About 15 percent of American adults have problems with their balance. Even children are not exempt, with about 5 percent suffering from dizziness. What causes dizziness, and what can be done about it?

A Definition of Dizziness:

Dizziness is a terrible term because it doesn’t actually tell the doctor what the patient is feeling. It would be better to say whether the world is spinning; or you feel light-headed, as though you might faint; or you feel completely out of balance, as though you might fall (without fainting). These could all be referred to as dizziness, but they have different causes.


One of the most common causes of vertigo–a sensation of spinning–is the onset of a migraine. People don’t always get the headache, or if they do, they might not realize that their headache is a migraine. But treating or preventing the migraine can be very helpful for this problem. Here is the Migraine Elimination Diet that Dr. Kaylie referred to during the show.

Migraine Diet

Benign Paroxysmal Positional Vertigo:

This condition with the long and complicated name is the most common cause of balance difficulties. In it, the tiny crystals in the inner ear become unmoored and move out of place. What triggers that, and how can it best be treated? Who is most susceptible to BPPV and how is the diagnosis made?

Meniere’s Disease:

What is Meniere’s disease and who is most likely to be affected? What can be done to correct this condition?

Dr. Kaylie recommended betahistine, but since it is not approved by the FDA, it must be compounded.

Call in Your Questions:

Dr. David Kaylie will be in our studio to answer your questions about balance disorders from 7 to 8 am on April 7, 2018. Have you been diagnosed with otoliths? Do you take a medication such as gentamycin that can cause dizziness? Give us a call to learn what you can do about dizziness: 888-472-3366 or email us: radio@peoplespharmacy.com

This Week’s Guest:

David M. Kaylie, MD, FACS, is Associate Professor of Surgery in the Division of Head and Neck Surgery & Communication Sciences at Duke University Medical School. He is also Medical Director of the Duke Vestibular Disorders Clinic, the Duke Otolaryngology Clinic and the Duke Skull Base Center. Dr. Kaylie’s research interests are in balance disorders after cochlear implant surgery as well as hearing preservation in skull base surgery. He serves on several committees of the American Academy of Otolaryngology.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99

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  1. Steven

    What is the evidence for the migraine elimination diet?

  2. Charles M

    I have been on Lisinopril for several years and I think t his drug is the reason I started having balance and ringing in my ears problems. I first notice it after about 6 months after starting the drug and I talked to my doctor about stopping Lisinopril and he would not listen saying it was not the cause of the balance or the ringing in the ears I would like to get off Lisinopril.

  3. Verna

    I think I developed BPPV from tilting my head under a laundry room faucet to wash my hair. Also, I don’t get my hair washed at a beauty salon lying back in the sink. Rather, I shampoo in the shower just in case. Some experience in the cause of this problem may be helpful.

    • Linda
      Danville, Va.

      I have the bvvp problem and can only sleep on my left side. It only bothers me when I lie down on my right side, since it affects my right ear. It is a very horrible vertigo. I went to the dr. and he did the maneuver that someone suggested, but it was terrifying to me.

      • Don

        When sleeping on your side, make sure your jaw is being held up by the pillow to keep it in alignment. This can also be used to ease snoring.

  4. Carmie
    Binghamton, NY

    Looking for the list of foods not to eat for Migraines, by
    Dr. Kayley . Thank you.

  5. Julie
    Charlottesville, VA

    When I removed wheat/gluten from my diet, the low-grade dizziness that I used to often get after a meal went away. People should know that wheat allergies can often affect the brain ir skin instead of the GI system.

  6. Cari

    When this happens to me, I go to NC EENT and get the Epley Maneuver.

  7. Linda

    My husband has Meniere’s and has used a device called the Meniett very successfully for years to control his episodes. It pumps pressure into the ear canal – painless and easy, five minutes, 3 times/day. This has been a lifesaver, eliminating the need for medications. I was disappointed that Dr. Kaylie did not mention it.

    Also, Joe and Terry – I think you need to silence your cell phone or whatever device was beeping throughout this latest episode – pretty distracting. I love your podcasts and listen nearly every week.

  8. Karen
    Tampa FL

    I heard only the last few minutes of this program and wondered if there had been any discussion about CSF leaks and dizziness, headaches, audio effects, etc. I have had several blood patches to repaid (temporarily) the hole in my spine and suspect that I am heading to another. There are many people like me and many go the Dr Gray at Duke for repair of spinal cord holes.

  9. Monika

    I tried to point out that I was following the recommendation to take calcium supplements after menopause and for 30 years swallowed 500 mg of calcium. for decades I complained to several doctors about serious constipation , like defocating every three days, and no one suspected that the answer to my problem was stopping the calcium.

    I found out by going to half the dose on my own a year ago and noticing some improvement. I then went to one pill twice or three times a week and seeing even better results. LOgically, I quit taking calcium altogether and I am enjoying totally regular Brel movements now.

    • Monika

      WHat is the conversation, if I may ask?

  10. Monika
    shenandoah County,VA

    For many years I had complained about serious constipation, before I finally made my own decision to reduce the Calcium Supplement I was taking to half the recommended dose which brought me some relief.

