First published in Spin Issue 105 (2021)
Stress is known to both trigger and exacerbate symptoms of Ménière’s, and stress reduction is one effective way to help manage the condition. Living as we are through a global pandemic, life for many of us has never been more stressful. But why does stress trigger Ménière's? And what if anything can be done to help manage it?
Stress activates the fight or flight response releasing stress hormones and increasing inflammation in the body. Fight or flight is the bodies way of responding to imminent danger, traditionally fleeing a lion! Fight or fight diverts energy to the muscles and brain, away from the gut, immune system and reproductive organs, so we can think and run faster. This works fantastically when stressors are brief.
But modern life, not to mention living through a global pandemic, can keep us chronically stressed. When fight or flight is switched on permanently the immune system is permanently disrupted, inflammation increases, blood sugar is imbalanced, digestion is switched off, food reactions develop and stress hormones affect fluid balance. For a few days or weeks we may be OK. But when this goes on for months or years we become vulnerable to disease. This chronic inflammatory state leads too many modern diseases. We now know that inflammation and oxidative stress are the driving force behind Ménière's disease too. So how can we reduce stress and inflammation to help manage Ménière's? You can’t necessarily reduce the stress in your life but you can reduce your bodies reaction to it. Let’s find out how.
The food we eat, our microbiome (gut bugs), immune system and stress response are intimately linked. What we eat can have a positive or negative effect on all of these responses. Thats why food can be both stressor and saviour. Food is the information which tells our cells how to behave. Food can increase or reduce inflammation, fluid balance, blood sugar, stress levels, hormone levels, improve or harm digestion. So what can we do about it?
1. Eat a rainbow of vegetables
Veg is anti-inflammatory. Veg feeds good bacteria in the gut, boosting the immune system and lowering inflammation. The more diverse the veg you eat, the more diverse your gut bacteria, the lower inflammation, the healthier you will be. A healthy microbiome also sends happy signals to the brain lowering stress hormones. So try new veg. Aim to eat half a plate of rainbow veg at each meal.
2. Drink more water
It’s easy to turn to tea, coffee and booze when we’re stressed, making us more dehydrated. But dehydration is stressful for the body increasing stress hormones which affect sugar and salt concentration and fluid balance in the ear. Increasing water can decrease stress hormones which affect fluid balance in the ear. Ideally drink filtered water.
3. Reduce or eliminate caffeine
Caffeine can increase the stress hormone cortisol making us feel even more anxious. Caffeine also dehydrates and affects sleep. Reduce it gradually to avoid withdrawal symptoms.
4. Find alternatives to comfort eating
Ironically the food we turn to for comfort can stress the body further, destroying the microbiome, and increasing inflammation. Yet we all do it. A slice of cake to cheer us up, a pizza, glass of wine. Once in a while this is no problem, but the pandemic has meant many of us are reaching for the biscuit tin more often. For example rather than suppressing feelings with food reach for the phone, read, dance, practice deep breathing, take a walk, enjoy nature or learn to meditate. Any absorbing activity that requires intense concentration and distracts can help reset the stress response.
5. Improve sleep hygiene
Sleep disorders are associated with Ménière's. Sleep is essential for the body to heal and repair itself. It only takes one night of poor sleep to increase inflammation, stress and hunger hormones, making us more sensitive to stress and inclined to overeat inflammatory comfort foods. A regular wake and bed time and sleeping in total darkness can improve sleep quality, decreasing stress hormones which affect fluid balance in the ear.
6. Switch off the screen
We are being constantly bombarded with negative news stories keeping Covid top of mind and stress levels high. Stress before bed can also stop us sleeping well. Blue light from devices also acts like sunshine on the brain, disrupting sleep hormones. So switch off the news and devices, particularly late at night. Watch once earlier in the day rather than checking your phone every hour.
7. Practice gratitude
It’s easy to worry about every little thing especially at the moment, even if you don’t have Ménière's. Research shows focusing on the things you do have, rather than the things you don’t, can help reset the stress response. Try to think of 5 things you’re grateful for each night
Eg The delicious beef stew, the beautiful sunset, my comfortable bed, the call with my grandchildren, the walk in the park etc.
Let’s hope that by the time you read this the pandemic is over, but regardless, stress management is essential to help manage Ménière's symptoms. To recap, you can reduce inflammation by eating more vegetables and increasing your water consumption. Reset the stress response by sleeping 8-9 hours a night, switch off the news and practice daily gratitude. But please don’t stress about trying to do everything on this list! Choose one thing that strikes a chord and do it daily.
There is still a lot to be learned about Ménière's. But we do know it is a condition driven by inflammation and oxidative stress. Learning to manage stress can be one of the ways to help reduce inflammation, either yourself at home, or sometimes clients need further support in clinic.
Beyond stress, dietary and other lifestyle factors can also increase inflammation and trigger and exacerbate symptoms. In my practice I use a Functional Medicine approach to identify biochemical imbalances underlying disease to help manage symptoms.
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