Meniere’s Disease: An Antiviral Approach to Eliminating Vertigo

I’ve been trying to get to the root of my Meniere’s Disease.  As I’ve stated before, there is no known cause or cure for the disease but many have found some relief from symptoms through different methods.  I’ve tried almost all methods except the antiviral method and I have also not yet been tested for candida overgrowth.  

My ENT doctor was unwilling to listen when I talked about doing an antiviral method so I contacted my family doctor and she is willing to try it.  It starts as a high dose and tapers down to a maintenance dose.  I had to get blood work done before starting the regimen.  The blood work is to get a baseline for kidney function as the long term use of the antiviral medicine can cause kidney issues.  I will then have to get regular blood monitoring every two months.  



I’m sharing this information for anyone else who may be suffering from this disease.  Below is the letter I sent to my doctor along with links to the medical studies.  If you are suffering from this I highly suggest sending your doctor this letter along with a printed copy of both medical articles a week or two prior to your appointment so they have time to review it before your appointment.  Once the doctor received my letter she called me to set up a 30 minute appointment to discuss.

Links to the medical studies I’ve referenced in the letter to my doctor below.
Dr. Gracek’s Article – HERE

Autoimmune Condition Article – HERE

Dear Doctor …,

Sorry for not getting this information to you sooner.  Just this morning I was able to secure an appointment for tomorrow afternoon to discuss my Meniere’s Disease, Bell’s palsy and an active cold sore. 


I had seen Dr. ENT but he is reluctant to take a look at viral issues being a cause for my Meniere’s disease.  Since Meniere’s disease has no cause or cure he is taking a wait and see approach.  Waiting for it to get worse then suggesting ear injections or surgery to destroy the inner ear and that is something I’m not willing to do. 

I respectfully ask you to scrutinize the information in this recent journal article. The author, Dr. Richard Gracek of Boston, is extremely experienced in antiherpetic therapy of Meniere’s, as the article will reveal.

Read closely the information on P. 103, for effective dosages and durations. Dr. Gracek gains an 88% to 90% complete relief of Meniere’s symptoms with his protocols, described in the paper.

I’m asking you to consider this antiviral treatment for me in hopes of some relief from not only Meniere’s, but the Herpes virus that is causing my cold sores and the Bell’s palsy causing the drooping of my left eye.

My thanks,

Sara 

For your information — here’s the cogent treatment text. I’ve taken the liberty to highlight crucial information:

The antiviral treatment protocol for patients with recurrent vertigo is as indicated below.

Discontinue all previous medical treatments; ensure that patients are cleared for normal
renal and liver function; use acyclovir tabs 800 mg t.i.d. for 3 weeks and reexamine. If there
is significant relief of vertigo, decrease to 800 mg b.i.d. for 3 weeks, then to 800 mg daily as a
maintenance dose. If valacyclovir is selected (in those who fail to respond to acyclovir), use
1 g t.i.d. for 3 weeks with taper to b.i.d. for a further 3 weeks and then 1 g daily as a maintenance
dose. The starting dose of acyclovir was given for a longer period (3 weeks) than that
used for zoster because it was felt necessary to cross the blood-brain barrier to reach ganglion
and satellite cells with virus.
Most patients experienced relief from vertigo in the first 2 weeks
but some required a longer period. The gradual lowering dose was then used to find the
lowest level maintenance dose for a given patient. Most were controlled on a single dose daily
but occasionally a patient required an adjustment to 1,200 mg of acyclovir or 1,500 mg of
valacyclovir.


These dosages may require adjustment in patients with impaired kidney or liver function.
The follow-up period was as short as 3 years in the most recent patients and 8 years in the
earliest patients in the series. Of 106 patients with VN (the earliest patients evaluated up to
8 years), 93 (88%) had complete relief of symptoms with oral acyclovir, 54 of 60 patients
(90%) with MD [Meniere's disease] were relieved of vertigo,
and 27 of 45 patients (60%) with posterior canal
BPPV were relieved of symptoms. Between the use of antivirals and repositioning maneuvers
(physical therapy), the number of chronically disabled patients who were candidates for
ablation of posterior semicircular canal function (canal occlusion or singular neurectomy)
was reduced significantly.
As a result of these morphological and clinical observations, our approach to the patient
with recurrent vertigo has been simplified. It goes without saying that the patient without
recurrent balance symptoms needs no further treatment after a hearing test and MRI of the
brain (assuming that these are normal). A Hallpike maneuver is included in the initial examination.
Those patients with recurrent vertigo are offered a trial of oral acyclovir (or Valtrex)
for 3 weeks.

