MenieresInfo.com Blog

A reader asks:

Is there a connection between Meniere’s Disease and the vagus nerve?

Not that we can see in PubMed.  Click here.

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:

I was diagnosed with cochlear hydrops.  I think my condition would be called “rotational” as it comes and goes.  When my problems worsen, the eye and the nasal passage on the affected side are usually congested, and I can feel pressure down the side of my neck and in the occipital bone.  How are these symptoms connected?

We have no idea.  You need to discuss this with your doctor.  We always recommend multiple medical opinions, both for diagnosis and for treatment options.

“Rotational” is a term that, when applied to Meniere’s Disease, refers to “rotational vertigo,” a specific form of dizziness.  Symptoms that come and go are said to be “episodic.”  Symptoms that change in intensity are said to be “fluctuating.”

A reader asks:

My father’s doctor suspects that my father may have Meniere’s Disease. His symptoms began to appear shortly after he recovered from a severe infection of Rocky Mountain Spotted Fever (RMSF). The diagnosis of RMSF came after he had been ill for quite some time due to the fact that he didn’t develop the characteristic rash. I found some connections between Lyme disease and Meniere’s Disease on the web, but couldn’t find any cases where Meniere’s Disease was associated with RMSF. Could Meniere’s Disease have been caused or “triggered” by the RMSF?

Meniere’s Disease is “idiopathic” — the cause is unknown.  Nothing in the world is known to cause Meniere’s Disease.  See the MenieresInfo.com Cause Page.  We know of no “connection” between Lyme Disease and Meniere’s Disease.  Click here to search PubMed for “Meniere’s” and “Lyme.”  Lyme Disease and Meniere’s Disease can have the same or similar symptoms — along with bunches of other disorders, which is why the symptoms of Meniere’s Disease (which are also the symptoms of all those other disorders) require a “differential diagnosis” to figure out what is the cause of the symptoms.  See the MenieresInfo.com Diagnosis Page.  We know of no connection between RMSF and Meniere’s Disease.  Click here to search PubMed for “Meniere’s” and “rocky” (there are no hits).  Meniere’s Disease always follows something in life, but that doesn’t mean that the “something in life” caused it.  See the MenieresInfo.com section on the “post hoc ergo proper hoc” fallacy.

We always recommend multiple medical opinions, both for diagnosis and for treatment options.

A reader asks:

I am researching my family’s medical history, and I have found that there is an extremely heavy incidence of Meniere’s Disease, or at least symptoms of Meniere’s Disease, in the Scot line of my paternal grandmother.  It looks like nearly 50% of her descendents had it, but the incidence does not run in a direct line.  I believe my father had it, although it was not diagnosed.  My brother did not have it, but two of his three children do.  Is there a research group that is researching genetic connections pertaining to Meniere’s Disease?

The research to date shows that Meniere’s Disease is not hereditary, but that the incidence is higher in some families, for reasons not understood.  Thus, Meniere’s Disease is said to be “familial.”

We don’t know one way or the other whether there is any current research into possible genetic connections to Meniere’s Disease.  As far as we know, there is no repository of current research (other than clinical trials — click here and here).  The world’s largest repository of medical research, PubMed, is pretty much limited to completed studies that have been published.

Click here to search PubMed for articles on the hereditary or familial aspects of Meniere’s Disease.

Perhaps an astute reader can enlighten us further.

Originally posted February 7, 2006.
Comment added February 16, 2006. 

A reader asks:

When working for long periods on computers, I get more frequent attacks than I do otherwise.  I am using a CRT monitor.  Do you think it would be better for me to use an LCD monitor?  Do you have any evidence that the old CRT monitors can bring on attacks?

 A “CRT” monitor is a cathode ray tube monitor — in effect, a television set.  (Perhaps today we should say “an old style television set.”)  An “LCD” monitor displays using “liquid crystal diodes.”  Click here for an explanation of the differences.

Like all things Meniere’s, some of us are bothered by CRT monitors and some of us aren’t.  We don’t have an authoritative source one way or the other — but would it make a difference?  Forgive us for stating the obvious, but if a CRT monitor bothers you, it makes sense to try using an LCD monitor, and the results for you are the results for you, no matter what any study might show for anyone else.

