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?
Read more: Drinks: Coffee, Alcohol and VertigoLet’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.