Meniere's disease

Named for the French doctor who identified it in the 1800s, Meniere's disease is an inner ear disease that typically affects one ear.  It can cause pressure or pain in the ear, dizziness or vertigo, hearing loss, and a ringing or roaring noise, also known as tinnitus.

Who gets Meniere's?

Although Meniere's disease can affect people of any age, people in their 40s and 50s are much more likely to experience it. This condition is considered to be chronic and there is no cure, but there are various treatment strategies that will minimize the effect on your life and relieve symptoms. 

Potential causes or triggers of Meniere's

Although there is no exact cause of Meniere's, it most likely has something to do with increased pressure in the inner ear, which is full of a fluid known as endolymph. Another name for Meniere's is primary idiopathic endolymphatic hydrops, which essentially means abnormal fluid in the inner ear. 

Potential causes or triggers of Meniere's disease include:

• Head injury
• Infection to the inner or middle ear
• Allergies
• Alcohol use
• Stress
• Side effects of certain medications
• Smoking
• Stress or anxiety
• Fatigue
• Family history of the disease
• Respiratory infection
• Recent viral illness
• Abnormal immune response
• Migraines

Symptoms of Meniere's disease

People with Meniere's can experience:

• a feeling of pressure in the ear
• sudden dizzy spells
• tinnitus
• muffled hearing or hearing loss

Symptoms vary from person to person, and some will experience many attacks over a period of several days, and others will have an isolated attack every once in awhile. To diagnose the disease, you must experience tinnitus, hearing loss and vertigo more than once. Since all of these issues can stand alone or be associated with other diseases, Meniere's can sometimes be difficult to diagnose. In some cases, people also experience diplacusis, known as "double hearing."

Classic symptoms of Meniere's include pressure in the ear, hearing loss, vertigo, and tinnitus.

Symptoms usually begin with the feeling of pressure in the ear, followed by tinnitus, hearing loss and vertigo. These episodes will last anywhere from 20 minutes to four hours. People with Meniere's will generally experience episodes in clusters with long periods of remission. When you experience an episode of Meniere's disease, it is best to lie down and focus on one sole, non-moving object. Often times, a sufferer will feel better after taking a nap. 

Hearing loss with Meniere's disease

Meniere's disease can cause hearing loss, including low-frequency hearing loss, meaning low-pitched sounds may be harder to hear (men's voices compared to women's voices, or the bass in music, for example). A person also might be more sensitive to higher-pitched sounds and find them uncomfortable. This is typically reversible and goes away. However, Meniere's disease is unpredictable and the hearing loss may not affect low frequencies, but instead high frequencies. Often the hearing loss is fluctuating, making it harder to diagnose. 

Some people will gradually develop more serious levels of hearing loss, which may be only in one ear or both ears. The hearing loss can range from mild to profound. Hearing aids can generally help, since the type of hearing loss is sensorineural in origin.

Stages of Meniere's disease and diagnosis

Meniere's disease commonly affects people in various stages, with symptoms developing over time. 

• Early stage: During this time, a person will experience sudden and often out-of-the-blue episodes of vertigo that last anywhere from 20 minutes to an entire day. An person's ear may feel blocked or full, and they may have some hearing loss, which typically goes away after the episode fades. It is also common to feel the effects of tinnitus.
• Middle stage: Symptoms of vertigo tend to become less severe during this stage, while hearing loss and tinnitus will increase in severity. Many people will also experience long-term remission (the disease goes away) that can last several months.
• Late stage: During the late stages of Meniere's disease, patients will not suffer from vertigo as often, and some people will be relieved from it forever. However, tinnitus and hearing loss will likely get progressively worse, and people will likely experience unsteady balance regularly. Most people at this stage feel unstable in dark conditions, for example.

Emotional impact

Along with the common symptoms of Meniere's disease, it's possible to suffer from depression or anxiety. Since the ailment affects hearing, you may lose the confidence to have conversations with others or at work, which can contribute to depression or anxiety. In addition, symptoms tend to pop up out of nowhere, so those living with Meniere's can be in a constant anxious state, unsure of when an episode will occur.

More: Facing the fear of hearing loss with Meniere’s and tinnitus.

Remedies and relief strategies for Meniere's

A variety of at-home remedies may help control Meniere's, although none of them have been studied extensively to know if they're effective or not.  

Meniere's diet recommendations

Dietary changes may decrease the amount of fluid in the inner ear, which can weaken the symptoms of the disease. Researchers looking at this issue concluded there aren't any good clinical trials on diet and Meniere's disease. The good news? These changes are worth trying because they aren't harmful and may improve your overall health:

• Reduce salt intake: Salt helps the body to retain water, so reduce intake of sodium-rich beverages and foods.
• Drink less caffeine: Caffeinated beverages can make symptoms like tinnitus worse, so it is best to decrease the amount of this stimulant in your diet.

Other lifestyle changes

• Stop smoking: Many people who suffer from Meniere's disease and who regularly smoke report weakened symptoms after quitting.
• Practice stress management: Stress and anxiety are both linked to Meniere's disease, but both can be a cause and symptom of the disease. Learning how to manage and identify stressors can bring relief. It also may be beneficial to try relaxation or meditation techniques.

More: How I manage Meniere's with a low-salt diet

Medical treatments for Meniere's

Unfortunately, many of the treatments for Meniere's haven't been studied extensively. The Cochrane Collaboration, which evaluates medical research, found only two treatments had any clinical trial evidence to support their use. Those are:

• Inner ear injections of gentamycin, an antibiotic, to help with dizziness. Cochrane researchers said one study showed it work, but it increases the risk of hearing loss. 
• Inner ear injections of steroids to combat inflammation. One study indicated this may be effective.

For both injections, though, more study is needed to know how effective they are, researchers concluded.

Other treatment options that have been less studied by scientists include:

• Medications that treat dizziness.
• Diuretics, which are drugs that treat fluid retention. 
• Surgery to reduce pressure and fluid in the inner ear. 

Who treats Meniere's?

If you experience symptoms of tinnitus, hearing loss and dizziness, see your primary care doctor for a referral to an ENT physician or visit a hearing center near you. Always seek help right away if you experience sudden hearing loss.