Ménière’s Disease
Stopping the Spinning
“I’ve gotten so dizzy and nauseated that I had to hold on to things to keep my balance,” says Linda Dowell of Gardiner, Maine, who has had Ménière’s disease since 1986. Her first bout woke her up in the middle of the night and was so frightening that it necessitated an ambulance ride to the emergency room. Less serious attacks leave people feeling nauseated, weak and disoriented.
Normally, the fluid in your inner ear is contained in two balloonlike chambers. The purpose of the fluid is to help you sense where your head is in reference to the rest of the world. This is done by a series of receptors in the inner ear that are sensitive to motion.
In Ménière’s disease, something, perhaps a virus, interferes with the proper balance of fluid in the inner ear. Fluid pressure builds, eventually rupturing a tiny membrane in the inner ear. The rupture is often preceded by a feeling of fullness or ear pressure, followed by a loud, roaring noise and hearing loss that can be temporary or permanent. Other symptoms may include nausea and vomiting as well as tinnitus, in which there’s persistent noise such as hissing or buzzing in the ear.
While the vertigo typically lasts for 10 to 60 minutes, the entire attack often encompasses hours. “I could be wiped out for days, and rest was the only thing that really helped,” Dowell says. Ménière’s disease can be helped by certain allergy drugs that are also ideal for relieving the symptoms of dizziness. If nausea and vomiting are major components of an extended attack, then antinausea suppositories may be used. For temporary relief, doctors frequently prescribe diuretics (water pills) to reduce fluid buildup in the ear. Some doctors also make several dietary recommendations.
Virginia Fitzgerald of Phoenix is a grandmother. And as the facilitator of one of the country's largest Ménière's disease and tinnitus support groups, she offers the same grandmotherly advice to anyone who cares to listen.
"I'm always telling people to make sure they eat right," she says. "I feel like that really is the best advice I can give them."
Ear doctors and their patients agree that healthy eating can go a long way toward alleviating ear problems, for plenty of reasons. Here are the details.
Nibble away at fat. A damaged inner ear is particularly sensitive to high blood levels of cholesterol. Some researchers believe that fat in the blood actually makes the blood more viscous, or thick, and impairs blood delivery through the tiny artery that leads to the inner ear.
So cut fat, especially saturated fat, from your diet. This means filling up on fresh vegetables and fruits, whole grains, beans, low-fat dairy products, fish and lean cuts of meat. Eat only the low-fat versions of lunchmeats, mayonnaise, cheeses, frozen desserts and baked goods.
Battle your sweet tooth. Loading up on sugar does several things. It prompts your body to pump up insulin production. (Insulin is a hormone that your body uses to get energy from sugar.) Too much sugar in your diet can also send your blood sugar level to extremes of high and low, says Charles P. Kimmelman, M.D., professor of otolaryngology at New York Medical College in Valhalla and a physician at Manhattan Eye, Ear and Throat Hospital. Your ears don't like that, he says.
It's easy enough to avoid the usual sugar-laden snacks: cookies, candy and soda. But the sweet stuff also lurks in some unsuspected foods. Low-fat cookies and other snacks, fruit-flavored yogurt, flavored teas and breakfast cereals can all pack a sugar wallop. If you're really looking to curb your sweet tooth, enjoy these foods only in moderation.
Know your salt sources. To cut salt, nutrition experts recommend reading labels carefully and avoiding foods with more than 150 milligrams of sodium per serving. Either eliminate potato chips, corn chips, pickles, olives, ham, hot dogs, canned foods (soups, beans and vegetables), hard cheeses, cottage cheese, tomato juice, tuna, lunchmeats, biscuits, pancakes, breads and pizza, or use low-sodium or no-sodium versions of these foods.
You can reduce the salt in some canned foods up to 80 percent by rinsing and draining the food for one minute.
Try using onion powder or garlic powder as seasoning rather than salt. In fact, there's a whole world of tastes worth exploring. Try sage or savory on chicken and rosemary or marjoram on meats, and add dried mushrooms and tomatoes to casseroles.
Shake the Salt Habit
Once salt is concentrated in the fluid within the inner ear, it draws in additional fluid, increasing the pressure in the inner ear until the membrane ruptures, setting off a dizzying attack. Eventually, the membrane heals and the ear settles down.
