First step info for Ménière's, Covid ear issues, tinnitus, and vertigo

Thanks so much for all the info you've shared! I'm organizing it in the hopes that it can be helpful to people seeking solutions. Here are some first thoughts to get you started. More to come!

Whew! You all are AMAZING. Thank you for your generous responses to my ask for info. I have DMed with folks, hopped on the phone, and exchanged emails. Everyone has been so giving with their time and knowledge. THANK YOU, thank you, thank you. If you’d like to see the original post which details my symptoms, you’ll find it here.

While most of what I will post here is about the symptoms of Ménière's disease (MD), I discovered while researching MD that there are people who have been suffering with Ménière's like symptoms since having Covid. Some of the info I’m compiling might be helpful to Covid ear, since the symptoms are similar. If you are suffering since Covid, you’ll want to pay particular attention to the things listed which are anti-viral.

For those of you new to Ménière's and vertigo issues, you might be wondering isn’t there a pill? As of this writing, the answer is sort of yes, sort of no. Sound Pharma is in phase-three of a trial of SPI-1005 which, if approved by the FDA, will be the first pharmaceutical approved to treat Ménière's Disease. Meanwhile, if you lived outside the US and were diagnosed with MD, tinnitus, dizziness or vertigo, you would be prescribed beta histamine (which in some countries is available over the counter). The brand name of this product is Serc. Oddly, despite its efficacy in other parts of the world, here in the US, it is considered a placebo. If you are vacationing in Cabo, Mexico, you can pick it up for yourself (and any other meds, without needing a prescription!). Otherwise, you have to work a little harder to get it in the States but it is possible. More info here.

If you are looking for non-pharmaceutical answers, I’m compiling a list both of info I have researched as I’ve tried to get a handle on this for myself as well as the incredible advice I received when I crowd-sourced for advice. Subscribe and stay tuned. While these won’t be recommendations per se, as I have not tried most of this (yet!), there is useful and actionable information to be had from the collective brain trust (more than I have gotten from either my doctors or over a year’s worth of internet searches). My best advice is to research anything you read here for yourself and consult with the practitioners who are supporting you.

Getting to the Root

This thing we call Ménière's disease (MD) is not a disease so much as a compilation of symptoms that’s been given a name. Because of this, there is overlap with other conditions like tinnitus, vertigo, Covid ear, and vestibular migraines. There are many different routes that people can walk to end up with this set of symptoms which means the root of the problem can be quite different from one person to the next. In herbalism, which is the field of study in which I trained (and taught and practiced) for over a decade, we work with the branch (ie the symptoms) as a way of helping a person get more comfortable, but we are always, ultimately, trying to address the root cause. So if you have just been diagnosed with or are dealing with Ménière's, Covid ear (this one’s a little more obvious), tinnitus, vestibular migraine, or vertigo, consider these common root causes, realizing you might be dealing with a combination:

• latent virus (this could be something in the herpes simplex family which also causes chicken pox, cold sores, and shingles; the SARS family, responsible for Covid; and—while not technically viruses—I also wonder about tick borne spirochete conditions like Lyme)

• allergies including environmental and food intolerances

• autoimmune issues including digestive intolerances to gluten, dairy, etc.

• generalized inflammation

• hormonal imbalances including thyroid, aldosterone, cortisol, and estrogen

• head or neck trauma

In the next few weeks, as I compile all the information I’ve gotten, I’ll note correlations between various options and these possible root causes.

Meanwhile, let’s look at where to start, regardless of causality. Those of you who are very familiar with holistic wellness may not need the rest of this post!

Hi! I’m Maia Toll. These days I spend most of my time writing books from my home in Asheville, NC. But long ago (and far away!), I traveled to Ireland where I did a year long apprenticeship, learning herbalism from the ground up. When I returned to the States, I continued my studies, going on the teach Botanical Medicine as a guest lecturer at Pennsylvania Hospital and the University of Pennsylvania. I was adjunct faculty at West Chester University and was even the focus of a PBS Sunday Arts piece.

