Eating in the Zone: My new Menieres Diet

I’ve gotten a lot of requests for more information since Twittering about the new diet my vestibular specialist has put me on, so I thought I’d try to summarize it here for everyone who is interested.

My particular vestibular disorder, Menieres Disease (aka endolymphatic hydrops) is caused by excess fluid in the inner ear’s hearing and balance structures. Normally these structures are independent of the body’s fluid system, but in Menieres Disease the independent fluid control is lost, causing fluctuating fluid volumes and concentrations in the inner ear, which in turn causes pressure, tinnitus, dizziness/imbalance, and loss of hearing.

For years, people with Menieres have been told to go on low sodium diets. Increased sodium means increased fluid retention, as we all learned in high school biology. But in nursing school physiology I learned that the body regulates sodium balance in the kidneys, so I knew that although eating too much salt would definitely cause increased volumes, eating less salt would, at least to some extent, just mean my body would excrete less of it in order to keep things balanced. Nevertheless, once I had cut back on sodium, I could cause instant symptoms of dizziness and vertigo just by eating something that was too salty, so I could definitely tell it had an effect. As a result, I have spent the last 10 years or so carefully avoiding foods I knew have more sodium than I can tolerate.

Last month, I started seeing a new vestibular specialist. My symptoms have been pretty well controlled, but my previous specialist retired about 3 years ago, and I figured it was probably about time to have a checkup. My new doctor explained to me that the fluid volumes in my inner ear are governed by the overall chemical / hormonal / electrolyte balance of the body fluids as a whole. The driving factor behind that overall balance is not sodium, but insulin.

The key to symptom management, as well as minimizing the permanent damage being done to the inner ear and even trying to restore some function, is managing the level of insulin in the blood and trying to keep it as steady as possible. The more consistent my insulin levels are, the less fluctuation there will be in the fluid volumes in my inner ears.

The diet he wants me to follow (and this is the sobering part: FOR THE REST OF MY LIFE!) is based on the Zone Diet. Where the Zone Diet uses 3 meals and 2 snacks per day, however, this version uses 6 equal small meals evenly distributed throughout the each day. The first one is to be eaten within an hour of waking up, and the last one before bedtime is the most important one, because of the long gap before the next meal.

Each meal consists of the same proportions of protein, carbohydrates, and fats. Carbohydrates, as probably everybody knows, increase the level of glucose in the bloodstream, which causes a corresponding rise in insulin levels. Protein causes the release of glucagon, which regulates insulin levels. And fats control various hormones that also work to keep insulin levels controlled. So the whole point is to balance intake in order to keep insulin at a relatively steady level.

At the Zone website there are lists of “Zone food blocks.” There are three types: a protein block contains 7 grams of protein; a carbohydrate block contains 9 grams of carbs (not counting fiber), and a fat block contains 3 grams of fat. There is also a “body fat calculator” that tells you how many “blocks” per day you should consume. I’m supposed to eat 12 blocks per day of each of the 3 types, so with 6 meals, that’s 2 blocks of each type per meal. I’m to eat every 2-3 hours, never going more than 5 hours between meals during the daytime.

The approach that the nurse recommended to me is to make lists of the foods I’m interested in in each of the 3 lists, stockpile those foods, and as much as possible, have them pre-prepared in block-sized portions. Then I can just mix and match for each meal. For the first 4 weeks, I’m not supposed to eat from the “less favorable carbohydrates” list, so that means the only grain I’m allowed to have right now is steel cut oats. Fortunately, that’s my favorite breakfast. 🙂

I’m also supposed to carry “emergency food.” One stick of string cheese is one protein block, and they don’t have to be refrigerated. One apple is two carbohydrate blocks; you can get your hands on an apple just about anywhere. Applesauce also comes in single-serving containers, and one of those is one block. Fat is easy – three almonds is one block. There are also Zone Balance bars and another brand called Balance Bare that have the right proportions and amounts for one 2:2:2 meal. And 6 ounces of 2% milk is a perfect 1:1:1 food, so in a pinch I can drink a half glass of milk and go a little longer before my next meal.

Besides the protein : carb : fat ratios, there are some other things that I have to monitor in my diet. Splenda and stevia are the only sweeteners I can use — all of the others can affect glucose levels. Caffeine increases insulin secretion, so ideally I should avoid it, although for people who just have to have a cup of coffee in the morning, my doctor says to do it consistently — the same amount at the same time every day. MSG is also to be avoided, as are aspirin and all other non-steroidal anti-inflammatory drugs. (I will have to ask again what the reason is, because I’ve already forgotten, but they do something that affects fluid balance in the inner ears.) And I’m supposed to drink a minimum of 64 ounces of water per day, evenly spaced throughout the day.

As for sodium, it’s to be avoided in large amounts. Like everything else, my meals should contain similar amounts of sodium — but the plan is to titrate me back up to within the ADA recommended 2000-3000 mg daily consumption range. Oh, and I’m supposed to eat a 1:1:1 snack 20 minutes before exercising.

It’s actually been kind of fun creating my meals, since I’m not cooking for a family any more, which means they can be as weird as I want. I’ve loaded the freezer with frozen protein servings (turkey sausage, chicken breasts, etc.) and frozen fruits, stocked the fridge with boiled eggs, tofu, apples, oranges, kiwi, and Mozzarella cheese, and stashed single-serving containers of salmon, tuna, sardines, and different flavors of applesauce in the pantry.

