Ending Vertigo Today

Drinks: Coffee, Alcohol and Vertigo

Common dietary advice for vertigo sufferers often calls for restrictions not just for what you eat, but also what you drink. Alcohol is often singled out as particularly likely to cause dizziness. Information sources frequently suggest that you should also avoid caffeine if you suffer from dizziness, including coffee, tea, and caffeinated soft drinks. As mentioned in Part 1 of this diet series, even too much water can cause dizziness. When you reach for a drink, how careful should you be?

Let’s start with our daily cup of joe. Caffeine does not damage the inner ears or the balance system. Its effect on these systems is fairly minor, certainly not enough to account for the common recommendation to avoid it. A few cups a day will not cause dehydration, for example. Fainting worsens with excessive caffeine ingestion, but that is a separate problem from inner-ear dizziness or brain-related imbalance.

The main problem with caffeine happens if you are currently having a dizzy spell when you drink it. Caffeine is a stimulant; it increases the sensations that you feel. If you are in the midst of an attack of dizziness, it will worsen the severity of the attack. You will be more dizzy and off balance. The increase in dizziness during an attack is not an indication that the caffeine is harming your balance system. It is merely magnifying the unpleasantness of the spell temporarily.

In between spells coffee is unlikely to have any effect and it won’t make an attack happen. If you are having a flare-up with many spells or if you have constant dizziness, cutting back on caffeine makes sense since avoiding it will turn down the intensity of each spell a bit.

Alcohol is in a different category entirely. Unlike caffeine, alcohol can cause permanent damage to the brain balance system. It has short-term, reversible effects on the inner ear. It magnifies any underlying balance system damage you may have. Over time, with heavy drinking, severe permanent dizziness and imbalance can develop.

The short-term, reversible effect is the sensation of being tipsy. This is a direct effect of alcohol on the inner ear. It is best to have a meal along with your drinks to help slow down how quickly the alcohol is absorbed.

If you drink too much too quickly, you may even have spinners. This is a strong feeling of spinning and nausea when you lie down that persists as long as you are reclining and lasts for up to several hours. This is another short-term effect of alcohol on the inner ear. In most people this resolves completely and does not progress. If you have experienced spinners, try to remember how much alcohol you had and stay well below this threshold in the future.

If you have a permanent loss of function or a constant vertigo problem in an inner ear, or if you have damage in your cerebellum (brain balance organ), this short-term effect of alcohol may greatly worsen your balance. Some people are very susceptible to alcohol effects and this can result in progressive symptoms that are not necessarily reversible. If you fall into this group and notice worsening with alcohol, it is best to skip drinking.

Heavy alcohol intake can deplete the body of key nutrients (thiamine and B vitamins for example) and this can damage the balance system permanently. Alcohol is also directly toxic to the brain when used excessively. You don’t have to feel drunk to get this damage. Some people are very tolerant to the immediate effects of alcohol and this makes it easy for them to drink larger amounts. However, these large amounts can still do permanent damage. Current recommendations are to restrict alcohol to no more than one daily drink for women and two for men. At that level permanent balance damage is unlikely. This restriction, however, does not prevent other complications of alcohol. For example, breast cancer is increased in women who drink as little as one drink per day (1.5 ounces of hard liquor, 5 oz wine, 12 oz beer), so the general rule is that you should try to keep your alcohol intake even lower.

Vitamins, minerals, and vertigo

It has long been known that diet can affect some vertigo disorders. Vitamins and minerals can help in some conditions but may not do much in other dizziness disorders. This article will break down some of the key categories of dizziness and how they respond to dietary treatments.

BPPV (Benign paroxysmal positional vertigo) is the most common cause of vertigo and causes brief spells of vertigo brought on by arising from bed, rolling over, or lying down quickly. It is caused by calcium crystals that become displaced from the gravity sensors and enter the spinning sensors of the inner ear. While it is simply treated with maneuvers, it has a tendency to recur. There is good evidence that vitamin D supplements can help reduce recurrences if you are deficient in this vitamin. Vitamin D insufficiency is a frequent problem in people and worsens with age.

