If you or someone you know has a recent diagnosis of Meniere’s Disease, it’s understandable when you find you desire more information. What is Meniere’s Disease exactly? How does it affect daily life? Is there anything people can do to decrease the severity of Meniere’s vertigo episodes, like making dietary changes? These are all good questions, so let’s tackle them one at a time.
What is Meniere’s Disease?
Meniere’s Disease is a disorder of the inner ear where fluids get out of balance and cause dizziness. Dizzy spells alone, however, do not mean you have this condition. There are other symptoms including ringing in one ear (tinnitus), stuffy ear, nausea, momentary or progressive hearing loss, blurred vision, and balance problems. A person may experience one or several of these symptoms at a time. The key here is vertigo attacks last at least 20 minutes and may continue much longer (up to a day).
Meniere’s is an exceedingly rare chronic condition. It appears in about .2% of the population, usually between the ages of 40-60 with more women developing the disease than men. There is no known specific cause or cure. However, there are factors that increase a person’s chances of manifesting Meniere’s. These include:
- Frequent migraines
- Head or neck injury
- Ear trauma
- Autoimmune disorder
- Genetic predisposition
For some people Meniere’s becomes a lifelong struggle. For some lucky others, it disappears one day, with no clear reason. Because Meniere’s symptoms can appear and cease all-of-a-sudden, it makes the disease a little difficult to treat.
If you have questions about your diagnosis, please reach out to the caregiver following your condition. There are many other diseases and physical problems that look like Meniere’s but are not.
How Does Meniere’s Disease affect Daily Life?
Each person who has Meniere’s has a unique experience. The severity and frequency of vertigo episodes for one person are quite different for the next. The add on symptoms also vary from person to person. If not confusing enough, each individual may find their attack symptoms change depending on various factors like fast movements, bright lights, and food allergies, each of which can be a trigger.
People with Meniere’s disease report that dizziness, by far, is the factor that sets the tone for daily life. They never know when they might lose their balance and feel like the room is spinning. It makes driving, using machinery, or even taking a walk alone risky.
Over time the best approach to these potential hazards is creating a proactive care plan. This plan details known triggers for an individual’s episodes, any medication they use, and how others can help them when a Meniere’s episode occurs. This takes time, but the result is something to which everyone can refer for help and insights.
What Can I Do to Help My Meniere’s?
Doctors recommend many changes for a Meniere’s patient with the goal of being an improved quality of life. These run the gambit between taking over-the-counter medications for nausea and motion sickness to surgery. However, there are things you can do that appear to lessen the severity of Vertigo or increase the time in between episodes. Begin by watching your alcohol consumption, drinking more water, avoiding stressful situations, lessen the amount of caffeine you drink and try to maintain a consistent sleep cycle (sleep hygiene).
With dietary changes, one of the most common recommendations for establishing greater well-being is salt reduction. Salt encourages water retention in your body. Since the liquid in your inner ear is the culprit for your Meniere’s vertigo, a reduction in salt intake may help minimize or cease vertigo attacks.
Enacting a Low-Salt Diet for Meniere’s
If you take a quick glance at a few of the foods in your pantry, you will notice salt or sodium appears on many of them. It is one of the most used additives in our edibles because it has a preservative quality (not to mention tasting good). Even items labeled “low salt” can add up fast.
The recommended daily intake of salt for a Meniere’s patient is 1500 mg/day. It sounds like a lot. But, one tablespoon of salt equals 2,300 mg of sodium. If you consume 1/2 teaspoon of salt each day, it uses up your daily allotment with about 300 milligrams to spare. Ten pretzels have about 43 milligrams of sodium. I think you can see where staying within the 1500 milligrams limit proves difficult.
First things first. You’re about to become a salt-savvy consumer. As you walk through your supermarket, you’ll now be looking at labels for serving size and the nutritional fact label for sodium, sodium bicarbonate, or NA. If the package has specific language regarding salt, the general rule of thumb is this:
- Unsalted (No Salt): While salt is not added to the product if the food itself has natural sodium, the product’s nutritional fact label will contain a listing of the sodium content.
- Sodium Free: Five milligrams or less salt per individual serving.
- Very-low sodium: Less than 35 milligrams. Of salt per individual serving size.
