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Meniere’s Disease: Causes, Symptoms & Treatment

Meniere’s Disease: Causes, Symptoms & Treatment

What Is Meniere’s Disease?

Meniere’s disease is a condition that affects the inner ear, the area responsible for balance and hearing. The condition usually affects just one ear. Symptoms include pressure or pain in the ear, intense vertigo or dizziness, a constant roaring or ringing in the ears and hearing loss. This condition could also lead to hearing problems later in life (x).

According to the National Institute on Deafness and Other Communication Disorders, about 615,000 people in the United States suffer from Meniere’s disease (x, x). In addition, doctors diagnose about 45,000 people each year. Although this condition can impact anyone of any age, it is much more likely to affect individuals in their 40s and 50s. Meniere’s disease is a chronic condition and there is currently no way to fully cure it. However, there are multiple treatment options that may help relieve symptoms.

Symptoms of Meniere’s Disease

It is important to note that symptoms can vary per patient (x, x). Usually, patients experience sudden attacks that last for a few hours. Some patients may experience attacks on a weekly, monthly or even yearly basis.

Vertigo

This condition is one of the most common and most noticeable symptoms. During an episode of vertigo, patients feel like the environment around them is spinning. It causes patients to feel dizzy, sick and have difficulty balancing. Some patients also suffer from “drop attacks” and they completely lose their balance and drop to the ground (x).

Tinnitus

Tinnitus is a condition that causes patients to hear sounds that are not caused by any outside source. Instead, the sound comes from inside the body. Patients hear ringing, buzzing, hissing or whistling sounds in the ears (x).

Patients with Meniere’s disease may also feel pressure in the ear and may suffer from hearing loss, specifically with low, deep sounds (x, x).

Stages of Meniere’s disease

Meniere’s disease usually occurs in three stages that reflect the condition’s progression rate (x). However, like the symptoms, the progression rate may vary. Not all patients experience all stages and the severity also is not uniform for all patients. Most patients experience sudden attacks within the first couple of years, but as the attacks begin to occur less frequently, the patient’s hearing often declines. There are a few warning signs for an attack and the patient should try to move to a safe and comfortable place to avoid injury. Before an attack, the patient often experiences the following symptoms (x):

  • Loss of balance
  • Lightheadedness and dizziness
  • Increased ear pressure 
  • Headaches
  • Hearing loss or tinnitus
  • Sensitivity to sound
  • Uneasiness

Early Stage

This stage causes immediate and sometimes random episodes of vertigo. It may also cause nausea, dizziness and vomiting. Some patients also experience hearing loss and tinnitus simultaneously. The patient may feel pressure or blockage in the ear and others may be extremely sensitive to sound. Sometimes vertigo attacks can last for an entire day, but they usually last for two to three hours and the patient’s hearing usually returns after it is over (x).

Middle Stage

In the middle stage, the patient experiences continuous vertigo attacks that often become more severe. Hearing loss and tinnitus may also worsen in this stage. Patients also tend to experience periods of remission where the symptoms temporarily decline. This phase could last for several months (x).

Late stage

In late stages of Meniere’s disease, episodes of vertigo occur less frequently with months or even years between them. In some cases, the episodes stop completely. However, the patient still experiences ongoing issues with hearing and tinnitus. In fact, these symptoms often progress and get worse (x).

Symptoms of Meniere's Disease

Causes of Meniere’s Disease

Currently, researchers have not identified the exact cause of Meniere’s disease. However, medical professionals believe it results from pressure buildup in the inner ear. The inner ear includes the cochlea and the vestibular apparatus. The cochlea is a coiled, spiral-shaped tube that houses two fluid-filled chambers. It is also responsible for hearing. The vestibular apparatus, on the other hand, is a complex set of tubes that help control balance (x, x, x). The fluid inside the inner ear is called endolymph, which stimulates receptors when the body moves. If endolymph pressure changes, it causes problems with hearing and balance (x).