Some doctors ask their patients to make sure that they get no more than 1,000 to 2,000 milligrams of sodium per day. The higher amount is for active people living in hot climates. One study of soldiers estimated that they got about 11,000 milligrams a day! (There are 2,000 milligrams of sodium in one teaspoon of salt.)
So it’s obvious that people with Ménière’s disease should cut back on salt. But they should also be looking at other mineral needs as well.
Other Minerals Balance Salt
Because these minerals are so important to healthy ears, some doctors tell their patients with Ménière’s disease to make sure that they get at least the Daily Values of these nutrients.
For magnesium, that’s 400 milligrams a day. Studies show that most people come up short, with men usually getting about 329 milligrams a day and women getting about 207 milligrams a day. Whole grains, nuts and beans are your best magnesium sources. Green vegetables are good sources, but bananas are the only fruit that provides much magnesium.
For calcium, doctors recommend aiming for the Daily Value of 1,000 milligrams. One cup of 1 percent low-fat milk offers about 300 milligrams of calcium; one ounce of hard cheese (part-skim mozzarella), about 181 milligrams; and eight ounces of low-fat yogurt, about 415 milligrams.
To get a healthy amount of potassium—3,500 milligrams or more a day—load up on fresh fruits and vegetables and their juices. A cup of tomato juice, for instance, has about 537 milligrams of potassium; orange juice, 496 milligrams; and prune juice, 707 milligrams. Potatoes, yams, avocados, Swiss chard and bananas are also good sources. Since potassium is leached out by boiling water, you’ll want to stick to fresh, baked or lightly steamed fruits and vegetables.
Note: Diuretics, pills that increase your flow of urine, are frequently prescribed for people with Ménière’s disease, says Dr. Kimmelman. Some types of diuretics can deplete the body of potassium and sometimes of magnesium. If you’re taking this kind of diuretic, he says, check with your doctor to make sure that you get enough supplemental potassium and magnesium to make up for the loss. Don’t take potassium and magnesium supplements on your own in this situation, however. Too much of either mineral can be harmful, especially if you have heart or kidney problems or diabetes.
Other Vitamins May Deter Dizziness
“We found out by accident that women taking a multivitamin/mineral formula for premenstrual problems had a reduction, or sometimes a complete abatement, of their Ménière’s or tinnitus symptoms,” says Susan J. Seidel, an otologist (hearing specialist) at the Greater Baltimore Medical Center. The women were taking Optivite, an over-the-counter multivitamin/mineral supplement that offers, among other nutrients, 300 milligrams of vitamin B6 and 250 milligrams of magnesium.
“We now recommend this supplement to people who have a sense of fullness or pressure in the ear or dizziness,” says Seidel. “We don’t know what in the vitamin is helping, but some people with these symptoms do say that it helps.”
Another doctor, George E. Shambaugh, Jr., M.D., professor emeritus of otolaryngology and head and neck surgery at Northwestern University Medical School in Chicago, prescribes a hefty multivitamin/mineral supplement called Basic Preventive, from Advanced Medical Nutrition in Hayward, California. This supplement contains a long list of ingredients, including 500 milligrams of calcium, 500 milligrams of magnesium, 100 international units of vitamin D, 20 milligrams of zinc and an array of other vitamins and minerals. He prescribes it, he says, because his patients report that it works. “Their ears often improve, along with other health problems that they may have,” Dr. Shambaugh says.
Even if you decide to take a multivitamin/mineral supplement, make sure that you follow the dietary measures recommended in “Food Factors” on page 382 as well. While nutrients can make up for some dietary indiscretions, says Dr. Shambaugh, it’s unrealistic to expect them to overcome constant bad eating habits.
Doctors recommend cutting back on salt and adding these nutrients to a healthy diet to reduce the dizziness of Ménière's disease.
Nutrient Daily Amount
Calcium 1,000 milligrams
Magnesium 400 milligrams
Potassium 3,500 milligrams
Plus a multivitamin/mineral supplement containing the Daily Values of all essential vitamins and minerals
MEDICAL ALERT: Some diuretics, which are often prescribed for people with Ménière's disease, can deplete the body of potassium and magnesium. Before taking supplements of either nutrient, however, talk to your doctor. Too much of either mineral can be harmful.
If you have heart or kidney problems, be sure to consult your doctor before supplementing magnesium.
Talk to your doctor before taking potassium supplements if you have kidney problems or diabetes.
Food Factors
Prescriptions for Healing
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