Vertigo is a feeling of spinning even though you are on solid ground. Sometimes the sensation is strong enough to cause nausea and loss of balance. It’s different from dizziness, which is more like feeling you’re going to faint. Vertigo may last for a few minutes, or hours, or even days. The first consideration with vertigo is dehydration, although, ironically, vertigo can also be caused by fluid retention in the inner ear. Make sure you have been drinking adequate amounts of fluids, preferably water, especially if you’re working out or in a warm climate. Vertigo is a side-effect of some prescription drugs, notably steroids. If symptoms such as headaches, slurred speech, double vision or weakness in an arm or leg are also present, this is more serious and could mean multiple sclerosis, a mini-stroke or a brain tumor and you should see a neurologist (nerve doctor).

Isolated vertigo, however, if not fixed by drinking more water, or checking your medications, is most likely an inner ear problem. A common inner ear problem is a “flu” in the semicircular canals: two tiny curved tubes at right angles to each other covered with hair-like projections that ultimately connect to the brain, via vestibulocochlear nerve, one of the twelve major nerves in the head. A build-up of fluid, or lymph, in the inner ear can disturb these sensitive nerves, and create a sensation of vertigo. Feeling balanced, in other words not having vertigo, depends on fully functioning in two out of three areas: vision, hearing and your sense of where you are in space (“proprioception”). Check it out. Try standing on one leg with your eyes closed a lot harder than with eyes open! The point is, when hearing is disturbed by an inner ear virus, or other infection or even tumor, vertigo is often a resulting symptom.

Vertigo has been associated with both high cholesterol and high blood sugar (diabetes). If you have been experiencing vertigo and haven’t evaluated your fasting cholesterol or glucose levels recently, now is the time. A report from Prevention Magazine claims that over 80% of people with vertigo had either high blood fats or sugars, and that their vertigo improved dramatically with dietary measures to correct these lab values. The proper treatment of vertigo depends on its cause. However, if you know for sure it’s not a serious neurological problem, and it has persisted longer than the normal course of a virus, here are some general suggestions from my medical practice that have been consistently helpful to most patients with vertigo. Often, a combination of these suggestions is necessary to achieve consistent relief from vertigo. (Read the section Dental Fillings below for more information on another chemical cause of vertigo.)

Gingko biloba is one of the most widely researched herbs worldwide. It is well known for increasing blood flow to the head and brain. For example, it can be very helpful in preventing or reversing tinnitus, macular degeneration, loss of taste or smell, or, in particular, short term memory loss. I sometimes tell my patients that I passed all my board exams on gingko! It gives me a photographic memory within about 3 days. Make sure you are getting a high quality gingko, that claims to contain 24% ginkgo heterosides, or gingkolisides. Start with 250 mg daily until the vertigo seems significantly diminished in severity and frequency, then reduce to a maintenance dose of 40-60 mg daily.

DHEA is the most abundant hormone in the body, for both men and women, and can convert into any of the sex hormones. Being low on DHEA, which has been called the “fountain of youth,” can produce many symptoms of malaise, such as fatigue, restless sleep, poor endurance and “spaceyness”. All of these together may conspire to create a sense of vertigo. Although I have not seen formal studies linking low DHEA with vertigo, I know from clinical experience that patients with vertigo and low DHEA invariably improve with DHEA supplementation. For women 25 mg daily should be sufficient. For men, up to 50 mg daily is recommended. I prefer to evaluate DHEA need (through blood or saliva testing) before prescribing this important and potent hormone. However, people don’t need to be clinically deficient, just low, to benefit.

There are many homeopathic remedies that address vertigo. In fact, in Kent’s Repertory (the homeopathic “bible”) there is a whole section on “Vertigo,” after the “Mind” section. An incomplete list of remedies includes Apis, Baptisa, Belladonna, Bryonia, Cannabis, Cocculus, Digitalis, Gelsemium, Lycopodium, Phosphorus, Silica, Rhus-tox. A German homeopathic company named BHI makes a popular product called Vertigo-HEEL.

Valerian in capsule or tincture form, can be helpful to some folks with vertigo. Some conventional docs use low-dose Valium, which works, but is problematic because of its addictive potential. However Valium doesn’t have the awful drying side-effects of the most popular vertigo drug, Antivert. Valerian is anti-spasmodic and a pain reliever, so would be especially helpful where these other symptoms are also present. I prefer the tincture form, and recommend _ teaspoon once or twice daily. Do not use with other barbiturates (downers).

Not infrequently, vertigo is caused by debris in the inner ears, called “otoliths” (or ear rocks) from head injury, infection or degeneration (usually from aging). Some physical therapists and doctors are trained to perform the “Halpike Test”, in which the patient is in a swivel chair, and rapidly repositioned in various directions. The therapist watches for eye changes (nystagmus) and can diagnose “Benign Paroxysmal Positional Vertigo” (BPPV). A further modification of these moves by a Dr. John Epley (based in Portland, OR) aims to “reposition” the ear rocks, and thus restore equilibrium to the patient.

In Traditional Chinese Medicine, vertigo is thought to be caused by “wind” which gets into the head through the ears and causes “phlegm” to accumulate. Protect you ears against wind, and avoid using a hairdryer directly over the ears. Foods that contribute to “phlegm” and should be avoided, include greasy, fatty foods, highly processed foods, sugary foods, eggs, animal fats including cream, poor-quality fats including margarine, and all intoxicants. Foods to help reduce the ill effect of “wind” include celery, basil, pine nuts, coconuts, flax oil and chamomile tea.

Dental Fillings

Several of my patients with vertigo have had high levels of mercury in urine or hair analyses. The most frequent source of toxic mercury in our bodies is dental amalgams, which contain multiple metals, predominantly silver and mercury.

I rarely urge people to jump into getting all their fillings removed, because the removal process often exposes you to toxic outgassing of the metals. However, if you can work with a healthcare provider who is skilled in detox, and can prepare you for chelating the mercury as it comes out of your body, replacing “silver” fillings with gold or bio-compatible composite may be the only solution to your vertigo.

Selected References

• Hindmarch I, Subban Z. The psychopharmacological effects of Ginkgo Biloba Extract in normal heathy volunteers. International Journal of Clinical Pharmacological Research 4; pp 89-93, 1984
• Gebner B et al. Study of the long-term action of a Ginkgo Biloba Extract on vigilance and mental performance as determined by means of quantitative pharmaco-EEG and psychometric measurements. Arzneim-Forsch 35; pp 1459-1465, 1985
• Pitchford P. Healing with Whole Foods. North Atlantic Books, 1993; pp 286-288
• The staff of Prevention Magazine. The Encyclopedia of Common Diseases pp 508-509. Charles Gerras, Executive Ed. Rodale Press, 1977
• Epley J. “Particle Repositioning for Benign Paroxysmal Positional Vertigo”, update on Otology and Neurotology, Part 1, Otolaryngologic Clinics of North America, Vol 29, No. 2, April 199