Does Diet Really Matter?
Many people with Ménière’s disease, secondary endolymphatic hydrops, and migraine-associated vertigo (MAV) find that certain modifications in diet are helpful in managing their disorder. Avoidance of non-dietary substances such as nicotine and some types of medications may also reduce symptoms.
Inner Ear Fluid Balance
The fluid-filled hearing and balance structures of the inner ear normally function independently of the body's overall fluid/blood system. The fluid (called endolymph) that bathes the sensory cells of the inner ear maintains a constant volume and contains specific and stable concentrations of sodium, potassium, chloride, and other electrolytes.
With injury or disease, the volume and composition of endolymph may fluctuate with changes in the body's fluid/blood. This fluctuation is thought to cause the symptoms of endolymphatic hydrops or Ménière’s disease—pressure or fullness in the ears, tinnitus (ringing in the ears), hearing loss, dizziness, and imbalance. Thus, for people with Ménière’s disease (primary idiopathic endolymphatic hydrops) or secondary endolymphatic hydrops, (which may follow damage to the inner ear) maintaining stability in the body's fluid/blood system is important.
Managing your diet to help regulate fluid balances involves modifying the amount of certain substances consumed and reducing fluctuations in those amounts. Strategies include:
- Distributing food and fluid intake evenly throughout the day and from day to day.
- Avoiding foods and beverages that have a high sugar or salt content. Foods with complex sugars (e.g., those found in legumes and whole grains) are better choices than foods with a high concentration of simple sugars (e.g., table sugar and honey). Sodium intake also affects body-fluid levels and their regulation. Each individual's physician will be the best judge of appropriate levels of sodium intake.
- Drinking adequate amounts of fluid daily. If possible, fluid loss from exercise or heat should be anticipated, and extra fluids consumed before and during exercise and in hot weather.
- Avoiding 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.
- Limiting or eliminating alcohol consumption. Alcohol can directly and adversely affect the inner ear by changing the volume and composition of its fluid.
- Avoiding migraine triggers including foods that contain the amino acid tyramine. Examples of such foods include red wine, chicken liver, smoked meats, yogurt, chocolate, bananas, citrus fruits, figs, ripened cheeses (e.g., cheddar and Brie), and nuts.
In addition to dietary adjustments, pay attention to other substances that can adversely affect the inner ear and increase symptoms of vestibular disorders. Examples:
- Antacids may have significant amounts of sodium.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can cause water retention or electrolyte imbalance.
- Aspirin can increase tinnitus.
- Nicotine (found in tobacco products and some cease-smoking aids) can increase symptoms, because it decreases the blood supply to the inner ear by constricting blood vessels; it also causes a short-term increase in blood pressure.
Many of these guidelines are commonly recommended to people with Ménière’s disease, endolymphatic hydrops, or vestibular migraine. A physician or dietician may incorporate some of these principles into an individualized treatment plan.