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Ménière’s Disease Low Sodium Diet

How To Keep Track Of Sodium Intake

Strategies, Tips, and Tricks for Adopting a Low-Sodium Diet

So when switching to a low-sodium diet, its important to keep track of what you eat, at least for the first while.

Its also important to spread out your sodium consumption as evenly as possible over the course of a single day. Often, one sodium-heavy meal is enough to trigger my symptoms, even if Ive kept my overall consumption under my daily limit.

Often, one sodium-heavy meal is enough to trigger my symptoms, even if Ive kept my overall consumption under my daily limit.

The important variable here is sodium concentration in the body. By spreading out your sodium intake, you can avoid major spikes in sodium concentration at any one time and reduce the overall impact on your symptoms.

My Experience With A Low Sodium Diet

Im going to throw out a disclaimer: I dont currently follow a true low sodium diet but I DO follow a clean eating diet mostly without processed foods. Going on a true low sodium diet didnt work for me so I now keep my sodium levels within the normal range recommendations by the CDC.

Ive learned through my experience chatting with others on web forums and through my own series of doctors, that EVERY doctor recommends a blanket statement of treatments for Menieres. Eliminate alcohol and caffeine, take a diuretic drug and adopt a low sodium diet. Im not one for one-size-fits-all recommendations though there are some people who are helped by all of these directives. I, however, was not one of them and lately, Ive been exposed to more and more individuals whos experience with diuretics and going low sodium is similar to mine.

My first couple of ENTs had recommended a low sodium diet of at least under 2000 mg and ideally under 1500 mg per day. Ive heard of others recommended even lower amounts of under 1000 mg per day. The only real benefit to Menieres patients is the slight decrease in blood pressure which IS supported by research studies.

Why Low Sodium Is Recommended For Menieres Disease

A low sodium diet is traditionally recommended for those of us living with Menieres Disease because it does have the ability to lower blood pressure. This change isnt always significant but the little bit of pressure change can help decrease the amount of pressure inside the ear which is thought to aggravate symptoms for those who are sensitive to sodium.

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Goals Of The Menieres Disease Diet

The goals of the Menieres disease diet are focused on reducing the frequency and severity of the episodic symptoms the disease causes. Menieres disease is closely related to and dependent upon the bodys blood system and fluid balances.

Certain dietary changes may help with managing the disease effectively. The first goal of Menieres disease diet is to get rid of substances that cause and stimulate water retention in the body. The retention of water makes the symptoms worse because excess fluid can continue to build up in the ear.

Another goal of this diet is to decrease overall volumes of fluid in the body through the consumption of natural diuretics. An overall reduction in body fluids can help reduce the fluid buildup in the inner ear.

Additionally, eliminating substances that cause the constriction of regular blood flow and limiting the use of dietary substances are more areas the Menieres disease diet places emphasis on.

Meniere’s Disease Symptoms And Diagnosis


Most cases of Meniere’s disease arent traceable to a specific cause. It may result from an ear injury or surgery, autoimmune problems, a viral infection, or an inherited condition.

People who have Meniere’s disease report symptoms such as:

  • Vertigo: the illusion that youre moving, or that the room is spinning, when youre standing still. This vertigo is typically severe, causes nausea and vomiting, and can last from 20 minutes to 24 hours.
  • Changes in hearing
  • Ringing in one ear
  • A feeling of pressure in one or both ears

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Caffeine And Alcohol Consumption

Caffeine is a balanced unbound plant alkaloid found in the diet as a component of coffee, cocoa, tea, and foods. Methylxanthine is the most common organic compound found in caffeine. Decreasing caffeine consumption can cause effects that can result in symptoms ranging from headaches to mental disorders). Increased caffeine consumption is believed to play a role in MD. As is known, caffeine increases vasoconstriction and decreased blood flow. In this way, impaired autoregulation of blood flow in

Ii Dietary Restriction For The Treatment Of Menieres Disease

There is no consensus about the first line medical treatment of Menieres disease to produce symptomatic improvement and slow the disease progress. Dietary restrictions is among the first line treatment that has been proposed for long. They include low salt diet, abundant water intake, moderate alcohol and caffeine consumption, gluten-free diet, intake of specially processed cereals .

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Description Of Menieres Disease

Menieres disease is an inner ear disorder known to cause vertigo, a type of dizziness that makes an individual feel like they are spinning. This disease can also cause intermittent hearing loss, sensations of pressure in the ear, and ringing in the ear.

In most cases, only one ear is affected by Menieres disease. The part of the inner ear containing structures that manage an individuals hearing and balance is called the labyrinth, and the buildup of fluid in this region is usually what causes symptoms of Menieres disease.

The fluid buildup causes interference with the transmission and receiving of brain signals that result in hearing issues and vertigo.

