MenieresInfo.com Blog

A patient writes:

I have had several Meniere’s attacks in my life, the most recent being over 10 years ago.  As a result, I had slight hearing loss in my right ear.  In January 2006, I had major surgery, after which I was given an ototoxic “loop” diuretic.  The next day after being given the loop diuretic, I found that I had lost all hearing in my left ear.  After several weeks, much of my hearing in the left ear has returned, but hearing remains distorted and I sometimes have a sensation of fullness.  After testing, my doctor found no evidence of Meniere’s disease in the left ear, but confirmed evidence of Meniere’s Disease in the right ear in the past.  He couldn’t say whether the ototoxic loop diuretic or Meniere’s Disease caused the sudden hearing loss in my left ear.  Can Meniere’s Disease cause sudden hearing loss?  My doctor recommended a low salt diet and avoidance of eating cheese.  I see no reference to cheese on any of the Meniere’s websites. Is it known as a frequent trigger? Should I go to a Meniere’s Disease specialist to better determine if the damage to left ear is from the ototoxic loop diuretic or from Meniere’s? Could this determination make a difference in the prognosis which at this time is to wait to see if it goes away?

Meniere’s Disease can cause sudden hearing loss (SHL) but it doesn’t happen often.  You can research this on Google here.

The logical reason why cheese might not be mentioned on any of the Meniere’s Disease websites is that it is not ”known as a frequent trigger.”  In fact, it isn’t. However, cheese contains sodium, which is at odds with your low salt diet (which is really a low sodium diet).  Sodium is known to be a trigger in some, but not all, patients (click here).  You are really asking, “Why did my doctor tell me to avoid cheese?”  But why ask us?  If you have a question about what you were told by your doctor, our advice is to ask your doctor.  It is simply not possible for us to know why your doctor or anyone else said anything about anything.  Our answer to “Why did he tell me that?” is always “We don’t know.”

Our answer to the question “Should I see another doctor?” is always YES.

“Prognosis” is the course of a disease.  Your “prognosis” is not “wait to see if it goes away.”  That is your “treatment.”  If you are asking whether one doctor might have a different opinion from an other doctor, both for diagnosis and for treatment options, the answer is YES.

What you are really saying through all of this is that you lack confidence in your doctor, to which we always say, “see another doctor.”

A reader asks:

Can people with Meniere’s Disease wear hearing aids?  I tried a hearing aid, and after three hours I had an episode of severe vertigo.  Did the hearing aid have anything to do with it?  I am afraid to try the hearing aid again.

Most people with Meniere’s Disease can wear hearing aids.  We have no idea whether your hearing aid triggered your episode of vertigo or whether the episode was mere random coincidence or due to some other trigger.  Every patient is different.  What is a trigger for one patient is no problem for another patient.  If it triggers your symptoms, it triggers your symptoms, no matter what “it” is.  We know of no way other than trial and error to determine whether your hearing aid triggered your vertigo.  We suggest that you discuss this with your medical professional to see whether your hearing aid is a problem for you and, if so, whether some adjustment to the amplification or the ear mold or something else can be made.

A reader asks:

I have found that taking birth control pills makes my symptoms worse.  Is there any further information on this?

We found no authoritative resources on this subject at PubMed, nor do we recall any anecdotal reports one way or the other.  But anything can be a trigger for Meniere’s Disease symptoms for any particular patient.  Our guess is that, like all things Meniere’s, some patients have no problem with birth control pills, and some patients do.  If it’s a trigger for you, then it’s a trigger for you, no matter what “it” is.  Read more about triggers at the MenieresInfo.com Triggers section on the Treatment Page.

A reader asks:

I recently was diagnosed with Meniere’s Disease, and I am on a low-sodium, no caffeine, and no alcohol diet.  I am miserable.  The low-sodium diet I can deal with, but no caffeine or alcohol?  I’ve read that the low-sodium diet is important, but received conflicting views on the necessity to abstain from caffeine and alcohol.  Is a glass of wine or a piece of chocolate no more than once a week going to bring back my symptoms?