Comment added February 16, 2006.

A reader comments:

This is a comment to the reader about CRT versus LCD monitors.I know that i had one of my WORST attacks ever after using CRT monitor for less than 5 minutes. Ever since then I will not even look at one. It was my son’s computer and i needed to access it since mine was down. My monitor by the way is a LCD — the flat screen kind. So, yes, like was said, do whatever works for you. I also know that i can only watch TV for very short lengths of time for this very same reason. Like so much about this disease, it is a process of elimination, trial and error, etc.

A reader asks:

As a young child, I had a mastoid in one ear. Thirty years later, I was diagnosed with Meniere’s Disease. Could the mastoid have weakened that ear and made it more vulnerable to eventual Menieres?

The mastoid is a bone behind the ear that is full of air cells, usually spoken of as “the mastoid bone.” Click here for images. Perhaps you mean to say that you had a mastoidectomy — the removal of a mastoid bone.

Meniere’s Disease is “idiopathic” — meaning that the cause is unknown. We haven’t seen anything in the literature that suggests that the mastoid bone — or lack of a mastoid bone — is implicated in the etiology (cause) of Meniere’s Disease, but, as we always say, we haven’t seen everything. Certainly the vast, vast majority of Meniere’s Disease patients have not had a mastoidectomy prior to developing Meniere’s Disease.

A reader asks:

I have been suffering Meniere’s Disease for three years. I went on a diet a year ago to lose some weight, and eventually lost about 25 pounds. Since then, I haven’t had a significant attack, I’ve been able to tolerate more salt in my diet, and I stopped taking diuretics. Can weight loss reduce the symptoms of Meniere’s Disease?

To search PubMed, click here. We didn’t find any articles on this subject one way or the other.

Can weight loss reduce excess endolymphatic fluid that is the prevailing (but not the only) theory of Meniere’s Disease? Dunno.

Can weight loss improve general health, both physical and mental, thereby reducing stress and improving the symptoms of Meniere’s Disease? Our sheer speculation in the absence of evidence one way or the other is, “sure.”

Could the improved symptoms be a coincidental fluctuation that is common with Meniere’s Disease or a temporary remission? That is always possible, given the fluctuating nature of the disease. One never knows.

But nothing succeeds like success and if it works for you, it works for you.

Glad to hear that you are doing better.

As always, we suggest that one talk to one’s doctor and get multiple medical opinions, both for diagnosis and for treatment options.

A reader asks:

I have been diagnosed with Meniere’s Disease. I have been with the airlines for twenty some odd years and specifically flew on a regular basis on turbo prop planes. I am just wondering if there is a connection.

Meniere’s Disease is “idiopathic.” The cause is unknown. The answer to every question that begins, “Is there a connection between Meniere’s Disease and . . .” is “no,” or, at least, “not that anyone knows.” If you knew what caused your symptoms, you wouldn’t have Meniere’s Disease. See the MenieresInfo.com Cause Page.

But who can help but wonder about flying? That “aural fullness” that comes with Meniere’s Disease — that awful “plugged ear” feeling that you can’t get rid of — it feels just like middle ear pressure as when you are descending in an airplane, doesn’t it? You can’t help but try to equalize the air pressure between the middle ear and the ambient pressure, can you? You hold your nose and blow — not too hard — and hope for a “pop.” But it doesn’t happen.

Even though aural fullness feels just like middle ear pressure, it isn’t middle ear pressure. Or if it is, it’s not due to Meniere’s Disease. If you have a dysfunctional Eustachian tube in addition to Meniere’s Disease, you might have real middle ear pressure. If you have a cold in which congestion blocks the Eustachian tube, in addition to Meniere’s Disease, you might have real middle ear pressure. But Meniere’s Disease does not cause middle ear pressure — it just feels that way. The way that you know this is because the Eustacian tube is a “vent” — a connection between the middle ear and the pharnyx. It equalizes the pressure between the middle ear and the ambient pressure, even if you have Meniere’s Disease.

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.

