3

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BPPV prevention

Answered on November 02, 2015
Created November 22, 2010 at 12:01 PM

Hi everyone.

I've just started a primal diet after being semi-primal for a while. I've been reading many of the questions on this site and it's always very informative. I found the primal lifestyle after much research on what I can do myself to improve my health and lose weight.

Ok, so let's get to the problem. In -02 I suffered a severe episode of Benign paroxysmal positional vertigo (BPPV). At the time I was physically exhausted [and mentally I suspect]. This destroyed my life in many ways since no-one could give me a proper diagnosis until -06. In -06 I got my second episode and found a doctor who could treat me with the Epley maneuver.

I haven't had any problems since then, but I'm constantly terrified that it will return. During the years I've developed severe panic-attacks and anxiety due to the fact that I can at any moment lose control. I feel very debilitated because of this.

Now, my questions are:
- Does anyone know if one can prevent the vertigo from happening?
- Is there anything I shouldn't be eating or doing?
- Is dairy an issue?
- Do I need to make sure to get any specific vitamins or minerals?
- Before I got the first ep. I did gain quite a lot of weight (over the course of about a year), could that have been the cause?
- Has anyone else suffered from this and improved on the paleo/primal diet?

I ask all these things because even though the doctor could diagnose me, he couldn't say what caused it or how to prevent it. My hope is that someone perhaps have heard something or have some ideas. Any thoughts that might be helpful are welcome.

Thanks.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 24, 2010
at 03:48 PM

Yes, the Semont seems easier to do. If I get a new ep. it's worth trying. The Epley is a bit tricky and is difficult to do yourself, at least for me. I've recently saw some hat, the Dizzyfix; it looks kinda funny but will make the Epley easier to do.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 24, 2010
at 03:42 PM

Dave S. - Yes, exactly. No-one seems to know, none that I've heard of anyway. Perhaps diet could have a role... there are so many things that interact. In either which way; I think it's an excellent idea to keep track of the nutrient intake to make sure everything is in balance.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 24, 2010
at 03:37 PM

That sounds reassuring. I've had them for years now and pretty much have to deal with them to the best of my abilities. I'm excited about what this change in lifestyle will mean for me.

61b801de5dc345b557cd4623d4a4f26b

(2682)

on November 24, 2010
at 02:11 PM

I just glanced at the Epley maneuver instructions I found on a website. The Epley maneuver seems much more precise than the Semont. All I do with the Semont is sit up, lie to the right for 30 seconds (or until the room stops spinning), sit back up for 30 seconds, lie to the left for 30 seconds...and repeat for about 20 minutes. No angles or exact positions. The lack of exactness may be why Michael's sources prefer the Epley Maneuver...but I'll stick with Semont as it works for me and seems simpler. 8)

61b801de5dc345b557cd4623d4a4f26b

(2682)

on November 24, 2010
at 02:05 PM

Great answer; thanks for all the details!

A968087cc1dd66d480749c02e4619ef4

(20436)

on November 24, 2010
at 12:21 PM

Part of what's great about paleo is getting various hormones back in balance. This should help with your anxiety/panic attacks. I have the same problems now that I had pre-paleo (work/money/family) - but they don't stress me out nearly as much - and I very rarly get 'down' anymore. I think it tends to smooth out mood and energy levels - but this can take a while - several months for me.

A968087cc1dd66d480749c02e4619ef4

(20436)

on November 24, 2010
at 12:16 PM

Thanks for the detailed explanation. An interesting question is why they become dislodged in some people but not others. And whether diet has any role in that process.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 24, 2010
at 11:40 AM

Thank you for explaining it so well! I wonder what cause them to dislodge; I haven't had any head trauma and I'm in my late 20's so it's not due to age. I guess it's one of those things that you simply have to accept and deal with, although it's hard.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 23, 2010
at 11:23 PM

I will check that one out too. I wonder what the difference is. I always felt like being on a high speed carousel during an ep. It's horrible.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 23, 2010
at 02:17 PM

Thanks. :) Until it was mentioned here I didn't think about calcium deposition. I will def. monitor my vitamin/mineral intake for a while to make sure. Doing the Epley every now and then makes sense. Good idea!

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 22, 2010
at 05:55 PM

Thanks a bunch for the links! Before I got the first ep. I had a very poor diet regime, ate very little meat, eggs and fat. I even had serious anemia for a while. It makes sense that it could've played a part. It's not until now that I'm eating real food and getting enough nutrients. I really appreciate your input! :)

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10 Answers

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3
A968087cc1dd66d480749c02e4619ef4

(20436)

on November 22, 2010
at 01:51 PM

Since I never heard of this until now, I looked it up and found these links:

http://www.tchain.com/otoneurology/disorders/bppv/bppv.html

http://en.wikipedia.org/wiki/Benign_paroxysmal_positional_vertigo

Apparently the problem is a debris of calcium crystals that build up in the inner ear that cause the vertigo. The Epley manuever is pretty successful at loosening them and getting them to clear out.

If the ear isn't properly clearing out particles, then it is possible you could see improvements in that from a good paleo regime. My understading is that the ear wax and tiny hairs in the canal need to be working properly for this function.

