For sure 
ā¦and this is why ARBS can help as it supports RAAS. It always comes back to either a lack of steroid hormones (why prednisolone helps) or an inability to handle a high amount (receptor burnout? Donāt know)
Post food, with stimulants, awakening response, post exerciseā¦ pregnancy (late stage when Progesterone and Estrogens are high - neurosteroids affecting brain excitability)
Probably also helps explain the common comorbidity with PCOS which would more properly be named pan endocrine disorder. Women are more likely to have TMJD.
Interesting!
Expansion of the Endolymph is itself considered by some a (natural) inflammatory response, so the involvement of Aldosterone isnāt entirely a surprise.
So this does start to look more and more like some kind of hormonal systemic dysfunction in women for those without other cause. Perhaps treatments focusing on that might bring relief to some classes of MAV sufferers?
Iām curious about this ā¦ what might be the driver there?
No idea on the TMJD though estrogen has a big effect on your ligament strength. And women are more prone to osteoporosis. Could be either of those.
I can say treatment for the endocrine disorder that is PCOS with Metformin (a glucose regulating diabetes drug) and Spironolactone (an anti-androgen) is helpful for me with respect to MAV. The less glucose in my system, the less ear fullness I have.
I remember reading an article where a woman in her 60ās presented with dizziness and MAV like symptoms. She was put on very low dose fludrocortisone for 2 years before tapering offā¦ fixed.
Yes, with stress you raise blood sugar and also retain sodium. Supporting these systems will help.
I read fludrocortisone and a beta blocker Bisoprolol are used to treat POTS.
Itās also then no wonder that psychiatry and psychotherapy are successfully prescribed and why some antidepressants are effective.
My issue with antidepressants is that I see them treating a downstream effect of MAV and why tapering off usually sees the return of symptoms.
There isnāt a single treatment that treats the underlying issue rather than masking symptoms.
I have read various clinicians saying they couldnāt understand why SSRIās would work but then on here we recently heard of a MAVers who had had eight years of success with Citalopram. I was once prescribed that when the Doc in question was convinced my dizziness was anxiety. Canāt help wondering now whether it would have worked and No I definitely didnāt have anxiety at that point. Most definitely not.
Antidepressants help with anxiety and therefore supports one pathway that evokes the sympathetic nervous system.
The answer will be multifactorial because the SNS is activated by numerous ways.
Must be natty little things ARBs (losartan, Candesartan etc). After much debate and indecision it is apparently now consensus that they help those taking them for heart problems in their fight against Covid-19.
Interesting!
Yes. Yes. Yes. Yes. What we all need now is for somebody medical somewhere to do something about it please.
Predictor of COVID-19 - Diabetes
Nearly half of C-19 patients have hyperglycaemia even with no prior diabetes diagnosis.
Candesartan - Prevents diabetes in heart patients
RAAS is implicated in glucose control. Diabetes patients have issues with dehydration. Dehydration = higher blood glucose
Feeling worse in the morningā¦ dehydration. Sodium / water retention (ear fullness)
Feeling worse nearing pregnancy or during luteal phase - high progesterone and estrogen - higher blood sugar / cause of insulin resistance
MAV catalyst:
Stress / high epinephrine levels induced hyperglycaemia. Damages insulin production.
High / dysregulation in aldosterone leading to blood vessel inflammation and constriction. Poor Nitric Oxide production leads to poor immunity and inflammation. MAV seems to link hormonal issues / insulin + blood sugar problems / electrolyte imbalances / immune system weakness / impaired circulation all in one condition.
I have had supportive benefits from supplementing with citrulline in the past when I was researching into NO before. Will reintroduce this into my current routine.
@Belindy do check out the paper @turnitaround posted above entitled Sex Hormones and Inner Ear. The sort of ear pressure I experience is pressure I find very much the same as the rear head pressure I have experienced which the neurologist told me was the migrainous element of the condition. Occasionally I get a little click but itās the pressure feeling that affects my balance.
The clicking is natural I suspect. It happens in my good ear. It just happens more often in my bad ear which leads me to suspect itās the body trying to clear junk in the middle ear by exercising the little chain of bones. A bit like an automatic coffee machine releasing the old coffee.
Wow how interesting!! There is definitely something to this thatās for sure. Would help to explain your case maybe Helen. Bloody hormonesā¦ I actually hate that they control so much of me all the time! Hope they research more into this. Itās hormones and earsā¦ there, we have solved it for them!