A reader asks:

I have been taking anti-depressant drugs for over a decade, including zoloft, welbutrin, seroquil, and effexor. More recently, I received inoculations for hepatitis a and b prior to international travel. Just a few weeks ago, I developed symptoms consistent with Meniere’s Disease. Could the anti-depressants, or the hepatitis inoculations, have caused Meniere’s Disease?

Meniere’s Disease is “idiopathic,” meaning that the cause is unknown. Therefore, the question “can this cause Meniere’s Disease,” is always answered “no,” or, at least “as far as is known, no.” See the MenieresInfo.com Cause Page.

Many, perhaps most, people who have Meniere’s Disease have not taken anti-depressant drugs or received hepatitis inoculations prior to developing symptoms. (It is not unusual to develop depression in conjunction with Meniere’s Disease and thereafter begin taking anti-depressant drugs.) Surely many people have taken anti-depressant drugs long term and or have received hepatitis inoculations without developing Meniere’s Disease.

But this means nothing one way or the other as to whether you have Meniere’s Disease. Remember that the symptoms of Meniere’s Disease are also the symptoms of many other disorders. Only a differential diagnosis by medical professionals can determine which of the many possibilities is responsible for your symptoms. See the MenieresInfo.com Diagnosis Page.

Updated January 17, 2006
Originally posted January 16, 2006

A reader asks:

What is the relationship of microvascular compression syndrome (MCS) to Meniere’s Disease?

Microvascular compression syndrome (MCS) (also called vascular compression and neurovascular compression) occurs when a blood vessel is situated so close to a nerve that it contacts and presses upon a nerve.

Under various theories, MCS is either:

In any event, MCS can cause the same symptoms as Meniere’s Disease. It is treated by surgery, called “microvascular decompression” (MVD), in which the offending blood vessel is moved off of the nerve. A pad may be placed between the blood vessel and the nerve. Update: Some drugs may give symptomatic relief.

Read more about microvascular compression at these links:

MenieresInfo.com Cause Page
MenieresInfo.com Start Page
MenieresInfo.com Diagnosis Page
MenieresInfo.com Treatment Page
Dr. Timothy Hain
PubMed

A reader asks:

I have Meniere’s Disease, and for the most part, it has been manageable. However, I was in a car accident last night. I know I have mild whiplash, but I’m wondering if it is possible for the accident to have had some kind of impact on my Meniere’s. When I woke up this morning, my equilibrium was completely shot. All day I have been having issues with my balance being off, and mild dizzy spells. There was no trauma to my head or ears that I am aware of in the accident. I’m seeking medical treatment this evening; but I was wondering if it has ever been heard of for a car accident to trigger severe changes and Meniere’s attacks?

By all means, seek professional medical attention.

We don’t know of any studies that establish that auto accidents do or don’t or can or can’t aggravate Meniere’s Disease symptoms. It would be difficult to set up a controlled study where patients would volunteer for actual or simulated auto accidents. Auto accidents come in many different varieties. For example, you say that you don’t know of having experienced any head trauma — yet you say you experienced whiplash. To us, who are not doctors, whiplash constitutes head-and-neck trauma. As you seem to imply, it is theoretically conceivable to have sustained head trauma without knowing or recollected it — as in concussion from one’s head being thrashed about.

But it seems as if you are asking whether a mere auto accident not involving head trauma (in this case, as far as you know) can aggravate Meniere’s Disease symptoms. If one’s only trauma from the accident were a broken foot, it would be hard to see a connection. If one sustained head trauma, one could envision a potential problem.

Remember that Meniere’s Disease, as commonly (although not exclusively) envisioned, is an idiopathic (cause unknown) form of endolymphatic hydrops (excess endolymphatic fluid in the inner ear), also called IEH (idiopathic endolymphatic hydrops). There are other forms of endolymphatic hydrops, including traumatic endolymphatic hydrops (TEH). Click here. TEH is not Meniere’s Disease because the cause is known. But if trauma can *cause* TEH, is it reasonable to suspect that it can *worsen* existing endolymphatics hydrops from any cause — in your case IEH or Meniere’s Disease or somehow “add” TEH to existing Meniere’s Disease? It is to us, but that’s something to discuss with your doctor.

