Advertise on podcast: Grounded | The Vestibular Podcast

Histamine and MCAS are everywhere on the internet right now, but there’s a huge piece missing from the conversation. Genetics. In this episode, I’m joined by two board-certified genetic counselors, Natalie Samson and Sarah Upp of Golden Genetics. They’re here to break down what’s going on at a DNA level when it comes to histamine intolerance, MCAS, connective tissue disorders, and the symptoms so many vestibular warriors are navigating. The biggest takeaway might just be how you can start advocating for yourself with your providers (especially if these things are new to them). This one is dense, practical, and unlike any conversation I’ve had on this podcast before. In this episode, we’ll dig into: How genetic changes affect how your body works How your environment and genetics work together The pentad super syndrome Why weak connective tissue may be at the root of these overlapping conditions What happens when the DAO and HMT genes aren’t working well Where histamine comes from and how to empty it The barn analogy for understanding mast cell stabilization Why a low histamine diet isn’t meant to be forever Foods to add in that lower histamine The two panels Golden Genetics recommends Why methylation matters for histamine breakdown What to do when testing for MCAS doesn’t give clear answers How to advocate for yourself when a provider dismisses MCAS as a social media diagnosis The ongoing research between Golden Genetics and the vestibular migraine community How to use the 2026 MCAS guidelines flowchart at your next appointment Histamine intolerance and MCAS aren’t just about what you’re eating.  They’re rooted in your genetics, and understanding your specific DNA can help you stop guessing and start identifying the right interventions for your body. Related Episodes: Toxic Products That May Be Making Your Dizziness Worse w/ Dr. Zach Spiritos: https://thevertigodoctor.com/podcast/53-toxic-products-that-may-be-making-your-dizziness-worse/   Meet Natalie Samson & Sarah Upp Natalie Samson and Sarah Upp are both board-certified genetic counselors and the team behind Golden Genetics, an integrative genetic counseling practice. They specialize in helping people understand their DNA, order the right tests and turn results into a personalized action plan—with a special focus on histamine, inflammation, connective tissue, and nutrigenomics.  Natalie founded Golden Genetics to bring genetics into the integrative health conversation, and together she and Sarah are currently conducting research on the genetic links to vestibular migraine. Connect w/ Natalie Samson & Sarah Upp: Website: www.goldengeneticshealth.com  What is a logistics call with Golden Genetics? https://goldengenetics.practicebetter.io/#/652843bfc5600d631946d7b9/bookings?r=67d88822ff4b8cf37956c65d&step=services Book a logistics call with Golden Genetics: https://www.goldengeneticshealth.com/book-a-discovery-call-1 Pre-test session with Sarah: https://goldengenetics.practicebetter.io/#/687574970c2232e0dccceef5/bookings?r=69bb16570d392e7826c8903b Instagram: https://www.instagram.com/goldengeneticshealth  Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit 2026 MCAS Guidelines flowchart: https://www.mastcellaction.org/assets/_/2025/04/01/d6de24e1-f6f6-4248-a3f4-12866d7bf713/mast-cell-activation-syndrome-mcas-a-primary-care-guide-final.pdf Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. is histamine intolerance genetic, genetics and mcas, genetics and histamine, genetic counselors, vestibular migraine, VM, chronic dizziness, PPPD, nervous system regulation, migraine management, vestibular group fit, VGF

If you have a vestibular disorder, there’s a good chance your thyroid is part of the story.  You know I love bringing in other qualified professionals to dig deeper on these more nuanced topics, so for this conversation we have Registered Dietitian and fellow Hashimoto’s patient, Alisha Knicely! She breaks down all things thyroid—what Hashimoto’s is, how it’s different from hypothyroidism, what optimal labs look like, how gut health and leaky gut are connected to autoimmune conditions, and what you can do about all of this. We also touch on gluten, dairy, mold, and water quality. You’re going to want to bookmark this one because it’s jam packed! In this episode, we’ll dig into: How Alisha became a Hashimoto’s patient turned registered dietitian Hyperthyroidism vs. hypothyroidism What’s included in a full thyroid panel How to understand optimal