The Vegan Diet for Vertigo?

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I initially received this question from my grandma who suffers from bouts of dizziness and imbalance. After searching a bit, I found this to be a somewhat common inquiry, at least more so than I thought it would be.

Could the vegan diet improve symptoms of vertigo? In sum, while there aren’t any studies measuring outcomes of the vegan diet on vertigo, unexplained vertigo is thought to be potentially reversed by a healthy diet, given that both impaired carbohydrate and insulin metabolism have been cited as the most overlooked causes of idiopathic vertigo.1

The more I think about it, the more the potential connection makes sense. After all, metabolic disorders, in general, can cause dizziness.

And there are more connections between diet and disorders of metabolism than you can shake a stick at.

Brief Primer on Vertigo

We all have our dizzy spells. Be it due to illness, or simply standing up too quickly, dizziness is a completely normal experience.

That’s obvious. But what’s perhaps much less obvious is that a more serious type of dizziness, in which the world seems to spin around you as if you just jumped off of a merry go round, is also relatively common.

This condition, known as vertigo, affects as many as 35% of adults aged 40 and over in the US.2 Further, according to the National Institute on Deafness and Other Communication Disorders (NIDCD), another 4% of American adults reported a chronic problem with balance.3

As for those 65 years of age and older, 80% have experienced dizziness with benign paroxysmal positional vertigo (BPPV)—the most common vestibular balance disorder—being a chief cause.3,4

Dizziness Vs. Vertigo

Both dizziness and vertigo are considered symptoms—not diseases—with the former being a potential symptom of the latter.

People often use these terms interchangeably, but they do differ subtly.

When someone says they’re dizzy, they can mean any of the following:

  • They’re unsteady—i.e. they lose their sense of balance and may stagger when walking.
  • Hyperventilation—panic attacks, etc. You expel a lot of CO2 in a short period of time and can get dizzy as a result.
  • They’re lightheaded—what’s known as presyncope, a condition in which people feel they are about to faint. This can be caused by low blood pressure among other things. If you’ve ever stood up too quickly from your seat, and got lightheaded, then you know the feeling.
  • Vertigo—a neurological phenomenon which I’ll cover shortly.

So, how do you know if you’re experiencing vertigo or a bout of dizziness due to some other reason such as those listed above?

Vertigo can be characterized by a feeling of floating, weakness, tinnitus, tremors, and sweat, nausea and vomiting.8 But while there are some telltale signs, you’ll need to consult your doctor to determine the root cause.

Etiology of Vertigo

There are various types of vertigo, many classified as peripheral vestibular disorders. As mentioned above the most common is benign paroxysmal positional vertigo (BPPV). Other common causes include:

  1. Meniere’s disease—a disorder of the inner ear that causes bouts of vertigo.
  2. Vestibular neuritis, or labyrinthitis—inflammation of the inner ear or nerves that connect the brain to the inner ear.
  3. Inflammation in the inner ear
  4. Cervicogenic dizziness—a sensation of disequilibrium due to abnormal afferent activity from the neck.
  5. A vestibular migraine or migrainous vertigo—a type of migraine that may not cause a headache, and can include a range of debilitating symptoms affecting the ears, balance, and vision.
  6. Various metabolic disorders

For reasons mentioned above, I will be covering vertigo related to disorders of metabolism.

Metabolic Dysfunction and Vertigo

A range of metabolic disorders impact the functioning of the inner ear.6-10

Specifically, disorders carbohydrate metabolism represent common causes of auditory and vestibular alterations, which in the majority of the cases, stem from disorders of glucose metabolism.9,11,12,13

Both hypoglycemia (low blood sugar), hyperglycemia (high blood sugar) and even mild fluctuations in insulin levels can be enough to induce changes impacting the labyrinth (inner ear).17-20Metabolic dysfunction is relevant, because it can be the major etiological factor in vestibular dysfunctions, or simply worsen pre-existing vestibular disorders.

I won’t be covering any pathophysiology here, because the specific role of insulin function in peripheral vestibular disorder is unknown.

The Vertigo-Diet Connection

In one study, fifty patients with unexplained vertigo or lightheadedness were evaluated. Five-hour insulin-glucose tolerance tests were given to all patients, with insulin levels being obtained at various intervals.

The results of the investigation were staggering: insulin levels classified as abnormal or borderline abnormal were found in 82% of patients. A whopping 90% were found to have either an abnormal glucose tolerance test or at the very least borderline insulin levels.1

Vegan Diet and Insulin Sensitivity

According to Joan Sabate, author of Vegetarian Nutrition, it’s quite possible that vegetarian diets high in complex carbohydrates may have some protective effects against glucose intolerance.21

One study by LM Goff, et al tested the hypothesis that factors in the vegan diet would lead to improved insulin sensitivity.22

They wondered if vegans, due to their characteristically chronically high intake of complex carbohydrates, would experience positive effects on insulin sensitivity.

