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A psycho-neuro-immunology perspective on MAV


Hi all,

I’ve been reading the book “When the body says no” by Canadian MD Gabor Mate where he defines psychoneuroimmunology thus:

“What is psychoneuroimmunology? As I learned, it is no less than the science of the interactions of mind and body, the indissoluble unity of emotions and physiology in human development and throughout life in health and illness”

In this book he makes a convincing case that most illnesses in modern society are caused by identifiable or often hidden, persistent stressors and their resultant effect on the body over many years.

Yet I see that in most of the MAV discussions on this site the emphasis is on pills, doctors, diet, exercise.
I too, used to think that diet and proper breathing are most important but if Gabor is right they are only part of the problem. Indeed, if the ratio of gases in your blood and tissues such as CO2, O2 is wrong (e.g. severe asthma) then diet would be the least of your problems. Furthermore, if you are living with persistent stress (which may be invisible, much the same way as overbreathing is not readily identifiable as hyperventilation), then your diet and breathing patterns may be the least of your problems.

If psychoneuroimmunology research is right then for all of us here to get to where we are (MAV, vertigo, etc) we have some serious psychological/emotional/stress issues to work through, and not until we resolve them can we begin the process of healing.
Some relevant quotes that I found illuminating here: good reads link


Hate to bang the drum again, but I reckon there are several causes of MAV … but my bet is all of them involve a disturbance of the homeostasis of the inner ear. It’s clear that MAV is vestibular-central and despite there being a huge migraine element to it (leading to lots of neurological symptoms and resistance to compensation), the vestibular-centric nature of it for me suggests inner ear involvement. For some that can happen with injury (classic Secondary Hydrops like myself) but for others it’s not so easily explained … there definitely is a scientifically identified ADH hormone influence on homeostasis of the inner ear and long-term stress might be a factor. I’ve heard neuro’s talking about the anxiety of the condition inhibiting recovery too …


Can we dig deeper than “a disturbance of the homeostasis of the inner ear?”.
What causes cancer/MS/rheumatoid arthritis/dementia/disturbance of the homeostasis of the inner ear?".
Medicine has no conclusive answers for these things.
Sure, there can be purely physical causes but how come most of us with vestibular issues don’t get better over the long term? You mention anxiety, yes this is what the MD I visited pointed out too. It’s one component.
The thing is what if pills/diet/physical therapy is not solving the root causes, such as repressed emotions, unhealthy relationships/etc. I am afraid many of us are seeking solutions that do not address the root causes of how we got here in the 1st place.


Yes, this was very surprising and shocking to me once I started digging deeper into the the journals. I’m sure in time there will be more answers, though.

This is a super-contentious subject but I’m unapologetic about challenging the dogma that some subscribe to - without challenge we don’t move things forward.

I’ve shared previously what I believe to be one of the most complete models of inner-ear homeostasis-gone-wrong in the attached paper:

Quite. Exactly my thoughts, except that at least the treatment may be working in some way, so let’s not discount that. We may not know why some of the treatments work, but at least they do.

I’m confident that a lot of people do get better, but a minority do seem to struggle on for reasons we don’t yet know … (estimates of between 10-20% of sufferers making up that minority according to some doctors)

I personally think the perception of rates of recovery is somwhat marred by the fact that recovery in any case can take years …


As stress is part of our lives, for some of us from cradle to grave, it will of course manifest itself in many ways, one of which may well be ill health. The problem is it is an unavoidable fact of life and we have to learn to deal with the consequences. If it manifests as VM then we have to take whatever steps necessary to alleviate the symptoms. Knowing that the root cause is stress does not actually solve the problems because we cannot undo the original stressors. If they were in childhood no amount of talking will put right the damage that has been done or the affect that level of stress has had on the personality and coping mechanisms of that person.

Maybe some people are happy knowing stress is the cause but I would then question why VM, why not cancer or an autoimmune disease? So round and round we go. Is there a genetic weakness that leads us to VM because of stress instead of another disease then.

I totally understand the thinking behind stress and disease but not why some people get one form of disease as a result of stress and not another. Which leads me back to why VM? What is the common denominator in all of us that gives us VM as apposed to some other disease?


For some answers to your question "What is the common denominator in all of us that gives us VM as apposed to some other disease?"
we can turn to the ancient medicinal system of Ayurveda.
The common denominator in all of us with VM is “vata dosha” imbalance per Ayurveda. Derangement of vata (i.e. air, ether element in body) is one of the main causes of dizziness.
Therefore, the majority of VM sufferers share these characteristics – thin and bony (as opposed to stocky) builds; flighty; tend to have excess gas (burps, flatulence), weak digestion and elimination; shallow sleep that is not revivifying; aversion to wind and cold, appendages that are cold; full hair (as opposed to balding/receding hair); propensity to move quickly; have nervousness, racing thoughts, anxiety (more prone to panic attacks too); not good with money, they easily slip away in their hands, hence have difficulty accumulating a high networth even if they come into a large inheritance; creative and full of ideas but do not follow through or abandon endeavors mid way; exhibit larger emotional amplitudes than others; irregular eating, sleeping patterns.