For breakfast today I ate 2 links of turkey sausage, and 2/3 cup of steel-cut oats with Splenda and 2/3 tsp of butter. I could have had 1/3 cup of oatmeal and mixed in 1/2 cup of blueberries instead — maybe I’ll do that tomorrow. I had a Balance Bare bar for one of my meals, and it was actually quite tasty. My latest meal was 3 oz. of canned salmon, 1/4 cup hummus, 1 kiwi, and 6 almonds.

I’m also expected to keep a diary of the foods I eat every day, what time I ate them, what time I noticed feeling hungry, my fluid intake, and my symptoms. That way, over time we’ll be able to fine-tune my diet to my needs. My diary is also supposed to show the barometric pressure each day — that’s the wildcard in the equation; it’s the one thing that can’t be controlled. (I still have to go buy a barometer.)

I’m the least-regimented person on the fact of the planet, but I’m determined to make this work. Wish me luck! Better yet, join me; then we can share ideas for making it painless and fun!

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59 Responses to Eating in the Zone: My new Menieres Diet

  1. Barbara Beck-Azar says:

    then i am the next to the least regimented person on earth as well: diets, schedules and plans do nothing for me.. Flexibility, spontaneity and variety rock my cradles! i know i need to be on some sort of healthy eating menu.. this sounds pretty good. Though I don’t have Menieres Disease I am sure i have something disordered and can stand a lifestyle change. Actually eating right has always been an issue with me and what you explained looks good. I’ll try it.

  2. Jennifer says:

    I accidently came accross your website and what a find. You won’t believe this but I am two months away from finishing nursing school as a second degreee student, love psych nursing but plan to start out LTC or hospital first for the esperience if I can get a job. And I have had menieres disease for aobut 20 years. Mine has been very severe in the past. Diagnosed celiac about 5 years ago and eating that way also helped my menieres. This may partially explain why. Love the insulin explanation and going to try to print your blog about it. Avoiding salt never did a thing for me but like you if I had lots and lots, like a half bag of real salty chips, would notice it. I am going to try the zone. Thanks. By the way if you do ever eat anything sweet like a peice of candy eating a spoonful of olive oil will slow down its absorption so your insulin does not spike. i have been doing that for years because i knew regulating my blood sugar made me feel so much better and now i know why! Now if I only had a weather machine…..

  3. Geek2Nurse says:

    Congrats on your near graduation!

    I didn’t buy a barometer after all, because I found this website: – you can find the barometric pressure for any location by date. 🙂

  4. Natalie says:

    I am in the process of being diagnosed w/the disease. I have had one vertigo attack, one year ago. Nothing else for nine months, however, am now having atypical attacks, a few times monthly w/o vertigo, dizziness,. I do have constant ringing/buzzing, and occasional pressure. I am suspicious it is moving bilaterally.

    I have a couple of questions:

    1) Do you ever splurge? Treat yourself? If so, are their major consequences? I have been cutting out refined sugars and using maple syrup and honey instead for months (before I even knew I was developing the disease). I have tried stevia in the past and am not a huge fan of it’s taste. Also, I have a friend with a Ph.D in Nutritional Biochemistry and she’s not a fan of Splenda, telling me it’s nasty stuff in the lab and humans shouldn’t be consuming it unless they have no other options. I’m very much into a all-natural foods life-style and using any sweetener that is not totally natural makes me a bit uncomfortable. I guess I should start growing stevia and get used to it?
    2) How has this diet been treating you? Any recipes you’d like to share? I’m a 32-year-old mom of two young toddlers, love to cook most of my food from scratch and find diets like The Zone or GAPS daunting. I also have allergies to almonds, soy, apples, peaches, cherries, strawberries, green beans, -the list goes on and keeps growing, despite allergy vaccines (these are cross reactions to a birch tree allergy I have). However, I can eat these items once I have cooked the allergen out of them. Unfortunately, the fruits I can eat, I don’t like and have been trying to force myself to develop a taste for them (i.e. bananas).

    I’m beginning to wonder if there is anything I CAN eat! I’m currently in the process of a military move and won’t be trying anything new, diet wise, for another month. When I get back to the States, I will seek further treatment and hope to understand more about the glucose, sodium link and how it applies to me if I am not having current issues with vertigo and dizziness. While I don’t mind cutting back on salt, upping my water intake and cutting way back in sugar, I don’t really want to have to do it unless I really have to. But, if it will possibly prevent the progression of the disease, I guess I will cry some tears and just get on board and do it. This post is inspiring because you seem to have such a positive attitude about such a bit life-style change. I could learn from that!

  5. Cecilia says:

    Hi there:
    I just came across your website while doing some research on Meniere’s. I was recently diagnosed with Meniere’s and my ENT put me on a low salt, low sugar, low flour diet – whatever “low” means – (he did not explain). I have pretty much eliminated whatever I can.

    I am awaiting my second opinion at Johns Hopkins in a few months and hoping to find some relief. I was wondering how the Zone Diet is working for you so far. I’ve been doing the “low salt/sugar/flour” thing for a week and I still feel miserable, if not worse. Was the barometric pressure explained to you somehow as to how it affects the inner ear? Anyway- I look forward to hearing back on how the Zone Diet is working for you and any other tips you can share, so I can see if there is hope for a little relief out there somewhere.

