Dr. Thomas Tedeschi
Chief Audiology Officer, Miracle-Ear
Miracle-Ear Chief Audiology Officer Dr. Thomas Tedeschi answers some of your common hearing-related questions.
What is Meniere’s disease?
Meniere’s disease is a chronic inner ear disorder that causes recurring episodes of severe dizziness (vertigo), ear pressure, tinnitus and hearing loss. It typically affects only one ear, although some people experience symptoms in both ears.
An estimated 615,000 people in the U.S. have Meniere’s disease, with around 45,500 new cases diagnosed each year. Onset is most common in adults 40 to 60 years old, though it can develop at any age.
Meniere’s disease is a complex, debilitating condition that can significantly impact a person’s way of life. Symptoms come on without warning, which can limit participation in social, leisure and work activities. And because scientists have yet to pinpoint the exact cause of the disease, it’s difficult to predict or prevent.
The good news is that we have gained a much better understanding of Meniere’s disease in recent years. There’s no cure yet, but there are a variety of treatments to help alleviate and manage symptoms.
What are the symptoms, and how is it diagnosed?
The four classic symptoms of Meniere’s disease are:
- Vertigo - People with Meniere’s disease experience recurring episodes, or “attacks,” of vertigo, an intense feeling of spinning that comes on suddenly. Vertigo causes nausea and vomiting, headaches, faintness and balance problems. Depending on its severity, people may be unable to drive or even leave the house.
- Aural fullness - A sensation of pressure in the affected ear that worsens when a vertigo attack begins
- Tinnitus - Ringing, roaring or buzzing sounds in the ear
- Hearing loss - Hearing loss comes and goes in the early stages of the disease, occurring mostly during episodes of vertigo. As the disease progresses, hearing loss eventually becomes permanent.
Many people with ear problems will experience these symptoms at some point, but a person with Meniere’s disease will typically have all four of them occur at once in several distinct episodes. If you have these symptoms, your doctor will perform an assessment to rule out other potential inner ear disorders. A Meniere’s disease diagnosis usually requires the presence of all four symptoms and at least two episodes of vertigo.
Each person’s experience with Meniere’s disease is different—for some, vertigo may be the first sign; for others, it may be hearing loss or tinnitus. However, it’s common for the disease to occur in the following stages:
- Early stage: Spontaneous episodes of vertigo that last anywhere from 20 minutes to 24 hours. During an episode, people may experience hearing loss, tinnitus and pressure in the affected ear.
- Middle stage: Vertigo episodes continue but are usually less frequent and less severe, yet hearing loss and tinnitus worsen as damage to the inner ear progresses. Sometimes people go through several months of remission with no symptoms.
- Late stage: In the advanced stages of Meniere’s disease, vertigo episodes become even less frequent and in some cases stop altogether. Sometimes people experience “drop attacks,” sudden falls to the ground without warning. Hearing loss, tinnitus and balance issues continue.
People often experience anxiety and depression due to the stressful, disabling nature of the disease. It’s important to talk to your doctor about these symptoms and, if necessary, seek support from a qualified mental health professional.
What causes Meniere’s disease?
The root cause of Meniere’s disease is unknown. However, researchers believe fluid buildup in the inner ear triggers the disease’s symptoms.
Canals in the inner ear contain hair-like receptors that detect movement and sending signals to the brain to help us maintain our balance. For this process to work correctly, fluid in the inner ear must be at the right volume and pressure. When the process is disrupted by too much fluid in the inner ear, symptoms such as dizziness can result. Researchers are still studying what initially causes these fluid changes.
What are the treatment options for Meniere's Disease?
Meniere’s disease treatment focuses on reducing fluid pressure in the inner ear and minimizing the effects of vertigo. Your doctor may recommend some of the following treatment methods:
Dietary and lifestyle changes
To effectively control symptoms of Meniere’s disease, nutrition and diet should be carefully monitored.
Consider the following Meniere’s disease diet strategies:
- Stick to a low-salt diet. Salt makes the body retain fluid, so the less consumed, the better.
- Eat and drink at regular intervals. Evenly distributing food and fluid intake throughout the day can help regulate body fluids.
- Limit caffeine and alcohol. Caffeine is a stimulant and can make tinnitus seem louder. Too much alcohol may also exacerbate symptoms.
- Avoid foods that contain tyramine. Tyramine is an amino acid present in foods such as red wine, bananas, nuts, yogurt and ripened cheeses. It is known to trigger migraines, which can provoke vertigo and ear pain.
Patients are also advised to:
- Steer clear of tobacco products. Nicotine constricts blood flow to the inner ear, which may make symptoms worse. Studies show that smoking increases the risk of hearing loss.
- Take steps to lower stress. Stress and fatigue can trigger episodes of vertigo.
- Motion sickness drugs. These help to counter the side effects of vertigo.
- Diuretics. Taking a diurectic, or “water pill,” reduces the amount of fluid body retains, which may reduce inner ear fluid pressure.
- Middle ear injections. Certain antibiotics and steroids can be injected into the middle ear to reduce dizziness.
- Meniett device. This device goes in the outer ear and sends air pressure pulses to the middle ear to normalize ear pressure and prevent dizziniess.
- Hearing aid. In addition to treating hearing loss, hearing aids can help relieve tinnitus.
Most people with Meniere’s disease either improve on their own or are able to manage symptoms by using the methods above. When those strategies don’t work, doctors may recommend inner ear surgery.
Meniere’s disease can greatly limit a person’s stability, independence and hearing ability. Some people find that cognitive and behavioral therapies help them cope with the anxiety and stress of unpredictable attacks.
Additionally, online and in-person support groups can provide a place to share challenges, tips and concerns with others who are going through a similar experience.
Could I be at risk for Meniere’s disease?
Scientists have studied many potential causes and risk factors—such as viral infections, genetics and allergies—but have yet to find any factors that play a significant role in the development of the disease. People with a family history of Meniere’s disease may be more likely to develop it, but research has yet to confirm a hereditary link. Though much about the disease remains a mystery, recent research shows promise for patients.
Here are some steps you can take to promote the overall health of your ears and hearing:
- See your hearing care professional for regular checkups
- Treat ear infections in a timely manner
- Don’t smoke
- Eat plenty of vitamins and minerals
- Protect your ears from loud noises