While this is no longer the water in which I swim on a daily basis, my own body calls me back to my studies over and over as I try to balance my own mercurial constitution. As an author, I’ve developed a wider reach than I ever had as an herbalist and I’m hoping that that reach helps get this info to those who need it.

If you want to know more about the magical circumstances that took me to Ireland, check out my memoir Letting Magic In. Purchasing this, or one of my other books, is a fabulous way to support my work.

Start Here

If you were recently diagnosed or are just beginning to think about holistic options, welcome. Below is generic info anyone can use at the beginning of any healing journey.

The building blocks of all holistic wellness protocols are:

• an anti-inflammatory diet

• stress reduction

• solid sleep

• movement

An Anti-inflammatory Diet

There are many diets out there and also many wellness “gurus.” Choose one.

Nope, I’m not going to tell you which is best.

Why?

Because what’s best for me and my specific constitution, might not be best for you. Each of these diets is a doorway into lessening inflammatory food intake and seeing how you react to the various ingredients you’re eating. So it truly doesn’t matter which you follow (okay, it matters a little: don’t go against your gut feelings about a person or protocol and do skip hard core cleanses unless you have a super robust constitution). The most important thing is to choose a plan that makes sense to you so you’ll stick with. It will take some discipline but I’ve noticed that the worse my symptoms, the more discipline I’m willing to have. When you eliminate foods that make you feel horrible, you start to feel better… which is incredibly motivational!

When I was in private practice, I had a client who I tried to get off gluten and sugar for a year. Every appointment, I’d close with it would be so helpful if you reduced or even got rid of gluten and sugar. One day she waltzed into my office brandishing a copy of Eat Right 4 Your Blood Type. She’d found it in a little bookstore on a trip to Maryland. Why, she demanded, had I not told her about this book? It was life changing! And it was for her: It got her off gluten and sugar and she made fast progress after that.

Some people like a strict protocol, some like flexibility. Some people resonate with a particular theory or person. Some people want to be given recipes while others like to write their own menus. And some people enjoy following an Ayurvedic or Traditional Chinese Medicine plan because eating new foods feels like an adventure. You might look for a diet specific to other things going on with your system, like a blood sugar balancing diet or the Low FODmap diet for IBS. Find your fit. And then pay attention. Remember, this is a doorway into healthier eating. Don’t act like you’ve joined a cult. Turn on your brain and fine tune the diet. If oatmeal is a “yes” food but your ears feel like crap every time you eat it, then its a “no” food for you.

If you have a lifetime of eating less than optimally, you might have a rough first week, so plan to make changes when you don’t have a lot of other stuff going on. It’s possible to have headaches as your body detoxes. Drink lots of water (like 64 ounces or more). You might realize you're addicted to things like sugar or cheese and have to work a bit to reduce your intake. A friend who is willing to do check-ins with you, or a wellness coach or nutritionist, can help with emotional support during these transitions because, trust me, at some point you will throw a temper tantrum about the piece of pizza you desperately want to eat but know you shouldn’t.

If you are new to dietary modifications, the best place to start is an elimination diet. This will help you identify the foods that might be inflammatory for you or difficult for your body to digest. More info here and here.

And, I’m very sorry to report, this is not a one and done. I’ve been working with my own food sensitivities for thirty years and just this week noticed I’m reacting to nuts and apples (WTF??). Once your body becomes inflamed, even things that are usually okay can set it off. Plus, our allergies change every seven years or so. Your body can also become sensitive to things similar in protein structure to those you’re intolerant of. So if you have a hay fever, you might find yourself sensitive to celery; if you have a gluten intolerance, you may not be able to eat sesame seeds. Pay attention! Inflammation is a shit show. Just know that even if you have to be strict during a flare, you’ll probably be able to loosen up a little once you stabilize.

General Guidelines:

• MD is often (but not always!) sodium sensitive. My doctor told me I could have up to 1,000mg of sodium a day but my limit is closer to 400mg, less when I’m in an episode.

• Many websites say no caffeine. This is a generic recommendation for any illness. Caffeine actually helps with blood flow to the ears and can be useful for some people. See how you feel on and off caffeine.