    🙂 Cecilia

  6. cate says:

    I am just now starting to get diagnosed w/ Meniere’s. At first I had a few of the symptoms, but not the vertigo…. but had 2 epidodes now in a week. Are there any natural supplements you found that help? And how is the diet working

  7. Shelli says:

    My friend sent ur link to me. I too have Meneires. Was in the bed for all of Nov 06. My husband made me go to my ENT. And they did lots of tests, and then Jan 07 is when we knew for sure it was Menieres. Mine was so bad I was having wht they called vertigo siezures and so they put me on an anti-siezuer med and a very low sodium diet – no more then 2000 mg a day. All though I dropped over 40lbs with this diet it was nerve racking. Trying to figure our how to cook and eat ( I would cry in the grocery store) from being overwhelmed with the task at hand. Anyway I am still learning and have a new workout program which my body needs over 2100 cals to fruction but the sodium is a problem 🙁 I’ll try ur suggestion!!

  8. Geek2Nurse says:

    Hi Cecilia,

    It would be nice if specialists would at least give you a dietary consult if they’re going to put you on a diet! Mine has his own in-office nurse who helps his patients get the diet figured out and work through any rough spots.

    As I said in another reply, I’ve been having a pretty good season with my Meniere’s, so it’s hard to say really how big a difference the diet has made. I can feel a difference when I “cheat,” so it’s doing *something.* But I also feel better physically, so it seems like a good diet for me in other ways, too.

    Barometric pressure definitely has an effect on Meniere’s sufferers. The problem is you have a fluid imbalance in your inner ears which increases the pressure in there, so external pressure changes tend to exacerbate it further. Changes in elevation, flying on planes, and weather changes all can cause symptoms.

    I hope your doctor at Johns Hopkins ends up being a little more helpful; let me know how it goes!


  9. Geek2Nurse says:

    Hi Natalie,

    Sorry for taking so long to respond; I was finishing up a summer grad school course and kind of got buried there for a while!

    Yes, I “cheat.” When we go out to eat, or have a special family occasion, I go ahead and enjoy it. I try not to go overboard, of course, and will at least take a stab at keeping the proportions of protein/carbs/fat somewhere in the ballpark even if I’m eating more quantity than I usually would at one sitting. So far the consequences haven’t been major, just some mild dizziness for a few hours afterward, but then I’ve been having a pretty good season and haven’t had any huge symptoms anyway.

    As for recipes, unfortunately I haven’t come up with any…I work and am in grad school, and my kids are all grown and gone, so I tend to take shortcuts and don’t do a lot of cooking! I’ve been eating a lot of fruit for the carbs (rest easy, bananas aren’t on the “good” list, so you don’t have to make yourself like them!), and for protein I go with cheese, boiled eggs, sausage links that I cook ahead and freeze, prepared snack packs of tuna, etc. that I find in the grocery store, and stuff like that. If you have Trader Joe’s in your area, they are a great place to shop. For instance, I get summer sausage there that’s not 50% sodium like the stuff in the regular grocery stores!

    I do have a suggestion for your allergies — find a NAET practitioner ( in your area; they can work wonders for food allergies. (See my post entitled “Attack of the Killer Strawberries.”) If you end up anywhere near Portland, OR let me know and I’ll connect you with the one who saved me from the strawberries!


  10. Geek2Nurse says:

    Ooh, wait, I *do* have a recipe! I’ve learned to make delicious smoothies. 🙂

    Put 3/4 cup of milk (1 protein, 1 carb, and 1 fat block) in the blender, then add 1/2 scoop (or however much the equivalent of 1 protein block is of your particular brand) of vanilla protein powder, and 1 block of your choice of frozen fruit (i.e. 1/2 cup of blueberries or 1 cup strawberries). I like them a little sweeter, so I toss in some Splenda or stevia as well. Blend well and enjoy — all you need to add to make this a 2:2:2 meal is 1 block of fat (i.e. 3 almonds).

  11. Geek2Nurse says:

    Hi Shelli,

    Vertigo seizures don’t sound like fun! 🙁

    My original low-sodium diet was no more than 1000 mg per day — definitely a challenge! And grocery stores are overwhelming anyway, due to the visual stimulation. That was new information for me too, by the way. When your brain loses the input of one sense, it compensates by sharpening others. Everybody knows that; it’s why blind people can hear and smell things the rest of us miss. I just didn’t know it applied to Meniere’s Disease. When your brain figures out the vestibular input is flawed, it drops all the filters on your vision. This impacts us especially in our peripheral vision. Things that normally would get filtered out and ignored by the brain are now observed and processed, which takes a tremendous amount of brain energy and can be very exhausting. (If you know someone with ADHD, you can now understand some of what they go through!) In grocery stores you’re surrounded on all sides by visual input as you walk down the aisles. Now I understand why I become zombie-like within 10 minutes of going into a store!

    Hang in there, and let me know how you’re doing!


  12. Geek2Nurse says:

    Hi Cate,

    I haven’t explored natural supplements too much; I’ve found my best results have been lifestyle changes, especially getting my stress levels down, making sure I get enough sleep, and staying on top of my seasonal allergies. And, of course, diet. I was much more sensitive to diet when I was a stressed-out, sleep-deprived nursing student, but now that I’ve graduated and have a life again and have been able to manage my schedule a little better, I find that my symptoms have improved so much that it’s hard to tell how much impact the diet is having. As I’ve mentioned, I do notice some minor dizziness sometimes when I’ve cheated, but other times it doesn’t affect me. I think it will make a bigger difference during times when other things aren’t as optimal — season changes, for instance, when the barometric pressure is bouncing around and my allergies are kicking in.


