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You have seen your health care provider for Ménière disease. During Ménière attacks, you may have vertigo, or the feeling that you are spinning. You may also have hearing loss (most often in one ear) and ringing or roaring in the affected ear, called tinnitus. You may also have pressure or fullness in the ears.

During attacks, some people find bed rest helps relieve vertigo symptoms. Your provider may prescribe medicines like diuretics (water pills), antihistamines, or anti-anxiety medicines to help. Surgery may be used in some cases with persistent symptoms, although this has risks and is rarely recommended.

There is no cure for Ménière disease. However, making some lifestyle changes can help prevent or reduce attacks.

Diet

Eating a low-salt (sodium) diet helps reduce the fluid pressure in your inner ear. This can help control symptoms of Ménière disease. Your provider may recommend cutting back to 1000 to 1500 mg of sodium per day. This is about ½ to ¾ teaspoon (2.5 to 4 grams) of salt.

Start by taking the salt shaker off your table, and do not add any extra salt to foods. You get plenty of salt from the food you eat.

These tips can help you cut the extra salt from your diet.

When shopping, look for healthy choices that are naturally low in salt, including:

• Fresh or frozen vegetables and fruits.
• Fresh or frozen beef, chicken, turkey, and fish. Note that salt is often added to whole turkeys, so be sure to read the label.

Learn to read labels.

• Check all labels to see how much salt is in each serving of your food. A product with less than 100 mg of salt per serving is good.
• Ingredients are listed in order of the amount the food contains. Avoid foods that list salt near the top of the list of ingredients.
• Look for these words: low-sodium, sodium-free, no salt added, sodium-reduced, or unsalted.

Foods to avoid include:

• Most canned foods, unless the label says low or no sodium. Canned foods often contain salt to preserve the color of the food and keep it looking fresh.
• Processed foods, such as cured or smoked meats, bacon, hot dogs, sausage, bologna, ham, and salami.
• Packaged foods such as macaroni and cheese and rice mixes.
• Anchovies, olives, pickles, and sauerkraut.
• Soy and Worcestershire sauces.
• Tomato and other vegetable juices.
• Most cheeses.
• Many bottled salad dressings and salad dressing mixes.
• Most snack foods, such as chips or crackers.

When you cook and eat at home:

• Replace salt with other seasonings. Pepper, garlic, herbs, and lemon are good choices.
• Avoid packaged spice blends. They often contain salt.
• Use garlic and onion powder, not garlic and onion salt.
• Do not eat foods containing monosodium glutamate (MSG).
• Replace your salt shaker with a salt-free seasoning mix.
• Use oil and vinegar on salads. Add fresh or dried herbs.
• Eat fresh fruit or sorbet for dessert.

When you go out to eat:

• Stick to steamed, grilled, baked, boiled, and broiled foods with no added salt, sauces, or cheese.
• If you think the restaurant might use MSG, ask them not to add it to your order.

Try to eat the same amount of food and drink the same amount of fluid at about the same time every day. This can help reduce changes in the fluid balance in your ear.

Other Lifestyle Changes

Making the following changes may also help:

• Some over-the-counter medicines, such as antacids and laxatives, have a lot of salt in them. If you need these medicines, ask your provider or pharmacist what brands contain little or no salt.
• Home water softeners add salt to water. If you have one, limit how much tap water you drink. Drink bottled water instead.
• Avoid caffeine and alcohol, which may make symptoms worse.
• If you smoke, quit. Quitting may help reduce symptoms.
• Some people find that managing allergy symptoms and avoiding allergy triggers helps decrease Meniere disease symptoms.
• Get plenty of sleep and take steps to reduce stress.

Medicines

For some people, diet alone will not be enough. If needed, your provider may also give you water pills (diuretics) to help reduce the fluid in your body and fluid pressure in your inner ear. You should have regular follow-up exams and lab work as suggested by your provider. Antihistamines may also be prescribed. These medicines may make you sleepy, so you should first take them when you do not have to drive or be alert for important tasks.

Surgery

If surgery is recommended for your condition, be sure to talk with your surgeon about any specific restrictions you may have after surgery.

When to Call the Doctor

Contact your provider if you have symptoms of Ménière disease, or if symptoms get worse. These include hearing loss, ringing in the ears, pressure or fullness in the ears, or dizziness.

References

Baloh RW, Jen JC. Hearing and equilibrium. In: Goldman L, Cooney K, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 396.

Crane BT, Minor LB. Peripheral vestibular disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 167.

Wackym PA. Neurotology. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 16.

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