Vertigo can be caused by peripheral and central disorders. Vertigo is usually associated with a problem in the inner ear balance mechanisms (vestibular system). It can also be caused by problems with the nerve that connects the inner ear to the brain, or there could be problems in the brain that cause vertigo. When the problem is in the inner ear, it is called peripheral vertigo. Peripheral vertigo is often associated with hearing loss or tinnitus (ringing in the ears).
Benign positional vertigo is the most common kind of peripheral vertigo.
It is a condition in which a person develops a sudden sensation of spinning, usually when moving the head. The inner ear has fluid-filled tubes, called semicircular canals. The canals are extremely sensitive to movement of the fluid, which occurs as you shift positions. The fluid movement allows the brain to interpret your body’s position and thus maintain balance. Benign positional vertigo occurs when a small piece of bone-like calcium breaks free and floats within the tube of the inner ear. This sends the brain confusing messages about the body’s position. The condition may partly run in families. A prior head injury (even a slight bump to the head) or an inner ear infection called labyrinthitis may make some people more likely to develop vertigo.1 There are no major risk factors. Less common vestibular ailments are below:
- Ménière’s disease results in severe vertigo, ringing in the ears (tinnitus), and progressive hearing loss)
- Vestibular neuritis (inflammation of vestibular nerve cells; may be caused by viral infection)
- Ototoxicity – Some medications and environmental chemicals (e.g., lead, mercury, tin) can cause ototoxicity
(i.e., ear poisoning), which may result in damage to the inner ear or the 8th cranial nerve (acoustic nerve) and cause vertigo.
Having a bone mineral density below normal, osteopenia, or having an even greater loss of bone density resulting in fragile porous bones, osteoporosis, which are both predominantly caused by a lack of calcium, are more common in men and women who also have benign positional vertigo. Dr. Ji Soo Kim, from Seoul National University College of Medicine in Korea, said “These findings suggest a problem with calcium metabolism in people with vertigo. Women most often have their first case of vertigo in their 50s, when they are also having a drop in bone mass due to loss of estrogen. Estrogen is one of the main hormones that influence calcium and bone metabolism.” 2
Call your health care provider if vertigo develops that has not been evaluated or if treatment is ineffective. Also call if you develop any associated symptoms (such as weakness, slurred speech, visual problems) that may indicate a more serious condition.
SYMPTOMS
- Spinning sensation, often triggered by head movement
- Typically starts suddenly and last only minutes
- Vision complaints, such as a perception that things are jumping or moving
- Often person cannot roll in bed or tilt their head up to look at something
- Vomiting (in severe cases) and dehydration
To diagnose benign positional vertigo, the health care provider will often perform a test called the Dix-Hallpike maneuver. The doctor holds your head in a certain position and asks you to lie quickly backward over a table. As you do this, the doctor will look for abnormal eye movements and ask if you feel a spinning sensation. A physical exam is otherwise normal. A thorough neurological exam and complete medical history and should be done to rule out other reasons for your symptoms.3
TREATMENT
Benign positional vertigo is uncomfortable, but typically improves with time. It may occur again without warning. Avoiding certain head positions that trigger vertigo can be helpful.
Research has shown that performing certain body-positioning movements at home could help alleviate the dizziness that results from a build-up of crystals in the inner ear. Medical studies indicate that a technique referred to as the modified Epley procedure (MEP) works more effectively on “benign paroxysmal positional vertigo” than another technique known as Semont maneuver (MSM). Based on the results from these studies, researchers are recommending MEP as the foremost self-treatment technique to achieving prompt relief from vertigo.
