For those who suffer from Ménière’s disease (“MD”), recurring bouts of vertigo and other forms of dizziness can be some of the most uncomfortable and debilitating symptoms of the illness. In seeking relief from the dizziness, it is important to consider how allergies can play a role both in the manifestation of MD and how the disease is treated.

According to Dr Jennifer Derebery from America's House Ear Institute, the suggestion that allergy might play a role in dizziness and Ménière’s disease was first published back in 1898. “Today, we officially say that we do not know the cause of MD; in other words, it is idiopathic,” she said. “However, in virtually any text book or chapter on MD, the list of possible causative or contributing factors will include allergy.

While originally developed to treat the symptoms of allergy, most Ménière’s patients today are prescribed antihistamines to treat vertigo (spinning dizziness). These medications are believed to suppress the symptoms of vertigo by blocking certain chemical pathways in the level of the brain.

“Antihistamines likely help to suppress vertigo by blocking some of the effects of the allergic mediator histamine” Derebery said. Histamine, a chemical known to produce the common symptoms of allergy, including itching, sneezing, nasal congestion and runny nose also greatly excites or increases electrical activity of the semicircular canals (balance organs.)

But not all antihistamines prescribed for the treatment of allergy of the nose (allergic rhinitis) are effective in suppressing vertigo associated with Ménière’s disease. Antihistamines that do not cause sedation do not cross the blood brain barrier. Therefore, these antihistamines cannot sufficiently penetrate into the inner ear or into the balance centers of the brain to be helpful. According to Derebery however it is surprising how often these are prescribed as the ‘treatment’ for patients with Ménière’s disease exaggerated by allergy.

“The most consistent treatment, in my experience, is very specific therapy given by either a dietary elimination of diagnosed food allergies or allergy immunotherapy (allergy shots for inhaled allergens),” said Derebery.

“Allergy immunotherapy is commonly misunderstood. It is actually a vaccination therapy, whereby extracts of the inhaled allergens that a patient has been found to be allergic to are injected into the body. This causes the body to make protective antibodies to help block both the effects and lessen the reaction in the future when they are exposed to the same allergens.”

“When patients get best relief, the MD symptoms are an essence in remission,” said Derebery.  “We have our best results with vertigo control.  The vast majority of our patients treated with allergy immunotherapy and/or food allergies have either a reduction, or in some cases, a cessation of their vertigo symptoms.“

Sometimes the benefits can extend to helping with the hearing loss aspects of Ménière’s. Derebery points out that in the early phases, when there is still a lot of activity (fluctuation) going on with MD, allergy therapy or other effective forms of therapy may help stabilize hearing and either improve or prevent it from getting worse.

For more information visit the House Ear Institute

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