SUCCESSFULLY ADDRESS YOUR VERTIGO NO MATTER THE CAUSE
Dr. Horst Conrad, in chapter 123 (Vertigo and Associated Symptoms) of his text, Clinical Methods: The History, Physical, and Laboratory Examinations, describes Vertigo thusly,
“….an abnormal sensation of motion. It can occur in the absence of motion or when a motion is sensed inaccurately. Spinning vertigo is usually of inner ear origin. Disequilibrium is a sensation of impending fall or of the need to obtain external assistance for proper locomotion. It is sometimes described as a feeling of improper tilt of the floor, or as a sense of floating. This sensation can originate in the inner ear or other motion sensors, or in the central nervous system. Positional vertigo is a sensation of spinning that occurs after the patient’s head has moved to a new position with respect to gravity.”
Furthermore, as stated by Britain’s public health system (NHS), Vertigo is, “a symptom, rather than a condition itself.” Seeing people diagnosed with Vertigo kind of reminds me of people being diagnosed with “SCIATICA” or “HEADACHES“. Great, but since it they are symptoms rather than problems unto themselves, the question that must always be answered pertains to cause?
According to Mayo Clinic, the difference between Vertigo and “dizziness” has to do with levels of specificity. For instance, “Dizziness is a term used to describe a range of sensations, such as feeling faint, woozy, weak or unsteady. Dizziness is one of the more common reasons adults visit their doctors. Frequent dizzy spells or constant dizziness can significantly affect your life. But dizziness rarely signals a life-threatening condition.”
In other words, dizziness is an extremely vague definition, meaning something — could be anything — that is affecting equilibrium or balance. Experts tend to agree that most (emphasis on most) actual Vertigo comes from the inner ear. Although they list a number of potential causes of Vertigo, the Mayo Clinic states, “BPPV (Benign Paroxysmal Positional Vertigo) is the most common cause of vertigo.” Which begs another question. What the heck is BPPV? Johns Hopkins states on their website that,
“Benign Paroxysmal Positional Vertigo (BPPV) is the most common of vestibular disorders and the most easily treated. In most patients, it can be cured with a simple physical therapy maneuver. BPPV occurs when small, microsized calcium crystals called otoconia become dislodged from their normal location on the utricle, one of the inner ear sensory organs.
These otoconia are usually embedded in a gelatin like material on top of the utricle. If the otoconia become detached, they are free to flow in the fluid filled spaces of the inner ear, including the semicircular canals which sense the rotation of the head. If there are enough otoconia floating around, they can aggregate into a larger clump. Because they are heavy, they migrate into the lowest part of the inner ear, the posterior semicircular canal.
Once in the semicircular canal, they may still move when the head changes position, such as looking up or down, over the shoulder, or when rolling over in bed. It is the movement of these stones that causes an unwanted flow of fluid in the semicircular canal even after the head has stopped moving. This leads to a false sense that the head and body are spinning around or that the world around you is spinning around.”
The “maneuver” Mayo speaks of is called the Epley Maneuver. Be aware that if you look up the Epley Maneuver on YouTube, you’ll find dozens of slight variations on how it’s done. Naturally, people have sought to find or create a DIY version of the Epley. Here’s an interesting example from 25 years ago.
My first year in practice I had a woman come see me who had already seen a neurologist for her Vertigo. His suggestion? She was told to sit on the bed and throw herself violently onto her bed to both the left and the right, over and over again, as fast as she could do it until the symptoms cleared or she vomited. A few years ago, Dr. Carolyn Foster came up with a better way.
Dr. Foster is the Director of the Balance Laboratory at the University of Colorado Hospital in Denver, where she is also a professor. Having been severely affected by dizziness herself (first Ménière’s Disease —- a combination of Vertigo, Tinnitus (ringing), hearing loss, and the feeling of the ear being full of fluid — and then BPPV), she had more at stake than most others in her field.
The Ménière’s Disease was so bad she had a surgery for it, which took care of her Vertigo until she came down with BPPV, for which she developed her now famous DIY HALF SOMERSAULT MANEUVER, which she successfully used to cure herself. But what if your Vertigo has nothing to do with tiny stones in your inner ear?
NON-BPPV VERTIGO: CAUSES & SOLUTIONS
The truth is, there are lots of potential causes of Vertigo, with BPPV believed to account for between 70 and 80%. While that covers a lot of people, it still means that there are huge numbers of individuals who have Vertigo of other origins. Frankly, the raw numbers are astonishing. MedScape has a two month old article on their site by a pair of MD / Ph.D’s from Egypt’s Balance Clinic, called Dizziness, Vertigo, and Imbalance. The authors state….
“The overall incidence of dizziness, vertigo, and imbalance is 5-10%, and it reaches 40% in patients older than 40 years. The incidence of falling is 25% in subjects older than 65 years. A report reviewing presentation to US emergency departments (EDs) from 1995 through 2004 indicated that vertigo and dizziness accounted for 2.5% of presentations. The estimated number of 2011 US ED visits for dizziness or vertigo was 3.9 million. Migraine is more prevalent (10%) than Ménière disease. About 40% of patients with migraine have vertigo, motion sickness, and mild hearing loss.”