It is common for doctors to advise patients to abstain from sodium, caffeine, and alcohol (and tobacco) (click here), as these substances are known to trigger the symptoms of Meniere’s Disease in many, but not all, patients.  Note “but not all patients.”  Only you can determine whether these substances will trigger your symptoms and, if so, to what degree.  Only you can determine whether you are more miserable with symptoms or more miserable without sodium, caffeine, and alcohol.  Most patients who suffer from bouts of severe vertigo will find the abstinence a small price to pay, but there are others, perhaps yourself, who prefer the vertigo.  We suggest that you discuss your concerns with your doctor.

A reader asks:

I don’t know what is “triggering” my attacks.  How can I find my ”triggers”? If the possibilities are nearly limitless, what questions can I ask myself to help me find what my triggers might be?

Some patients either have no triggers or no identifiable triggers.  There’s nothing magical about trying to find your triggers.  Some patients have allergies, known or unknown, that can trigger attacks, and allergies are best identified by a doctor who specializes in allergies.  Some people unknowingly have food allergies.  When one has an attack, one might ask oneself what was different about the day of the attack or the day or two preceding an attack.  Possibilities include food, condiments, cloth, clothing,  bedding, fragrances, air quality, and many other factors.  Finding one’s triggers, to the extent that finding one’s triggers is possible, requires thoughtful deduction and the process of elimination.  There is no “cookbook” on the subject.

For more information on triggers, visit the MenieresInfo.com section on Triggers.

April 7, 2006 — another reader comments:

I used to go often to an Indian restaurant close to where I work.  On a couple of occassions, I had a vertigo attack about halfway through my meal.  The last time it happened, it was a REALLY bad attack; my partner had to pick me up and I couldn’t walk or think for two days following.  Afterwards, my partner and I made the connection between eating Indian food and me getting vertigo attacks.  We realized, that five out of five times, over a period of about six months, I had an attack after eating at that restaurant.  Regretfully, I have taken Indian food off of my diet, being unable to narrow down what exactly in the food is triggering attacks.  This is by no means the only trigger I have, and I am far from figuring them all out.  But this is one less contributing factor in the daily struggle with the affects of Meniere’s Disease on my daily life.

A reader asks:

I am trying desperately to become pregnant.  I am older and I feel like I am running out of time.  Due to difficulties getting pregnant, I am taking Clomid.  More expensive procedures, such as in vitro fertilization, are not within my reach.  However, when I take Clomid, I get terrible Meniere’s attacks.  Of course, the Meniere’s attacks affect my ability to be intimate with my husband in order to get pregnant.  My obstetrician doesn’t seem to understand how Meniere’s Disease works.  I can’t get in to see my Meniere’s Disease doctor for another month.  Does anyone else have this problem?  Is there any solution?

You are looking for people to share personal experiences, which is fine except that this blog is not a good forum for people looking to share experiences.  Try forums that are specifically aimed at coping and support.  Click here.

Many patients ask whether X or Y could trigger vertigo attacks, including drop attacks.

The answer is that virtually anything can be a trigger for any one individual patient.  If it’s a trigger for you, then it’s a trigger for you, no matter what “it” is.  There is a discussion of triggers, including common triggers, in the trigger section of the MenieresInfo.com Treatment Page.  But even the so-called common triggers are not triggers for everyone.  For example, consumption of sodium in the form of salt bothers many patients, but it also does not bother many patients.  Simarly, consumption of alcohol bothers many patients, but it also does not bother many patients.  The treatment objective is to identify the things that are triggers for you, regardless of whether they are triggers for anyone else, and to avoid them.

A reader asks:

I bought hearing aids six weeks ago and have since had three severe attacks of vertigo. I have never had attacks that strong in my 22 years of dealing with Meniere’s Disease. Can hearing aids trigger vertigo attacks and make them stronger than they were before the hearing aids?

You are really asking whether others have found that hearing aids trigger vertigo attacks, but we don’t think that matters.  It’s the nature of Meniere’s Disease and triggers that virtually anything will affect some patients and yet not affect others.  If something is a trigger for you, it’s a trigger for you, whether it’s a trigger for a million others or no one else.  We take it that you have eliminated, at least in your own mind, the slim yet real possibility that you are experiencing a progression that coincidentally occurred at the time that you obtained your hearing aids.