This disease comes in the form of episodes that can last anywhere from twenty minutes to twenty-four hours. When the disease progresses, symptoms will become more constant instead of episodic.

Menieres disease is diagnosed using an electronystagmogram to analyze an individuals balance, as well as the use of an electrocochleography or a test that measures the pressure of the fluid in the ear.

Salt Intake: How Do You Compare

How do I keep a low salt/low sodium diet if I have heart failure?

The average person consumes about 6 to 18 grams of salt daily. Thats roughly one to three teaspoonfuls. Your body actually needs only about 2300 mgms. of salt a day and if you suffer from Menieres disease, or other health conditions, too much salt may cause problems for you.

Reducing the amount of sodium you consume may help you reduce or avoid high blood pressure. High blood pressure, is more likely to lead to heart disease and stroke. Cardiovascular disease is the No. 1 cause of death in the United States. High blood pressure may also be linked to some of your symptoms.

The American Heart Association recommendations healthy American adults should reduce their sodium intake to no more than 2300 mgs per day. This is about 1-1/4 teaspoons of sodium chloride . Many foods in their natural state contain sodium, but most sodium in our diet is added to food while its being commercially processed or prepared at home.

Thats why you need to be aware of both natural and added sodium content when you choose foods to lower your sodium intake. When buying prepared and pre-packaged foods, read the labels.

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Salt Substitutions For The Menieres Diet

Youll 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, whats 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 Menieres patients. Its a decision you should discuss with a dietitian or nutritionist familiar with Menieres 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 Braggs 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 . Potassium may offer the additional benefit of helping reduce your blood pressure .

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.

Tips For A Low Sodium Diet

A low sodium diet is very important when it comes to managing Secondary Endolymphatic Hydrops, Menieres Disease, Vestibular Migraine, and some other vestibular diagnoses. Additionally, it is good for your heart, brain, and blood pressure!

The average American eats about 3,400 milligrams of sodium a day, thats almost 50% more than what we should be consuming on a daily basis, 2300 milligrams . Every person needs some sodium in order to carry out normal daily function, so no ones diet should be completely eliminated of sodium. We should, however, try to stick to the 2300 milligrams/day, or slightly less, depending on your needs. Sodium reduction needs are completely person dependent, and beginning a new diet should always start with a conversation with your healthcare team. Discuss how much sodium you should aim for with your dietician, physician, or physical therapist.

Although sodium and salt are frequently identified as the same thing, sodium is actually a big umbrella term for many ingredients that contain sodium, not just salt. Sodium can be found in foods like salt and soy sauce, which taste salty, or baked goods, which do not. Because its hidden in so many food items, its important to remember that we read labels to find out what may be in your foods!

Making the switch to a low sodium diet can be difficult & seem intimidating, but there are a few tips and tricks that help many of my patients stick to the new routine!

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Low Sodium Diet Do Not Add Salt To Food Or Cooking

  • What to use instead:
  • Ground pepper or dry mustard powder
  • Lemon juice, lime juice, vinegar
  • Chopped fresh herbs basil, oregano, mint, parsley, rosemary, thyme, chives, sage, tarragon
  • Garlic, curry, chilli, onion, fresh ginger, spring onions
  • Add red wine to cooking
  • Spices cinnamon, nutmeg, cardamom, ginger, cumin
  • Also try slowly cutting down your salt intake over a few months to allow your taste to adjust
  • Tips For Eating Less Salt

    Eating Well with Menieres Disease
    • Dont add salt to food when youre cooking. Season foods with flavorings such as lemon, pepper, garlic, onion, and dried herbs instead.

    • Take the saltshaker off the table. Replace it with salt-free herb mixes, spices, and salt substitutes.

    • Get a cookbook of low-salt recipes. It can give you ideas for healthy and great-tasting meals.

    • Choose low-salt snacks such as no-salt pretzels or crackers, air-popped popcorn, or low-fat frozen yogurt.

    • Don’t use condiments high in sodium. These include mustard, relish, ketchup, soy sauce, and Worcestershire sauce.

    • When you eat out, ask that your food be cooked without added salt. Watch out for fast foods. These are often heavily salted.

    • Read labels before buying any food that isnt fresh. Check the label for the milligrams of sodium in each serving. Watch out for high-sodium ingredients such as baking soda and saccharin.

    • Don’t eat foods that are pickled, smoked, or packed in brine or broth.

    • If you buy antacid tablets, choose a sodium-free brand.

    • Certain toothpastes, mouthwashes, and medicines may have salt added. Ask your pharmacist to recommend low-salt substitutes.

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    Final Thoughts On Meniere’s And Salt

    In the early days of my Menieres diagnosis, salt was one of my biggest triggers. Yet it still took a while for me to get serious with the diet.

