Ménière's Disease

Ménière's disease is a chronic inner ear condition that causes episodes of vertigo, hearing loss, tinnitus, and a feeling of fullness or pressure in the ear. It is caused by an abnormal amount of fluid in the labyrinth of the inner ear and can occur in one or both ears. The exact cause of Ménière's disease is unknown, but it is believed to be a combination of genetic and environmental factors. Symptoms can vary in frequency and severity and can start at any age, with men and women being equally affected. Ménière's disease can have a significant impact on daily life and quality of life, and treatment options include medications, lifestyle changes, and surgery.

What are the symptoms of Ménière's disease?

Symptoms of Ménière's disease may include, but are not limited to the following:

  • Recurring episodes of vertigo: A spinning sensation that starts and stops spontaneously. Episodes of vertigo occur without warning lasting 20 minutes to several hours, but not more than 24 hours. Severe vertigo can cause nausea.
  • Hearing loss: At first hearing loss can come and go, specifically when having an episode of vertigo, but eventually some permanent hearing loss is experienced.
  • Tinnitus: Tinnitus is ringing, buzzing, roaring, whistling, or hissing sound in your ear. Tinnitus can be consistent or come and go.
  • Feeling of fullness in the ear: People with Ménière's disease often feel pressure in the affected ear.
  • Nystagmus: Rapid, sudden, and uncontrollable eye movements occur with Ménière's disease because the same part of the inner ear essential for balance also controls eye movement.

Often people will start with just one symptom, but eventually over time all or most symptoms will start to appear. Episodes and symptoms can come and go, and it can seem like things improve and might disappear entirely for a while. Over time, the frequency of episodes may lessen, but the unpredictable episodes of vertigo and the prospect of permanent hearing loss can be the most difficult problems of Ménière's disease. The disease can unexpectedly interrupt your life, causing fatigue and stress, and symptoms can become more severe as the disease slowly progresses.

What are the stages of Ménière's disease? 

Ménière's disease develops in two stages. Between these stages, a person might not experience symptoms for extended periods (even years).

  1. Early Stage: The early stage of Ménière's disease causes sudden and unpredictable episodes of vertigo. During these episodes, there will be some loss of hearing, which typically returns to normal once the vertigo subsides. After a vertigo attack there is often extreme exhaustion and the need to sleep for multiple hours. The ear may feel uncomfortable and blocked with a sense of fullness or pressure. Tinnitus is also common in this stage. People may also experience the following during the early stages of the disease: diarrhea, blurry vision, nystagmus, nausea, vomiting, cold sweat, palpitations or a rapid pulse, or trembling.
  2. Late Stage: As the disease progresses, vertigo episodes become less frequent and, in some cases, never come back. However balance, hearing, and vision problems can continue, and usually get steadily worse. It is also common to experience drop attacks, which involve spontaneously losing posture or suddenly falling down while remaining conscious. These attacks can lead to serious injuries and often the person is unable to drive or work. 

What are triggers of Ménière's disease?

Ménière's disease is a chronic inner ear disorder characterized by symptoms such as vertigo, hearing loss, tinnitus, and a feeling of fullness or pressure in the ear. The exact cause of the disease is not known, but there are certain triggers that may worsen the symptoms for some people. These triggers include:

  • Diet: Consuming high levels of salt, sugar, alcohol, MSG, and caffeine can be triggers for Ménière's disease symptoms.
  • Stress and anxiety: Stress and anxiety can be triggers for vertigo episodes and other symptoms.
  • Loud sounds: Exposure to loud noises can worsen symptoms of tinnitus and hearing loss.
  • Visual environments: Bright lights or disoriented movement can trigger vertigo.
  • Environmental triggers: Certain chemicals and fragrances can trigger symptoms.
  • Food allergies: Some people may have allergic reaction to specific food, it can cause the symptoms to worsen.
  • Hay fever: Hay fever can be a trigger for Ménière's disease symptoms. It's important to note that these triggers may vary from person to person, and not everyone with Ménière's disease will have the same triggers.

What causes Ménière's disease?

Ménière's disease is a chronic inner ear disorder characterized by symptoms such as vertigo, hearing loss, tinnitus, and a feeling of fullness or pressure in the ear. The exact cause of Ménière's disease is not known, but it is believed to be caused by a build-up of fluid in the inner ear. Some possible causes or contributing factors that have been suggested include:

  • Improper fluid drainage: A blockage or anatomic abnormality in the ear can cause fluid to build up in the inner ear.
  • Autoimmune disease: Ménière's disease may be related to an autoimmune disorder in which the body's immune system mistakenly attacks the inner ear.
  • Viral infection: Some researchers believe that a viral infection, such as herpes simplex, may cause Ménière's disease.
  • Genetic predisposition: There may be a genetic component to Ménière's disease, as it tends to run in families.
  • Allergies: Allergic reactions can cause inflammation in the inner ear and may contribute to Ménière's disease.
  • TMJ disorders: Temporomandibular joint disorders (TMJ) can also cause inflammation and pressure in the inner ear. It's important to note that the cause of Ménière's disease is not fully understood and likely to be multifactorial, and not all people with Ménière's disease will have the same cause.

What testing is there for Ménière's disease?

Ménière's disease is a chronic inner ear disorder characterized by symptoms such as vertigo, hearing loss, tinnitus, and a feeling of fullness or pressure in the ear. Diagnosis of Ménière's disease requires the presence of two episodes of vertigo lasting 20 minutes or longer but not longer than 12 hours, hearing loss verified by a hearing test, tinnitus or a feeling of fullness in the ear, and exclusion of other known causes of these problems.

Other testing that can be used to diagnose Ménière's disease include:

  • Videonystagmography (VNG): a test that records eye movements during different head and body positions to assess inner ear function.
  • Rotary-chair testing: a test that assesses inner ear function by measuring eye movements during rotation of a chair.
  • Vestibular evoked myogenic potentials (VEMP) testing: a test that measures the response of the muscles that control balance in response to sound.
  • Posturography: a test that measures balance and stability by having the patient stand on a moving platform.
  • Video head impulse test (vHIT): a test that measures the ability of the inner ear to detect and respond to sudden head movements.
  • Electrocochleography (ECoG): a test that measures the electrical activity of the inner ear in response to sound.

Blood tests and imaging scans may be used to rule out disorders that can cause problems similar to those of Ménière's disease, such as a tumor in the brain or multiple sclerosis (MS). It is important to note that there is no single test that can confirm the diagnosis of Ménière's disease and a combination of tests are used to make a diagnosis.

What does treatment for Ménière's disease look like?

Conventional treatment options can include medications to control vertigo, nausea, and diuretics, physiotherapy, injections, and surgery. In addition, a low sodium diet is often recommended to minimize fluid build-up. However, for many patients, these treatments may not provide complete relief from symptoms.

Ananta Health offers a holistic approach through an assessment of the patient's history and BioScan SRT testing, personalized lifestyle recommendations, diet changes, and supplements and herbs can be used to help control the symptoms of the disease. 

Can acupuncture help?

Acupuncture is a traditional Chinese medicine treatment that involves the insertion of thin needles into specific points on the body to stimulate healing and balance. It is also used to help with Ménière's disease as it has been shown to be effective in reducing vertigo, nausea, and fatigue. Studies have shown that acupuncture can help improve symptoms of Ménière's disease by reducing inflammation, improving blood flow to the inner ear, and regulating the nervous system. Acupuncture can also help to reduce stress and anxiety which can be a trigger for symptoms.