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Ménière’s disease and allergies. Is there a connection?

What is Ménière’s disease?

This is a disorder of the inner ear resulting in severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness, plugging or congestion in the ear.  It usually affects only one ear.  In severe cases, it can affect both ears.

Attacks of dizziness can come on suddenly or after a short period of tinnitus or muffled hearing.  Some people have single attacks of dizziness separated by long periods of time with no symptoms. Other people may experience frequent attacks closer together over several days.  Some patients with Ménière’s disease have vertigo so extreme that they lose their balance and fall. These episodes are called “drop attacks.”

While Ménière’s disease can develop at any age, it is more likely to happen to adults between 40 and 60 years old. The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates 615,000 individuals in the U.S. are currently diagnosed with Ménière’s disease and 45,500 cases are newly diagnosed each year.

What causes Ménière’s disease?

Many theories exist about what causes Ménière’s disease, but to date, there are no definite answers available. Some researchers believe it is the result of constriction of blood vessels similar to those that cause migraine headaches. Other theories suggest it could be a consequence of viral infections, allergies, or autoimmune reactions. Because Ménière’s disease appears to run in families, it could be the result of genetic variations causing abnormalities in the volume or regulation of endolymph fluid in the inner ear.

What is the link between Meniere’s disease and allergies?

One of the earliest reports of a link between allergies and Meniere’s disease was published in 1969.  Since then there have been several reports analyzing this relationship.

The reason allergy is suspected is due to the seasonal timing, relationship to ingesting a particular food, the observation that those with Meniere’s are more likely to have allergies, bilateral ear symptoms and poor response to surgery or other treatments.  In 1992, a study showed the majority of patients with Meniere’s disease tested positive for low levels of airborne allergens and some of these patients had “hidden” food triggers.

In 2004, a study evaluated the role of allergy contributing to Meniere’s disease by measuring cytokine profiles (chemical mediators of the immune system), allergen IgE and lymphocyte subgroups (particular type of white blood cell).  There were 46 patients (age 26-68 years) diagnosed with Meniere’s disease that were compared to 46 healthy volunteers. Total IgE levels, and specific IgE levels pertaining to tree, mold, fruit, egg, milk, wheat, corn, beef, and rice were measured. Total IgE levels were above normal in 41% of the patient group, compared to only 19% in the control group.  A history of allergy was found in 67% patients compared to 34% in the control group.  Specific IgE levels were more likely to be positive in patients compared to controls. This study found that the prevalence of allergy was higher in patients with Meniere’s disease than in the control group.   Some studies have shown benefit from allergy immunotherapy and/or specific dietary limitations.  Some foods that may trigger attacks include caffeine, alcohol and chocolate.

At Family Allergy Asthma & Sinus Care, we work with our ENT colleague to improve the quality of life of patients with troubling symptoms.  Even though extensive data is not available to understand the murky waters of Meniere’s disease, we assist our patients in every way possible.

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