6 Ways to Help You Manage Meniere’s Disease Attacks

Meniere’s disease is caused by fluid buildup in the inner ear, which controls hearing and balance. People with Meniere’s disease have sudden, unpredictable attacks of dizziness (vertigo), nausea, and headaches. They may also experience intermittent hearing loss and ringing in the ears (tinnitus). These attacks can last for hours, making it difficult — or even impossible —- for people to do everyday activities. Since attacks can start without warning, it’s easy to be caught off guard. 

Here are 6 helpful methods you can use to manage Meniere's attacks. 

1. Avoid things that can trigger attacks

Certain actions or events can trigger Meniere’s attacks or make attacks last longer. These triggers can be different for different people, but the most common are:

• High-exertion activities or sudden head movement, including tilting your head back

• Bright lights or flashes of light

• Strong smells, like smoke or cleaning products

• Exposure to allergies, like pollen and dander

• Weather changes, like barometric pressure and humidity

• Foods containing tyramine, like smoked meats, beer, and pickles

• Smoking

• Stress

• Travel

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Avoid these triggers when possible. During your next attack, see if anything specific makes your symptoms worse. You can also time your attacks to see if they last longer when you’re doing certain activities. This will help you identify your triggers so you can avoid them in the future. 

2. Keep your emergency medications with you

Many people take medication daily to help fluid from building up in the inner ear. But people also need medication to get through attacks. These are called emergency medications. Some people need two or more emergency medications during attacks. Some common ones include:

• Clonazepam (Klonopin)

• Diazepam (Valium)

• Promethazine (Phenergan)

• Zofran (ondansetron)

Attacks are unpredictable, so it’s important to be prepared. Have your medication with you at all times — especially if you’re out of the house. If possible, keep an emergency kit in your car, office, or any other location where you spend a lot of time. 

Friends and family naturally want to help when you’re having an attack, but make sure they don’t accidentally give you medication that can make your attack worse. Let your friends and family know that the following medicines can actually worsen your symptoms:

• Aspirin

• Antacids, like calcium carbonate

• Ibuprofen (Advil, Motrin)

• Naproxen (Aleve, Naprosyn)

• Caffeine-containing medications, like Excedrin

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3. Limit salt, alcohol, and caffeine intake

Data shows that certain foods and substances can worsen attacks by increasing fluid buildup in the inner ear. Try to follow these rules of thumb:

• Eat only 1 to 2 grams of salt per day.

• Avoid caffeinated and alcoholic drinks if possible.

Nicotine and monosodium glutamate (MSG) can also increase fluid buildup, so avoid them when possible. 

4. Don’t overlook your physical safety

A Meniere’s attack can come with a risk of physical injury. You can lose your balance and fall or have an accident while driving during an attack. When your symptoms start, find a safe place where you can sit or lie down. It can be helpful to have a place picked out in or near the places where you spend a lot of time, like at the gym, at work, or at school. 

If you’re driving, make sure you pull over at the first sign of an attack, so you don’t get into an accident. 

Changes in barometric pressure can also trigger attacks. Before going out, check the weather forecast and keep a weather or barometer app on your phone. If you see a storm or rain alert, consider changing your plans — and definitely don’t get behind the wheel. 

5. Learn how to recognize your aura

Many people with Meniere’s disease have an aura before an attack. Auras are a set of mild symptoms that can warn you that you’re about to have an attack. You might miss your aura if you aren’t paying attention. Aura symptoms include:

• Lightheadedness

• Feeling off balance

• Headache

• Ear pressure

• Sensitivity to sound

• Feeling uneasy

Recognizing your aura can help you prepare — whether it’s getting off the road or making sure you have your medication on hand. Once your aura starts, you should:

• Find a safe, comfortable place to rest.

• Move and turn your head slowly.

• Keep your eyes closed or focus them on an object that isn’t moving.

• Take your emergency medication.

6. Focus on your mental health

There’s no cure for Meniere’s disease. But with treatment, you can go years — or even decades — without having an attack. Studies also show that with treatment, most people with Meniere’s disease can go about their usual activities. 

While that’s good news, it’s important to recognize that attacks are stressful. Being worried about having an attack also adds to stress as does the worry of losing your hearing. Many patients with Meniere’s disease report higher levels of stress and depression. So it’s important to address your mental health — as well as your physical health — and to consider:

• Working with a therapist

• Joining a support group

• Talking to your healthcare provider about other treatment options

Why trust our experts?

Written by:

Ronald W. Dworkin, MD, PhD

Ronald W. Dworkin, MD, is a board-certified anesthesiologist who has been practicing anesthesiology in a community hospital for 30 years. He has taught in the honors program at George Washington University for over 10 years and works as a senior fellow at the Hudson Institute.

Edited by:

Samvida Patel, MNSP, INHC

Samvida Patel, MNSP, INHC, is a health editor at GoodRx. She is a nutritionist and integrative nutrition health coach with over 8 years of experience in health communications.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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