Doctor Q&A: Can the Covid vaccine give you vertigo? Dr Renée Hoenderkamp answers all your burning questions

Can the Covid jab give you vertigo? I work on a building site and I am convinced I am suffering from it since I last got jabbed. Have you heard of this?

This is a very interesting question, because the real answer is that we don’t know for sure! However, I will try and help.

There are certainly plenty of anecdotal reports of tinnitus getting worse or starting in following the administration of the covid 19 vaccine. However there are also reports of the same following Covid-19 infection.

This would point to the spike protein on the virus itself being the culprit as this is then replicated by administration of both the Moderna or Pfizer vaccine, which tells the cells of the body to make the spike protein.

So what is happening? The spike protein, however it is delivered into the body (vaccine or infection), has a inflammatory effect on lots of tissues and scientists have suggested that this effect is a potential cause of tinnitus, particularly when the brain or spinal cord are affected and the inflammation does not settle and is ongoing. This inflammation is mediated by anti-spike antibodies which may react with antigens anywhere along the auditory pathway and fuel an inflammatory reaction.

In the UK there have been 8,078 yellow card reports (the method pf report adverse drug reactions to the MHRA3) of tinnitus after the covid vaccine and it appears that these are mainly connected with the first administration. This suggests that some people have a predisposition to tinnitus and this ongoing inflammation is the trigger that starts it. It is worth noting that there is some evidence that the flu vaccine also has similar links.

So it seems that what you are thinking may well be correct and whilst treatment options for tinnitus vary significantly, corticosteroids appear to be the treatment choice for Covid vaccine-induced tinnitus reported in the literature. So this may be worth pursuing if you have not as of yet. I would also make sure you are seen by an ear, nose and throat (ENT) consultant if you have not yet been referred by your GP.

Trials of other interventions that may help with vaccine-associated tinnitus are urgently needed. See a useful resource here

I have been prescribed tablets for my B12 deficiency but they are not easing my symptoms. Why is nothing working?  

This is an interesting question as many people are potentially ‘deficient’ of vitamin B12 but there is a grey area on what that level actually is and many people may sit below the optimal level without symptoms at all.

A deficiency occurs when your body is either not getting or absorbing enough vitamin B12 from food that it needs to function properly.

Vitamin B12 is an important nutrient that helps your body make red blood cells. When you are low in vitamin D, it can cause physical, neurological and psychological problems. These can include:

• Loss of appetite
• Nausea, diarrhoea, vomiting
• Sore mouth/tongue
• Fatigue/weakness
• Numbness or tingling in your hands and feet.
• Vision problems.
• Memory issues
• Mood issues

Vitamin B12 deficiency can be treated with daily oral medication but if severe or if causing anaemia, is sometimes better treated with injections.

Whilst all of these symptoms can be caused by vitamin B12 deficiency, they also cross over massively with other deficiencies/illness, e.g. thyroid disease.

So in your case I would suggest the following approach to see why you still feel unwell after treatment:

• Check your levels of Vitamin B12
• If in range, your symptoms are likely being caused by something else and your doctor needs to investigate this further.
• If not in range, then the treatment is not working for you and you need to look at a different delivery method, e.g. injections, nasal spray etc and if you have tried this, a higher dose. Also check other vitamins like folate which are necessary for healthy B12 levels.

• Check your diet and ensure
• You have plenty of Vitamin B12 rich foods (red meat, fish, poultry, eggs, milk and other dairy products)
• Avoid alcohol as frequent/excessive alcohol can make it difficult to absorb vitamin B12
• If you have digestive disease, e.g. Crohn's/coeliac, ensure that it is managed optimally

Other investigations should include iron studies, thyroid function tests and auto-antibodies, bowel inflammation/inflammatory disease.

I hope that this helps or at least gives you some pointers!

I've got frozen shoulder in both shoulders and it's nigh on impossible to sleep at night and it's driving me around the bend. If I catch my right shoulder wrong the pain puts me on the floor. How do I put an end to this suffering?

Frozen shoulder, or Adhesive Capsulitis as it is known, is an inflammatory condition of the shoulder which gradually causes stiffness, pain and reduction in movement, particularly external rotation. It can come on slowly and then equally slowly resolve, but is often sudden onset with slow resolution. It is four times more common in women and common diseases such as diabetes and thyroid disease increase the risk.

The pain can be debilitating and more so of course when both shoulders are affected. Frozen shoulder disability affects everyday actions such as reaching, particularly overhead (e.g. hanging clothes) or to-the-side (e.g. fastening a seat belt), carrying and lifting bags, difficulties in personal hygiene, dressing and brushing hair. Neck pain is also often associated with frozen shoulder.

There are no definitive treatments for frozen shoulder I’m afraid so whilst I will cover them here, what works for one person may not for another, and it is generally a combination of physical therapy, adjusted activities, pain relief and time. The physical therapies will aim at restoring motion of the joint over time and can include stretching, manual therapy (hands on physio), ultrasound, cryotherapy or Transcutaneous electrical nerve stimulation (TENs).

Intra-articular steroid injections can help (if there are no tears to the ligaments) followed by rehabilitation exercises.

If you have been through all of the above and are at least six months into the process then more invasive treatments can be considered and these include capsular hydrodilatation by injecting saline in to the joint to stretch the joint capsule, manipulation under anaesthesia where the capsule is torn or stretched manually, and surgical release of the capsule via key hole surgery.

In terms of the natural lifespan of this injury, frozen shoulder will usually resolve, with its normal duration from 1 to 3.5 years with an average of 30 months. In 15 percent of patient, the other shoulder will suffer within five years. So you have been unlucky!

I thought I would share one other tip with you that I have seen work well to alleviate pain and can be worn easily under clothes and at night and it is this support brace. Good luck!