We recommend that you see your doctor and/or your credentialed audiologist (usually having a master’s degree) about this.  If your medical professional believes that the aids are the trigger, the professional may suggest adjustments that might be tried.  With digital hearing aids, adjustments may need to be programmed for you.  It might be that it is certain frequencies at certain volume levels that are triggering your attacks. Like most other trigger-related issues, one must engage in trial-and-error to figure out the trigger and then to narrow the circumstances under which one will experience the trigger effect.

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January 30, 2007 — A reader sends this information:  

“I am responding to the question regarding whether hearing aids can trigger vertigo attacks. I say YES! I have had profound hearing loss for 34 years, and then Meniere’s Disease for 7 years. My Meniere’s symptoms are relatively mild most of the time — moderate tinnitus and mild vertigo. However, I have learned that when I am in a noisy environment such as a sporting event, party, church with loud singing and music, etc. my dizziness and tinnitus get worse. If I turn my hearing aid off and shut off the sound, the dizziness immediately goes away, and the tinnitus takes a little longer to abate. So with me there is a huge correlation between loud noises and vertigo. I feel fortunate I can just ‘turn off’ the dizziness just by turning off the sound.”

A reader asks:

What drugs are contraindicated with Meniere’s Disease?

We haven’t seen any authoritative listing, comprehensive or otherwise, of drugs that are *always* contraindicated with Meniere’s Disease. (Remember that the cause of Meniere’s Disease is unknown.) Of course, we haven’t seen everything.

The better answer is to ask your Meniere’s Disease doctor about any drug that has been prescribed by any other doctor and whether it will adversely affect your Meniere’s Disease or adversely interact with any drug that your Meniere’s Disease doctor has prescribed.

Some substances are known to trigger or exacerbate the symptoms of Meniere’s Disease in *some* patients, such as caffeine, nicotine, and salt. Therefore, initial treatment will usually include avoidance of these triggers. Other patients find that they are not affected by these substances.

Some substances are known to be “ototoxic” to a greater or lesser degree. “Ototoxic” means toxic to the ear, either by impairing balance, damaging hearing, or inducing tinnitus. We’ve not seen anything authoritative that indicates that Meniere’s Disease patients are any more sensitive to these substances than anyone else, but, as we always say, we’ve not seen everything. (Note that exposure to loud sound can also damage one’s hearing.) On the other hand, having already suffered the effects of Meniere’s Disease, one might want to reduce any controllable exposure to anything that might further worsen one’s condition, no matter how remote the chances.

The bottom line: talk to your doctor.

A reader asks:

For a couple of years, I have had all of the symptoms of Meniere’s Disease, plus fever on the left side of the head but focused on the ear. When I recently moved to a city at a higher elevation, my symptoms were more pronounced during the drive. Has there been any research on the effect of atmospheric pressure on the symptoms of Meniere’s Disease?

Virtually all published research can be found at PubMed. You can search PubMed for connections between Meniere’s Disease and atmospheric pressure by clicking here. Virtually all current clinical trials can be found here. Forms of research not falling into these two categories can be difficult to find.

What you describe is a decrease in atmospheric pressure. Anecdotally, some patients have reported that increases in barometric pressure, as from an approaching storm, can trigger or exacerbate their symptoms. Avoiding one’s triggers, or at least, observing one’s triggers, can be an important part of treatment. See the MeniereInfo.com Treatment Page. Also anecdotally, most patients seem able to fly without problems due to pressure changes, and we don’t recall any anecdotal reports that patients have worsened or bettered their symptoms in the long term by simply moving to different elevations. One of the treatments for Meniere’s Disease is the Meniett Device, which introduces pulses of pressure into the middle ear.

All that said, it seems to us that atmospheric pressure, like almost everything else, affects us all differently, and that there have been no certain conclusions reached.

We don’t know what you mean by “fever on the left side of the head but focused on the ear,” but whatever it means, it is not one of the four classic symptoms of Meniere’s Disease. See the MenieresInfo.com Symptoms Page.

We recommend that you proceed with all possible haste to medical professionals for the purpose of finding out what is causing your symptoms and getting treatment. There are resources to help you to find a doctor at the MenieresInfo.com Doctors Page. The symptoms of Meniere’s Disease are also the symptoms of many other disorders. It takes medical professionals and a differential diagnosis to determine what might be the cause of the symptoms that are shared by Meniere’s Disease and other disorders. See the MenieresInfo.com Diagnosis Page.