The People's Perspective on Medicine

Show 992: Overcoming Vertigo

Vertigo is a troubling symptom; the cause can be difficult to diagnose and therefore to treat.
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Overcoming Vertigo

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Dizziness is a common problem, but not easily diagnosed. A little lightheadedness could be a reaction to dehydration or blood pressure medication. But when the room is spinning, walking can become difficult or even dangerous. A fall, especially for an older person, can have very serious consequences.

When Is Dizziness Dangerous?

When does vertigo signal a potentially serious condition? Could it be a sign of a stroke or a migraine? We’ll find out how to determine if this symptom deserves an emergency department visit, and what can be done to treat the most common causes of vertigo.

Call in your questions and comments at 888-472-3366 or email radio@peoplespharmacy.com between 7 and 8 am EDT.

This Week’s Guest:

David Kaylie, MD, FACS, is Associate Professor of Surgery in the Division of Otolaryngology at Duke University Medical School. He is also the Medical Director of the Duke Vestibular Disorders Clinic and Medical Director of the Duke Skull Base Center.

His website is https://www.dukemedicine.org/treatments/ear-nose-and-throat/balance-problems

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I’ve tried ginkgo biloba, pine bark extract, and now onto activated charcoal to ease the fullness and roaring tinnitus in my ear. Ménière’s has already taken most of the hearing from my right ear. I’m willing to deal with that. I’m even willing to deal with the days I just can’t hear. But I cannot accept the debilitating vertigo that I experience.

I am going to buy Flonase today and hope that it helps me. I’ve also considered going on disability but it seems to go into remission by the time I decide to take action. I have PCOS and I am convinced these are linked. Hormones, insulin. I wish doctors and specialists here in Phoenix would do more research.

Dr. Kaylie was also asked about car sickness. He replied that the driver of a vehicle does not normally get car sick because he has his hands on the steering wheel and a more panoramic view… or something to that effect.
That is not the reason. The driver of the vehicle (and the front-seat passenger, usually the parents) do not normally suffer from car sickness because their eyes are on the road ahead. Their eyes are not darting back and forth as are those of the back-seat passengers (usually children), looking out the side windows.
This was first observed by Scientist Robert Barany. He noticed it in those riding in railway cars. He called it “railway nystagmus.” Sometimes called optokinetic nystagmus. His study was published in the journal Laeger in 1921. See Wikipedia.

After almost 3 years of dizziness and lack of coordination I have decided to ask my doctor to try taking me off lisinopril htcz to see if this helps my condition. I am also interested in BRAIN PLASTICITY being part of my problem as I fell down stairs at my condo [nov 2012] and was involved in a fender bender [aug 2012] and have had 2 MRIs done recently which show no visible abnormalities but I feel constantly drunk.

I flew on a plane a 3 years ago. Something happene- I had a sinus infection and the planes air pressure dropped suddenly for about a minute. From then on I had severe vertigo. I was afraid to leave my house. An ENT said it was a hole in my inner ear that surgery would correct. I was overjoyed, but the surgery did nothing for the vertigo. The doctors finally decided it was migraine associated vertigo. What a bummer!
I knew when the weather would change with drops in barometric pressure. I couldn’t drive very far, grocery shopping was a nightmare. Any event with a lot of people sent my balance off.

I hadn’t flown since that last flight. I decided to try it again. It was a 2000 mile flight trip. I did all the things my internist recommended. Afrin, airplane earplugs, migraine medication, anti-anxiety medication and anti-nausea meds. I have no idea what happened, but since that flight, my vertigo is about 80% gone! So amazing. I now leave my apartment all the time and have re-started my old life! I wish I could say what happened. I still have migraines, but those, I can deal with.

I have constant tinnitus and would experience episodes of positional vertigo. I have never found anything that relieved the tinnitus but I did find what causes my vertigo. If I eat any foods with yeast such as bread or wine or being exposed to mold then I have vertigo that lasts from a few days to a few weeks. Gluten causes me to have a feeling of imbalance but no nystagmus.

Experienced my first ever vertigo attack and had to wait three weeks for appointment with Ear/Nose/Throat doctor. My hair dresser told me to take Dramamine and Claritin D per instructions on the boxes. I did and the vertigo cleared up in 24 hours. Kept the ENT appointment and he told me the same (I didn’t tell him it was already cleared up.) NOTE – Dramamine no longer contains Meclizine which is necessary; instead use CVS Motion Sickness II which contains Meclizine as the active ingredient.

I get Vertigo from repeated head movement. Like leaning in the same direction many times to do a task…..such as working in the garden. Bending & tilting your head in the same direction. I have learned to do the Epley maneuver & if repeated several times a day brings complete relief. I have cured vertigo so bad I was nauseous & had trouble walking. I’m sure you can look it up on the computer & it will include instructions & diagrams.

My husband was having severe dizzy spells for months. He was diagnosed with benign positional vertigo (ear crystals), The BPV was resolved by the Epley maneuver (head positioning therapy), but he still was having episodes of fairly severe dizziness. He consulted with an ENT, tried craniosacral therapy, tried a migraine trigger elimination diet in case he was having vestibular migraines. He was still having incapacitating vertigo.