• Alcohol is not your friend when your ears are acting up especially if you have vertigo or dizziness.

• Sugar is both inflammatory and builds dampness in the body (and when your ears feel like you are sitting at the bottom of a swimming pool, the last thing you need is additional dampness). This includes honey, maple syrup, agave, coconut sugar, etc. Sugar is also addictive for many people. This makes it challenging to only have small amounts. Dark chocolate (70% or higher) is dense enough that I can eat just a few squares and not go on a sugar binge. Plus it’s delicious when paired with a tangerine. :)

• Sugar substitutes aren’t great either. Most damage the nerves. The nerve that feeds the inner ear is involved in almost all of the conditions we’re discussing so the last thing you want is to be imbibing something that damages it. Stevia, also called sweet leaf, is an exception to this rule. It is RIDICULOUSLY sweet and has an aftertaste if you use too much. I get the liquid version and use 1 drop (1 DROP, not one dropper full) per cup of tea or hot chocolate (make your own with unsweetened cocoa).

Stress Reduction

Again, this is a “find your thing” thing.

Meditation is the gold standard. It calms your sympathetic nervous system (fight or flight) which lowers BP and heart rate. Over time, it can strengthen the parts of the brain responsible for memory and attention. And you don’t have to sit still! Walking meditation is a fabulous option for those with the fidgets (me!). While we are often told to focus on our breath, you can also choose a tactile focus (I use a bead necklace) or a mantra.

Ready to meditate? Basic info here. Types of meditation (there are soooo many!) here. If you’re struggling and want to check out someone else’s meditation struggles with brain scan videos, check this out.

While meditation is one of the more explored forms of stress relief, did you know that in a recent study on depression, dancing out performed anti-depressive drugs? So sit and breathe, do yoga, get your groove on, or walk in the woods. Find the thing that let’s your brain quite and rest.

My go to’s?

Sitting and breathing on my vibration plate (on a low setting), walking the labyrinth, listening to music, doing guided meditations or journeys, or simply being outside in the trees.

Solid Sleep

Sleep is when your body does its healing and repair work so getting a good night’s rest is essential for revitalizing your system. If you have trouble falling asleep, herbs can help. (Note that they aren’t as useful for those who wake up in the night because they only stay in your system for 4-6 hours.) My favorites:

• Passionflower and/or skullcap for a busy brain.

• California Poppy for a deep and dreamless sleep.

• Zizyphus for nightmares.

• Chamomile, cardamom, peppermint, and fennel for post-dinner digestive complaints. Note: peppermint can increase acid reflux because it relaxes the sphincter between the stomach and throat.

• Chamomile and milky oat for general relaxation.

• Valerian for a restless body.

If your sleep is poor due to restless leg, try magnesium.

And if you are waking up deep in the night, melatonin might help. I micro-dose it: 300 mcg in a time release pill. When I take a “normal” dose, I wakeup groggy.

Movement

It’s vital to keep your body moving… and what this looks like with vertigo and balance issues might be quite different from what it looks like when you aren’t in an episode. Sadly, I’ve had to give up horse back riding and bouncing around the trampoline. Even when I’m not in an episode, these no longer feel like the smartest choices.

My go to’s now are dancing along with Body Groove, walking, and using a vibration plate. The vibration plate has been a game changer for me— even if I’m a hot mess, I can still sit in a chair and put my feet on the vibration plate which gets muscles twitching and blood and lymph flowing.

In chatting with others with balance issues, I’ve spoken to one person who plays pickle ball and another who plays pingpong (the eye hand coordination is supposedly great for keeping your brain tuned up). Other folks do well with yoga as long as they avoid inversions. Personally, my measure for movement is can I do this without feeling anxious? So a stationary bike or elliptical machine might feel doable to you. A couple of people have told me that working with a PT has given them tools for better keeping their balance.

Phew! That was a lot! And there’s more to come: I have quite a bit of info to compile and get into digestible form. If you aren’t subscribed, be sure to do that so you don’t miss a thing.

More soon!

xx Maia