Stress is a factor with Meniere’s Disease symptoms. Could stress from an auto accident induce or exacerbate symptoms of Meniere’s Disease? One would think so. And one never knows whether one’s symptoms, or the aggravation of one’s symptoms, are just due to a normal fluctuation of symptoms or are attributable to some other connection.

Could an auto accident cause some other condition that results in balance problems in addition to Meniere’s Disease? Sure. The obvious thing that first comes to mind is concussion, mentioned above. Symptoms of concussion include dizziness and vomiting. Although both of these manifestations of concussion differ from manifestations due to Meniere’s Disease, it might be hard to distinguish them at first. (Dizziness from concussion is not the same as rotational vertigo from Meniere’s Disease. Vomiting from concussion is not the same as the nausea and vomiting that occurs as a consequence of rotational vertigo from Meniere’s Disease.)

Surely you are not the first to experience worsened Meniere’s Disease or Meniere’s Disease-like symptoms following an auto accident. Whether can be connected to the auto accident is something to discuss with your doctor.

Celiac Disease is an inherited disease that prevents the body from digesting gluten. It is *not* an allergy to gluten. Gluten is a protein found in wheat, rye, and barly, as well as in envelope adhesive, some medicines, and some vitamins (apparently in the binder that holds the medicines and vitamins together). When gluten is eaten by a person with Celiac Disease, the small intestine is damaged. The symptoms of Celiac Disease are varied and it is quite possible to have it and not know it, or to have it and be misdiagnosed with something else.

There is nothing in the literature to suggest any connection, including triggers, between Celiac Disease and Meniere’s Disease.

Celiac Disease is far more common in the U.S. than was previously thought. There was a comprehensive front-page article on Celiac Disease published in The Wall Street Journal on December 9, 2005. This article was also printed in the Pittsburgh Post-Gazette that same day; click here.

Celiac Disease is another one of those mysterious diseases. It is hard to recognize symptoms and hard to diagnose. The only treatment is abstention from eating gluten.

Some patients report anecdotally that their Meniere’s Disease symptoms were lessened when they discovered that they had Celiac Disease and starting abstaining from eating gluten. Nothing succeeds like success, but there is nothing to say that anyone else would (or would not) experience the same improvement in Meniere’s Disease symptoms.

However, Celiac Disease is pretty serious, and if one has it, one would surely want to know it and treat it, whether one did or did not have Meniere’s Disease. If treating one’s Celiac Disease (remember that the only treatment is abstaining from eating gluen) also resulted in reduced Meniere’s Disease symptoms, then that surely would be an added bonus.

Update, December 17, 2005: See this post.

A reader asks:

Is Meniere’s Disease hereditary?

Meniere’s Disease occurs more frequently (but does not “run”) in some, but not all families. Thus, it is not hereditary. There is no known reason why Meniere’s Disease occurs more frequently in some families.

Click here for a link at the MDIC to research at PubMed. Click here to visit the MDIC Cause Page for more information about the cause of Meniere’s Disease.

Updated January 12, 2006.
Originally posted December 9, 2005.

A reader asks:

After having Meniere’s Disease for years, but being free of symptoms for the past eight months, I was tested for obstructive sleep apnea. As part of the test, I was equipped with a CPAP (continuous positive airway pressure) sleep mask. A few hours after the test, I had an attack of vertigo accompanied by nausea and vomiting. I experienced intermittent vertigo for another 36 hours. I asked the doctors whether the use of the CPAP sleep mask could have triggered vertigo due to Meniere’s Disease. One said no, another said don’t know, and the third said maybe. Is there any connection between CPAP sleep masks and the symptom of vertigo due to Meniere’s Disease?

[Added January 12, 2006]

[End addition January 12, 2006.]

Patients are always searching for connections with either causes of Meniere’s Disease or triggers for Meniere’s Disease symptoms.

Meniere’s Disease is “idiopathic” — the cause is unknown. (See the Cause Page at the Meniere’s Disease Information Center, MenieresInfo.com.) There is a whole lot of research going on to find the cause of Meniere’s Disease, but there seems to be little progress so far. (See the MDIC Research Page.) There is little, if anything, that a patient can do to try to figure out the cause of Meniere’s Disease.