I read that dizziness is an uncommon side effect of simvastatin. He was on 20 mg a day. As a trial he decided to go off the statin for 2 weeks.. Within 3-5 days the dizziness subside. Within 11 days there was a marked decrease in dizziness. He has stayed off the simvisatin. It has been over 5 months and dizziness is no longer a big problem for him.

I felt hopeful when I saw a homeopathic product on your page that would relieve vertigo. But when I saw the high price, I was disappointed. There is no way most people could afford this.

We do not personally offer any homeopathic remedies for vertigo. What you saw was an advertisement on our site for another company’s product. We apologize for any confusion this may have caused. We do use advertising to help pay for the site, but we are not personally or professionally directly affiliated with every advertiser on our site. We do take care to block advertisers that we feel are not appropriate for our site when we come across them. Once again, we apologize for any confusion between us and our advertisers.

DEAR DORY: How I agree with you. A lot of places out there are in this health business for the big bucks. Nothing else. They do not even know who YOU AND I are so why should they be concerned about the two of us?

I tend to get vertigo when i get into bed in the normal horizontal way … then my head spins. And I am being SOBER at the time! Mind you, if I have three vodkas and cola, my head spins then, too!!
REGARDS, DESMOND, DUVLIN, SOUTHERN IRELAND, WED-MAY-13-2015.

I notice quite a few of us are from the dallas-fort worth area. In 2000 I had a violent episode with vertigo. I was teaching at the time & was home from work for 7 weeks. The first week I couldn’t walk – I crawled to the bathroom with my eyes closed. The usual over-the-counter drug did nothing. Allergist noted the “flickering eye motion” (my description – have forgotten the medical term for it). Hearing was (thankfully, mostly temporarily) lost to a large extent. Still have some ringing in my ears. MRI showed nothing (thankfully). It just took that amount of time to recover enough that I could walk steadily, not be nauseated & return to the classroom. I’ve had a heart attack & I’ve always said I’d rather have another one of those rather than another vertigo attack.

I’d had one 24 hour episode prior & a 20 minute minor attack previous to that. Guess that made it meniere’s, per the ENT. Nothing until the other day when I woke up spinning – thankfully only lasted about 2 hours. I had had a horribly salt-filled day the day before which is NOT my norm and that was the only thing different I could recall. While I put Irving for my place of residence, I now live in the pacific northwest.

Having read richard from raleigh’s thoughts, I wonder about the weather-related possibilities. It WAS “pollen season” in dallas at the time, which is amongst the worst in the nation. I still “fear” vertigo as it had such a traumatic effect on me and i thank everyone for their thoughts. You never know when someone will share something that makes sense in your case.

A few years ago I had an MRI to determine the extent of a knee injury. For a week or ten days after I experienced very uncomfortable dizziness and fatigue. I was told by the technician when I had the procedure done that the MRI “lines up all the hydrogen ions in the body, and this can sometimes result in dizziness”. It sure did for me. Can you explain why?

I wondered if you could get two different types of Vertigo at the same time? I had a car accident back in the 90’s and had double whiplash and the Vertigo began then; lately every time I get a sinus infection (which averages twice a year) I get Vertigo afterwards. I wanted to call in this question, but was listening to a re-broadcast of the program and could not.
I don’t have it all the time, but have had relief from my Chiropractic physician when my neck acts up from the previous car accident. I have now found an electric raised bed helps me and also a product called VertigoX (all natural roll-on). Any thoughts?

Starting in 2006 I had numerous incidents of weakness, dizziness, a suspected TIA incident, and eventually being taken to the emergency room in an ambulance with dizziness so severe I couldn’t stand up. I was found to have depleted levels of Potassium. I was prescribed a daily dose of 10 MEQ of Potassium. Even after that I went to the emergency room with dizziness, weakness and balance problems, and was found to have lowered levels of Potassium, but not until my current primary care physician referred me to the Endocrinology Clinic.

This was all at the local VA hospital. At the Endocrinology Clinic they found that I have a benign tumor on one of my adrenal glands, which causes an overproduction of Aldosterone, depleting Potassium. I was prescribed a drug called Spironolactone, but became doubtful about the side effects. Now I take 50 MEQ of Potassium daily. This was a year ago, so from 2006 to 2014 I repeatedly had low levels of Potassium, sometimes to near-zero levels, but only after removing one primary care physician after another did I finally get one who bothered to look into the matter.

The VA is pretty good for most purposes, but the bias is towards moving people in and out the door, almost like cattle. If a condition or symptoms don’t fit within a narrow range of known illnesses, then, oh, well, next patient. Medical professionals are real big on having discussions in the hallways among themselves about the drama and importance of what they are doing, but the actual patients may not be their highest priority.