Another idea is that maybe too much calcium is getting deposited there. I would look at your Vitamin D levels (it regulates calcium blood levels) and other calcium absorption co-factors (Vitamins K, A, E, magnesium and saturated fat, iirc) and make sure you have these in good amounts. They are synergistic, so you don't want too much of one/not enough of another. I don't think dairy really affects calcium levels one way or another, but I could be mistaken on that. Here is a link on calcium absorption:

http://www.paleodiet.com/losspts.txt (not sure I agree with all the points, but it is interesting)

You may want to avoid sticking things in you ear (like Q-tips) which tend to damage the whole ear wax clearing out process.

A968087cc1dd66d480749c02e4619ef4

(20436)

on November 24, 2010
at 12:21 PM

Part of what's great about paleo is getting various hormones back in balance. This should help with your anxiety/panic attacks. I have the same problems now that I had pre-paleo (work/money/family) - but they don't stress me out nearly as much - and I very rarly get 'down' anymore. I think it tends to smooth out mood and energy levels - but this can take a while - several months for me.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 24, 2010
at 03:37 PM

That sounds reassuring. I've had them for years now and pretty much have to deal with them to the best of my abilities. I'm excited about what this change in lifestyle will mean for me.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 22, 2010
at 05:55 PM

Thanks a bunch for the links! Before I got the first ep. I had a very poor diet regime, ate very little meat, eggs and fat. I even had serious anemia for a while. It makes sense that it could've played a part. It's not until now that I'm eating real food and getting enough nutrients. I really appreciate your input! :)

best answer

3
A3fbe6c99607a88d498e3950f78a7108

on November 24, 2010
at 07:10 AM

Leia,

Please bear with me on the lengthy answer. People are making guesses without having an understanding of BPPV and the anatomy of the vestibular system so you're not receiving good advice.

The calcium carbonate crystals that end up in the semicircular canal and cause your symptoms of vertigo are part of the vestibular system (your balance sensors) in your inner ear. When they're in the place they're supposed to be they're called otoliths (also called otoconia). Their home is inside a vestibular organ called the utricle. Unfortunately they can become dislodged and get lost inside canals in your inner ear that detect head movement. These "lost" otoliths inside the canals are now called canaliths. The canals are filled with fluid and when the fluid moves, signals are sent to your brain so that you can process your head position in relation to gravity. If canaliths are floating around in your canals or sticking to "sensors" in the canal they can cause abnormal signals to be sent to the brain and you get the sensation of spinning.

It's important that you understand the mechanism behind BPPV because it will make it easier for you to treat yourself if the vertigo returns. As you probably know, the fact that you've had it before means you're more likely to get it again.

The Epley maneuver (known as the canalith repositioning procedure) uses gravity to float the canaliths through the canal and deposit them back home where they belong. That's why the technique involves moving your head through different positions and staying in that position for 30 seconds. The idea is that the canaliths float down the U-shaped canal. Each positional change moves the canaliths further down the canal until they get dropped back home. You can do this maneuver yourself if the BPPV returns. I recommend sticking with Epley/CRP over the Liberatory/Semont maneuver. A review in the journal Physical Therapy found the most effective treatment to be Epley/CRP combined with self-administered Epley/CRP.

The American Academy of Neurology has an excellent collection of videos associated with their practice parameter for BPPV therapies. They also recommend the Epley/CRP as a more effective treatment. The Epley/CRP is demonstrated here:

http://www.neurology.org/content/suppl/2008/06/09/70.22.2067.DC2/Video_4.wmv

Practice parameter: http://www.neurology.org/content/70/22/2067.full

You can do this on your own but make sure to have a pillow positioned under your upper back when you lay down. Due to the orientation of the canals it's important that your head is positioned in slight extension when you lay back.

So now to your original question. Hopefully you can see how the calcium carbonate crystals are merely "misplaced" from another part of your inner ear. They're not due to a buildup of dietary calcium or other dietary deficiencies. Therefore, there is no reason to assume that dietary mineral changes from following a paleo diet would affect BPPV.

A968087cc1dd66d480749c02e4619ef4

(20436)

on November 24, 2010
at 12:16 PM

Thanks for the detailed explanation. An interesting question is why they become dislodged in some people but not others. And whether diet has any role in that process.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 24, 2010
at 03:42 PM

Dave S. - Yes, exactly. No-one seems to know, none that I've heard of anyway. Perhaps diet could have a role... there are so many things that interact. In either which way; I think it's an excellent idea to keep track of the nutrient intake to make sure everything is in balance.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 24, 2010
at 11:40 AM

Thank you for explaining it so well! I wonder what cause them to dislodge; I haven't had any head trauma and I'm in my late 20's so it's not due to age. I guess it's one of those things that you simply have to accept and deal with, although it's hard.

61b801de5dc345b557cd4623d4a4f26b

(2682)

on November 24, 2010
at 02:05 PM

Great answer; thanks for all the details!

1
61b801de5dc345b557cd4623d4a4f26b

(2682)

on November 23, 2010
at 10:05 PM

I had this problem when I was around 14 years old. I compared the sensation to being on a roller coaster even though I would be standing (or sitting or lying) still. I would have this experience multiple times a day and made sure if I was moving my head at all that there was something nearby I could grasp or lean on.

