Vertigo & Balance

Vertigo is the false sensation that you or your surroundings are spinning or moving.

It usually points to a problem in the vestibular system of the inner ear or in the nerve pathways that connect it to the brain.

Balance depends on a constant flow of information from the inner ear, the eyes and the muscles.

When the inner ear sends faulty signals, the brain receives conflicting messages and the result is dizziness, unsteadiness and sometimes nausea.

One of the most recognised causes is Meniere's disease, a long-term inner-ear condition linked to a build-up of fluid in the labyrinth.

It typically causes recurring episodes of rotational vertigo, a feeling of fullness in the ear, fluctuating hearing loss and tinnitus.

Attacks can last from minutes to several hours and may be unpredictable.

Not all dizziness is vertigo. Lightheadedness, fainting and general unsteadiness can have other causes such as low blood pressure or medication side effects.

Understanding the pattern of your symptoms, including how long episodes last and what triggers them, helps a doctor decide whether inner-ear treatment is appropriate for you.

Betahistine dihydrochloride is the active ingredient in Betaserc. It is a histamine analogue that acts as a weak agonist at H1 receptors and a stronger antagonist at H3 receptors.

Through this dual action it is thought to improve blood flow in the small vessels of the inner ear, particularly in the stria vascularis of the cochlea.

By enhancing this microcirculation, betahistine is believed to reduce the pressure of fluid in the inner ear and help restore normal signalling from the balance organs.

In people with Meniere's disease this can mean fewer and less severe vertigo attacks over time, along with some improvement in associated pressure and ringing in the ears.

Betahistine is usually taken as tablets several times a day, with the exact dose set by the prescribing doctor.

It is taken regularly rather than only during an attack, because the benefit builds up gradually.

It is not a sedative and does not generally cause drowsiness, which means most people can continue their normal routine.

As with any prescription medicine, it should be taken exactly as directed and reviewed periodically to check that it is still helping.

The hallmark symptom in this category is true vertigo: a spinning or tilting sensation that may come on suddenly and force you to sit or lie down.

During an attack you may also feel nauseous, sweat, or have difficulty focusing your eyes. Many people describe a feeling of pressure or fullness in one ear just before an episode begins.

Other symptoms linked to Meniere's disease include tinnitus, often heard as a low roar or ringing, and hearing that comes and goes, especially for lower tones.

Over the years, hearing in the affected ear may decline more permanently. Between attacks, some people feel completely well, while others have lingering unsteadiness.

Certain warning signs need urgent medical assessment rather than online care.

Sudden one-sided hearing loss, a severe headache, double vision, slurred speech, weakness in the face or limbs, or vertigo following a head injury can signal a more serious problem and should be checked in person without delay.

If you are unsure, always seek face-to-face medical advice first.

Alongside medication, simple lifestyle steps can make vertigo more manageable. Many people with Meniere's disease find that reducing salt in their diet helps limit fluid retention in the inner ear.

Spreading fluid and salt intake evenly across the day, rather than in large amounts, may also reduce the chance of an attack.

Caffeine, alcohol and nicotine can affect inner-ear circulation and are worth limiting if you notice they trigger symptoms.

Regular sleep, staying well hydrated and managing stress are all helpful, since tiredness and tension often make episodes worse.

Keeping a simple diary of attacks and possible triggers can reveal useful patterns to discuss with your doctor.

When an attack strikes, sit or lie still in a quiet place and fix your gaze on a stationary point until the spinning eases. Avoid driving or operating machinery while symptoms are active.

Vestibular rehabilitation exercises, taught by a physiotherapist, can help the brain adapt to faulty balance signals and improve steadiness over time.

Combining these habits with prescribed treatment gives the best chance of keeping symptoms under control.