70 subjects with vertigo were selected at random to try MEP or MSM to alleviate their symptoms. The subjects were asked to repeat the maneuvers of the treatments three times a day until their vertigo symptoms didn’t last more than 24 hours. After administering the treatment for one week, the participants following the MEP method no longer experienced symptoms of vertigo, while MSM was only effective 58% of the time.4
THE MEP METHOD
- The patient begins by sitting on a bed with their head tilted slightly toward the affected ear
- Using a pillow for shoulder support, the patient quickly reclines to their back
- After 30 seconds pass, the patient then moves their head to the right 90 degrees for an additional 30 seconds
- Finally, the head and body are turned another 90 degrees to the right for 30 more seconds before returning to a sitting position
DIETARY RECOMMENDATIONS
There are many things that you can do to help alleviate your vertigo symptoms naturally. Keep yourself hydrated, change positions slowly to avoid disorientation and dizziness, and limit sodium intake to decrease the pressure of your inner ear. People who suffer from vertigo also tend to experience nervousness; reducing stress levels can benefit anyone who experiences regular bouts of dizziness. Establish regular sleep patterns, eat frequent, regular meals (to keep blood sugar levels stable), and take supplements to benefit the nervous system. In addition, it is important to have your blood pressure checked as fainting and dizziness may be brought on by low blood pressure.
Dietary strategies for regulating fluid balances involve modifying the amount of certain items consumed and reducing or eliminating substances that can adversely affect the inner ear:
- Eat at regular intervals daily, and try to keep that pattern consistent from day to day
- Drink 4-6 glasses of filtered water daily. Other good beverage choices are coconut water, water with lemon, cucumber and orange, bone broths and raw milk.
- Avoid foods and beverages with caffeine. Caffeine is a stimulant that can make tinnitus louder. Its diuretic properties also cause excessive urinary loss of body fluids.
- Avoid foods and beverages that have a high sugar or sodium content. Sugar causes blood sugar imbalances, and sodium intake also affects body-fluid levels and their regulation. Use Real Salt, which is full of minerals, instead of table salt. For sweeteners, try a small amount of raw honey, xylitol, Rapadura or coconut crystals.
- Reduce or eliminate alcohol. Alcohol can adversely affect the inner ear by changing the volume and composition of its fluid.
- If you tend towards migrainous vertigo, avoid migraine triggers, including foods that contain the amino acid tyramine. Examples of such foods include red wine, smoked meats, chicken liver, yogurt, nuts, bananas, chocolate, figs, citrus fruits, and ripened cheeses.
Non-dietary substances to avoid
Some nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can cause water retention or electrolyte imbalance and it is possible that such medications cause damage to the inner ear. Because pain is sometimes due to inflammation in the body due to prostaglandins and leukotrienes, these symptoms can be reduced by adopting a healthy diet that reduces overall inflammatory markers; you may, therefore, be able to lessen your need for pain medications.
Aspirin can increase tinnitus, and nicotine decreases the blood supply to the inner ear by constricting blood vessels; it also causes a short-term increase in blood pressure. 5
SUPPLEMENT RECOMMENDATIONS
Elevated blood lipids and diabetes increase the risk for vertigo. We address this with natural anti-inflammatory agents, and also recommend certain supplements to balance blood sugar and soothe the nervous system.
As was the case with my dad, vertigo may be as simple as a B12 deficiency. After one day of supplementation, his vertigo disappeared.
Anti-inflammatory, improve circulation and reduces blood pressure
3. Thorne Calcium and Magnesium
Help correct possible deficiencies.
Make sure your doctor approves any of the supplements that you plan to take since certain herbs can interact with medicines. Do not take all these supplements at the same time. Give each one a week to learn how it makes you feel. Once you know the effects on your body of each one separately, you may combine them in low doses. Supplements, in many cases, do not interact with prescription medicines.
Resources
1. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0003582
2. Neurology, March 2009
3. Crane BT, Schessel DA, Nedzelski J, Minor LB. Peripheral vestibular disorders. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 165
4. Neurology July 13, 2004;63(1):150-2
5. VEDA publication S-17: Dietary Considerations with Endolymphatic Hydrops, Meniere’s Disease, and Vestibular Migraine
