Antiviral Approach to Meniere’s – Month 17 Update



I’ve now been on Valacyclovir for 17 months and still doing great.  I started with the 3 times a day for 3 weeks, then 2 a day for 3 weeks and now on the maintenance dose of 1 pill a day.  I’ve had no vertigo since taking the Valacyclovir.  Some minor dizziness but I never know if that’s from the prescription and supplements or just a side effect of MM.



I reduced the number of “John of Ohio’s” Meniere’s supplements I was taking and seem to be doing well.  My doctor continues to monitor my kidney and liver function with blood draws every 6 months to ensure there is no damage from the extended use of the prescription.  I’m contemplating taking it every other day but terrified that the vertigo may return.  My doctor said she’s comfortable with whatever I decide. 

A trigger for me is definitely gluten.  I’m totally gluten free and it has helped tremendously.  Now if I dine out and there happens to be gluten in something I immediately get the brain fog, dizziness, headache and my bad ear starts to feel full.  I’m also eating organic foods as much as possible and exercising regularly.  I’ve also cut back on my NUCCA (chiropractic) appointments to every 8 weeks.

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Antiviral Approach to Meniere’s – Month 8 Update

I’ve now been on Valacyclovir for 8 months and doing great.  I started with the 3 times a day for 3 weeks, then 2 a day for 3 weeks and now on the maintenance dose of 1 pill a day.  I’ve had a couple minor setbacks but overall feel back to “normal.”


I reduced the number of John of Ohio’s supplements I was taking due to having my first ever experience with kidney stones (may have been caused by the number of JOH supplements I was taking or the Valacyclovir…either way I’m now doing well only taking two of the JOH supplements daily).  The only side affect I’ve noticed with taking the Valacyclovir is that I now get UTI’s every few months.  My doctor continues to monitor my kidney and liver function with blood draws every 6 months to ensure there is no damage from the extended use of the prescription. 


A trigger for me is definitely gluten.  I’m now totally gluten free which was a major lifestyle change but it has helped tremendously.  Now if I dine out and there happens to be gluten in something I immediately get the brain fog, dizziness, headache and my bad ear starts to feel full.  I’m eating organic foods as much as possible, using essential oils and still seeing my chiropractic doctor…but have cut my visits down to just once every 8 weeks. 


I’m so happy to be able to go to the grocery store and not need to park by the cart return to grab a shopping cart in order to get into the store without falling.  It really is about the small things in life that we so easily take for granted.

Knock on wood…everything is going well!


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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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TMJ, TMD and Meniere’s

I’ve said this before but I truly love my upper cervical chiropractic doctor. Unlike medical doctors who seem quick to get you in and out and write a script I feel as though she’s genuinely concerned about my health and what is causing my issues. Each visit she spends at least 30-45 minutes with me going over all symptoms and possible triggers. Although she has been able to resolve several of my symptoms (fullness, tinnitus, and vertigo) I have at times slight dizziness. In reviewing my symptoms she noticed that my dizziness increases with stress. At my last appointment she asked if I had any issues with TMJ. I stated that I have never had any popping or locking of my jaw, nor do I grind my teeth but I do clench my jaw when under stress.

I had no clue that several TMJ/TMD symptoms are similar to Meniere’s http://www.midwestheadaches.com/symptoms.vertigo.asp

She asked me to open my mouth. When I did she stated my lower jaw moves slightly to the right (my affected ear is the right ear) I had lots of dental work done (braces) in adolescence which may be the cause of the jaw being off alignment. Of course as I’ve stated before, Brian is a skeptic but I told him when I recently went to a new dentist and at my first exam he also stated my jaw opens to the right. When looking in the mirror it is very obvious that my lower jaw moves to the right when opening my mouth.

During my last visit the doctor massaged the outside of my jaw area and while she pushed on the joint asked me to open my mouth. I was in tears from the pain and could barely open my mouth as she was applying pressure but have never previously had jaw pain in my life. She massaged the facial muscles on the outside then massaged the muscle on the inside of my cheek. After she was done I had such a relaxed feeling. She will now focus on realigning my jaw.

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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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