vs. conventional lab ranges When to consider medication How thyroid hormones impact every single cell in the body Chronic vs. acute inflammation Practical, sustainable steps to lower inflammation naturally The elimination diet and reintroduction approach The best way to address leaky gut Why you should consider the GI Map stool test Why water quality matters especially for thyroid patients Alisha’s personal mold story and how she cleared her mycotoxin levels Air quality, infrared sauna, and other mold detox resources Whether it’s your thyroid, your gut, your water, or the air you’re breathing, the root causes are addressable and you don’t have to figure it out alone. Related Episodes: Ep 91 Mold & Dizziness: https://thevertigodoctor.com/podcast/91-mold-dizziness-what-you-need-to-know/ Meet: Alisha Knicely, RD Alisha Knicely is a Registered Dietitian, certified in Integrative and Functional Medicine, and a fellow Hashimoto’s patient of nearly a decade. Her own experience navigating an autoimmune thyroid diagnosis (and not getting the answers she needed) led her to specialize in thyroid and hormonal health. She helps clients get to the root of their Hashimoto’s through nutrition, gut health, lifestyle and functional testing so they can finally start feeling like themselves again. Connect w/ Alisha Knicely: Instagram: https://www.instagram.com/lisha_thyroid_rd/ TikTok: https://www.tiktok.com/@lisha_thyroid_rd Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit (which is where you’ll find the Histamine Webinar with Isabel Smith where we talked water filters) Alisha’s Instagram post on optimal labwork mentioned: https://www.instagram.com/p/Dbqf3TqjoAD/ Dr. Jill Crista’s mold detox resource: https://drcrista.com/ Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. hashimoto’s and gut health, integrative functional medicine, autoimmune thyroid condition, thyroid dietitian, graves disease, vestibular migraine, chronic dizziness, hormone health, gut issues, lifestyle changes, optimal lab values, migraine management

Histamine is quite possibly the most popular buzzword in healthcare right now and for good reason. For those living with a vestibular condition and dealing with a histamine intolerance, it can feel like a lot to understand and manage. In this episode, I’m breaking down what histamine is, what histamine intolerance can look like, how it’s impacting vestibular disorders and migraine, and what you can do about it. In this episode, we’ll dig into: What histamine is and its role in your immune system, digestion, sleep, mood, memory, and more The 4 types of histamine receptors and what they have to do with your symptoms Histamine intolerance vs. MCAS What happens when you don’t have enough of the DAO enzyme What contributes to histamine intolerance and what it can look like How to properly diagnose histamine intolerance What you can do to support your liver if you have histamine intolerance How to do a low-histamine diet the right way How food freshness affects histamine levels The histamine-migraine connection What research is showing about histamine’s role in the vestibular system and inner ear How addressing histamine can make previous treatments that didn’t work suddenly start working When there’s too much histamine in the body than what the body can actively remove, you’ll have more histamine reactions and a harder time processing histamine in general. I want you to remember though that all hope is not lost! For additional support, we have the webinar with Isabel Smith that touches on histamine intolerance, as well as liver and gut support inside Vestibular Group Fit.  We will also have Natalie Sampson, a Board Certified Genetic Counselor, joining me on a future podcast episode! Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Citations Cleveland Clinic. “Histamine.” Cleveland Clinic, Cleveland Clinic, 28 Mar. 2023, https://my.clevelandclinic.org/health/articles/24854-histamine. Accessed 10 July 2026. Jochum C. (2024). Histamine Intolerance: Symptoms, Diagnosis, and Beyond. Nutrients, 16(8), 1219. https://doi.org/10.3390/nu16081219  Sánchez-Pérez S, Comas-Basté O, Duelo A, Veciana-Nogués MT, Berlanga M, Vidal-Carou MC and Latorre-Moratalla ML (2022) The dietary treatment of histamine intolerance reduces the abundance of some histamine-secreting bacteria of the gut microbiota in histamine intolerant women. A pilot study. Front. Nutr. 9:1018463. doi: 10.3389/fnut.2022.1018463 Jackson, K., Busse, W., Gálvez-Martín, P., Terradillos, A., & Martínez-Puig, D. (2025). Evidence