BPPV is more common in older women, and these women also often have osteoporosis, a loss of calcium in the bones, and this responds to vitamin D supplementation. This has raised the possibility that BPPV indicates a problem in calcium metabolism similar to osteoporosis. However, treatment of osteoporosis using estrogen, calcium, or medications to restore bone density has not yet been shown to have a major effect on BPPV.

Meniere’s disease is a damaging inner ear disorder that results in violent spells of vertigo lasting hours associated with ringing in the affected ear and hearing loss that gradually becomes permanent. Vitamin D supplements do not seem to be able to prevent these spells. No simple supplements have been shown to control this disorder, although it can respond to sodium restriction as noted in the previous post.

Vestibular neuritis is a viral infection of the balance nerve in one ear. It causes severe vertigo for several days, without hearing loss and can take weeks for recovery. Since it is an infection, it is not surprising that no simple vitamin or mineral supplement can prevent it or hasten recovery.

Migraine associated dizziness is a low-grade form of dizziness in people who also have frequent severe headaches, often on one side of the head. Taking magnesium supplements has been shown to help reduce the headaches and can help manage the dizziness.

Multisensory imbalance is responsible for the decline in balance with aging. It results from gradual declines in inner ear balance combined with visual impairments and loss of sensation in the legs and feet. Vitamins are often given for visual impairments such as macular degeneration, and B vitamins are important to maintain sensation in the limbs. Having a complete examination by a provider is important to guide decisions on supplements for these connected conditions.

In summary, then, you will benefit most from seeing a provider to look at your nutritional status, particularly vitamin D, and taking any supplements needed to help correct these deficiencies. If you have BPPV and are low in vitamin D, this will often help reduce your vertigo. There isn’t a magic supplement that can reliably control most vertigo disorders. If you have a concern about nutrition and your vertigo, a daily multivitamin may be enough to reduce the risk of deficiencies.

Foods, supplements and vertigo: Part 1

If you do an AI search on foods to embrace or avoid for vertigo, you will get a long list of suggestions. We are told to stay hydrated, avoid salt, take calcium, magnesium or vitamin D, and to avoid caffeine and alcohol, just for starters. Some lists have dozens of do’s and don’ts. Have people with vertigo been creating their own problem by eating the wrong foods or not taking the right supplements?

There are two problems with these kind of lists. First, vertigo encompasses many completely different disorders, but these lists lump all kinds of vertigo together. If you carefully avoid the “bad” foods for a disease you don’t have, you have wasted your time for no reason. Secondly, medical websites in general tend to give diet more importance than it actually has compared to other disease causes like genetic deficiencies, aging, or trauma. That’s because changing the diet is “easy”. Restricting the diet is seen as having minimal side effects and it gives people the feeling they are doing something for themselves. This may be just an illusion if the problem they are treating is not really responsive to these foods.

Let’s start with water and salt intake. Vertigo advice often includes increasing water and decreasing salt. Dehydration makes people dizzy, but this is not the vertigo-type dizziness with the room spinning. If you are dehydrated, you might feel faint or woozy if you stand up quickly or exercise, but the world does not usually spin. Often this will come on when you’ve been exercising in the heat and not drinking enough fluids. Heavy sweating makes it more likely.

The treatment for dehydration is to drink plenty of fluids. Plain water is fine if it’s just a hot day and you are not working out, but if heavy sweating is involved you will need to have some salts too (like sodium and potassium), so sports drinks, teas and fruit juices are more useful.

Unfortunately, young people take the advice to drink fluids for dizziness even when they aren’t dehydrated. They’ll carry around bottles of water and sip constantly. Drinking too much water that does not contain salt can cause headaches, faintness and dizziness also, called water intoxication. Most people can avoid being dehydrated by simply drinking something (not necessarily only water) when they feel thirsty. There is no benefit to forcing water intake.

Most vertigo advice also recommends avoiding salt, which of course conflicts directly with advice for dehydration, when salts are needed. Restricting salt has been used for many years to treat Meniere’s disease. This disorder causes progressive deafness, usually in just one ear, and ringing in the ear, with spectacular vertigo spells lasting hours with the room spinning. If you don’t have all these symptoms, cutting salt out of your diet has no benefit. Salt in the diet helps maintain normal blood pressure, but can cause high blood pressure if too much is taken, so being moderate in your intake is the best course.

In the next post we will deal with vitamins and minerals for vertigo.