Besides migraines which we’ll talk about in a moment, some of the more common causes of non-BPPV Vertigo include ……
- BRAIN DYSFUNCTIONS (There are a wide array of potential culprits here — frequently in the brainstem and CEREBELLUM. You may need to see a FUNCTIONAL NEUROLOGIST trained by Ted Carrick’s organization to get things figured out.)
- CERVICAL SPINE DYSFUNCTIONS (DEGENERATION or SUBLUXATION has the potential to cause Vertigo as verified by 25 years of practice, as well as peer-review. Upper cervical techniques can sometimes be very effective in this class, particularly when coupled with POSTURAL RETRAINING)
- MULTIPLE SCLEROSIS & PARKINSON’S
- CERTAIN KINDS OF EAR INFECTIONS (For instance, Labyrinthitis — also called Vestibular Neuritis — is an INFLAMMATION of the inner ear caused mostly by viral infections, but by ALLERGIES as well)
- POST-STROKE SYNDROME & CERTAIN KINDS OF TUMORS
- OTHERS (The list is almost unlimited)
- REACTIONS TO MEDICATIONS
How common are reactions to medications? The part of the iceberg that we actually see — the part above the water — shows that they are crazy common. According to DrugWatch (Prescription Drug Side Effects),
“With record numbers of patients suffering or dying as a result of prescription drug side effects, many wonder why medications that are considered dangerous are allowed on the market. Each year, about 4.5 million Americans visit their doctor’s office or the emergency room because of adverse prescription drug side effects. A startling 2 million other patients who are already hospitalized suffer the ill effects of prescription medications annually.”
One of the most common of these side effects happens to be dizziness. But you have to remember that the vast majority of the iceberg lies unseen below the water’s surface.
Because Vertigo is so widespread, and because only about 1% of drug Adverse Events (AE’s) are ever reported (HERE & HERE), this Adverse Drug Reactions are by far the most overlooked of the list above. In 2013 a group of eight MD / PH.D researchers published a study the Journal of Pharmacology and Pharmacotherapeutics (Vertigo/Dizziness as a Drug’s Adverse Reaction) agreeing with this assessment and then going farther.
“Spontaneous reports of vertigo or dizziness, as side-effect of certain drugs, received at our Pharmacovigilance Center, represented the 5% of all reports in 2012. Considering the high incidence of this ADR for several drugs’ classes, it can be speculated that under-reporting also affect vertigo and dizziness.”
Although they essentially said that dizziness can be problematic with almost any class of drug, the ones they mentioned by name as part of this “impressive list” were “anti-convulsants, anesthetics, anti-depressants, analgesics, anti-diabetics, contraceptives, anti-inflammatory drugs, cardiovascular drugs, sedatives, tranquillizers, cytotoxic agents, and anti-hypertensive agents.”
I have any number of articles about each of these classes (HERE). By the way, the authors said of the anticonvulsants that, “half of these reports comes from the use of anti-epileptic drugs.” This provides a perfect segue in to the final section of today’s post.
GLUTEN, BLOOD SUGAR, AND CHRONIC INFLAMMATION
AS DRIVERS OF EQUILIBRIUM ISSUES
Getting AN ACCURATE DIAGNOSIS is great, but as with any health problem, the question that requires needs answering is what can be done about it. Non-BPPV Vertigo is no different. What can be done about some, if any, of these various non-BPPV cases of Vertigo?
The truth; for most of them, probably far more than you have been led to believe. for starters, under its listing for ‘Vertigo,’ Wikipedia says, “The characteristics of an episodic onset vertigo is indicated by symptoms lasting for a smaller, more memorable amount of time, typically lasting for only seconds to minutes. Typically, episodic vertigo is correlated with peripheral symptoms and can be the result of but not limited to diabetic neuropathy or autoimmune disease.”
I would argue that this is at least partly true for most neurological problems (HERE) as blood sugar dysregulation is a common starting point for all manner of chronic illness (DIABETES / NEUROPATHY).
Were you aware that when it comes to seizure-disorders such as Epilepsy, one of the single most effective ways of treating it happens to use the same method that was used 120 years ago —- THE KETOGENIC DIET? The truth is, when you can control carbs and blood sugar, you will solve lots and lots of health problems (click the link to see just how many). While this might be true of at least some cases of Vertigo, we still have to contend with GLUTEN.
We’ve known for decades that Gluten is associated with Autoimmune Diseases — that would be all Autoimmune Diseases (HERE). We also know that Gluten is heavily associated with MIGRAINE HEADACHES — a major factor in non-BPPV Vertigo. For example, head injuries (TBI / MTBI) are linked to autoimmunity, which is linked to both Gluten and Vertigo (click the links). I am not going to get into it due to lack of time, but I would challenge you to simply Google, Gluten Vertigo and see what comes up.
Add this to the fact that numerous medical researchers and practitioners are coming to the conclusion that Gluten is heavily linked to any number of hardcore neurological problems (HERE, HERE, and HERE), and it’s no wonder people are looking to diet as a potential solution to a wide array of health issues, including Vertigo. Here’s the really cool thing about any or all of this; you can quite possibly kill multiple birds with one stone by going PALEO. Why does the Paleo Diet work for so many different problems? Because it does an amazing job of solving the blood sugar conundrum, while simultaneously cutting the most potentially reactive (inflammatory) foods from your diet (HERE).