There is a lot a person can do on their own to reduce the occurrences of, or severity of, vertigo. Words fail to describe how bad I feel when I get vertigo. I was diagnosed with Meniere’s Disease many years ago and I have been looking for clues all that time. The big clue came on a day that I got vertigo and two friends got migraine headaches at the same time. I found that a big decrease in barometric pressure occurred then. The second clue came from emails I sent to my work or school because I was absent because of vertigo. Vertigo always occurred during spring or fall allergy seasons. I went back and confirmed it with historical pressure data from other episodes. This is my hypothesis. My inner ear is swollen from Meniere’s Disease, my eustachian tubes close due to allergies and create a vacuum in my ear, the drop in barometric pressure lowers the vacuum further, making my inner ear swell more in a short time, and that triggers the vertigo episode. The remedy? I now use the nasal spray Flonase and pill Loratadine (Claritin) to keep the eustachian tubes open in allergy season. I have not had a full blown vertigo episode in about three years. But, in the past, when I felt one coming on, I would immediately take meclizine and go to bed in complete dark and quiet. Sleep is the real remedy. I don’t go anywhere without those three drugs. So, stress, sleeplessness, diet (salt), allergy, genetics (my father had it), and barometric pressure are all contributors to the disease. It will only stop when my inner ear is destroyed by it. I don’t believe research is focused on a pharmaceutical or genetic remedy. You can improve your condition. I hope this helps. Good luck.

It made me wonder about dizziness and sleep. Before I cleaned up my diet right before sleep i would feel like my head wanted to twist off my body and i would occasionally respond with levitating shudders to noises and had light and easily interrupted sleep. Any relationship? I also wonder how low ones blood pressure has to go for dizziness. And urba matti just knocks me out! As you can tell I enjoyed the show.

Thanks for the information. I had to go to the hospital with vertigo that caused dehydration. I never been so sick. My Dr. did say to take Claritin and Flonase. Also he told me to sit on middle of bed and flop to one side, sit up and flop on the other side, several times. to do this often. It is suppose to knock things back together, in the brain. Never thought about it but it was in the springtime it last hit. I pray everyday that vertigo does not hit me again.

addition….

and of course….management of diabetes, and other co-morbities…like obesity and hypertension.

What might cause a sensation of feeling as though one is being pushed from behind as if by a straight line wind? The condition rises and falls in severity; and has been in effect for 8 or more years?

Having worked in the field of Endocrinology/Diabetes for more than forty years(RD, CDE, CCN) I have counseled hundreds of individuals with Meniere’s… working in the Endo department at MUSC, we observed (early 90’s), that when a newly diagnosed diabetic returned after receiving an initial dose of insulin(often a substantial dose…these were the early days of treating hyperglycemia outpatient rather than inpatient), the patient would often complain of Tinnitis, dizziness, and other inner ear symptoms. Over the subsequent years, my own ‘data’ set revealed the best results addressing:
Insulin Resistance
Grain/wheat/and or gluten intolerance
Dairy (especially casein) intolerance
Sugar excess
Salt excess (although i rarely saw this as a primary intervention)
Msg sensitivity (also sulfites)
Toxic overload (mercury, other toxins)
Pathogens
Nutrient imbalance (B12, B6, other nutrients)
Just my experience!

A friend of mine had been experiencing vertigo, migraines and vision problems for about 9 months when she finally was diagnosed with a hemangioblastoma the size of a pea on her cerebellum. The tumor was removed and her symptoms disappeared immediately.

I have had dizziness for ten years. It was initially dx as Mal de Debarquement and I was put on clonazapam. I have taken it ten years and it does help the symptoms. The odd thing is I have this every other day. Can this be explained by anyone?

I was suffering from dizziness each time I bent over or got up suddenly. I also lost coordination. I had panic attacks, hair loss and mood swings. Doctors kept putting me on stronger antidepressants. I finally found a doctor that tested me for mercury poisoning. My mercury levels were 80 mg. She put me on a natural supplement, Amino D-Tox. If that didn’t work, I would have had to have chelation. After two years, my mercury level is very low. All my symptoms are gone. It is interesting, if I eat a fish known to have high levels of mercury, such as Chilean Sea Bass, I get the symptoms again for a day or two.

I was at the health food store and heard a customer comment she takes ginger for dizziness. I started taking Ginger and have a noticed a remarkable difference. I take one soft gel daily. Plus I am receiving other benefits from the ginger.

According to Dr. Kaylie, ginger could help with nausea but it is not likely to help much with dizziness.

Agreed – ear rocks/crystals.

A few years ago, I had an onset of severe vertigo. I had to hold my head carefully in a certain position or the room began spinning. I was afraid to go to bed because that guaranteed a nauseating dizzy spell if I dared move positions. As a life long insomniac, I had been taking melatonin. I had stopped taking it because I wasn’t sure it was helping, and the vertigo went away. I didn’t put 2 and 2 together for awhile, but started melatonin again and the vertigo came back. The lightbulb came on and I stopped the melatonin. A few weeks later, I did an experiment and took it and that night the bed began spinning. I’ve not taken it since and I’ve not had any dizziness since.
This is not to say that melatonin affects anyone else the same way. This was just my experience, and perhaps it might help one or two people.

In October 2014 I turned over in bed in the middle of the night and got extremely dizzy. After a few more incidents, I visited the clinic and was given meclizine to use as needed. After a month or so with more incidents, I went to my regular dr. who set me up for head positioning therapy. I needed 5 treatments and by February I was no longer having problems and am fine now.

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