Examination at the 3-week period will determine the sensitivity of the particular NT
virus to the antiviral. If there is no relief of vertigo with acyclovir or valacyclovir, treatment
is followed by vestibular tests (videonystagmography and vestibular-evoked myogenic
potential) to determine the responsible ear. If these results are abnormal chemical labyrinthotomy
is offered. The patient is offered a choice between dexamethasone (12 mg/ml) or
gentamycin (80 mg/2 ml), considering the risk of hearing loss (dexamethasone 0%; gentamycin
usually negligible if used in a single small dose).
Bell’s Palsy Information on Page 93. 
 A major deterrent to the acceptance of a viral neuropathy in these common vestibular syndromes is the lack of history pointing to a recognizable viral insult to the ear. However, the mucous membrane of the aero digestive tract is a ready portal of entry for NT viruses to invade sensory terminals of cranial nerves (olfactory, trigeminal, facial, vagus and glossopharyngeal). The facial nerve has a unique location adjacent to the vestibular nerve and ganglion in the internal auditory canal.
A neuropathy causing facial nerve dysfunction (Bell’s palsy) is thought to be caused by virus reactivation in the sensory ganglia of this nerve ( fig. 1 ). The human facial nerve has 2 sensory ganglia, geniculate and meatal [41, 42]
Although the geniculate ganglion represents the major sensory input (80–85%) in most facial nerves, the meatal ganglion is present in all specimens and may outnumber the geniculate in 10–15% of TB.
Four TB from patients with a history of facial paralysis (Bell’s palsy) demonstrated only degenerated meatal ganglion cells and no degeneration in the geniculate [43]. Several MRI studies of patients with Bell’s palsy show that the earliest enhancement of the facial nerve is in the fundus of the internal auditory canal where the meatal ganglion is located [43]

Article: Meniere’s Disease Might Be an AutoImmune Condition

Arnold and Niedermeyer [32] evaluated the presence of higher IgG antibodies against herpes simplex virus (HSV) in the perilymph of patients with Meniere’s disease. This result supported the hypothesis that the herpes simplex virus may play an important role in the aetiopathogenesis of Meniere’s disease. Higher titres of IgG against adenovirus (ADV) and varicella zoster virus (VZV) were found in patients with Meniere’s disease compared with a control group. These findings support the hypothesis that adenovirus and varicella zoster virus may be important in the development of Meniere’s disease [39].

Recently, direct evidence of viral neuropathy in Meniere’s disease has been provided by the transmission electron microscopic observation of viral structures in vestibular ganglion cells excised from a patient with Meniere’s disease (Picture 3 and Picture 4) [45] and [46]. The clinical response to antiviral medication indicated that vertigo due to Meniere’s disease was relieved in 85–90% of patients. It is not surprising that control of vertigo was not greater than 85–90%, as mutant strains of the herpes virus group would be resistant to the acyclovir class of antivirals. Until newer antivirals are developed, approximately 10% of Meniere’s disease patients with vertigo will not be controlled. The auditory symptoms are less effectively treated by the antiviral approach because loss of hair cells and spiral ganglion cells secondary to the toxicity of viral proteins in the perilymph is not reversible.”

“The antiviral approach to the very common disabling balance symptoms experienced by patients with Meniere’s disease has virtually eliminated the use of various surgical methods used in the past. These include labyrinthectomy, endolymphatic sac decompression and vestibular nerve transection. The high (90%) rate of vertigo control with orally administered antivirals should be considered as a frontline treatment for vertigo.”

Take-home messages


Meniere’s disease is an autoimmune disorder. Its etiopathogenesis includes viral infection. The histopathological correlate of Meniere’s disease is endolymphatic hydrops and vestibular endorgans demonstrates variable degrees of neuroepithelial degeneration

Due to the possible autoimmune pathogenesis of the disease, pharmacotherapy for Meniere’s disease may include corticosteroids, etanercept and warfarin. The use of antiviral agents corresponds to the viral hypothesis and has eliminated the various surgical methods of the past.

Gene therapy could be used in the future to transfer genetic material into inner ear cells using viral vectors and to protect, rescue, and even regenerate hair cells of the inner ear


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Meniere’s Disease Update



Yesterday I had my follow-up with my ENT.  He reviewed my hearing tests and stated that at this point we will continue with the low sodium diet.  He stated that there are several ways to treat the disease and over time the effectiveness of each treatment can diminish. 
 
