13 Facts About Vertigo

Illustration by Mental Floss. Images: iStock
Illustration by Mental Floss. Images: iStock

It comes on suddenly. You feel like you're spinning—or maybe the world is spinning around you. Your stomach heaves, and you hold onto something so you don't fall. This is vertigo, a hallucination of motion—a mismatch between reality and the signals your eyes, inner ears, and sense of touch are sending your brain. Vertigo is a symptom, not a disease—an indication that something is wrong in the body—and it's surprisingly common. Here's what you need to know about the condition.

1. HAVING VERTIGO ISN'T THE SAME THING AS BEING DIZZY.

Dizziness is an umbrella term that describes the sensation of feeling lightheaded or faint. As kids, many of us experienced (and even enjoyed) that kind of garden-variety dizziness while spinning on a merry-go-round, but the sensation can also be caused by dehydration, motion sickness, or even a drop in blood pressure after standing up too fast.

While vertigo does make you dizzy, it also makes you feel like you’re spinning, swaying, or tilting. Some people with vertigo sense their bodies moving in space even though they’re standing still, while others sense their surroundings moving around them. A good way to tell you're experiencing vertigo and not just dizziness is that you feel like you're going to lose your lunch: “A person with vertigo can feel ill with nausea, vomiting, and other motion sickness-like symptoms,” says David Zee, a neurologist at Johns Hopkins University and a specialist in vertigo.

2. IT'S A VESTIBULAR DISORDER.

The name refers to the system located in parts of the inner ear and the brain that control balance and eye movements. The most common vestibular disorders often induce vertigo. Others include bilateral vestibular hypofunction (which causes balance problems), acoustic neuroma (a kind of benign tumor that can cause tinnitus or hearing loss), and a variety of autoimmune inner ear diseases.

3. MOST CASES OF VERTIGO ARE CAUSED BY TINY ROCKS IN YOUR HEAD …

Doctors split vertigo into two categories: peripheral or central. The former, which originates in the inner ear, is far more prevalent than the latter.

The most common form of peripheral vertigo is benign paroxymal positional vertigo (BPPV). BPPV comes on quickly, causing disorientation and stumbling; some even fall out of bed. (People can mistake it for a stroke, and not without reason—sudden vertigo and loss of balance experienced at the same time can be signs of one.) Most episodes last about a minute and recur over a period of a few days or weeks.

The majority of peripheral vertigo is caused by otoconia (also called canaliths), tiny limestone and protein crystals that reside deep inside your ear in the vestibule. You’d need a high-powered microscope to see a single otoconium—they’re roughly 10 microns across, or about 0.000393701 inches. Despite their small size, "otoconia create a lot of mischief,” Zee says. “These little stones can get dislodged and kind of float around, producing a powerful false sense of spinning.”

Most of us likely have a few renegade stones floating around in our inner ears, but it’s only when large clumps of more than three or four stones form and get loose that there’s a problem. Why they dislodge and relocate remains a mystery, but in some cases, the stones' movements can be triggered by external motion—a knock on the head or a ride on a bumpy road.

4. … BUT THERE ARE OTHER TRIGGERS.

Migraine headaches can bring on the dizzying sensation, as can lying in the magnetic field of an MRI machine. Other causes include labyrinthitis, an infection in the inner ear, and vestibular neuronitis, an infection of the vestibular nerve, which controls balance. Some people have a rare type of chronic peripheral vertigo called Meniere’s disease, which is caused by a buildup of fluid in the inner ear. Often doctors can’t pinpoint a specific cause for an episode of vertigo.

5. ONE TYPE OF VERTIGO CAN PERSIST FOR A LIFETIME—BUT IT'S RARE.

Far less common is central vertigo, which originates in the brain. Symptoms can vary, but a person with central vertigo is often unable to walk due to severe imbalance and may have nystagmus—strange, involuntary eye movements. This type of vertigo can be caused by diseases or injuries to the brain, such as multiple sclerosis, tumors, concussions, or strokes. In some cases, it lasts for weeks or even the rest of someone's life, especially if they have permanent brain damage.

6. VERTIGO AFFECTS MILLIONS OF PEOPLE OF ALL AGES.

Nearly one-third of people over the age of 40 in the U.S.—roughly 69 million people—will experience vertigo at least once in their lives. It’s much more common in older people, especially those over the age of 60. But anyone can get vertigo, including children (though it may be harder to spot in kids because they can have difficulty describing their symptoms). Professional golfer Jason Day was just 27 when he developed vertigo during the U.S. Open, and basketball player Pau Gasol was in his early thirties when the condition benched him. Some medical historians believe Charles Darwin suffered from vertigo later in life.

