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Suggest Treatment For Ménière's Disease, Fatigue And Fluctuating Fluid Levels In Inner Ear
Question: Hello Doctor,
I'm looking for information on a seemingly chronic condition of borderline low Potassium.
I've been hospitalized 3x in the past 6 months with that diagnosis (lo K), along with some other diagnosis.
May 2015: ER with violent vomiting along with an episode of feeling like I was being pushed the other way from which I wanted to go. I knew my legs wouldn't navigate properly, and, I had to get to the bed, and, call my Doc, who sent 911. ER Doctor said Potassium was dangerously low. My Primary Care Doctor sent me to an ENT after this episode because of my tinnitus, and, she questioned Vertigo as a diagnosis. I wasn't "dizzy". Just as I have described it above, unless this symptom can be called dizziness nowadays.
August2015: Same thing happened. The ER Doc said my Potassium was low again.
Hospital Doctor went along with "dizzy". I didn't have a spinning feeling.
October 2015: Pleurisy, but, had to go to ER because of chest pain. Again my Potassium was low.
Went to ENT Doctor, who diagnosed me with Menieres Disease.
Past Potassium Levels since 2012: 3.7; 3.8; 3.1 had Dx of "near syncope"; 3.5 latest
I was put on Hydrochlorthiazide Nov.1, 2014 by the ENT for what he called Menieres and a balance problem which was due to "fluctuating fluid levels in the inner ear"
I still feel weak and fatigued. Would appreciate your opinion. Thanks.
I'm looking for information on a seemingly chronic condition of borderline low Potassium.
I've been hospitalized 3x in the past 6 months with that diagnosis (lo K), along with some other diagnosis.
May 2015: ER with violent vomiting along with an episode of feeling like I was being pushed the other way from which I wanted to go. I knew my legs wouldn't navigate properly, and, I had to get to the bed, and, call my Doc, who sent 911. ER Doctor said Potassium was dangerously low. My Primary Care Doctor sent me to an ENT after this episode because of my tinnitus, and, she questioned Vertigo as a diagnosis. I wasn't "dizzy". Just as I have described it above, unless this symptom can be called dizziness nowadays.
August2015: Same thing happened. The ER Doc said my Potassium was low again.
Hospital Doctor went along with "dizzy". I didn't have a spinning feeling.
October 2015: Pleurisy, but, had to go to ER because of chest pain. Again my Potassium was low.
Went to ENT Doctor, who diagnosed me with Menieres Disease.
Past Potassium Levels since 2012: 3.7; 3.8; 3.1 had Dx of "near syncope"; 3.5 latest
I was put on Hydrochlorthiazide Nov.1, 2014 by the ENT for what he called Menieres and a balance problem which was due to "fluctuating fluid levels in the inner ear"
I still feel weak and fatigued. Would appreciate your opinion. Thanks.
Brief Answer:
seems to be drug induced hypokelemia.
Detailed Answer:
Hi,
I had gone through your question and understand your concerns that you are having hypokelemia (low potasium values) with dizziness / imbalance. I would like to know if you also have fluctuation hearing loss.
In my opinion,
1. You do not seem to have Menière's disease (assuming you have no fluctuating hearing loss). If you do have hearing impairment, then Meniere's is a possibility.
2. If it isn't Meniere's disease, then I would stop Hydrochlorthiazide since this drug can further lower potassium levels.
3. Hypokelemia- Perhaps the most obvious cause is insufficient consumption of potassium (that is, a low-potassium diet) or starvation. But as there are other causes for low potassium, it needs to be evaluated by your physician / neprologist. In the meantime, maintain potassium by taking foods, such as leafy green vegetables, avocados, tomatoes, coconut water, citrus fruits, oranges, or bananas.
4. "stroke dot"- fresh or old stroke can cause dizzy spells. If the imbalance issue persists, I will order for a neurologist opinion
5. Besides this I will also suggest that your ENT surgeon performs posture/balance tests to differentiate between central or peripheral causes of vertigo. Hearing tests (pure tone audiogram and audiometry) to see any fluctuating hearing loss.
Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.
Wishing you good health.
seems to be drug induced hypokelemia.
Detailed Answer:
Hi,
I had gone through your question and understand your concerns that you are having hypokelemia (low potasium values) with dizziness / imbalance. I would like to know if you also have fluctuation hearing loss.
In my opinion,
1. You do not seem to have Menière's disease (assuming you have no fluctuating hearing loss). If you do have hearing impairment, then Meniere's is a possibility.
2. If it isn't Meniere's disease, then I would stop Hydrochlorthiazide since this drug can further lower potassium levels.
3. Hypokelemia- Perhaps the most obvious cause is insufficient consumption of potassium (that is, a low-potassium diet) or starvation. But as there are other causes for low potassium, it needs to be evaluated by your physician / neprologist. In the meantime, maintain potassium by taking foods, such as leafy green vegetables, avocados, tomatoes, coconut water, citrus fruits, oranges, or bananas.
4. "stroke dot"- fresh or old stroke can cause dizzy spells. If the imbalance issue persists, I will order for a neurologist opinion
5. Besides this I will also suggest that your ENT surgeon performs posture/balance tests to differentiate between central or peripheral causes of vertigo. Hearing tests (pure tone audiogram and audiometry) to see any fluctuating hearing loss.
Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Prasad
Hello Dr. Siddiqh,
Thanks for the clear, detailed answer. A few questions:
1.
Is fluctuation hearing loss the same thing as hearing that is good at times, and, bad at other times? Mine is like that.
I had the audiologist and he did a test in a little booth, along with something that he put in my ear and listened. He didn't tell me what he was doing. Can you take a guess? (I guess I should be more forward with my questioning.)
2.
The ENT ordered some "balance tests. VNG testing
An ABR
An ECOG
I am afraid of these tests because several people have told me that they make you sick, and, you need a driver to get home. I am already sick enough and it seems he has already made the diagnosis of Menieres without the tests. I have cancelled them twice because I was too down. Thank you Doctor. XXXXXXX
Thanks for the clear, detailed answer. A few questions:
1.
Is fluctuation hearing loss the same thing as hearing that is good at times, and, bad at other times? Mine is like that.
I had the audiologist and he did a test in a little booth, along with something that he put in my ear and listened. He didn't tell me what he was doing. Can you take a guess? (I guess I should be more forward with my questioning.)
2.
The ENT ordered some "balance tests. VNG testing
An ABR
An ECOG
I am afraid of these tests because several people have told me that they make you sick, and, you need a driver to get home. I am already sick enough and it seems he has already made the diagnosis of Menieres without the tests. I have cancelled them twice because I was too down. Thank you Doctor. XXXXXXX
Brief Answer:
Go ahead.
Detailed Answer:
Hello again,
Thanks for considering my answer and for your follow up.
Answers for your queries.
1. yes. Fluctuating hearing loss can be confirmed through audiometry ( pure tone audiogtam picks up the hearing loss).
2. Kindly attach the reports of audiometry from audiologist, so that, I can read that audiogtam.
3. Except ENG (electronystagrophy), other tests are simple tests (does not cause any weekness or vertigo, infact some tests can cure your vertigo. Therefore, kindly go ahead for the tests.
All the best.
Take care.
Go ahead.
Detailed Answer:
Hello again,
Thanks for considering my answer and for your follow up.
Answers for your queries.
1. yes. Fluctuating hearing loss can be confirmed through audiometry ( pure tone audiogtam picks up the hearing loss).
2. Kindly attach the reports of audiometry from audiologist, so that, I can read that audiogtam.
3. Except ENG (electronystagrophy), other tests are simple tests (does not cause any weekness or vertigo, infact some tests can cure your vertigo. Therefore, kindly go ahead for the tests.
All the best.
Take care.
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Above answer was peer-reviewed by :
Dr. Sonia Raina
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