He stated that once the low sodium no longer gives positive results then he will put me on a diuretic.  After that eardrum injections and lastly – surgery.   

I stated that several people have had success with Acyclovir and asked if that would be something for me to try and he said no.  He stated that there is no known cure and although some people may have had success it’s not successful for all.  In several studies of cadavers and double blind studies nothing has stood out pointing to a viral infection causing Meniere’s.


He stated that the University of Iowa is leading in Meniere’s research.  He stated that they do several research studies but mainly with people who’s Meniere’s has advanced.  He also stated Dr. Rauch in Boston is well known for treating people with Meniere’s.   

He stated that I’m lucky we caught and diagnosed it early.  And that we will continue to monitor it.

He stated once my hearing starts to deteriorate then he will refer me to a Doctor at the Hearing and Balance Institute in North Florida.  I’m hoping that won’t happen :)

I’m continuing with my upper cervical care and natural supplements to help treat the symptoms and hopefully slow the hearing loss.

At this point I’m having good and bad days but more good days so that is keeping me hopeful!


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Become Your Own Health Advocate: Living with Meinere’s Disease

I strongly believe that you need to be your own health advocate. My family physician has roughly 1,000 patients so as much as I think she’s great she doesn’t have the capacity to research and investigate each patient’s issues. Last week after the ENT told me that I more than likely have Meniere’s disease I started researching online. There is no cure for the disease but several things a person can do to treat the symptoms. I also spent time researching several cases studies online about the disease.

I talked to Brian and told him that I could handle hearing loss and tinnitus but I can’t handle the vertigo. In addition to the low salt diet I found several online forums for people with Meniere’s. There is a list of natural supplement’s referred to as the “John of Ohio” Meniere’s regimen. I’ve started taking a few of these supplements in hopes of some relief.

In several of my online searches of case studies for Meniere’s disease I found Upper Cervical Chiropractic care was beneficial to people with Meniere’s. This is totally different from traditional chiropractic as it does NOT involve twisting and popping. You can read the article HERE.

Another website stated the following:

What causes Meniere’s Disease?

I’ll start with a study from the Journal of Orthopaedic & Sports Physical Therapy 2000; 30 (12) titled Cervicogenic Dizziness: A Review of Diagnosis and Treatment. Here is a quote: “Cervicogenic dizziness is most often associated with flexion-extension injuries and has been reported in patients with severe cervical arthritis, herniated cervical disks, and head trauma.” In other words, with a head or neck trauma your neck can misalign and cause dizziness. Another study by Bogduk, a well-known chiropractic author of many studies reported that monkeys injected with anaesthetic into dorsal roots of upper cervical vertebrae to C3 had balance problems. In other words, the nervous system in the upper neck is highly related to our balance.


The medical community currently believes Meniere’s disease is caused from an overproduction of fluid in the inner ear. That could very well be the case too.

I found a handful of recommended doctors in Florida who specialize in Upper Cervical care. Luckily one is only one hour away. I had my consultation with her last week along with x-rays of my spine. This was so informative and I’m thankful that I found her! My spine did indeed show previous trauma. My spine is not curved like a normal spine. My spine is straight. My axis is turned up and to the right and the vertebra below is twisted left. So many indicators and the right side of my body is the most reactive – I’m not able to turn my head to the right as easily as the left. I’m not able to lift my right leg up as easily as my left…little unforeseen things until you really put it all together. The adjustment was light pressure behind my ear to the point that it felt as though she didn’t do anything. Once I stood up she retested a few things with amazing results. For instance there was a knot in my lower back that was gone, the brain fog I was experiencing was gone and 10 minutes after the visit I felt the affected ear draining. I will have to go for a couple visits a week to start off with until my body trains itself to stay in the proper alignment but good results so far. Feeling very optimistic.

During my second visit to the chiro she asked if my doctor had ever mentioned Bell’s Palsy to me.  She stated that my left eye droops as well as the right corner of my mouth.  I indicated to her that my doctor hasn’t but a year ago when I was under a lot of stress Brian and I started to notice the eye droop.  One more thing to mention to my doctor on my next visit. 
 

You have to be own best health advocate. I don’t want to be put on a bunch of medications. I want to be able to treat my symptoms naturally. Hopefully through the upper cervical chiropractic care and natural supplements I will be able to do so. 

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