- Reduced salt: About 25% less salt than the same salt-containing product by the same company.
- Low-salt (or sodium): From the normal levels, this product has only 140 milligrams of salt present per serving size.
NOTE: Process foods have the highest amount of salt per serving. But, please remember it is hard to measure if you are eating out or at a party.
Salt Substitutions for the Meniere’s Diet
You’ll hear repeatedly that you can use things like herbs or lemon for flavoring your meal. Salt has a unique flavor profile. Without it, some of your recipes seem downright bland. So, what’s the answer?
One thing you have to know is that it will take your body and taste buds about four months to adjust to a low-salt diet. Salt removal decreases our sense of sweetness while increasing bitter notes. On the upside when something has salt in it, it tastes amazing!
One option is the use of MSG. This gives you the sense of saltiness and can reduce the overall sodium in a recipe by about 40%. Some studies show the use of MSG is not ideal for Meniere’s patients. It’s a decision you should discuss with a dietitian or nutritionist familiar with Meniere’s Disease.
A second, less controversial idea is using vinegar. Balsamic and Chinese vinegar both seem to help with the flavor of specific dishes like soups and stews. There are also Bragg’s Amino Acids which have natural sodium and can replace soy sauce without making you give up that rich taste.
Third, there are commercial salt substitutes. These have a base of potassium chloride that tastes like table salt (perfect!). Potassium may offer the additional benefit of helping reduce your blood pressure (Warning: Do not use this if a doctor prescribes you ACE inhibitors or hypertension medication).
Last, you can consider herb and spice blends. You can make these at home or purchase them commercially. Just remember the herb and spice blends may not satisfy you as much as salt until you adjust to your low-salt intake.
Moving Too Fast: Weaning Out Salt Over Time
Unless your Meniere’s symptoms are severe, you don’t have to just jump off the salt train. Instead, start out with the goal of 2,300 milligrams a day. Do this limitation for a week. Then over the next few weeks, decrease the amount by about 200 milligrams. You’ll reach 1500 mg within a month. Keep a notebook or a kitchen white erase board so you can note everything you eat and drink (this is just like counting calories, and it’s easy to miss some). By far, packaged food, processed food, and snacks are your biggest enemies from a purchasing standpoint. Avoiding the processed foods and snacks will get you closer to your goal faster than you might imagine.
Shopping Options: Buying Food for a Meniere’s Diet
When you are shopping for food for supporting your low-salt Meniere’s diet, there are a few guidelines that help:
- Fresh items may have natural salt, but it’s far less than a prepared food.
- Frozen items have varying salt levels–watch your labels.
- Certain canned goods have plenty of salt like broth, soup, and even vegetables. If there isn’t a low-salt alternative, do not add salt to when cooking.
- Fish goes well with lemon instead of sauce (or 1/2 teaspoon of regular horseradish equaling eight milligrams of sodium).
- Buy vinegar, citrus juice, or hot peppers for extra flavor to dishes like greens.
Spice it Up: Using Spices to Supplement a Low-Salt Food Plan
You don’t have to be a culinary genius to use herbs in smart ways. Making home-cooked meals is the best way of regulating your salt intake with the greatest accuracy. Now, your life may be busy. If that’s the case try to make several meals ahead on your day off and freeze them in individually-sized, labeled packages. Then you can just grab and go!
The general rule in cooking is that fresher is better.
When you have fresh herbs, by all means, use them. If not make sure you store your spice jars in cool, dark areas. Sunlight and heat both deteriorate the flavor of these dried goods. If you look in your cupboard, you’ll find a lot of the spices on this list already there. Now you are just going to use them with greater care: As supplements to your low-salt Meniere’s diet.
- Basil: A favorite herb for Italian recipes like pesto and spaghetti sauce. Also used with fish, various Greek dishes, stew, salad, and soup. Basil is a good source of magnesium. The mineral helps in dealing with dizziness and vertigo.
- Cayenne Pepper: A hot spice that works well on most meats and is tasty when combined with orange, lemon, or lime. Cayenne has vitamin A. It may deter tinnitus and hearing loss.
- Dill: Useful in a variety of fish dishes, stews, and cucumber/tomato salad. Also, cabbage, potatoes, lean beef, and some fish sauces contain iron and calcium. Calcium can strengthen the bones in the inner ear.