  13. shelli tredway says:

    Hi there,
    thanks for your reply.. yes, i agree about the different sense’s being stronger then others when one is week. that’s so true..i am losing my hearing in both ears. my left ear is worse. i had nasal surgery a few yrs back, and my sense of smell greatly improved. but when my allergies are acting up, i tend to feel “off” or my balance is way yes the barometric pressure very much so have every bit to do with it!! i can tell when the weather is going to take a change cause my head starts hurting, and my balance starts getting way out there. in fact this morning and yesterday morning i had a very hard time getting out of bed, my balance was way off, and i had to hold onto to walls and furniture to get to the bathroom and to go ck on my kids. sometimes i just really hate this cause all i want to do is stay in bed, my balance is so off.. my personal trainer, has been working with me on my core, he says my core is so bad, and he has triggered my “spells” and that’s what he wants because he is helping me train my brain to counter act. my balance has improved some, like when we first started i couldn’t stand on a bosu ball ( half ball half flat on each side) and now i can hold my balance and do sitting squats while standing on the flat side with the ball side down.. but i still have a long way to go, but get so discouraged because i never know from day to day how i am going to feel. one day is good the next is bad.. and so on.. i seperated my lower rib about a month ago, and couldn’t work out with him, and now i feel like crap.. i haven’t been working out or doing my walking. not working out because i was giving my rib time to heal and the walking i could have been doing, but because everyday i wake up and i am “off”. not the mention everyday outside has been a heat advisory. anyway, right now i am just i don’t know… the only word i can come up with is depressed.. but i don’t think i am.. anyway, i know i need to get back into the my schedule of going to the gym.. i felt so good when i was working out. 🙁 ok im getting off my soap box now.. 😛

  14. Natalie says:

    Have any of you tried Serc? I just moved back to the US from Europe and my doctor there really encouraged me to stay on it. It’s the drug used for the disease in Europe and Canada. It’s been approved for a few decades, I believe. My specialist in Portugal said that at high doses (I take 24mg’s, two times daily) for a MINIMUM of six months, many (not all) sufferers will see very good results. I tried it for a week and then went off it b/c I knew I was moving back to the US soon and it wasn’t FDA approved (the small studies here show it doesn’t really work – this I no longer believe is true at all – I think it’s just not a drug that will make much money, therefore, intensive studies are lacking, etc).

    Long story short, once I went back on it and stayed on it, it gave me my life back. Now, I must say that I was having a lot of roaring, hissing and atypical attacks at the time (I have only, so far, had one full blown attack and several atypical attacks – w/o vertigo. I also have had floating hearing loss). After a few weeks on the drug, my symptoms started to subside. I now how flare ups of pressure, aching, mild hissing and mild ringing (always mild ringing, both ears). Sometimes I get very very short waves of dizziness. My point though, is that some patients may want to order this drug out of Canada. I ran into one PA here who’s wife has it and he said, “Stay on you Serc. That drug is nearly as good as the invention of peanut butter. My wife loves it)” I say my Portuguese doctor is is right. I haven’t even hit the six month mark – when most people start seeing the best results – and I feel so much better! I say it’s worth any Meniere’s patient, who has never tried the drug, to give a try for one year (it can be ordered online through Canadian drug stores). When I do have flare ups now (of hissing, pressure, etc) I find that it’s usually related to stress, pressure changes, fatigue, and very very very little to do with food. In fact, I use raw agave and maple syrup (low-glycemic sweetner) and cook from scratch (making salt nearly a non-issue b/c I cut out 95% of all processed food). But, really, I was already eating that way before the Meniere’s. With this drug, as long as I eat healthy, watch my portions, stay well-rested and watch my stress, I do well…Anyway, just a shout out to Serc.

    Also, I was given a drug called Sturgeon Forte (sp?) to use during a full-blown Meniere’s attack. It works kind of like a migraine medication. When having an attack, you take the drug (75mg’s, I believe), lay down and in 20-mins, it makes the attack subside. My babysitter in Portugal has had the disease for 27-years and calls it her Meniere’s SOS drug (it does not make her tired – I haven’t taken it yet – but, the pharmacist also told me that it shouldn’t make me too tired either – she was appalled to hear what dr’s give Meniere’s patients here to take during an attack when there is a much more affective drug, with less side-effects in Europe. Forte has been approved in Europe since 1955). I snagged 120 pills (one taken during each attack) that do not expire for five years. I hope never have to have to take one. But, if I do, I feel so much better knowing I have a drug that will help me through an attack w/o knocking me out (I know some people chose not to take anything during an attack – I have two kids and a husband in the Army – I need to function and function quickly! Especially when he’s deployed and I’m on my own).

    Sorry for the rant, but having been diagnosed in Europe and given the drugs they have, I’m saddened that we have so little available to us here! I know Serc may not always work, especially as the disease progresses, however, for now, I have a life again. I take one day at a time and try not to worry so much about the future. Having much milder symptoms, helps me do that!

  15. Geek2Nurse says:

    I was on Serc (aka betahistine) for a year or so. You can get it in the US, if to go to a compounding pharmacy. When my insurance stopped covering it I couldn’t afford it any more, but I hadn’t noticed much difference with it. It definitely seems to help some people, I just wasn’t one of them, I guess!

    One note — since it’s a histamine, it triggers the release of acids in the stomach, so when you first start taking it, it can cause stomach upset. Definitely take it with meals, and stick with it — your body adapts after a while and it’s not so bad then.

