Dr Ross Walker answers Overnight listener questions

Published Jun 24, 2025, 3:21 PM

Phil chats with Dr Ross Walker, Cardiologist and host of Nine Radio’s Healthy Living, to answer listener questions — including Susanna’s concerns about vertigo and John’s question about menopause for his wife.

This is a question that came in from Susanna. My question is about vertigo. What do you know about the crystal calcium carbonate particles.

Yeah, well this has felt to be the cause for why people get BPPV, which is the bard positional paroxss more vertio that you mentioned, and what happens you get these little microcrystallizations within the.

Little bone cells.

You've got these little semicircular canals which are full of a little bit of fluid. So instead of having this normal fluid going through these semicircular canals, which when you turn your head they spin around, and so you don't get dizzy. If you get little crystals in there, the fluid doesn't move properly. The hell's care cells are affected and you can get the feeling of vertigo. So the vertigo is where you're looking at something and it's spinning. So your environment spinning, you're not spinning yourself. Vertigo is where you feel that spinning sensation. That's the first type of dizziness and the most common cause of that is just benign positional vertigo. But there are other causes well, things like men years disease. Some drugs can do there's a pretty rare thing called an acoustic neuroma, which is associated with deafness. So when someone gets significant vertigo, you don't just say I've got vertigo, therefore I'll just take a few pills and let it rest. You must get a firm diagnosis to make sure it is just benign positional vertigo. And we feel that probably the commonest cause of that is you get some sort of toxic exposure, like exposure or virus. And normally when you get a virus, the virus hits the back of the throat, throat's a bit sore, you get a bit of a running nose when a few days it goes away. But in some people that virus penetrates into the bloodstream. You get an immune reaction with that, so a little bits of virus with the antibodies gets stuck in things like the inner ear, causes the crystals, and then you get the vertigo. Now, the treatment of vertigo, that cause of dizziness is firstly you want to cool it down to let it settle with things like there's a drug called stemotil, which is a drug that's commonly used for nausea and vomiting, but it's also highly effective in the short term, and I stress the word the short term because long term it has nasty side effects. And there's also a standard across the counter for nergen, which is an antihistamine, a long the antihistamy that works, and this is.

A strange one pill.

Good old fashioned valium, which is used for anxiety, is also very good for vertigo.

So someone's getting bad vertigo over.

A day or two, you take the stematil for a day or two, but not for too much longer because there are nasty side effects with stemotil and people who take it for a long time. There's a thing called tardev disk kind eesier where you can get funny facial movements that you can't control. So please anyone listening, if you're a sufferer vertigo, don't hit the stematil too hard. But then good old fashion and over the counter fenergen twenty five milligrams of fernergan you just take a half before you go to bed at night, because it's a bit sedating.

That can really help with vertigo. And good old fashioned valium five milligrams, maybe a half to or full one of those before you go to bed will help to settle it down acutely. If people get a lot of vertigo, I.

Suggest they go off to see a specialized physiotherapist who can teach you particular neck exercises that can break up the crystals in the inner ear and really settle down the vertigo and stop you from having recurrent bouts. To this, there are some other drugs, heavier drugs, and the drug will beta historine, which can also help with people who get a lot of vertigo. And then sometimes you may need to go to a specialized balance clinic where they have more intensive therapies as well.

Over and above, that's one aspect of dizziness.

Another common cause of dizziness which is not vertigo is what we call pre syncope, where the heart's not being up enough blood to the engineery up to the brain and so you feel like you could blackout. That is not vertigo, So you need to have your heart investigated if that's happening. So recurrent bouts of dizziness or where you may have collapsed, that's a totally different thing needs to be investigated in a different way. But probably the commonest cause of dizziness, which most people don't even think about, is what we call dis equilibrium, and that's typically due to a neck problem.

So many people over the age of fifty.

Start to get problems in their neck where they get arthritis in the neck.

The blood flow going up to the back of the brain.

Gets affected by the arthritis and they can start to get these weird bouts of dizziness where they they feel a bit disordered their gait, they may sway to one side or whatever. So it's not the environment that's spinning there, actually feeling like they're unsteady themselves, and so you need work on the neck to try and sort.

That one out. But that's a bit of an over view of dizziness and vertigo.

Right, Okay, if my wife takes anti histamineo vertigo and that seems to work well for her as well. Well more, and this came in from John who said, my wife is having a terrible time with menopause. Lots of joint pain, mouth and neck pain. Have you got any suggestions.

Menopause is a dreadful time for women because when the hormones start to change, you can have a profound effect, not just in causing hot flushing, but it can cause palpitations, It can cause brain fog and it can markedly exacerbate things like arthritis, aches and pains in the joints. In the last five years or so, there's been a movement back to appropriate hormone replacement therapy, and there are different camps. I'm in the camp that believes we should really be focusing on progesterone therapy with little estrogen. And if you're going to have estrogen therapy, I wouldn't be having much and I'd be just using it in local therapy such as a patch or creams, Whereas there is very highly effective progesterone therapies that work in this situation and can markedly reduce the risk for arthritic pain and a whole lot of things.

But I say to people, go and

See a good integrative GP who specializes in the area, and you'll get the best results in that situation.