    The next time my doctor had me fill out my medical history again and list current medications, I explained why I had reduced my calcium intake and that I was seeing an improvement in my uncomfortable constipation. After many more months, I started taking that half dose somewhat irregularly and was astounded how I was even less constipated. So I made the self-researched decision to go off calcium altogether, and to my great joy, I am now totally regular in my bowel movements.

    I guess my decades of misery could have been avoided, if I had made my own decision earlier. Thank you for speaking up and spreading the important new scientific discovery!!

  11. Patti

    I’ve read Meniere’s disease is a cluster of symptoms. The FDA has a pdf on Lisinopril that I downloaded and it says dizziness and tinnitus “may” happen while taking it. That’s the way I take it anyway. Those two symptoms can happen with Meniere’s.

    My husband has taken the drug for a few years and the last couple of years lost his hearing (probably severe if not profound loss) in the only ear he could hear from. He had hearing come and go one week good, next week bad & now I read in webmd that that can happen in Meniere’s.

    It’s gone mostly now, but we did invest in a Starkey hearing aid very expensive but worth it. Otherwise he’d not hear me at all. I sure am wondering if Ace inhibitors can possibly cause hearing loss.

  12. Bob
    South Carolina

    Regarding the Epley Maneuver the way you turn your head for the first position depends on which ear is causing the vertigo problem. How does one determine which ear is causing the vertigo? No doctor has been able to answer this question.

    • Kathy
      St. Louis, MO

      While you’re having vertigo, you should notice that your body will lean toward the left side or the right side. Mine leans towards the left, which means the vertigo is in my left ear. Also, while I’m sleeping, the vertigo will come on if I’m lying on my left side, so I have to be sure to sleep on the opposite side, which for me is the right side.

      So, when I do the Epley Maneuver, I start with my head at a 45-degree angle facing left. I do the maneuver morning, afternoon, and evening and it usually clears up after a day or so. The maneuver is simple to do once you get the hang of it. Sometimes I even do it 4 times a day. I recently got vertigo because I was sitting outside on a VERY windy day without anything covering my ears, and that brought it on for me.

    • Kara

      Bob, if your doctors can’t answer this question, you’re going to the wrong doctors. You should see a neurologist who specializes in movement disorders. When you are having a BPPV “spin”, your eyes move back and forth in a condition called “nystagmus”.

      Based on the way your eyes are moving subsequent to having you turn your head in each direction while laying down and tilting your head back, they can tell which ear it is. YOU cannot tell this way – they are looking at your eyes while you are doing this so they can tell.

  13. Kathy
    St. Albans, WV

    I had several bouts with vertigo several years ago. They would last anywhere from 2 to 3 days. Sometimes I would have a 3 day episode – then in as little as 2 weeks I would have another episode of vertigo. I went to several doctors – gave me medications – did the epi routines – had an MRI – nothing was found or helped with these episodes of vertigo. Finally I went to a chiropractor who performed acupuncture on me. I had 20 sessions – 2 times a week – and I was cured. Recently I have been having “weather-related” migraines – when the barometric pressure comes crashing down. I am getting ready to start acupuncture for these migraines now.

  14. John

    I listened with keen interest to this particular show because our daughter had a virus, actually she had three separate virus attacks in September of 2008 or 2009. One was upper respiratory which turned into a head cold, two were stomach viruses.

    When we figured she was passed the episodes she was back in school and experienced sudden onset of dizziness. But, that was only the obvious symptom, what also began to occur was a drop in blood pressure, elevated heart rate, terrible reactions to heat, exhaustion, lack of any energy especially in the mornings, and on and on the symptoms kept piling up.

    We went through dozens of tests, including looking for inner ear issues. She was finally diagnosed after seeing a cardiologist who determined she had Dysautonomia, the umbrella label for malfunctions of the Autonomic Nervous System. More specifically she had Neurocardiogenic Syncope (NCS). The incidence of Dysautonomia has risen to the 1 to 3 million known or properly diagnosed patients.

    This literally took over her life for 8 years…I think you might consider informing both your audience and the contacts within the medical community who may not recognize some of the symptoms the callers described during your show of the possibility that this scary and very debilitating disease exists.

    Source: http://www.dysautonomiainternational.org/page.php?ID=34

  15. Vince
    Fort Pierce, Florida

    Does the prescription drug Meclizine 12.5mg 3-times daily help for dizziness.

  16. Jean
    Chapel Hill, NC

    I did the Epley maneuver, which you can find on line, and it took care of getting the crystals in the inner ear in the proper position.

  17. Carol S

    An additional factor, that causes dizziness, is oscillating sound (acoustic) waves of a low frequency (not audible to humans, but are audible to animals other than humans) called “infra-sound” waves, that are produced by very large wind farm turbines that are located too close to pre-existing human habitation.

    Infra-sound waves are also produced by large rotating fan blades, airplane propellers (harmonics with fusilage).

    Many rural humans are complaining of multiple symptoms, including dizziness, caused by what some are calling “Wind Turbine Syndrome”, which has been documented, and verified by doctors (MD’s), and acoustic (sound) scientists.

    It may be the oscillating nature of the infra-sound waves, that causes dizziness, but also, infra-sound waves interfere with both human and animal body functions, including inner ears.

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