Wednesday, October 31, 2012

Updated Thoughts on The Vertigo Epidemic I Observed

This is a short update to my previous message on the increased incidence of vertigo I observed some months ago and which I properly labeled an epidemic. First, let me say that it is still occurring, as there are new people complaining of vertigo, though it does seem to be slowing down through the later month of October. And second, after looking in many possible online sites, and calling several public health authorities, there does not seem to be an awareness of this increased incidence, and it is that which I want to discuss.

Since we sent out the first notice, we have gotten over 200 emails with stories of people having experienced or experiencing new attacks of vertigo. And if I may, I would like to both thank and respond to many of those emails.

First let me try to describe what I think the vertigo is not caused by. Some people thought it related to the recent earthquake experienced in the northeast US. However, this increase in vertigo has been taking place for a number of months before that earthquake, and has been occurring throughout the US, so I don’t think these two things are related. Some people thought it is somehow related to lowered levels of Vitamin D. However, this issue of lowered vitamin D has been true for many years, and this increase in vertigo has only been noted in the last 3 months, so I do not think this is the case either. Also, I had looked at the vitamin D levels of some of these individuals in my own practice and their numbers were in the high normal range, so I do not think this is the issue.

Some people thought it may be related to the recent economic crisis. However, the recent economic crisis is actually not so recent, has been in place for several years, and yet, now, when it looks like the economics in the USA have been improving slightly, we have had this recent vertigo. I actually do not think this is related. Also, people experiencing vertigo have been those wealthy and not so wealthy, those who just lost a job or just found employment and those with stable work. Solar flares, radiation, etc., do not account for it as well, I think, given the nature of the symptoms.

I also do not think it is Lyme disease, as some have written to us to consider, since many of the people are spread out geographically, living in cities and rural areas. Also, Lyme disease, when characterized by symptoms of vertigo, does not present in the epidemic ‘spread pattern’ that this epidemic had.
What I do think is causing this is a viral infection. But here is were it gets tricky for me, which will explain why I worded my prior notice the way I did. First, there are numerous people who had a sort of ‘cold’ or minor upper respiratory tract infection, prior to the beginning of vertigo symptoms. Some patients had mild sinusitis with that infection. And so, for these people, it would be easy to say that vertigo is an odd, persistent vestige of the infection that they had just prior to beginning the vertigo. However, there were just as many people who did not seem to have a cold, but were feeling ‘run down’, tired, exhausted, for no apparent reason. And just as many people who did not experience anything at all that they are aware of prior to the onset of vertigo.

Here is what I believe is going on, though it would have cost too much to prove it. I think there is/was a viral infection that spread through the population, just as these things typically do. However, it think most people were either not susceptible, in which case did not develop any symptoms. Others were susceptible, and this is where it gets interesting. In those that were very susceptible, they developed respiratory symptoms plus the vertigo. Others that were differently susceptible still had to deal with the virus and were therefore run down or fatigued, and later developed the vertigo. And lastly, some patients are subclinical, meaning they were/are dealing with the virus, but do not show clinical symptoms, and perhaps later became clinical with regard to the vertigo.

The long and short of it is this: I believe that many of the people experiencing this vertigo had a virus, a cold of sorts. Some had symptoms of the cold and some did not. However, at the end they are experiencing this vertigo, which for some is ongoing. I cannot prove that a viral infection was the cause, and therefore left that out of the prior note. But I thought I should respond to all the emails I received, and at least add my thoughts.

There are two specific reasons I thought it important to describe. First, anytime there is an increased incidence of an ailment, people should be made aware of it. And second, many people who are experiencing this went to their physicians, who did not find anything. In fact, many of the people thought that they had a brain tumor or multiple sclerosis or some other serious problem. The level of anxiety of some patients has been exceedingly high. Finding out that there may be a less severe reason to explain this symptom is helpful. Obviously, one still needs to follow diagnostic protocols to make sure there is no other, more serious, underlying reason for this symptom. If all the diagnostic work-up is negative, then I would venture to guess that the vertigo may be related to a prior viral infection. As with all other viruses, this epidemic is likely to die down. As mentioned before, the most common treatment was Cocculus indicus, with its attendant symptoms. I am curious, though, to find out what happens to the people who have been settled with the vertigo for an extended period of time. If you are one of the people who had this happen to you, would you mind keeping in touch? I would love to know what happened to the vertigo one year hence, in the Fall of 2013.

Until next time,
Paul Herscu ND, MPH

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