I have always assumed the cause was related to my sinuses and my other ear issues because I had to have tubes in my ears several times as a young child. I never considered diet or other factors as a cause; however, I was at summer camp, so I'm sure my diet was horrible and my amount of sleep less than optimal, not to mention the normal stresses of being a teenager.

The doctor who diagnosed me had me use the Semont maneuver twice a day for 20 minutes until the symptoms went away. They were gone in less than a week. He did not recommend any dietary changes or other treatments besides the Semont maneuver.

A few times a year I feel a bit of that roller coaster sensation when I move my head around; luckily, the sensation immediately disappears after just one or two sessions of the Semont maneuver.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 24, 2010
at 03:48 PM

Yes, the Semont seems easier to do. If I get a new ep. it's worth trying. The Epley is a bit tricky and is difficult to do yourself, at least for me. I've recently saw some hat, the Dizzyfix; it looks kinda funny but will make the Epley easier to do.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 23, 2010
at 11:23 PM

I will check that one out too. I wonder what the difference is. I always felt like being on a high speed carousel during an ep. It's horrible.

61b801de5dc345b557cd4623d4a4f26b

(2682)

on November 24, 2010
at 02:11 PM

I just glanced at the Epley maneuver instructions I found on a website. The Epley maneuver seems much more precise than the Semont. All I do with the Semont is sit up, lie to the right for 30 seconds (or until the room stops spinning), sit back up for 30 seconds, lie to the left for 30 seconds...and repeat for about 20 minutes. No angles or exact positions. The lack of exactness may be why Michael's sources prefer the Epley Maneuver...but I'll stick with Semont as it works for me and seems simpler. 8)

1
62ed65f3596aa2f62fa1d58a0c09f8c3

(20807)

on November 23, 2010
at 06:04 AM

I would look into nutrients that help control proper calcium deposition. Magnesium and K2 come immediately to mind. Check your daily intake of those and make sure you are plush on a regular basis. Sounds like repeating the Epley manuever from time to time, even if no vertigo symptoms, might also be in your best interest. That will help flush out calcium crystals regularly before they have time to build up in your ear. And since the process is safe and harmless and easy, if there are no calcium crystals, it won't hurt you at all anyway.

2c0ea0fbcc8c143a03ae4c3aa5b20ba2

(30)

on November 23, 2010
at 02:17 PM

Thanks. :) Until it was mentioned here I didn't think about calcium deposition. I will def. monitor my vitamin/mineral intake for a while to make sure. Doing the Epley every now and then makes sense. Good idea!

0
08b7f1977feef22a012670667cdd3528

on November 02, 2015
at 12:33 AM

manganese deficiency.  Eat whole grains.

0
B20b38d6257fe036ff0b8ff0021b0e31

on September 06, 2013
at 12:37 PM

I've recently been suffering with severe panic attacks after experiencing dizziness, with the room feeling like it's spinning, it is the most frightening feeling I have ever endured. Which causes me to feel extremely anxious because of me feeling constantly on edge, dreading the next one to occur as they come and go at random times. The panic attacks I have recently been able to control a little better as it was getting me into an unhealthy state, I also had thoughts I was going mental which wasn't at all the best of things to assume. I've only just turnt 18 so me going back to college is a big nail biter, with these seconds of dizziness creeping up on me at random times. Breathing exercises help with the panic, but due to me just assuming it's BPPV because a doctor assumed so, it's extremely scary that I may not have that and it's something else, however after reading this, I am convinced it is BPPV. I am due to see another doctor in the next few days for a more solid response to these frightening experiences I have been having. I also have tingling and numbness in my arms and legs which make things even scarier, so when the room does feel like its spinning, holding on to a wall or something stable makes it feel dreamy, but according to a few doctors, that is the bodies response to the foreign feeling I'm not used to and a physical response to panic. I doubt I've been any help but the frustration of me feeling like I was the only one experiencing these wild events made me want to find companionship online, so I thought I'd give you an insight on my personal experiences.

0
0e9bd862928a7b629ab40f7b18a61995

on August 23, 2013
at 09:51 PM

I have this now and have bad panic attacks. I've only had the spinning vertigo 3 times but after I have this residual dizzyness for weeks. My husband finally found a study that shows that vitamin d deficiency could be the cause.

0
A1a7208c2d6110fae14c3b6ee50a0c12

on September 11, 2011
at 05:45 PM

I think I may have this. It's been suggested by a neurologist I see but I've never really gotten a straight answer or any real help. I am frustrated beyond beleif. I've been diagnosed with anxiety/depression even though I would never consider myself the least bit depressed. I do not know why I am dizzy all the time but for a long time I thought I was losing my mind, which really fed into the anxeity. I wish it would just go away Its been about a year now...

0
7431586c21bca496c5a7ec7bd0ca4d6e

(974)

on November 24, 2010
at 04:16 AM

Consider supplementing with vitamin K2, under the theory that it prevents soft tissue calcification.

Consider dropping dairy as a test to see if your symptoms alleviate.

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