Risk Factors for Meniere’s Disease

Even though medical researchers have not identified a specific cause for Meniere’s disease, there are certain factors that may increase the risk of developing it. For example, if a patient suffers from an immune condition that causes the immune system to attack healthy cells, they may contract Meniere’s disease. Patients may have a chemical imbalance in the fluid in the inner ear, as a result of too much sodium or potassium in the body. It may also be related to genetics, a problem with the blood vessels or certain viral infections, such as meningitis (x).

Treating Meniere’s Disease

At the moment, Meniere’s disease does not have a definite cure, but there are multiple treatment options that may be able to alleviate symptoms and slow down its progression (x).

Medications

Dizziness is often the most debilitating symptom that patients experience with Meniere’s disease. However, medications may be useful in combating it. Medications like diazepam, lorazepam, meclizine and glycopyrrolate may help relieve dizziness and reduce the length of an attack (x).

Cognitive Therapy

This form of therapy helps patients focus on how they interpret and react to different experiences in their everyday lives. Some people use cognitive therapy to better cope with the unexpected attacks and reduce anxiety about future ones (x).

Diuretics

Using water pills called diuretics can help patients control dizziness by reducing fluid retention in the body. This may help lower fluid volume and pressure in the inner ear (x).

Surgery

Doctors recommend surgery if other forms of treatment fail to relieve the symptoms. During the procedure, the surgeon may operate on the endolymphatic sac to compress it or cut into the vestibular nerve. However, the latter is not very common (x).

Dietary Changes

Behavioral and dietary changes may also help patients control their symptoms. Specifically, some patients discover that caffeine, alcohol and chocolate may trigger the symptoms and try to avoid them to control it (x).

Injections

Doctors may inject an antibiotic called gentamicin into the middle ear to help control vertigo. However, the injections may also increase the risk of hearing loss because it can damage the microscopic hair cells in the inner ear that help with hearing. Some doctors opt for of corticosteroid injections instead, since it does not pose the same threat to the patient’s hearing (x).

Pressure Pulse Treatment

Recently approved by the Food and Drug Administration (FDA), pressure pulse treatment uses a small device that fits into the outer ear. The device emits an intermittent air pressure pulse to the middle ear, which helps relieve endolymph fluid pressure to prevent dizziness (x).

Living with Meniere’s Disease

Behavioral Adaptations

Living with Meniere’s disease can be very difficult and frustrating. Fear and anxiety over suffering from an attack often interferes with patients’ everyday lives. Because the attacks are often so unpredictable, patients may need to avoid certain tasks or activities, such as swimming, climbing ladders, operating heavy machinery and even driving. Patients may also need to have someone with them in case of an attack (x).

Dietary Adaptations

According to research, there are also some dietary changes that may reduce fluid retention in the body. In general, if the body retains less fluid, these types of symptoms are less frequent and less severe. Eating certain foods can help the body retain less fluid and reduce symptoms (x).

See Also
Headaches

Patients should eat smaller meals more frequently. Practice portion control by evenly distributing food and drinks throughout the day to regulate bodily fluids. Try substituting three large meals for six smaller ones. Cut back on salt. The less salt a person consumes, the less fluid the body retains. Practice gradually and progressively decreasing salt intake and eventually eliminate it completely. Patients should also make sure to drink enough water and reduce alcohol intake because it can affect fluid volume in the inner ears (x).

Supplements for Ear Health

Pine Bark Extract

Pine bark extract comes from the Pinus pinaster tree that grows in Europe. Ever since the fourth century, pine bark has been used for medicinal purposes, particularly reducing inflammation. Research states that it helps promote inner ear health by reducing symptoms of ear poisoning, which occurs from chemical or drug exposure that can cause damage to the inner ear. This supplement is a powerful antioxidant that helps the body combat radical damage. It promotes healthy levels of vitamin C and vitamin E and reduces inflammation. The recommended dosage for pine bark extract supplements is 250 mg per day, with a physician’s approval.