7. WOMEN ARE THREE TIMES MORE LIKELY TO DEVELOP VERTIGO THAN MEN—BUT SCIENTISTS DON'T KNOW WHY.

Recent research suggests the disparity might be related to bone loss caused by aging, vitamin D deficiency (which impairs how the body metabolizes calcium—a key component of the otoconia’s mineral composition), or the increased frequency of migraine among women.

8. VERTIGO CAN BE EXTREMELY DISTRESSFUL.

Because it's so disorienting and comes on so suddenly, vertigo can cause anxiety and panic attacks. Chronic vertigo can cause depression in some people because doing everyday tasks—like caring for themselves, their children, or their family—is often impossible. They might even lose their job because driving is out of the question.

9. IT'S POSSIBLE TO GET SOME RELIEF FROM CERTAIN MEDICATIONS …

Drug treatments vary, based on the type of vertigo a person has, and generally target the symptoms of vertigo, not the cause. Antiemetics such as meclizine may inhibit the nausea or vomiting that accompanies most types of vertigo. For migraine-associated vertigo, doctors may prescribe beta blockers, anticonvulsants, or antidepressants. People with Meniere's disease may benefit from steroids or non-pharmaceutical approaches, such as a low-salt diet, which reduces fluid retention, or surgical procedures that help drain the inner ear.

10. … BUT PHYSICAL THERAPY IS THE ONLY THING THAT REALLY HELPS MOST CASES OF VERTIGO.

The most commonly used therapy for BPPV is the Epley maneuver (also known as a canalith repositioning procedure). Essentially, the exercises are human versions of those ball-in-a-maze puzzles you played as a kid, where you rolled a bead around in a maze, trying to get the bead to go into a hole. The goal is to roll the renegade otoconia (the beads) through the maze of canals inside your ear and return them to the vestibule (the hole). These moves, which take 15 minutes or less, resolve symptoms in about two-thirds or more of people with vertigo—usually after just a few tries.

11. DANCING CAN MAKE IT BETTER.

As you get older, you lose neurons in your inner ears, your brain’s coordination center, and in your feet—a triple whammy of losses that sets up a perfect storm for balance problems, Zee tells Mental Floss. But activities that challenge your sense of balance—like tai chi, yoga, or dancing—help in the long run. You don't get have to be as nimble as Johnny Castle log dancing or blind Frank Slade doing the tango—just get moving to the beat when your favorite songs come on.

12. VERTIGO DOESN'T STOP A GUINNESS WORLD RECORD HOLDER FROM SCALING BUILDINGS.

In 1982, French climber Alain Robert sustained massive injuries when he took a header from a rocky cliff during one climb—and though he recovered from multiple broken bones, the severe head trauma he sustained left him with chronic vertigo. Despite his condition, Robert returned to climbing (almost always without safety equipment), tackling the Empire State Building, the Eiffel Tower, and a multitude of other tall structures, eventually scaling the Burj Khalifa—the world’s tallest building. He now holds the Guinness World Record for climbing the most buildings.

13. IN VERTIGO, HITCHCOCK GOT THE SPECIAL EFFECTS RIGHT BUT THE CONDITION WRONG.

Named the “greatest film of all time” by the British Film Institute’s Sight and Sound magazine, Vertigo, starring Jimmy Stewart and Kim Novak, is a twisted tale about the human psyche, full of mystery, romance, and suspense—classic Hitchcock. The film is famous for its pioneering use of the dolly zoom—a camera technique sometimes called "the Vertigo effect" that recreates the unsettling experience. Although Hitchcock got the special effects right, the condition that Jimmy Stewart’s character had is not vertigo—it's acrophobia, or fear of heights. When a person with acrophobia looks down from a great height, they might feel vertiginous—but they're not experiencing a vestibular disorder. The reaction may be rooted in humans’ natural fear of falling.

The CDC Is Here to Ruin the Holidays By Reminding You Not to Eat Cookie Dough

iStock.com/YinYang
iStock.com/YinYang

The holidays are upon us and, right on schedule, the Centers for Disease Control and Prevention (CDC) has arrived to crush one of the small joys the season has to offer. As The Takeout reports, the CDC issued a statement recently reminding us to abstain from eating raw cookie dough while baking, no matter how great the temptation may be.

