Vertigo & Your Blood Sugar

When I started practicing in 1986 I asked a female patient to perform Rhomberg's Test, in which a patient stands with eyes closed and arms stretched out in front of them like a sleepwalker. If the patient sways or their arms drift from midline, the test is positive—there is a problem. My female patient fell over.

She was later diagnosed with diabetes. To date, this was the most dramatic relationship between balance and blood sugar that I’ve ever witnessed.

Sugar is the brain’s sole source of energy. If blood sugar is too low (hypoglycemia) or high (hyperglycemia) the brain may not be able to function normally. Abnormal blood sugar levels can cause vertigo, dizziness and balance problems. The problem is that hypoglycemia isn't easily diagnosed because:

1. To determine whether or not you have a healthy glucose level, you must fast for 10 to 12 hours before the blood test is performed. Many of my vertigo patients have had their blood tested in a non-fasting state, which often does not accurately reveal abnormal glucose levels.

2. To interpret blood test results, you need to consider the “functional range” for glucose in the body. There is a difference between a functional range and a lab range, the range typically used to interpret blood tests of glucose level. Lab ranges are determined by a statistical analysis of all the blood that goes to a lab. Your glucose level is compared to the glucose levels of all other lab samples. If your glucose level is worse than 95% of the populace, then your test will be flagged as abnormal. Lab ranges for fasting glucose levels are often 60 to 99.

In contrast, functional ranges are based upon what the American Institute Of Chemists determines is a normal range. A functional range is not based on a sick population but rather normal physiology. Functional ranges for fasting glucose levels are 85 to 99.

Remember, in the medical model once pathology is ruled out for a vertigo patient, often a diagnosis of Benign Paroxysmal Positional Vertigo (BPPV)—or “inner ear problems” is given. Many patients don't respond to the medication or vestibular rehabilitation for this diagnosis. It's important to consider other factors that can cause or play a role in vertigo—and blood sugar is one of them.

Here are some of the symptoms of abnormal blood sugar levels:

- Craving sweets but eating sweets does not satisfy craving
- Irritability if meals are missed or delayed
- Dependence upon caffeine (coffee/tea) to keep yourself going
- Getting lightheaded if meals are missed
- Eating relieves fatigue
- Fatigue after meals
- Feeling shaky, jittery, tremors
- Feeling agitated, easily upset, nervous, anxious
- Poor memory, forgetful, confusion upon wakening
- Blurred vision
- Bad temper, mood swings
- Waist girth is larger than hip girth

If you are experiencing any of these symptoms along with vertigo, blood sugar abnormalities may be to blame. Talk with a functional medicine practitioner to get the treatment you need.