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How Do Chronic Conditions Affect the Balance System? - Part 1

By Eric Bostwick, AuD, CCC-A, FAAA; Amanda McVey, AuD, CCC-A | September 16, 2018

Hearing and balance are two functions of the body that are often taken for granted—until something goes wrong. In fact, there are many common diseases and disorders that can cause a person's balance system to “go wrong.” If you suffer from a chronic disease, you may already have a doctor who manages your care, so why should you consider an additional evaluation from an Ear, Nose and Throat (ENT) doctor and Audiologist? In celebration of this year's Balance Awareness Week (September 16-22, 2018), take a few minutes to learn why it may be time for you or your loved one to visit an ENT doctor or audiologist.

What is the balance system?

Maintaining balance is an important aspect of any type of movement, from getting out of bed in the morning to physically demanding activities like sports and exercise. A person’s balance and sense of stability depends on the brain connecting information from three complex systems:
  • Visual system (eyes and related anatomy)
  • Proprioceptive system (our ability to know where our body is in space)
  • Vestibular system (the balance sensors in the inner ear)
If one or more of these systems is not functioning correctly, it can cause dizziness, loss of spatial awareness, imbalance, vertigo (spinning sensation), visual disturbances, confusion, hearing difficulties, and in some cases, falls.

How do your ears contribute to balance? 

Your ears are used for more than just communication—they play a vital role in your overall health and your balance system. Your inner ear canals have hair cells and fluid that help your brain sense movement and spatial awareness, ultimately helping you keep your balance as you move. And just like other parts of your body, your lifestyle choices and health conditions can have a major impact on how well or poorly your ears function. 

Chronic Disease and Balance

Chronic conditions can affect multiple areas of the body, including the ones in charge of maintaining balance. Heart disease, diabetes, kidney disease, temporomandibular joint disorder, and thyroid disorders are a few of the diseases and disorders that can cause damage to these systems. 

We discuss how heart disease and diabetes can affect your hearing and balance systems in the sections below. Check out part two of this blog post to learn more about the effect of kidney disease and thyroid disorders. 

Heart Disease 

Cardiovascular disease describes many conditions that affect the heart and the connected blood vessels. Examples include high blood pressure, stroke, and congestive heart failure. These conditions stop blood from being effectively delivered to the many organs in the body. 

One main artery supplies blood to the organs of the hearing and balance systems. Due to this blood vessel’s small size and the lack of alternate routes for blood to travel, the hearing and balance systems are particularly susceptible to decreased blood flow and damage. The organs responsible for hearing and balance require a significant amount of oxygen and nutrients carried by blood to perform their tasks, and decreased blood flow can be harmful to their function. 

A cardiovascular injury to the inner ear may cause you to lose hearing and/or experience dizziness for long periods of time, sometimes for several days. The best way to prevent damage to the balance system is to prevent or manage the cardiovascular disease itself. Treatments for cardiovascular disease include diet and lifestyle changes, medications, or surgical procedures. 

Diabetes

Diabetes is a chronic disease that can affect almost every organ of the body and has the potential to cause serious, widespread complications. Diabetes causes an increase in blood sugar levels due to a lack of the hormone insulin, which allows the body to process sugar. This metabolic stress causes damage to blood vessels and the nerves and can affect all three important aspects of balance – the visual, proprioceptive and vestibular systems. 

Overall, the changes to these systems can result in balance problems and increase fall risk, particularly in low-light situations (e.g. walking through your house at night to use the restroom) and with tripping hazards (rugs, stairs, etc.). If diabetes has affected your balance system, you may benefit from rehabilitation to improve dizziness symptoms, including targeted exercise plans, balance retraining, and development of compensatory strategies that emphasize other sensory inputs.

If you experience dizziness and balance issues, talk to your doctor immediately. You may benefit from an evaluation by an ENT doctor and Audiologist. Call 844-570-1767 or submit a request online.