Fish Oil

Fish oil has omega-3 fatty acids that help promote heart health, reducing the risk of heart attack and heart disease. According to research, fish oils may also help protect hearing. Specifically, when patients paired it with flaxseed oil, it helped prevent earwax buildup (x). This supplement is also a bioavailable source of omega-3 fatty acids. The recommended dose for fish oil softgels is one to two capsules two to three times per day, or following a doctor’s instructions.

Zinc

Even though it is the second most abundant mineral in the human body, humans cannot produce zinc naturally. Instead, people need zinc from dietary sources or supplements. It helps with immune system and cardiovascular system function and also enhances vision and skin health. Because of its immune defense abilities, it can even help prevent ear infections, enhancing ear health. Research suggests it may even help patients manage tinnitus (x).

This mineral promotes digestive, reproductive and immune health. It’s also an essential component in toothpaste that helps keep gums healthy. The recommended dose for zinc gluconate powder is 225 to 450 mg per day, unless a physician advises a different dosage.

Vitamin B12

Vitamin B12 is a water-soluble vitamin in meat, fish, eggs and dairy products. It has a couple of different names, including methylcobalamin—the natural form—and cyanocobalamin—the synthetic form. Vitamin B12 deficiency may result in a condition called megaloblastic anemia, which can affect balance, a symptom of Meniere’s disease. Research also states that vitamin B12 may be an effective tool to help reduce symptoms of tinnitus. However, medical researchers did not conclude that it (x). As a dietary supplement, the recommended serving size for vitamin B12 (cyanocobalamin) powder is 100 to 200 mg once a day, after consulting a doctor.

Bilberry Extract 

Bilberry is a shrub related to blueberry and cranberry. It contains antioxidants, which researchers believe help promote cardiovascular and circulatory health. In the past, people also used it to relieve diarrhea, burns and infections. In studies, medical researchers also tested its ability to reduce symptoms of ear poisoning. The researchers concluded that treatment with bilberry extract significantly protected the ear from toxicity and may effectively help prevent the condition (x). The recommended dose for bilberry extract powder is 400 mg once or twice a day with food, or following a doctor’s instructions.

Ginseng Root

Ginseng root originates in China and originally, people used it as a source of food. But eventually people discovered its medicinal properties. Several natural products around the world contain ginseng and it has become one of the most popular supplements, along with garlic and ginkgo biloba. It helps control inflammation in the body and may even help reduce the risk of cancer. It may also help aid male reproductive health, menopause, energy, focus and immune health and cardiovascular health. Studies also state that ginseng may improve symptoms of tinnitus and combat inner ear cell damage (x). The recommended dose for American ginseng extract powder is 1,000 to 2,000 mg up to two times a day, with a doctor’s permission.

The Bottom Line

Meniere’s disease has a complex array of symptoms, including ringing or buzzing in the ears, pressure in the ears and hearing loss. Patients may also experience headaches, loss of balance and loss of hearing. Meniere’s disease develops from fluid buildup in the inner ear. Medical researchers do not know exactly what causes the fluid to build up, but there are several risk factors, such as a chemical imbalance, genetics and even certain viral infections.

Treatment aims to relieve the symptoms with medication, diuretics and surgery. Patients may also undergo cognitive therapy to cope with the condition because it may trigger stress, fear and anxiety. Attacks can be very frequent and they may interfere with a patient’s daily life and impact how they function, possibly causing emotional distress. Coping with Meniere’s disease may require lifestyle changes and avoiding certain foods or activities that may trigger the attacks or make the symptoms worse. Supplements may also help promote ear health, protect hearing and reduce the risk of infections. However, supplements are not a proper medical treatment for any disease, even though research suggests their potential to enhance overall health. Always consult a doctor before starting a supplement regimen.

 
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