Everybody experiences tinnitus at some point in their lives. That telltale ringing, humming, hissing or buzzing in the ears is extremely common, whether you experience it only occasionally after a loud event like a rock concert or football game, or you struggle with it chronically.
But what if you have other symptoms?
If you having ringing in your ears and you are also experiencing episodes of vertigo and hearing loss, you may have more than just tinnitus. You may be developing Meniere’s disease.
What is Meniere’s Disease?
Sometimes called endolymphatic hydrops, Meniere’s disease is an inner ear disorder. It typically only strikes one ear, affecting your hearing and balance. Although Meniere’s disease can set in at any age, you are most likely to begin developing symptoms in your 40s and 50s. Of the 50 million Americans who struggle with tinnitus, about 615,000 of them are also living with Meniere’s.
What Causes Meniere’s Disease?
Much like tinnitus, there is no one cause of Meniere’s. However, doctors believe it has something to do with the fluid that lives in your inner ear. You see, your inner ear is made up of a labyrinth of swirling passages, pathways and cavities.
Deep in that labyrinth, tiny hair-like cells called cilia sense and respond to changes in the fluid. If there’s too much fluid or it somehow gets otherwise disrupted, the cilia can misfire, sending confusing sound and balance signals to the brain.
Again, there is no single cause to Meniere’s, though some conditions and situations are known to trigger it — many of which run parallel with the triggers for tinnitus.
- Head injuries
- Infections to the inner or middle ear
- Respiratory infections
- Recent viral illnesses
- Abnormal immune system responses
- Side effects of certain medications
- Stress or anxiety
- Alcohol use
- A family history of Meniere’s
What are the Symptoms of Meniere’s Disease?
Meniere’s disease can vary dramatically from person to person, flaring up occasionally, daily or even just once a year. The symptoms include:
- Pressure in the ear: this is one of the earliest symptoms patients notice.
- Vertigo: vertigo is one of the most obvious symptoms of Meniere’s disease, and often one of the most distressing. Vertigo attacks often strike Meniere’s sufferers without warning. They can last from 20 minutes to four hours, and are characterized by several symptoms, including a feeling that you are spinning, dizziness, sweating, an irregular heartbeat, nausea and vomiting. Because the vertigo attacks are so unpredictable and disorienting, many countries restrict Meniere’s patients from driving until their symptoms are under control.
- Tinnitus: this could be a ringing, buzzing, roaring, whistling or hissing in the ear that has no external source.
- Hearing loss: hearing loss and the sense that sounds are “muffled” can come and go, especially early on in the disease. You may also develop a sensitivity to loud sounds.
How Does Meniere’s Disease Progress?
Meniere’s disease commonly affects people in three stages, with symptoms developing over time.
1. Early Stage: in this stage, sudden and unpredictable episodes of vertigo are common. During a vertigo attack, you will experience some hearing loss which will return to normal after the vertigo fades. The affected ear may feel uncomfortable and full, and you may experience tinnitus symptoms, as well.
2. Middle Stage: in this stage, your vertigo episodes will continue but are generally not as strong, as frequent or as debilitating. However, your tinnitus and hearing loss will get worse. During the middle stages of Meniere’s, some patients see their symptoms disappear, with periods of remission lasting months at a time.
3. Late Stage: in the late stages of Meniere’s, your vertigo episodes become even less frequent—and some patients will see them disappear altogether. However, tinnitus and hearing loss will get progressively worse, as will your ability to maintain balance, especially in the dark.
How Do I Get Diagnosed?
If you experience symptoms of Meniere’s, see your personal doctor. They will refer you to an ENT for testing and diagnosis.
Unfortunately, no single test for Meniere’s exists. The ENT will collect your medical and family history, interview you and perform a physical exam. They may perform various balance assessments and an audiogram to test for hearing loss. To rule out other diseases that can have similar symptoms to Meniere’s, your doctor may also order an MRI or CT scan.
What Treatment Options Can My Doctor Offer?
While there is no cure, your doctor can provide you with some options to help make living with meniere’s disease manageable and help improve your symptoms, such as:
- Medications for vertigo: these include motion sickness drugs, anti-nausea medications, and diuretics to reduce the pressure in your ear that causes the vertigo symptoms.
- Middle ear injections: these include the antibiotic gentamicin and steroids like dexamethasone.
- Rehabilitation therapy: exercises and activities aimed at helping the body and the brain regain the ability to process balance information correctly.
- Hearing aids: for patients experiencing hearing loss.
- Surgery: surgery may be considered if symptoms are severe. Surgery options include:
- Endolymphatic sac decompression, in which a small portion of bone is removed from over the endolymphatic sac.
- Labyrinthectomy, where a portion of the inner ear is surgically removed.
- Vestibular nerve section, in which the vestibular nerve is cut.
What Can I do at Home to Prevent an Episode?
Meniere’s disease is not curable, but you can work to manage the disease and reduce the symptoms. Many at-home treatment options involve making positive life changes to in order to improve your overall health. These changes include:
- A low-sodium diet: salt helps the body retain water. Cutting salt can decrease the amount of fluid in the inner ear, which can weaken the symptoms of the disease.
- Limit caffeine: caffeine can act as a stimulant and make symptoms like tinnitus worse.
- Avoid monosodium glutamate (MSG): although many food manufacturers no longer use MSG, check all food labels to be sure it’s not being used as an additive.
- Eat several small meals instead of three large ones: this dietary pattern can improve symptoms of Meniere’s disease by keeping your metabolism moving evenly throughout the day.
- Quit smoking: many smokers who suffer from Meniere’s disease have reported fewer and weakened symptoms after quitting.
- Manage your stress: stress, depression and anxiety are all linked to Meniere’s disease—as both causes and side effects. Work with your doctor to come up with a plan to address the life stresses and the stress of the disease before they escalate and make your symptoms worse. In your own time, you can add several stress-reducing techniques to your regular routine, including yoga, meditation, journaling and walking in nature.