Chronic ear congestion is an uncomfortable reality for many. Its discomfort can color everyday activities and the resultant sensory deprivation can lead to depression and anxiety.
Just because a symptom is not life-threatening does not mean it is unimportant.
After confirming with an Ear Nose and Throat specialist (ENT) that there is no serious problem, many patients find themselves with no way forward but to wait to see if the congestion clears up on its own.
Anti-histamines can be a partial solution for some, but for others, they can make the problem worse or cause unwanted side effects.
When ear congestion persists for weeks, months, or even years, the path forward is to determine what underlying imbalances are keeping you from hearing normally.
Companion Symptoms to Ear Congestion
Every case is unique - your ear congestion may come with nausea, nasal drip, sinus congestion, a bad taste in your mouth, tooth decay, brain fog, migraines, balance problems, tinnitus, fatigue or motion sickness.
Ear congestion may initially occur during an ear infection and never go away, or it may get worse when eating certain foods or when you become dehydrated. Ears can also become plugged at the onset of an autoimmune condition.
For many patients, they are able to ‘pop’ their ears to equalize pressure, but the feeling of fullness never goes away.
We had a patient whose ears became blocked after having Sclerotherapy for varicose veins. The technicians mixed the foam medication with air in the room instead of an oxygen canister, resulting in an excess of nitrogen in her bloodstream. This caused a wide range of neurological symptoms including ear congestion that lasted for many years.
How your symptoms develop matters, as their origin usually suggests a solution.
Standard Approach to Chronic Ear Congestion
The most common diagnosis an ENT gives these patients is eustachian tube dysfunction, which was the case with the above-mentioned patient.
This diagnosis usually has a limited range of treatment options. If no surgery is required and the fluid affecting your inner or middle ear is clear (uninfected), a ‘wait and see’ approach will likely be recommended.
Blood tests are generally not ordered in cases of chronic ear congestion. Your general practitioner will usually investigate structural causes of hearing impairment, such as certain genetic conditions, wax buildup, or inflammation-based fluid.
If other new symptoms accompany your ear congestion or it does not resolve on its own, additional testing is warranted to uncover the underlying causes of your new health status.
‘Functional Range’ and Why it Matters
When you order blood testing, a marker in the ‘normal’ range does not necessarily rule out a problem.
Results in the normal range just mean that you are in the average range of all the patients who have had their testing at that lab. It is, essentially, a range of people who are already sick.
By the time your values reach a level that is outside normal, you may already have a chronic condition or have a problem with the functioning of a vital organ.
Functional medicine appreciates that subtle variations in testing results can indicate underlying problems. These underlying problems can often be addressed before they advance into full-blown conditions.
At our clinic, we focus on an optimal range of function for the values we measure and do not dismiss signs that the body is struggling.
Useful Testing Markers for Ear Congestion
Testing will be individually ordered for each individual based on their detailed medical history and symptom presentation. Specificity matters in discovering the sources of chronic symptoms; these are only a few examples that have proven helpful to many.
Urine Mycotoxin Test - By far the most important and useful testing for this symptom. Accumulated mold toxins affect every part of the body, including the sinus passages and eustachian tubes. Until proven otherwise, this is seen as the primary dysfunction.
Hs-CRP - Tests for general inflammation.
Salivary Hormone Testing - Tests both sex hormones (testosterone, estrogen, progesterone) and adrenal hormones. The ears are part of an integrated system that includes the kidneys and adrenal glands. As one area is affected, other parts of this system can manifest symptoms.
Comprehensive Stool Analysis - Checks for viral, bacterial, fungal, and parasitic infections. It also assesses the health of your microbiome and digestive capabilities.
Food Sensitivity Testing - ELISA/ACT testing tends to be the most accurate.
Nasal Culture - For fungal or antibiotic-resistant bacterial infections.
CBC - Complete Blood Count - This test evaluates general immune system activity. This test is often done but is rarely interpreted from a functional perspective.
Plasma Histamine - This test evaluates systemic histamine levels, which are important to test for any type of congestion. It can indicate reactivity even though other testing comes back negative.
Potential Causes of Chronic Ear Congestion
These are just a few examples among a wide variety of underlying conditions that can cause ear congestion.
Underlying Infection
A basic CBC test can often reveal signs of an underlying infection, but since the infection is detected at a relatively low level, these findings are frequently dismissed.
A low WBC (white blood cell count) with low lymphocytes may indicate the body’s fighting a chronic virus like the Epstein-Barr virus or Cytomegalovirus. A high lymphocyte count may indicate an active viral issue.