    It was hard at first and I really struggled for a few weeks. I didnt have much guidance and I was making a lot of other difficult lifestyle changes at the same time. But my symptoms continued to improve, and that was all the motivation I needed to keep going.

    After a month or two, it just became a part of my life. My taste buds adapted, my preferences changed, and in the end, it was worth the initial struggle.

    Its important to remember that a low-sodium diet is by no means the end all be all of managing a chronic condition like tinnitus or Menieres disease. I do a lot on an ongoing basis to keep my symptoms in check.

    But if sodium makes your symptoms worse, I encourage you to give the diet and these suggestions a try. Even if it only raises your quality of life slightly, every little bit counts.

    How Does Menieres Disease Affect Daily Life

    Each person who has Menieres 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 Menieres 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 individuals episodes, any medication they use, and how others can help them when a Menieres episode occurs. This takes time, but the result is something to which everyone can refer for help and insights.

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    History Of The Hydrops Diet:

    An early version of the hydrops diet was proposed by Furstenberg . He suggested that protein and calories need not be restricted, but that salt should be “low”. Dr. Furstenberg provided an elaborate list of foods to be taken daily or avoided. He did not restrict caffeine at all, and did not mention sugar, alcohol, or nicotine. Dr. Furstenberg advocated use of “acid producing salts” such as Ammonium chloride. Thus it can be seen that the Furstenberg diet is not synonymous with the “hydrops” diet, and in fact, does not even set the amount of sodium.

    How does what I eat affect my dizziness?

    Your inner ear fluid is influenced by certain substances in your blood and other body fluids. For instance, when you eat foods that are high in salt or sugar, your blood level concentration of salt or sugar increases, and this, in turn, will affect the concentration of substances in your inner ear.

    People with certain balance disorders must control the amount of salt and sugar that is added to food. You must also become aware of the hidden salts and sugars that foods contain. Limiting or eliminating your use of caffeine and alcohol will also help to reduce symptoms of dizziness and ringing in the ears.

    Inner Ear Fluid Balance

    Meniere’s Disease

    The fluid-filled hearing and balance structures of the inner ear normally function independently of the bodys overall fluid/blood system. The fluid that bathes the sensory cells of the inner ear maintains a constant volume and contains specific and stable concentrations of sodium, potassium, chloride, and other electrolytes. With injury or disease, the volume and composition of endolymph may fluctuate with changes in the bodys fluid/blood.

    This fluctuation is thought to cause the symptoms of endolymphatic hydrops or Ménières disease: pressure or fullness in the ears, tinnitus , hearing loss, dizziness, and imbalance. Thus, for people with Ménières disease or secondary endolymphatic hydrops, maintaining fluid/blood stability is important.

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    Food And Drink To Consume

    The best food and drink to consume for an individual with Menieres disease are those with limited simple sugars and low sodium. Foods with complex sugars instead of simple sugars that are better to consume are raw nuts, fresh beans, lentils, whole grains, sweet potatoes, and brown rice.

    Food and drink known to be natural diuretics are great to help reduce fluid retention in the body. Natural diuretics include fresh asparagus, ginger, beets, fresh watermelon, fresh lemons, nettle leaves, cucumbers, fresh mint leaves, fresh peaches, fresh pineapple, and cilantro leaves.

    When an individual eats food they should be consuming an equal amount of water or other caffeine-free fluids. Having an equal distribution of food and fluids helps manage levels of inner ear fluid.

    In addition, dark leafy greens like kale, spinach, cabbage, collard greens, broccoli, plantain, arugula, chard, and turnip greens should be readily consumed for symptom reduction.

    Fresh meat without additives is also okay to consume, however, individuals with Menieres disease should be diligent not to eat any processed meats.

    C Alcohol And Caffeine Consumption

    Regarding alcohol, many clinicians recommend to avoid or reduce its consumption. A recent work by Sanchez-Sellero et al evaluated the possibility that alcohol consumption delays the age at onset of Menières disease the authors explained this by the inhibitory effect of alcohol on hypothalamic production of vasopressin: a lower release of this neurormone increases diuresis while decreasing endolymphatic pressure.

    However, actually the literature doesnt offer review to evaluate if alcohol consumption is more prevalent or more intense in patients with MD.

    Another substance highly considered in the preventive treatment of MD is caffeine, an alkaloid present in many foods and as an additive in cola-type drinks and energy drinks.

    Pharmacological effect of caffein might include antagonistic effects on adenosine receptors, renal effects as diuresis and natriuresis, activation of renin-angiotensin-aldosterone system, release of corticosteroids by adrenal cortes and catecholamines drama adrenal medulla .

    Also Sanchez-Sellero observed that caffeine should be considered as a precipitating factor for the onset of symptoms in people predisposed to developing Menières disease. The authors suggested that it should be recommended to reduce caffeine intake in those population groups with higher risk of Menières disease.

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