- Pressure pulse treatment. The U.S. Food and Drug
Administration (FDA) recently approved a device for Meniere’s disease
that fits into the outer ear and delivers intermittent air pressure
pulses to the middle ear. The air pressure pulses appear to act on
endolymph fluid to prevent dizziness.
Location of endolymphatic sac
Credit: NIH Medical Arts
- Surgery. Surgery may be recommended when all other
treatments have failed to relieve dizziness. Some surgical procedures
are performed on the endolymphatic sac to decompress it. Another
possible surgery is to cut the vestibular nerve, although this occurs
- Alternative medicine. Although scientists have
studied the use of some alternative medical therapies in Meniere’s disease
treatment, there is still no evidence to show the effectiveness of
such therapies as acupuncture or acupressure, tai chi, or herbal
supplements such as gingko biloba, niacin, or ginger root. Be sure to
tell your doctor if you are using alternative therapies, since they
sometimes can impact the effectiveness or safety of conventional
What is the outlook for someone with Meniere’s disease?
Scientists estimate that six out of 10 people either get better on
their own or can control their vertigo with diet, drugs, or devices.
However, a small group of people with Meniere’s disease will get relief
only by undergoing surgery.
What research about Meniere’s disease is being done?
Insights into the biological mechanisms in the inner ear that cause Meniere’s disease
will guide scientists as they develop preventive strategies and more
effective treatment. The NIDCD is supporting scientific research across
the country that is:
- Determining the most effective dose of gentamicin with the least
amount of risk for hearing loss.
- Developing an in-ear device that uses a programmable microfluid pump
(the size of a computer chip) to precisely deliver vertigo-relieving
drugs to the inner ear.
- Studying the relationship between endolymph volume and inner ear
function to determine how much endolymph is “too much.”
Researchers are hoping to develop methods for manipulating inner ear
fluids and treatments that could lower endolymph volume and reduce or
C and vitamin
E - strong antioxidants provide extra ‘fighting power’ to the
immune system, neutralizing free radicals and acting as very strong anti-inflammatories,
drawing away unneeded fluid from the cells. A daily dose of a vitamin
B complex consisting of vitamin
B6 and vitamin
B12 will help keep your stress under control. People with Meniere's
disease use the supplements to decrease their tinnitus symptoms, according
to MayoClinic.com. The National Institutes of Health warns that zinc
supplements may affect the way antibiotics and other medicine works. Talk
to your doctor about the safety and efficacy of zinc supplements for
Herbs such as Ginkgo biloba and Rosmarinus officinale support the
circulatory system, increase energy levels and promote mood balance.
Ginkgo biloba promotes proper
circulatory functioning and helps keep your blood vessels protected.
Consuming ginkgo biloba may improve blood flow to your brain and cognitive
functioning. This herb also helps to diminish symptoms associated with
tinnitus and vertigo as well. It can take four to six weeks to note the
benefits associated with ginkgo biloba; take 120 mg of ginkgo biloba a day
in divided doses.
Side effects may include rash,
headaches and gastrointestinal upset. Pregnant women and breastfeeding
females should not use ginkgo biloba. Stop using ginkgo three days before
surgery to reduce any risks associated with excessive bleeding. Ginkgo
biloba may interfere with certain medications like carbamazepine, valproic
acid, fluoxetine, sertraline, paroxetine, escitalopram and phenelzine. It
may also interfere with medications like nifedipine, aspirin, clopidogrel,
dipyridamole, heparin, ticlopidine, ibuprofen, thiazide diuretics and
trazadole. Diabetics should speak with a doctor before taking ginkgo
biloba because it can increase insulin levels in the blood.
Rosemary helps to improve circulatory and cognitive processes. Take 4 to 6
g of dried rosemary and brew it in 2 cups of hot water for 15 minutes.
Strain the mixture and consume 3 cups a day to improve your circulatory
processes and tinnitus. Possible side effects include nausea and vomiting,
and in extreme cases, coma and pulmonary edema can result. Pregnant women
may miscarry if using rosemary, and breastfeeding females should also
avoid the herb. If you have Crohn's disease, hypertension, ulcers or ulcerative
avoid consuming rosemary. Do not consume rosemary oil orally because it is
toxic. Rosemary can interact with warfarin, clopidogrel, aspirin,
captopril, enalapril, lisinopril, fosinopril, diuretics like furosemide
and hydrochlorothiazide, lithium and diabetic medications.
Lysine. A naturally
occurring amino acid, lysine is popular in
France for treatment of vertigo (Rascol et al, 1995). COMMENT: Possibly
useful for vestibular neuritis.
Manganese - 1000 mg. of magnesium will relieve the ringing in
your ears as well as protect the ears from permanent hearing loss and
(MSM) restores tissue health in the middle ear. It will also
reduce the possibility of allergic reactions, making this vitamin regime
more effective and agreeable to your systems.
Vertigoheel is available with prescription (Cocculus
Compositum is the same composition available without
Vertigoheel is a homeopathic concoction. Vertigoheel
works in the brain, not the inner ear. It apparently helps the brain deal
with confusing balance signals coming from the Meniere’s-diseased ear. This
treatment will eliminate confusion from aberrant balance signals, and it
will offer immediate relief. Any symptoms of dizziness, imbalances, and
motion sickness will find immediate relief from Vertigoheel or Cocculus
Compositum. Has to be taken under the tongue, consistently for 2-3 days
without a break.