Life Advice



Annie's Mailbox: About Dizzy in New York

Kathy Mitchell and Marcy Sugar on

Dear Annie: "Dizzy in New York," who suffers vertigo and ringing in the ears after eating citrus foods, may have migraine-associated vertigo and tinnitus. Such patients often have a history of headaches (which they may mistake as "sinus headaches"), but many have only inner ear symptoms. Chocolate, fermented foods (especially red wine), and other foods can be triggers, as can use and withdrawal from caffeine, hormones and headache medications. Eliminating these triggers often relieves symptoms; some patients require medications that help prevent migraine.

"Dizzy" should consider seeing a neurologist or neurotologist (an otolaryngologist who specializes in inner ear disorders) who has a special interest in treatment of vertigo and is knowledgeable about migraine-associated vertigo. -- Charley C. Della Santina, Ph.D., M.D., Dept. of Otolaryngology -- Head & Neck Surgery, Johns Hopkins School of Medicine

Dear Dr. Della Santina: Thank you for your expert diagnosis. Our readers really came through with suggestions and referrals. We can't promise that any of them will solve the problem, but we hope at least one will prove helpful. Read on:

From an Integrative Physician: This patient clearly has food allergies, and I also recommend that tests be run for gluten intolerance. Often, food allergies become more numerous over time. We usually develop allergies from the very foods we like the best, simply because we eat them so often. People should rotate foods so they are not eating the same ingredients frequently.

Florida: "Dizzy" should locate a physician who specializes in autoimmune diseases and ask to be checked for dysautonomia.

Brooklyn: "Dizzy" said tomato sauce also gives her vertigo. Tomatoes canned in the United States contain citric acid. She should look for tomatoes canned in Italy.


New Jersey: She may have acid reflux. I, too, get nauseous and dizzy when I eat citric acid.

California: Has she had an MRI? I had similar symptoms, and an acoustic neuroma was found. I had it removed a couple of weeks ago, and although I still have some tinnitus, the dizziness is gone, and I can eat what I want.

Arkansas: My husband's cardiologist told me to take ginger or ginger root capsules two to three times a day, and then gradually decrease it to a single capsule.

Santa Cruz: Tell "Dizzy" that she's having gall bladder problems. I endured three months of horrible vertigo, and when my acupuncturist had me cut back on oils and acids, it went away. If I have a flare-up, I use milk thistle tablets.


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