Cookie dough, though delicious, is unfortunately unsafe to consume any time of year. The dough contains raw eggs that can potentially harbor salmonella, a type of bacteria that causes fever, diarrhea, and abdominal pain. And the risk of salmonella poisoning isn't the only reason to avoid raw dough: Uncooked flour hasn't been treated to kill germs, which means it may be carrying E. coli. The bacteria—which induces symptoms similar to those seen with salmonella exposure—can stay dormant in flour for months and reactivate when it's mixed with eggs, oil, and water. The only way to make sure your cookies are safe to eat is by giving them plenty of time to bake in the oven.

It's widely known that sampling raw cookie dough comes with health risks, but some of us need an extra reminder ahead of holiday cookie swap season.

"There are many special occasions through the year that are perfect to spend time with loved ones while preparing delicious baked foods in the kitchen," the CDC said in its statement. "When you prepare homemade cookie dough, cake mixes, or even bread, you may be tempted to taste a bite before it is fully cooked. But steer clear of this temptation."

Cookies are so appealing in their uncooked form that there are entire businesses built around cookie dough that's purportedly safe to eat. New York and London are both home to cookie dough cafes, and in 2014, a company that sells edible dough by the tub found success on Shark Tank. If you don't have access to safe-to-eat dough this holiday season, there are plenty of fully-baked cookie options out there to choose from.

[h/t The Takeout]

14 Facts About Celiac Disease

iStock.com/fcafotodigital
iStock.com/fcafotodigital

Going gluten-free may be a modern diet trend, but people have been suffering from celiac disease—a chronic condition characterized by gluten intolerance—for centuries. Patients with celiac are ill-equipped to digest products made from certain grains containing gluten; wheat is the most common. In the short-term this can cause gastrointestinal distress, and in the long-term it can foster symptoms associated with early death.

Celiac diagnoses are more common than ever, which also means awareness of how to live with the condition is at an all-time high. Here are some things you might not know about celiac disease symptoms and treatments.

1. Celiac an autoimmune disease.

The bodies of people with celiac have a hostile reaction to gluten. When the protein moves through the digestive tract, the immune system responds by attacking the small intestine, causing inflammation that damages the lining of the organ. As this continues over time, the small intestine has trouble absorbing nutrients from other foods, which can lead to additional complications like anemia and osteoporosis.

2. You can get celiac disease from your parents.

Nearly all cases of celiac disease arise from certain variants of the genes HLA-DQA1 and HLA-DQB1. These genes help produce proteins in the body that allow the immune system to identify potentially dangerous foreign substances. Normally the immune system wouldn't label gliadin, a segment of the gluten protein, a threat, but due to mutations in these genes, the bodies of people with celiac treat gliadin as a hostile invader.

Because it's a genetic disorder, people with a first-degree relative (a sibling, parent, or child) with celiac have a 4 to 15 percent chance of having it themselves. And while almost all patients with celiac have these specific HLA-DQA1 and HLA-DQB1 variations, not everyone with the mutations will develop celiac. About 30 percent of the population has these gene variants, and only 3 percent of that group goes on to develop celiac disease.

3. Makeup might contribute to celiac disease symptoms.

People with celiac disease can’t properly process gluten, the protein naturally found in the grains like wheat, rye, and barley. Patients have to follow strict dietary guidelines and avoid most bread, pasta, and cereal, in order to manage their symptoms. But gluten isn’t limited to food products: It can also be found in some cosmetics. While makeup containing gluten causes no issues for many people with celiac, it can provoke rashes in others or lead to more problems if ingested. For those folks, gluten-free makeup is an option.

4. The name comes from 1st-century Greece.

A 1st-century Greek physician named Aretaeus of Cappadocia may have been the first person to describe celiac disease symptoms in writing [PDF]. He named it koiliakos after the Greek word koelia for abdomen, and he referred to people with the condition as coeliacs. In his description he wrote, “If the stomach be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs.”

5. There are nearly 300 celiac disease symptoms.

Celiac disease may start in the gut, but it can be felt throughout the whole body. In children, the condition usually manifests as bloating, diarrhea, and abdominal discomfort, but as patients get older they start to experience more “non-classical” symptoms like anemia, arthritis, and fatigue. There are at least 281 symptoms associated with celiac disease, many of which overlap with other conditions and make celiac hard to diagnose. Other common symptoms of the disease include tooth discoloration, anxiety and depression, loss of fertility, and liver disorders. Celiac patients also have a greater chance of developing an additional autoimmune disorder, with the risk increasing the later in life the initial condition is diagnosed.

