Low-Sodium Diet
The value of a low-sodium diet in treating Ménière's Disease has been known since 1931, and many patients notice they develop vertigo after eating salty foods.

The FDA recommends an intake of no more than 2,400 mg of sodium per day, yet most people consume 3,000 to 4,000 mg a day. People can safely get by with a 240 mg/day sodium diet. Experts do not agree about the ideal level of sodium for individuals with Ménière's Disease— some say 1,800 mg/day, others say 1,500 mg/day. Either diet level takes effort to be successful. For additional information, including a list of high-sodium foods to avoid, click here.

Diuretic Therapy
Diuretics reduce the body's total sodium count and, with it, the amount of water in the body. Because fluids shift from compartment to compartment, loss of salt and water into the urine will shrink the amount of fluid in the body generally as well as in the inner ear. This approach makes sense because people with Ménière's Disease have too much fluid in the inner ear. However, some individuals do not tolerate diuretics well and others do not appear to benefit from them.

Diuretics cause the kidneys to increase the amount of sodium, chloride, potassium, and other chemicals in the urine. These chemicals are called electrolytes because they are electrically charged. A side effect of the sodium and other electrolyte removal is a passive increase in the amount of water in the urine. This type of treatment is known as diuresis.

There are several classes of diuretic agents. The most widely used type for Ménière's Disease is the thiazide class, which includes hydrochlorthiazide (HCTZ). This is often combined with another, potassium-sparing agent, triamterene, in a drug called Dyazide™. Dyazide is probably the most frequently prescribed diuretic for Ménière's Disease because it is safe, effective, and does not require taking extra potassium.

Dyazide is a combination of triamterene (37.5 mg) and hydrochlorthiazide (25 mg). Hydrochlorthiazide blocks the Sodium (Na+) - chloride anion (Cl-) symporter in the distal convoluted tubule of the kidney, resulting in increased excretion of both Sodium (Na+) and chloride anion (Cl-), as well as Potassium (K+), and, long term, Magnesium (Mg2+) and Calcium (Ca2+). Triamterene blocks Sodium (Na+) channels in the distal tubule and collecting duct to increase urinary Na+ and Cl-, but does not increase the excretion of K+. Treatment of Ménière's Disease is an off-label use of Dyazide, based on a 1986 European study.

Fluid Intake
Adequate fluid intake, particularly water, is vital for proper kidney function, and may be equally important for proper inner ear function. The part of the inner ear that forms the endolymph (the stria vascularis) contains cells that have the same structure and function as the distal tubule cells of the kidney. In fact, many drugs that affect kidney function can also affect the function of the stria vascularis. Thus, adequate water intake may be as important to strial function as it is to kidney function.

For individuals who take diuretics, adequate water intake is especially important. There has to be enough fluid flow to remove the extra salt excreted as a result of diuretic treatment. Diuretics cannot work if the volume of water in the body's system is low. It is important to ask your doctor how much fluid your body needs while you are taking diuretics.

Stress Management
While no one believes that stress causes Ménière's Disease, most people with the disease recognize a relationship between stressful events and the recurrence of their symptoms. Many patients believe that stress is a factor in how well they can prevent recurrent attacks and cope with the disruption caused by Ménière's Disease. Not knowing when the next attack of vertigo may occur is a significant stress all by itself. For these reasons, patients with Ménière's Disease are advised to manage their stress as much as possible. Professional counseling may be helpful in this regard.  

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