- Cilantro: Is citrus-like in terms of flavor. Use it with avocados, salsa blends, and various Mexican dishes. This is a source of fiber and iron. Some studies show that iron deficiency increases the chance of hearing loss by twice as much.
- Coriander: Used with smoked meat, soup, fish, and fowl. Coriander may lower cholesterol while moderating blood sugar. Cholesterol can impact blood flow to your inner ear in a negative way.
- Garlic (fresh, oil, or powder): Used in a marinade, with eggs, soup, salad dressing potatoes, barbecue, bread, and much more. Garlic is an anti-inflammatory perfect for Meniere’s.
- Onion or Chives: Used on meat, in a stew, or mix with salad and vegetable blends, soups, and garnishes. Onion has several vitamins beneficial to Meniere’s patients including Vitamin C, Vitamin B9, and Vitamin A.
- Paprika: Dust it into sauces, soups, and salad. Use it when preparing lean meat, fish, and eggs. Paprika helps with sleep hygiene by promoting a healthy night’s rest. It also seems to have anti-inflammatory properties for regulating inner ear fluid.
- Parsley: A very versatile herb for pasta, fish, chicken, and potatoes just to name a few. Parsley has Vitamin C, A, and K. Vitamin K supports stronger bones, heart health improves brain function and has anti-inflammatory properties.
- Rosemary: Add this to roasted meat and meat sauces. It also makes a nice accent for tomato, mushroom, chicken, veal, pork, bean, and spinach dishes. Rosemary contains calcium and iron and shows potential for improving circulation.
- Sage: You can use sage in savory dishes. It’s a regular feature in sauces, stuffing, biscuits, lean meat dishes, and cheese. Sage acts as an antioxidant which supports a healthy immune system.
- Turmeric: A favorite addition to curry and some stir-fry dishes. It has manganese that targets inflammation and improves healthy blood flow to the ear.
Meniere’s Low-Salt Diet on the Road
There will be instances where it seems impossible to count the milligrams of salt when you are away from home. What about dinner at a friend’s house? Traveling by air or bus? Or, what about just going to restaurants? Don’t worry too much. There are ways of preparing for these occasions.
Restaurants and Low-Salt Dining
If you are planning to head out to a restaurant, place a call first. Ask if they offer low-salt or no-salt dishes. Or, see if the Chef will prepare something suited to your limitations (many will if you ask in advance). Should the answer be yes, communicate what you want and when you’re arriving, so everything goes well.
When you land at a restaurant by happenstance go with fish, grilled chicken (no sauce) or a plain salad with vinaigrette. Don’t hesitate to quiz your server about options that may not seem obvious.
As much as we love fast food, such selections are the worst option. One salad with prepared dressing can use up 2/3 of your salt milligrams for the whole day. Fast-food destinations also use a lot of processed foods, so they’re not a good choice when you have Meniere’s Disease.
Traveling and Choosing Low-Salt Options
When you are going away, it’s likely that you will eat out a lot so you can refer to the information on restaurants already provided. Do your research, call ahead and make your reservations with the places that accommodate your needs.
Food served on airlines, cruises, and some trains make monitoring salt intake a trickier undertaking. Try calling the reservation desk and ask them if they have dietary information available. Some airlines have special meals for dietary restrictions. Cruises have a lot of different fares (some with the chefs present so you can ask in person). Overall, bring some healthy snacks for the road and remember: “Forewarned is forearmed.”
Summing It Up: Salt Control to Manage Meniere’s
If some members of your family or friends do not already know about your Meniere’s now is a great time to educate them before the gathering. Explain your diet and ask if they can make some dishes without salt or using salt alternatives. You will find people feel great about helping.
At a party gathering, it’s different. When you confirm your attendance, let them know about your situation in private. If they can’t accommodate your diet, have a hearty meal before you pack a few snacks for the duration. You can eat tidbits of food for the sake of being polite but watch those choices. One tablespoon of crab dip without a cracker comes in with around 85 milligrams of salt. Three party meatballs come in with a whopping 220 milligrams!
If you know the cook–ask about ingredients. If not, you may find you overdo it and the salt level triggers Meniere’s symptoms. Don’t beat yourself up. Just make sure you are careful for the next several days until your system balances out again.