6. Some patients show no symptoms at all.

It’s not uncommon for celiac disease to be wrecking a patient’s digestive tract while showing no apparent symptoms. This form of the condition, sometimes called asymptomatic or “silent celiac disease,” likely contributes to part of the large number of people with celiac who are undiagnosed. People who are at high risk for the disease (the children of celiac sufferers, for example), or who have related conditions like type 1 diabetes and Down syndrome (both conditions that put patients at a greater risk for developing new autoimmune diseases) are encouraged to get tested for it even if they aren’t showing any signs.

7. It’s not the same as wheat sensitivity.

Celiac is often confused with wheat sensitivity, a separate condition that shares many symptoms with celiac, including gastrointestinal issues, depression, and fatigue. It’s often called gluten sensitivity or gluten intolerance, but because doctors still aren’t sure if gluten is the cause, many refer to it as non-celiac wheat sensitivity. There’s no test for it, but patients are often treated with the same gluten-free diet that’s prescribed to celiac patients.

8. It's not a wheat allergy either.

Celiac disease is often associated with wheat because it's one of the more common products containing gluten. While it's true that people with celiac can't eat wheat, the condition isn't a wheat allergy. Rather than reacting to the wheat, patients react to a specific protein that's found in the grain as well as others.

9. It can develop at any age.

Just because you don’t have celiac now doesn’t mean you’re in the clear for life: The disease can develop at any age, even in people who have tested negative for it previously. There are, however, two stages of life when symptoms are most likely to appear: early childhood (8 to 12 months) and middle adulthood (ages 40 to 60). People already genetically predisposed to celiac become more susceptible to it when the composition of their intestinal bacteria changes as they get older, either as a result of infection, surgery, antibiotics, or stress.

10. Not all grains are off-limits.

A gluten-free diet isn’t necessarily a grain-free diet. While it’s true that the popular grains wheat, barley, and rye contain gluten, there are plenty of grains and seeds that don’t and are safe for people with celiac to eat. These include quinoa, millet, amaranth, buckwheat, sorghum, and rice. Oats are also naturally gluten-free, but they're often contaminated with gluten during processing, so consumers with celiac should be cautious when buying them.

11. Celiac disease can be detected with a blood test.

Screenings for celiac disease used to be an involved process, with doctors monitoring patients’ reactions to their gluten-free diet over time. Today all it takes is a simple test to determine whether someone has celiac. People with the condition will have anti-tissue transglutaminase antibodies in their bloodstream. If a blood test confirms the presence of these proteins in a patient, doctors will then take a biopsy of their intestine to confirm the root cause.

12. The gluten-free diet doesn’t work for all patients.

Avoiding gluten is the most effective way to manage celiac disease, but the treatment doesn’t work 100 percent of the time. In up to a fifth of patients, the damaged intestinal lining does not recover even a year after switching to a gluten-free diet. Most cases of non-responsive celiac disease can be explained by people not following the diet closely enough, or by having other conditions like irritable bowel syndrome, lactose intolerance, or small intestine bacterial overgrowth that impede recovery. Just a small fraction of celiac disease sufferers don’t respond to a strict gluten-free diet and have no related conditions. These patients are usually prescribed steroids and immunosuppressants as alternative treatments.

13. If you don’t have celiac, gluten probably won’t hurt you.

The gluten-free diet trend has exploded in popularity in recent years, and most people who follow it have no medical reason to do so. Going gluten-free has been purported to do everything from help you lose weight to treat autism—but according to doctors, there’s no science behind these claims. Avoiding gluten may help some people feel better and more energetic because it forces them to cut heavily processed junk foods out of their diet. In such cases it’s the sugar and carbs that are making people feel sluggish—not the gluten protein. If you don’t have celiac or a gluten sensitivity, most experts recommend saving yourself the trouble by eating healthier in general rather than abstaining from gluten.

14. The numbers are growing.

A 2009 study found that four times as many people have celiac today than in the 1950s, and the spike can’t be explained by increased awareness alone. Researchers tested blood collected at the Warren Air Force Base between 1948 and 1954 and compared them to fresh samples from candidates living in one Minnesota county. The results supported the theory that celiac has become more prevalent in the last half-century. While experts aren’t exactly sure why the condition is more common today, it may have something to do with changes in how wheat is handled or the spread of gluten into medications and processed foods.

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