  16. Natalie says:

    Yes, Serc, like many drugs with all illnesses, only works for some. For me, it’s given me my life back. I have a friend with RA and one of the latest and greatest RA drugs doesn’t work for her. For her, steriods work the best and she can’t be on them long. My point is that I think any drug, long approved in Europe, that may work for even a small fraction of a diseased population, should be easily approved in the US. I feel it’s almost morally wrong not to. I’m glad to hear it is approved, sort of (I’ll have to check out whether my insurance will cover it or not) here. Sorry to hear it didn’t work for you! I am aware that it may not always work for me. But, for now, it’s my new best friend and I’m anxious to see just how much better I feel when I’ve been on it over six months!

    I do know about the reflux/stomach acid issues. Fortunately, I haven’t had any problems with it and I’ve been on Serc for three months now.

  17. CARMEN says:


  18. sharla says:

    Thanks so much for sharing your diet information. One desperate dizzy day I was searching the web to see if there was anything I hadn’t yet tried and I came upon your site. I was familiar with the zone and thought I’d give it a try. I was feeling better within a couple of days. When I feel better for a while I get lazy with the diet and can surely tell a difference in the way I feel.

    I was amused that you mentioned the killer strawberries. I gave a speech on that article in college. (It was a great speech)!

    My husband and I enjoyed your artwork. He’s an artist as well as a fellow Aggie (class of 81). If you’re interested in seeing his work check out Richard Prather fine art.

    Thank you Ruth, your willingness to share has helped me a great deal! Please thank your doctor as well.

  19. sheli tredway says:

    Hi Ruth, just an update, going in Feb 2010 for my hearing tests and visit with my doc.. i know that’s sometime from now.. and i should have had it done back in June 09 but the health ins wasn’t letting me saying i was pre-exciting… anyway, that will drop Feb 1.. so i called and made the appt. 🙂 i can tell however that my hearing has gotten worse 🙁 Will try and remember to update after my appt.. hope you and your family have a Merry Christmas and a Happy New Year!

  20. shelli tredway says:

    Hi Ruth.. been having problems with my ears… had bronchitis at the end of Oct and then the first part of Nov ended up with double ear infections.. and now i have another ear infection in my right ear.. this is more painful then the double one.. 🙁 i never got ear infections before.. but was told that with meniere’s comes ear problems! will not for sure in Feb… what else is going one… i’m so tired of this disease….

  21. dianne fagerness says:

    Hi, I have had menieres for about 8 years now. I find that the air pressure is a big trigger for vertigo. I have started taking ginger root, it’s used for motion sickness and it seems to have helped me.
    I live in the northwest and the weather can change very quickly, today for example the air pressure is very low so I took a dramamine because I can actually tell when the pressure is changing. (I usually just take 1/2 a pill because I don’t like how it makes me groggy) This seems to help me, I hope it can help someone else.
    Take care, Dianne

  22. nancy says:

    Hi Ruth,
    As I searched “meniere’s and diet” ( I think that was it??) I saw you. Your words leaped out at me (meniere’s and the Zone diet). I saw a specialist two weeks ago (The House Clinic) and I told him that the low sodium diet worked somewhat but I still was taking Bonine(25mg) twice a day. Did I have to take it forever? Sometimes I needed three a day. This recent round of dizzy events coincided with menopause, also. He said the problems come from circulation, metabolic and a host of other issues. Sodium levels, allergies, menopause, etc. all play a part. Then he wanted to sign me up for a shunt surgery in the vestibule. As I read up on that procedure I thought there must be some other way to tackle this. I have read elsewhere that there is a high incidence of people with hypoglycemia symptoms who have Meniere’s so when I saw your finding I jumped in. I was on the Zone eleven years ago to take off the 12 pounds I gained cooking for my three men during the high school years. I really like that diet. I pulled out my book to reread and began 5 days ago. I also added daily walks instead of just 3 times per week. I have had only one Bonine in five days. Sometimes my ear feel full and I have a little roaring but it never goes the full distance into Vertigo. My energy has improved and certainly my mood. I’ll keep you posted. Where can I find Low sodium breakfast sausage without nitrates? Breakfast protein is my biggest challenge. I worry about whole eggs and I am not a fan of egg white only omelettes. Thanks again. Who is this wonderful md. you went to. Nancy j

  23. Geek2Nurse says:

    Hi Nancy,

    I’m not sure where you are, but here in the Pacific NW we have Trader Joe’s, and they have a lot of great low-sodium foods. I’ve also found breakfast sausages with more acceptable sodium levels at Whole Foods. Incidentally, my doctor’s instructions were actually to gradually bring my sodium intake back up to normal levels (~2g/day) once I got going on the Zone diet, rather than keeping it low.

    My specialist’s name is Dr. F. Owen Black, in Portland.


  24. Judy says:

    Please tell me what you do for the pressure in the ear. It absolutely makes me insane! I can’t sleep with it, I walk the floors all night. I will be going to a specialist tomorrow, but I think I have MM. I’ve cut out almost everything except frsh fruit, chicken, and veggies. But I still get the pressure for days. Today is the first day in 3 that I feel “normal”. Have you tried lemon bioflavinoid tablets, or vinpocetine? I understand these are supposed to help alot with the hydrops. I will do whatever I have to to get rid of that stuffed, plugged up feeling. I really can’t take it!

  25. nancy says:

    Thanks Ruth,
    I have a TJ’s just around the corner and a Whole Foods. I am in Huntington Beach Ca. I wonder if Dr. Black has a colleague in my area – one who is aware of the possible relationship between insulin balance and inner ear functioning. I will give him a call. I wish I could say sodium wasn’t much of an issue but everytime I overdue, even maybe only 500 mgs., my tinnitus gets loud the next day and my ear feels full. Except for the breakfast protein, I, too, find the diet fairly easy to follow. Thanks again, Nancy J

  26. Geek2Nurse says:

    Judy, diet seems to be the best way to control that inner ear pressure. The pressure is caused by fluid imbalance, and fluid balance in the body is controlled by chemical balance, and the most direct way to control the chemical balance is through diet. Sodium is a big player in that game, but as my post notes, sodium balance is affected by hydration and insulin levels. So the bottom line is working to stay hydrated and keep your insulin levels as steady as possible.