While some of those are kind of true, I’m a burly bearded Canadian who loves wind and cold, is always warm and is balder than a cue ball. VM still got to me


In your case pitta (fire element) is dominant, that’s what led to baldness and love of cold.
Causes vary, VM may be due to inner ear imbalance or pituitary tumors or something else entirely.
Vata imbalance is the most typical cause of dizziness, often attended by tinnitus.
The thing that people fail to grasp is that illness cannot and should not be viewed in isolation from the environment, upbringing, emotional baggage, relationships with others (healthful, toxic, etc), social isolation.
In NIH publications and countless others the focus is on cellular level interactions and minutiae.
But this is utterly non-sensical per Gabor Mate’s contention because it fails to take into consideration the above factors. They ultimately explain disease or health, rarely can a health issue be traced to purely physical causes.

It is a shame that in our pill popping society many VM sufferers have no genuine interest whatsoever in other points of view. Through short-sightedness they believe in doctors, pills, diets, positive thinking (which is often a costume we don to protect ourselves and to hide our inability to face reality as it is). Depth of soul searching is too much to ask for.


All I have to say is please show the scientific data that explains all this then. Tests show results and data. I’m in the field of work where you quantify with data. Not mystery energies. All I ask for is quantify with data so I can believe or be persuaded in your thought.


And I repeat, stress is a fact of life so how on this earth do we lead such a purified, blissful existence to avoid it and thus I’ll health!!!It is not a question of being narrow minded and wanting to pill pop, it is a matter of practicality, life and survival in the environment we find ourselves in. If we could all go sit on a mountain top and meditate perhaps that would help, but reality is we deal with work, relationships, money and our health in the every day world in which we find ourselves. What about all those poor people in war torn countries, or those plagued by drought and famine? They won’t all get VM I hope!!!


I think every migraine and MAV website and specialist cites Stress as a major trigger, perhaps the most important. Dr S certainly does.

“He said the vast majority of people with this condition have been under undue or chronic stress in the 18-24 months prior to its onset.”

Stress is cited as a major factor even for Ménière’s. Destressing and lifestyle change is one of the most often quoted ways to manage the condition. So I’m agreeing but it’s not a revelation, it’s well-known.

But I do think it rather pointless though to suggest MAV affects predominantly skinny people with flatulence who are not good with money. That seems to me to be in the realm of unicorns and pixies. Let’s stick to evidence-based reason.

James (turnitaround) previously posted a good article on migraine as allostatic load model, which proposed that migraine is more common for those with maladaptive stress response, in other words those who physiologically do not deal well with stress, it actually makes them unwell (as opposed to functioning better/faster etc). There may be some truth in that.


The mind and body are one. Emotions play a large role in our health. Someone told me if you do not express your emotions your body will.


Interesting that you brought up stress. I just saw an otologist who said that my symptoms were not all that serious, and that a lot of it was due to anxiety, and that I should get an antidepressant. He thinks that it will eventually go away. No advice about what to do in the meantime, except to resume my life as much as I could. Well, that’s kind of hard to do when I can’t read, sit at the computer, write, or do anything for too long without becoming dizzy, feeling sick, having headaches and feeling overcome with fatigue, so exhausting. And this has been going on for almost three months But I think his advice may have been influenced by my telling him that I had quit smoking pot and drinking 7 days prior to coming down with the inner ear virus. I’m also a very intense person to begin with, and tend to over do, over think and obsess a lot, so I do think stress plays a role, and certainly makes the symptoms a lot worse. Meanwhile, my optometrist, who had tested my eyes before I got the virus, and then tested them afterwards, concluded that whatever attacked my vestibular system, has affected my vision big time. My eyes cannot focus at the computer for very long, and I feel they have to work twice as hard. But I also wake up sometimes with dizziness, a sick feeling and a headache, so there are many factors at play. My optometrist suggested getting vestibular rehabilitation. I got evaluated by them and they diagnosed me with BPPV, vestibular hypofunction, and also observed that my eyes were not behaving normally. I have my first session tomorrow, and I just want this to all go away!! and it’s rough staying sober, I have to tell you! I have an herbalist who is sending me a bunch of stuff for the nervous system, and I will also be trying CBD oil for the headaches. I am considering seeing a neuro-opthomologist, just to rule out anything more serious. I keep hoping that maybe if I just get a prescription for computer glasses, that might solve the computer problem, but I don’t know that I can get an accurate one, when my vision is allover the place. Thanks, any thoughts?


Your symptoms match mine to a T, except mine was stress induced originally and had no extra substance issues. The otologist is wrong. This is a big deal and it’s not mainly due to anxiety.

My optometrist won’t give me a new Rx until I get my meds regulated. In the meantime, Google Theraspecs to at least help with the computer.

The crazy visual stuff led my VRT to suggest I see a neuro-ophthalmologist, too. I’m not sure it’s worth it. I can say the visual exercises for VRT are awful, but I think they help. It’s too early to tell.


+1 on the Theraspecs