Inflammation and Vestibular Disorders
Recent headlines about the link between depression and inflammation have gained great public attention.1,2 Past research focused largely on the “chemical imbalance” hypothesis of depression; that is, imbalance of chemicals in the body may negatively impact mental health. More recently, research has started to examine the association between depression and inflammation. This is supported by an increased recognition across the medical community on the role of inflammation in chronic illness. In fact, some studies propose that many, if not most, chronic illnesses have an inflammatory part that contributes to the growing global burden of disability and mortality.3,4 The CDC estimates that 6 in 10 adults have a chronic disease, and 4 in 10 have two or more chronic diseases.5 As a Clinical Health Psychologist and vestibular patient, the growing attention to chronic illness and inflammation has captured my interest, especially since we know there is a very high co-occurrence of inflammation and depression alongside vestibular disorders, and with mental health concerns, including depression, anxiety, and panic disorder.6 That is why I have taken the opportunity to dive into the scientific literature to review our current knowledge of inflammation and vestibular disorders.
I have seen great improvement in my vestibular symptoms by working to reduce inflammation. In this post, I will share with you some information I have found that may offer useful and practical applications for your day-to-day life.
What Is Inflammation?
Inflammation helps our immune system protect us from foreign invaders and injury. A well-functioning immune system will engage an immediate inflammatory response to protect us from harm and then return to a more stable state. Trouble arises when our inflammatory mechanisms stay activated over months and years, which can be caused by many different or perceived threats. This is known as chronic inflammation and has been linked to many chronic illnesses. In addition, once the immune system has become imbalanced, a vicious cycle can begin where the immune system starts to perceive anything as a threat. For example, if the immune system starts to perceive food as a threat, someone might develop food sensitivities; if the immune system starts to perceive its own bodily tissues as a threat, someone might develop autoimmunity.
Vestibular Disorders and Chronic Inflammation
Those of us living with vestibular disorders might be wondering how chronic inflammation plays a role in our vestibular symptoms. Although this is a new area, research has linked inflammation to multiple vestibular diagnoses including vestibular migraine, benign paroxysmal positional vertigo, Meniere’s Disease, vestibular schwannoma, and persistent postural perceptual dizziness.7-11 Inflammation is not measured as part of a routine workup for a vestibular disorder diagnosis; rather, inflammation is measured exclusively for research purposes within the conventional medicine setting.
What Causes Chronic Inflammation?
We are living in a time when we are surrounded by toxic substances. In 2014, The National Institute of Medicine estimated that there are between 25,000 and 84,000 chemicals used in US commerce, with only a few hundred of them tested for safety.12 Of those approved for use in the US, studies have demonstrated that many are associated with chronic inflammation and chronic disease.13,14 We are constantly exposed to chemicals through ingestion, inhalation, and skin exposure. This includes chemicals in food, drinking water, food storage containers, personal care products, cleaning products, and beauty products, to name a few. This also includes air quality. The EPA estimates that Americans spend 90% of their time indoors (and this was before COVID) and indoor air contains 2-5 times more pollutants than outdoor air.15
The Standard American Diet is known to be inflammatory due to the following factors: low in fruits and vegetables (and therefore, fiber) and high in animal fat, hydrogenated fats, sugar, and ultra-processed foods.16 Other things that contribute to inflammation throughout the body include previous injuries (like concussions or traumatic brain injury) and chronic infections (e.g., bacterial, viral, and parasitic).17,18
What Reduces Chronic Inflammation?
Although all of the factors that contribute to chronic inflammation might feel overwhelming to address, it is possible to take a step-by-step approach in daily choices and behaviors to reduce inflammation.
First, reducing your exposure to toxins is possible through the decisions we make every day. These include the foods we eat (e.g., choosing whole, unprocessed foods), how we store our food (e.g., in glass instead of plastic), and the cleaning and personal care products we choose. Moreover, we can filter toxins from air and water. Research shows that a Mediterranean Diet and specific supplements can help combat inflammation (e.g., specific compounds in fish oil and turmeric).19,20
As a Health Psychologist, I’m very interested in things we can do in our daily lives that can reduce inflammation. There is good evidence that breathing exercises, mindfulness meditation, social support, exercise, better sleep (and especially addressing sleep apnea), quitting smoking, and mindset all have a measurable and positive impact on chronic inflammation.21-27
Finding a Clinician to Help Target Inflammation
Measuring inflammation is not part of a typical treatment for vestibular disorders. However, functional medicine is a practice that looks at how all body systems relate to one another and considers “root causes” for illness, in other words, what is out of balance in the body that contributes to your chronic dizziness. Many functional medicine providers will measure inflammation using blood tests. If you are interested in working with a functional practitioner, you might consider finding a local provider via The Institute for Functional Medicine’s “find a practitioner” tool on their website: ifm.org.
By Emily Kostelnik, Ph.D.