    Other things that affect your inner ear pressure are stress levels (stress causes increased levels of cortisol, which increases blood sugar, which increases insulin production), seasonal allergies (antihistamines and decongestants help), and barometric pressure fluctuations. The only one of those we can’t at least somewhat control is barometric pressure — that one you just have to ride out!


  27. Judy says:

    Ruth, Have you tried any of the supplements? I have been researching and came across a regimen of different supplements, and from what I understand, people have had wonderful results from them. I can’t take antihistimines or decongestants due to an A-fib problem. I also have been diagnosed with a goiter that will be addressed next month. This is such a nightmare to me right now, and I don’t even have the official dx.

  28. Geek2Nurse says:

    Hi Nancy,

    Yes, you will have a reaction to eating sodium, because it directly affects sodium levels in your body and that affects the whole fluid balance. The thing about sodium, though, is that your body needs a very defined amount in order to function. Sodium is extremely important, down to the cellular level. Without it, your muscles can’t work, your nerves can’t conduct signals, your kidneys won’t work right, and on and on. As a result, no matter how much or how little you take in, your kidneys rapidly compensate to keep the balance, either hanging on to sodium or letting it be flushed out in your urine. That’s why a low-sodium diet really isn’t the answer. No matter how little sodium you take in, your body is going to keep those sodium levels where they need to be. All you’re doing with a low-sodium diet is avoiding *fluctuations* in the sodium level. When you suddenly take in a larger amount of sodium, your reaction is actually more significant, because you’ve been sensitized to it.

    The reason the Zone diet helps is that sodium levels are controlled ultimately by your insulin levels. Once you get those stabilized, you can gradually (key word is GRADUALLY, to let your body get used to it again) increase your sodium intake to normal levels, and let the usual control systems manage the balance.

    I hope that makes sense!

  29. nancy says:

    Hi Ruth,
    The Zone diet is really helping. I found the turkey sausage links at Whole Foods and they are delicious but only two little skinny links have 230 mgs. of sodium. The other proteins for breakfast also have sodium and it really adds up for one meal. So today I bought ground turkey at TJ’s and made the sausage patty recipe in the Zone book. They are scrumptious. I made them in 4 block sizes – 1/2 for 6:00 am 2 block meal and the other half for the 9:00 meal. I froze some for another time.
    What do you take for your seasonal allergies? My doc recommended Zrytec every night but that doesn’t do much. How do these allergies affect Meniere’s? Tylenol Sinus, RobitussinPE and Sudafed all help reduce my ear problem. At least temporarily. Why? Nancy

  30. nancy says:

    Thanks again Ruth,
    Your article really got me moving in a productive direction. I was so tired and brain dead when I went off caffeine. I wasn’t connecting all the info I received from the specialist in a meaningful way. My return to the Zone diet has given me energy and my brain back. My system is working better and the possible metabolic component of this vestibular problem is being addressed. Having more energy, now, has renewed my interest in exercise – the circulation component my doctor mentioned. I also try to lay perfectly still for 15 minutes mid-day, everyday and this seems to renew my energy which allows me to do more things which aids circulation. The lower sodium diet helps because I notice a difference when I go
    above 1500 mgs. What has really helped is addressing the allergy component. 20 years ago I had allergy testing done after a few small episodes of this problem. I followed the advice of Dr. William Walsh and the Meniere’s disappeared for 18 years. Maybe it was just a coincidence but I do much better now when I follow his advice of no artificial sweetener, avoid citrus and other acids, no MSG and really reduce refined sweeteners. My allergy test confirmed that I was sensitive to tomatoes and potatoes (nightshade family). Tomatoes, peas, corn and mushrooms are foods high in MSG and tomatoes are also high in citrus. So, I have my best days when I do all of the above. I am also sensitive to soy, wheat, egg whites and citrus. Every once in a while I have to take a Sudafed for airborne allergy. This helps also. I hope this helps others. Note, MSG occurs in many different forms, like hydrolyzed yeast protein and “natural flavors” and in other ways. One of the surprises was aged cheese and yogurt. They really need to be limited. Thanks again for getting me problem solving and more thoughtfully attacking this problem. Nancy

  31. Karen says:

    This is the first I have seen of this website and I am really curious, I have barometric pressure menieres and I was told by my ENT that I should stay on a very low sodium diet and right now I am on only 1000 mgs a day of salt. I usually only eat once or twice a day and this whole website has really taken my interest as I have had Meniere’s since 2004 and had two surgeries on both ears. I want my life back again and cannot seem to get it back. I also want to lose some more weight as I was told by my ENT that the more weight I lose the easier it will be on me. I have lost 80 lbs with the low salt but I am always so tired and cold and worn out. Is this due to the sodium level??? Also, I am always asked by all doctors if I am a diabetic but my PCP says I am not. I would love to try the ZONE DIET but my income is also very low and it is hard for me to find food that can get me through the month.
    Thanks Karen

  32. Anna Spivey says:

    I was just sentenced I mean diagnosed. I have been trying to stick to 1300 mg of sodium a day (at my doctor’s recommendation) but like the sound of this Zone Diet. I think. I need whatever will (a) maintain my hearing so I don’t lose it and have to take the dreaded Steroids!! again and (b) be liveable with my having to cook for a family. My question is… this Zone Diet totally throws my 1300 mg of sodium out the window. How do I reconcile the two with my Cochlear Hydrops? Thanks!