When the values are too high or low but still within the normal range, functional medicine calls these a ‘high’ normal or ‘low’ normal value. These values can be very useful in pointing us toward a probable cause.
Dental Health
It is vital to consider dental and ear health as interconnected systems. Many cases of poor dental health and improperly done dental work, including failed root canals, have caused sinus and ear symptoms and contributed to systemic inflammation.
Be diligent in ruling out dental problems as the source of your ear congestion.
Food Allergy/Sensitivities
This is a cause that is disregarded by many because it is assumed that if a food allergy were ‘serious’ enough, it would cause obvious, immediate symptoms like the anaphylaxis from a peanut allergy.
Even food sensitivities can cause severe symptoms like migraines, memory issues, gastrointestinal distress, vision problems, dizziness, anxiety, panic attacks, insomnia, ear congestion, sinus congestion, and depression.
Many sensitivities have tell-tale symptoms (like the onset of a rapid heartbeat after eating), but others are more subtle. Food allergy and sensitivity symptoms can manifest immediately or appear hours or even days after ingesting food.
An Example Patient Case
Sometimes, it is helpful to see how functional medicine is applied in an example patient case.
In this scenario, John* (male, 43) presents with fullness in both ears, headaches, tinnitus, digestive upset, and a general feeling of illness and fatigue. His symptoms had been steadily worsening over the past year, and he was reacting to most foods.
His general practitioner had put him on long-term antibiotics. Our clinic ordered similar testing to that listed above, and a fungal infection was detected in both the nasal culture and the comprehensive stool analysis.
During his new patient appointment, he reported having a stressful job and home life in addition to the stress of not feeling well. We tested his adrenal hormone levels to assess his body’s ability to handle stress. The results indicated stage two adrenal insufficiency in which his adrenal system was no longer able to produce adequate amounts of cortisol and cortisone.
For patients like John, taking antihistamines can make his adrenal insufficiency much worse very quickly.
Interestingly, from a Chinese Medical perspective, the ears are connected to the kidney and adrenal systems. We often see a correlation between connected body systems despite there being no apparent biological relationship.
We also get clues from quieter symptoms of larger systemic problems. Often, fluctuating eye problems like the transient blurring of vision or floaters can be traced to the liver struggling to filter and clear the blood supplying the tiny capillaries in the eyes. In Chinese Medicine, the liver and the eyes are part of the same system.
Multiple tests are useful in cases of complex and chronic conditions. If the nasal culture is not done correctly, it may have come back as a false negative, but both tests provide additional confirmation.
By continually wiping out beneficial bacteria with the antibiotics and not treating the fungal infection, John’s symptoms predictably deteriorated. The fungal infection continued to spread through his gastrointestinal tract via nasal drip.
An overtaxed immune system also drained his nutrient reserves to the point of deficiency, further compounding symptoms. We discovered that John had four severe nutrient deficiencies: vitamin B12, D, A, and magnesium.
Our priorities in our example case are to weaken and kill the fungal infection through targeted treatment and dietary and lifestyle changes. We also replenished his deficiencies using high-grade supplementation.
In addition to these treatments, we encouraged a range of activities to promote stress-relief. The one he chose was beginner yoga, which had the side effect of the elimination of his recurrent back pain. Consistent yoga practice helped his nervous system reset, which helped his adrenal glands heal and normalize the cortisol levels.
John had a standard American diet - lots of coffee, fast food, too much sugar, and not enough vegetables and fruits. We modified his diet, cutting out fast food and excess sugar and adding in fruits and vegetables and specific food recommendations based on his bloodwork.
We also used nasal antifungal propolis along with xylitol to clear sinus biofilm.
Twelve weeks later, comprehensive stool analysis testing and nasal culture revealed that the fungal infection was 100% cleared. His ear fullness and sinus congestion were gone, and his digestion was normal.
Remote Consultations Available
Specificity is the key to your full recovery. Just because a symptom is not life-threatening does not mean it should be taken less seriously. Do not settle for long-term, low-level symptoms because you were too readily dismissed.
Know that there is a biological cause for many cases of long-term ear congestion that can be identified and treated.
Dr. Brian Lum is an IFMCP functional medicine practitioner currently accepting new patients. He has spent over a decade specializing in chronic, complex conditions.
With functional medicine diagnostics and treatment options, scientifically supported mind/body practices, powerful natural supplements, and specific and personalized applications - recovery is absolutely within reach.
*Patient details have been changed to safeguard privacy
Written by Stephanie Lum and Dr. Brian Lum
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