As it turned out, vegans had a significantly higher dietary intake of carbohydrate, nonstarch polysaccharides, and polyunsaturated fat.

And as such, vegans were found to have favorable fasting glucose concentrations, compared to nonvegans in the study.22

In Sum

Metabolic disorders, specifically those accompanied by alterations in insulin, seem to play a role in the etiology of certain types of peripheral vestibular disorders (a fancy umbrella term for various causes of vertigo).

Because many facets of a well-planned vegan, whole food diet are thought to improve glucose tolerance, it’s possible that a properly planned vegan diet may help manage conditions that cause episodes of vertigo and dizziness. 

References

  1. Proctor CA. Abnormal insulin levels and vertigo. 1981;91(10):1657-62. https://www.ncbi.nlm.nih.gov/pubmed/7026944
  2. Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults. Arch Intern Med. 2009;169(10): 938-944.
  3. National Institute on Deafness and Other Communication Disorders (NIDCD). Strategic Plan (FY 2006-2008). Available at: www.nidcd.nih.gov/StaticResources/about/plans/strategic/strategic06-08.pdf. Accessed May 20, 2010.
  4. Ator GA. Vertigo—Evaluation and Treatment in the Elderly.
  5. Fife TD, Iverson DJ, Lempert T, Furman JM, Baloh RW, Tusa RJ, Hain TC, Herdman S, Morrow MJ, Gronseth GS. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurol. 2008;70:2067–2074.
  6. Bittar RSM, Medeiros IRT. Tratado de Otorrinolaringologia, 1a edição, São Paulo, Roca, 2003:496-504.
  7. Ganança MM, Caovilla HH. Vertigem tem Cura? Primeira Edição, São Paulo:Lemos Editorial 1998:302.
  8. Fórum sobre Vertigem. Rev Bras Otorrinolaringol. 2003;supl 1:6-36.
  9. Updegraff, WR. Impaired Carbohydrate Matabolism and Idiopatic Ménière’s Disease. Ear Nose Throat J. 1977;56:160-3.
  10. Murbach VF, Caovilla HH, Munhoz MSL, Ganança MM, Guerrero AI. Distortion Product Otoacoutic Emissions Amplitude Variations During Glucose Tolerance Test and Insulin Titration. Acta ORL. 2003;22(4):32-42
  11. Silva MLG, Munhoz MSL, Ganança MM, Caovilla HH, Ganança CF. In:Silva MLG, Munhoz MSL, Ganança MM, Caovilla HH. Quadros Clínicos Otoneurológicos Mais Comuns, 1a edição, São Paulo, Atheneu, 2000:37-45
  12. Maia CAS, Campos CAH. Diabetes Mellitus como causa de perda auditiva. Braz J Otorhinolaryngol. 2005;71(2):208-14.
  13. Ramos S, Ramos RF. Síndromes cócleo-vestibulares por distúrbios do metabolismo dos glicídios. Tratamento com dietas nutricionais e evolução dos sintomas e limiares auditivos tonais. Rev Bras Otorrinolaringol. 1993;59(2):112-20
  14. Bittar RSM, Sanchez TG, Santoro PP, Medeiros IRT. O Metabolismo da Glicose e o Ouvido Interno. Arq Otorrinolaringol. 1998;2(1):39-44.
  15. Sanchez TG, Medeiros IR, Coelho FF, Constantino GTL, Bento RF. Frequência de alterações da glicose, lipídeos e hormônios tireoideanos em pacientes com zumbido. Arq Otorrinolaringol 2001;5(1):142-7.
  16. Proctor CA. Abnormal insulin levels and vertigo. Laryngoscope. 1981;91(10):1657-62.
  17. Kirtane MV, Medikeri SB, Rao P. Blood levels glucose and insulin in Meniere’s disease. Acta Otolaryngol. Suppl 1984;406:42-5.
  18. Standards of Medical Care in Diabetes. Diabetes Care. 2008;31:suppl 1:S12-14.
  19. Kraft LR. Detection of diabetes mellitus in situ (occult diabetes). Lab Med. 1975;6:10-22.
  20. Miller O. Laboratório para o Clínico, 8a edição, São Paulo, Atheneu: 1999;3-32.
  21. Vegetarian Nutrition Rosemary Ratzin-Turner-Joan Sabaté – Crc Press – 2001