  33. Geek2Nurse says:

    This diet replaces the low-sodium diet. Note where I said, ” The driving factor behind that overall balance is not sodium, but insulin.” Control insulin levels, and your sodium level will also be controlled. My doctor actually had me slowly titrate my sodium intake back up to normal levels once I started on the Zone diet. Good luck! 🙂

  34. Leslie says:

    I have just been kind of diagnosed with Menieres disease. I have been off balance and dizzy for the last 4 years but never had any violent attack of vertigo. We have been remodeling our house all summer and have no kitchen and I have been eating fast food for breakfast, lunch and dinner for the last 3 months. All of a sudden one morning I rolled over and BAM!!!! Violent vertigo that sent me to the ER and admitted overnight. They suspected menieres and it took me 3 days to get out of bed. I wanted to try the low sodium diet but it was going to be difficult since I can’t even cook. Within the week I was feeling fine and back on my feet. Until 10 days later when I ate 4 slices of pizza. That evening I was lying on my side in my daughter’s bed and BAM!!! It happened again!!! I also suffer from anxiety and panic attacks so it was really horrible. Is this going to be my life now? I have 2 young children and all I can do is lay in bed as my husband or another family member takes care of them. I used to have The Zone book and I am willing to try anything. Does anyone else have advice for me? Can you add suppliments like Lipoflavonoids and Ginko to the Zone Diet? I amd desperate for anyone’s help. I live in the Oregon and saw that someone saw a Dr. Black?

  35. Geek2Nurse says:

    Leslie–The positional element makes me wonder if your attacks may be from BPPV (Benign Paroxysmal Positional Vertigo) rather than Meniere’s. Has anyone tested to rule that out? If it’s BPPV, it’s caused by debris in the inner ear, and there is a sequence of positions you can use to move it out. Do a search on “Epley Manouver” online — there are videos on YouTube to show you how to do it. As for supplements, I don’t know of any reason you can’t add them to the Zone diet. Good luck!

  36. andi says:

    I am so glad to have found this website!!! I have have this dreadful disease over a year now. Have had “small attacks” and recently a rather “big one”. I will try the Zone diet and hope it will work as well for me as it has for others.

  37. Nina says:

    I have meniere’s for a long time,I used to joke with a friend that I’m dizzy because of the
    barometric pressure. I got diagnosed 2 years ago. I am much worse than then. I really have hard time of eating whats right,I think I’m not good at this because I am worse not better. My ear doctor just said less salt,sugar that is all. I need a diet that says what to eat a every meal and what in between. This is 2/10/12 are you still doing the zone? I will wait for your answer before I buy the book .
    Thanks Nina

  38. Kathie says:

    I too was a patient of Dr. Black in Portland Oregon. That man was my life saver. He is now retired and Dr. Wackym took over his practice. I have seen Dr. Wackym for two years now and he has some of the same ideas as Dr. Black and some new ones also. I do the diet of eating every 3 hours, it’s a modified Zone diet prescribed by Dr. Black. It’s almost been 5 years now on the die. I have hydrops in both ears. So, I’m doing much better but Menieres is with me every day, just it that I can function now.

  39. Vivian says:

    Diagnosed in summer 2006, I had two attacks, 28 days apart. The first attack of “the swoopies” in which I could not turn my head or drive sent me for an MRI (negative) and they suspected BPPV. The second attack was violent “bed-spins” and I was very ill and had to sleep it off. I was then diagnosed w/ Menieres.

    I went on the low sodium diet and not problems for months. My slightly clogged left ear felt better after summer passed (I said I felt like the close summer days were a trigger; I was mocked) and I gradually added back my normal salt intake, avoiding only splurges – stuck to two pieces of pizza and lower sodium chips. No soy sauce.

    The next summer – boom – two more attacks, 28 days apart. The first, mild swoopiness that sent me to bed for a day and the second that was an episode of being violently ill and having to sleep it off. At this point, I said that I felt my hormonal changes (peri-menapause) were playing a role. Again, my doctor scoffed and said to cut the salt again.

    I went on HRT – birth control pills – to stop hot flashes and leg cramps – and I cut out the sodium again. I had on one day of slight dizziness that fall and was symptom free when I came law school in fall 2010. I tried not to splurge on salt, but had one piece with breakfast and gradually quit thinking about it. Summer of 2011, I was wnjoying pizza and wings with my family. I ate hummus and felafel.

    Then, law school got very stressful fall of 2011. Also, as I had ceased menstruating in June, I had stopped taking the HRT. My life became a series of debilitating vertigo attacks in October. One saw we in the ER for 4-5 hours as they tried various anti-nausea meds . . .only to have me unable to keep them down. They finally gave me a Phenergan shot to stop me heaving so I could sleep. My last major attack, I burst blood-vessels in my eyes.

    I did ultra-low salt, and I might have gone a week here and there without an attack. I was just struggling through school and listening to lesson podcasts when I could not make it to school. Went back on the birth control and noticed my attacks came on again only when I hit the week of inert pills.

    I went on a bio-identical hormone patch and started “grazing” and watching my salt. I ate nuts and dates and mini wheats for breakfast and snacks. I started eating salads with low-no sodium fruity vinaigrette. A bag of Harris Teeter’s “No-Salt” popcorn often comprised my lunch. And my husband starting grilling w/ no-salt marinade, so I’d have a small portion of protein at night with steamed veggies. I was symptom-free throughout the spring semester (except after one splurge on pizza) until I moved to DC for my summer clerkship.

