Meniere’s disease is a disorder that affects the inner ear of an individual of approximately one in every 600 people, generally aged between 30 – 50.

 

From a Western medical perspective Meniere’s affects the inner ear resulting in a build-up of fluid in the compartments of the inner ear, called the labyrinth. Generally, it will affect only one ear. It causes a persistent ringing sound in the ear known as tinnitus. Other symptoms include severe dizziness which is called vertigo, hearing loss and a feeling of blockage or congestion in the ear.

 

Meniere’s Australia describes Meniere’s disease as generally seen to progress through three distinct stages of symptoms:

  • STAGE ONE:

Vertigo as usually the main symptom at this point. This vertigo may be accompanied by severe vomiting. Vertigo attacks may last for hours, even days, and usually occur in clusters.

  • STAGE TWO:

This is where we see the ‘classical’ the symptoms of Meniere’s disease. These are; continuing attacks of vertigo, increasing and continuous tinnitus, a feeling of pressure or fullness in the ear, fluctuating hearing ability that doesn’t return to normal.

  • STAGE THREE:

This stage is commonly known as “burnt out Meniere’s”.
In this stage hearing loss may be severe. There is no longer fluctuation in hearing levels. There is still tinnitus, but the patient may see it as less of a problem as they are now used to it. Attacks of vertigo now rarely occur and will eventually cease. Vomiting is now rare, and the nausea is mild. When the ear has lost 50% of its balancing function, a persistent feeling of unsteadiness may replace the attacks of vertigo.

Some patients may experience ‘drop attacks’ (Tumarkin’s crises). This is where balance is lost for several seconds and the patient falls. These attacks happen without warning and with minimal vertigo.

 

From a Chinese medicine perspective, we generally organises Meniere’s disease in the following categories:

xuan yun – dizziness

xuan mao – veiling dizziness

tou xuan – head dizziness

tou feng xuan – head wind dizziness

e xin – nausea

 

As it can be seen here the same symptoms which are mentioned in the Western outline are covered in the Chinese medicine standpoint. We view the cause of disease as likely to be from a combination of external contraction of one of the six environmental excesses, internal damage by the seven affects and poor diet and lifestyle choices.

 

Some examples of common presentations we may encounter when supporting a patient with Meniere’s are as follows:

 

  • A patient who is yang in nature and exposed to emotional stress, frustration, anger, over-eating spicy, acrid, hot, fatty foods or drinking alcohol may result in liver yang becoming excess. In extreme cases this may create wind and transform into fire.

 

  • Liver damage or deficiency can occur in patients with unrealised desires or anger. This may also transform into fire. Accompanied with aging, disease, over exertion, the use of drugs, or excessive sexual activity, yin deficiency may lead to yang excess with subsequent wind and fire. The wind and fire may ascend and harass the clear orifices above, thus resulting in dizziness.

 

  • Ongoing disease or fatigue may consume and damage the qi and blood, too much thinking or worry and anxiety may damage the spleen, or simple blood loss may all result in qi and blood dual deficiency. Either way, there may be dizziness.

 

  • Poor constitution aging, ongoing disease, drug use, and excessive sexual activity may all result in kidney essence deficiency. Essence engenders the marrow which gathers in the brain. If kidney essence deficiency fails to fill the brain with marrow, dizziness may occur.

 

  • Over-eating fried or sweet foods and/or drinking excess alcohol, dampness is formed internally, this dampness could transform into phlegm. Excessive worry and anxiety may also damage the spleen which may fail to transform fluids in the body. Phlegm dampness or phlegm turbidity may obstruct the centre, block the clear orifices and cause dizziness. If phlegm turbidity becomes depressed and creates heat or transforms into fire, phlegm and fire may ascend to assail the clear orifices. This can cause even more serious dizziness.

 

Because the root cause of Meniere’s disease is often from factors such as stress, overeating and drug or alcohol consumption it is important when we take this into consideration when supporting our patients. Along with the appropriate acupuncture and herbal treatments it is important that good diet and lifestyle advice is provided to the patient. As with the TCM approach to any disease the patient must be considered as a whole, and all factors must be addressed to overcome imbalance and restore optimal health.

 

Below are some potential acupuncture treatment protocols I may use for Meniere’s disease based on TCM pattern discrimination:

 

  1. LIVER YANG RISING PATTERN;
  • According to (Flaws & Sionneau 2005, pp.359-361).

 

MAIN SYMPTOMS: Dizziness, tinnitus with a loud noise, possible diminished hearing, head distension and pain, easy anger, over exertion worsening the condition, insomnia, profuse dreams, a bitter taste in the mouth, a flushed red facial complexion, a red tongue with yellow coat, and a wiry, fine, rapid pulse.

 

TREATMENT PRINCIPLES: Calm the liver and subdue yang, tonify and nourish the liver and kidneys.

 

  1. QI & BLOOD DEFICIENCY PATTERN;
  • According to (Flaws & Sionneau 2005, pp.361-362).

 

MAIN SYMPTOMS: Dizziness and vertigo made worse by movement, over exertion causing recurrent attacks, a marked sombre white facial complexion during attacks, otherwise either a sombre white or sallow yellow facial complexion, heart palpitations, insomnia, lassitude of the spirit and a desire to sleep, slight but continuous tinnitus, decreased hearing, disinclination to speak, devitalised eating and drinking, cold hands and feet, a fat, pale tongue with teeth-marks on its edges, and a fine, weak pulse.

 

TREATMENT PRINCIPLES: Supplement and tonify the qi and blood, reinforce the spleen and harmonise the stomach.

 

  1. KIDNEY ESSENCE DEFICIENCY PATTERN;
  • According to (Flaws & Sionneau 2005, pp.362-363).

 

MAIN SYMPTOMS: Dizziness, continuous tinnitus which increases during attacks, marked decrease in hearing during attacks, devitalised essence spirit, impaired memory, insomnia, profuse dreams, low back and knee soreness and limpness, and premature ejaculation. If yin vacuity is predominant, there is vexatious heat in the five hearts, a red tongue, and a fine, rapid pulse. If kidney yang deficient is predominant, there is lack of warmth in the four limbs, aversion to cold, decreased sexual desire, a pale tongue, and a deep, fine, force less pulse.

 

TREATMENT PRINCIPLES: Tonify the kidneys and support the essence. If tending to yin deficiency, also enrich yin. If tending to yang deficiency, also invigorate yang.

 

 

  1. PHLEGM TURBIDITY OBSTRUCTING THE CENTER PATTERN;
  • According to (Flaws & Sionneau 2005, pp.363-364).

 

MAIN SYMPTOMS: Dizziness, vertigo, tinnitus with a low sound, decreased hearing, profuse phlegm, heavy-headedness, chest oppression, nausea, vomiting, devitalized eating and drinking, possible heart palpitations, slimy, white tongue fur, and a soggy, moderate (i.e., slightly slow) pulse.

 

TREATMENT PRINCIPLES: Transform phlegm and eliminate dampness, harmonise the stomach and stop vomiting.

 

 

The acupuncture protocols which have just been shown are a great help to assist in the treatment of Meniere’s disease. There is always variables with every individual patient so these are simply an example of some patterns that may present and may alter in a clinical setting.

 

Meniere’s is a debilitating disease that has a big impact on the patient’s life and the ability to function fully in certain aspects of their lives. If you or someone you know suffer with Meniere’s and would like to explore the Traditional Chinese Medicine approach to managing your symptoms, please get in touch.

 

 

Scott is available for consultation at Mornington Chinese Medicine on Wednesday and Thursday.

To book please call us on ph: 59736886

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