There is a lot of research to try to find out what triggers the symptoms of Meniere’s Disease, too. The conventional medical wisdom is that there are triggers that are common for many, but certainly not all, patients, such as sodium in the form of salt, caffeine, nicotine, and alcohol. Many patients find that these substances can trigger their symptoms. But many many patients find absolutely no relationship between these substances and their symptoms. Dr. Jennifer Derebery is researching the relationship between allergies, known and unknown, including food allergies, on the symptoms of Meniere’s Disease. Some patients find that allergies can trigger their symptoms and other patients find no relationship between allergies and their symptoms. Some patients are never able to connect a trigger to their symptoms. Other patients are able to deduce, through trial and error, their own triggers — which may or may not be triggers for any other patients. (See the MDIC Treatment Page section on Triggers.)

With that background, we, who are not doctors, agree with all three of your doctors. We see no obvious medical reason why CPAP should trigger vertigo due to Meniere’s Disease. We also don’t know whether CPAP could be a trigger for you or anyone else. We also think that it is possible that CPAP could be a trigger, either only for you or for other patients.

We sure are heartened to see that you talked to your doctors. Talking to one’s doctor is a very good thing to do. Talking to three doctors is an even better thing to do. Many times there are no answers to Meniere’s Disease questions, but bless the doctors who are honest with us.

There is a logical fallacy called “post hoc ergo proper hoc,” meaning “after this, therefore because of this.” (See the MDIC here.) Just because A is followed by B doesn’t mean that A *caused* B. However, it might have. For most of us, trial and error while keeping detailed journals is the way that we try to figure out our own individual triggers.

The thing to remember is that, if IT is a trigger for you, then IT is a trigger for you, even if IT is not a trigger for anyone else in the world — no matter what IT happens to be. Said differently, if one finds that one’s life is improved by avoiding something that may trigger one’s symptoms, it makes sense to avoid that something, unless the benefits of that something outweigh the adverse effects.

If your doctors approve, the only way for you to figure out whether the CPAP sleep mask triggers your symptoms may be for you to conduct experiments while keeping a detailed journal. The possibilities are that the CPAP sleep mask never seems to trigger your vertigo again, it sometimes seems to trigger your vertigo, or it always triggers your vertigo. In the event of the latter two cases, you’ll have to figure out whether the CPAP is worth the price you pay in vertigo.

Keep in mind that you may or may not have been due for another Meniere’s Disease attack, anyway. Periods of remission come and go with this disease. Remissions are extremely variable.

It is also hard to tell whether something else may have triggered a vertigo attack, coincidentally at the same time that the mask was tested. Just for starters, consider the following:

You get the idea.

Keep in mind that triggers are not always immediate. We know a patient whose symptoms of a condition other than Meniere’s Disease are triggered by certain foods, but the symptoms don’t begin to appear for two-five days later. It took this patient forever to make the connection, but the eventual realization dramatically improved this patient’s quality of life.

A reader asks:

I know a patient whose large intestine has been removed and who has developed Meniere’s Disease. Is there any connection between Meniere’s Disease and intestinal function? I also wonder whether there is any connection between Meniere’s Disease and potassium absorption.

We haven’t seen anything that relates Meniere’s Disease to intestinal function in general, but we haven’t seen everything. A search at PubMed didn’t turn up anything that leads us to see a connection (but click for yourself). We have no idea what role the removal of one’s entire large intestine might play with regard to Meniere’s Disease.

We haven’t seen anything that suggests that Meniere’s Disease is caused by or treated by high or low potassium levels, but we haven’t seen everything. (Note that Meniere’s Disease is “idiopathic” — the cause is unknown.) A search at PubMed didn’t turn up anything that leads us to such a connection (but click for yourself). Diuretics are often prescribed to treat Meniere’s Disease, under the theory that Meniere’s Disease results from excessive endolymphatic fluid in the inner ear, and that by reducing fluids in the body in general, one might also reduce endolymphatic fluid in particular. Diuretics may deplete levels of potassium in the body to dangerously low amounts (affecting heart function), so patients on diuretics are usually tested for potassium levels and are often given a potassium supplement or instructions to eat a banana (a potassium-rich food) a day.