    I had an attack at work that I clawed my way through. I HAVE to function, but I’ve had to take diazepam the past three days to push through attacks, and I am terrified. I just flew home, so the pressure likely helped trigger the problem – I barely made it through my daughter’s 5th grade promotion ceremony today. And unlike years past, I now feel the attack of vertigo coming on from right between my eyes. The pressure builds there.

    Can you suggest a site where I could learn about the Zone Diet? I have never done any kind of diet, so I need immediate help. And should I try the Serc med, too? OR the European SOS med. I just HAVE to function at this job for 6 more weeks. I’ll get the nerve section if I have to, but want to try all other alternatives. I have long KNOWN it was not just salt!! I ate pizza and wings for all of summer 2011, so there had to be other factors.

    I do not know how I will live without sugar, so I’ll need more on that. No CHocolate Babka? No dark chocolate covered pomegranate? Is there any room for a handful or small serving of these??

    I’d deeply appreciate a response.

  40. Vivian says:

    Sorry for the many typos – I’m in bed recovering from an attack as I type!

  41. admin says:

    Hi Vivian,
    Follow the link in the post to the Zone Diet website. 🙂 I’ve found that as long as I do things in moderation, I don’t have to be terribly strict with my diet. It probably helps that I’m out of school and not under nearly as much stress now! I mostly only have problems now when the barometric pressure fluctuates or my allergies act up.

  42. Holley says:

    Hi…have had vertigo Meneires for about fifteen years.
    I nave had good years in between…then vertigo started nine months
    Ago. In desperation i have researched everything…tmj, diet, neck issues,
    Allergies etc. now that insee insulin levels, it makes sense. Inhave hypoglycemia,
    Allergies, temp sensitivity, Etc. i gave up coffee, now coke, and will ttry
    The Zone Diet. I get so sick i want to die sometimes…im trying not to
    Lose my job and home. The mental stress is a huge burden thay my faith
    Needs to carry. Thanks for info. Will be starting
    Steroids today for first time. Not Looking forward to it. Will also have hormone
    Levels checked.

  43. I was diagnosed with multiple vestibular disorders following head trauma 27 years ago. I was so fortunate to have found Dr. F. Owen Black in Portland, OR within the first year. I had multiple surgeries for bilateral perilymphatic fistulas (still unresolved), BPPV, secondary hydrops/Meniere’s and an enlarged cochlear aquaduct. I have been totally disabled by the vestibular problems and on Social Security Disabilty. There have been many changes in my life since I last saw Dr. Black years ago including menopause and the development of type 2 diabetes. I was very interested in the fact that he stressed insulin levels for control of Meniere’s symptoms. I wonder if anyone knows how this relates to diabetes and those of us that have to take insulin? I have been following a low sodium diet as suggested by Dr. Black back in 1986 but am getting progressively worse and losing my hearing. I learned recently that Dr. Black passed away in May of this year, bless his kind soul. Have any of you seen Dr, Wackym?

  44. Yvonne says:

    I was diagnosed with Meniere’s in 2008, and was good til 2009. Since then have had vertigo on a regular basis, even on a low-salt diet. I started the Zone Diet in March of this year, and have not vertigo since. The Zone Diet has worked for me.

  45. Pam Klein says:

    I have been diagnosed with Metabolic Menieres (reaction from high sugar levels opposed to high salt levels) disease from the Mayo Clinic in AZ. I work as a nurse and cannot be afforded the time off from work when I am very ill. I am in 100% agreement with the explanation of the benefits of the Zone Diet. How do I get the Zone Diet book that is more geared for Menieres illness.

  46. Pam Klein says:

    Please give me more information on how to obtain the Zone Diet book that is more geared tword the menieres illness.

  47. Geek2Nurse says:

    Hi Pam,

    There’s no Zone Diet book geared toward Menieres. You just follow the regular Zone Diet. 🙂

  48. James says:

    I have recently be diagnosed with Cochlear Hydrops. I just discovered your site and also the Vestibular Disorder Association’s site. I am VERY interested in the possibility of managing this condition through diet. I have a few questions I would love to ask you and your readers. My symptoms are at a manageable level now – but I’ve yet to figure out what exactly send my system over the edge.

    My ENT just suggested that I might try the Arches Tinnitus Formula supplements. Has anyone tried any of them and had any success?

    I’ve eliminated wine from my diet (pretty much the only alcohol I drank anyway) – but would love to know if anyone has been able to have an occasional glass and not had it cause problems.

    Has anyone had any decrease in symptoms from losing weight? I do need to drop some and I am somehow hoping that this will go away when I back down to a more healthy weight.

    Thank you all.

  49. Barbara Rycheneb says:

    How did you find a vestibular specialist? I live in a rural area and the closest neurotologist is 4 hrs away. When he said i had meniere’s he didnt even suggeat low sodium diet or a diuretic. Attacks more frequent and come on unannounced (actually they cause me to fall backward – awful when alone in a store while on vacation!) it is currently unsafe for me to drive. I will try the diet you suggest and will ask Dr about the insulin also. I also have migraines and just read that some are using a prophylatic migraine med. Any experience with this? Appreciate all the info.

  50. Geek2Nurse says:

    Barbara, as I recall, I just did a Web search on “vestibular.”

    I don’t know about the migraine med; that’s thankfully not something I’ve suffered with.

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