Ménière's disease and food allergy

Ménière's disease is an autoimmune condition with vertigo, tinnitus and hearing loss caused by an inflammatory attack on the sensorineural structures of hearing and balance in the inner ear. It's surprising how often food and inhalant allergies are overlooked as a contributing cause. A paper just published in Otolaryngologic Clinics of North America reminds us of their importance.

"Ménière's disease (MD), which by definition is idiopathic, has been ascribed to various causes, including inhalant and food allergies. Patients with MD report higher rates of allergy history and positive skin or in vitro tests compared with a control group of patients with other otologic diseases and to the general public."

The authors review immunologic research and clinical trials involving allergy avoidance and immunotherapy and report:

"Recent immunologic studies have shown higher rates of circulating immune complexes, CD4, and other immunologic components in patients with MD compared with normal controls. Published treatment results have shown benefit from immunotherapy and/or dietary restriction for symptoms of MD in patients who present with allergy and MD."

A very interesting paper published in the Journal of Laryngology & Otology delves deep into the matter by evaluating...

"...the role of allergy in the pathogenesis of Ménière’s disease by means of cytokine profiles, allergic parameters and lymphocyte subgroups."

The authors measured lymphocyte subgroups in the peripheral blood, IFN-γ, IL4, total IgE levels, and specific IgE levels pertaining to tree, fungus, fruit, egg-white, cow’s milk, wheat flour, corn flour, beef, and rice allergens, and compared them in the patient and control groups. What did the data show?

"This study found that the prevalence of allergy was higher in patients with Ménière’s disease than in the control group. Thus the authors suggest that allergy should be taken into account when patients with this disease are treated."

Hormonal factors promoting inflammation can exacerbate the symptoms, as discussed by another paper in Otolaryngologic Clinics of North America recognizes how premenstrual hormonal dysregulation can be an exacerbating factor:

"Some women with Meniere disease demonstrate exacerbation of symptoms during the premenstrual period. It is believed that the hormonal stress of the premenstrual period acts on the volatile inner ear with Meniere disease to result in dysfunction. Migraine, Meniere disease, and the premenstrual period may be a complex interaction leading to exacerbation of symptoms."