for Dietary Management of Histamine Intolerance. International journal of molecular sciences, 26(18), 9198. https://doi.org/10.3390/ijms26189198 Kong, L., Domarecka, E., & Szczepek, A. J. (2023). Histamine and Its Receptors in the Mammalian Inner Ear: A Scoping Review. Brain sciences, 13(7), 1101. https://doi.org/10.3390/brainsci13071101  Tighilet, B., Trico, J., Marouane, E., Zwergal, A., & Chabbert, C. (2024). Histaminergic System and Vestibular Function in Normal and Pathological Conditions. Current neuropharmacology, 22(11), 1826–1845. https://doi.org/10.2174/1570159X22666240319123151  Chen, Z. P., Zhang, X. Y., Peng, S. Y., Yang, Z. Q., Wang, Y. B., Zhang, Y. X., Chen, X., Wang, J. J., & Zhu, J. N. (2019). Histamine H1 Receptor Contributes to Vestibular Compensation. The Journal of neuroscience : the official journal of the Society for Neuroscience, 39(3), 420–433. https://doi.org/10.1523/JNEUROSCI.1350-18.2018  Ferretti, A., Gatto, M., Velardi, M., Di Nardo, G., Foiadelli, T., Terrin, G., Cecili, M., Raucci, U., Valeriani, M., & Parisi, P. (2023). Migraine, Allergy, and Histamine: Is There a Link?. Journal of clinical medicine, 12(10), 3566. https://doi.org/10.3390/jcm12103566  histamine and vestibular conditions, vestibular migraine, chronic dizziness, migraine attacks, vestibular disorders, vestibular group fit, food sensitivities, MCAS, gut issues, holistic approach, bucket theory, lifestyle changes, allergies and vestibular disorders

If you have recurring sinus infections, got the allergy shots, maybe even had sinus surgery, and still don’t feel better, this episode might shock you. For starters: 75-90% of people with self-diagnosed sinus headaches actually meet migraine criteria. I’m so excited to welcome back Dr. Jessica Lee, double board-certified ENT and lifestyle medicine physician to hopefully provide some answers you’ve been looking for. We’re going deep on sinus headache vs migraine, Eustachian tube dysfunction, as well as migraine and sinus management.  So many people are cycling through antibiotics, steroids, and booking surgeries without anyone ever connecting the dots to what’s going on in the body as a whole. Dr. Lee is here to change that and to give you the questions to ask, the scans to request, and the framework to finally get some answers. In this episode, we’ll dig into: How to start differentiating sinus issues from a migraine attack What’s actually happening with the pressure, fluid, and full feeling in your ear Why researchers believe TMJ may not be as common as we think How to best use CT scans as a diagnostic tool for sinus migraine What a deviated septum or mucosal cyst may not be the full diagnosis Why antibiotics are so overprescribed for sinus headaches Why you may feel like you never fully recover from sinus infections How GLP-1s and mouth breathing affects Eustachian tube function Why Dr. Lee’s surgical volume has gone down over the years The PACT framework for doctor’s appointments Whether it’s sinus headaches, ear pressure, or chronic infections that never fully resolve, the answer might not be another antibiotic. And with what you heard in the episode, you’ll be able to ask the right questions to get the help you need. Related Episodes: Sinus Headache, Nasal Breathing, and Dizziness with Dr. Jessica Lee: https://thevertigodoctor.com/podcast/69-sinus-headache-nasal-breathing-and-dizziness-with-dr-jessica-lee-ent/ Meet Dr. Jessica Lee: Dr. Jessica Lee, MD, DipABLM is a double board-certified Otolaryngologist (ENT) and Lifestyle Medicine physician with over 100 hours of additional training in integrative and functional medicine. After more than a decade in traditional medicine, Dr. Lee noticed a major gap in how chronic inflammatory conditions (like sinusitis, allergies & sinus headaches) were being treated, and set out to change that. She’s the founder of Integrative ENT Health, a Castle Connolly Top Doctor (2023–2026), and co-founder of the Keto Hope Foundation. She brings a whole-person approach to ENT care, blending conventional expertise with nutrition, lifestyle & root-cause thinking to help patients get real, lasting answers. Connect w/ Dr. Jessica Lee: The Sinus Reset Program: https://www.integrativeenthealth.com/sinus-reset-program Integrative ENT Health (virtual practice): https://www.integrativeenthealth.com/ Instagram: https://www.instagram.com/entchat Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Sinus Reset Program (Open September 13th; stay tuned for free bonuses and discounts!): https://www.integrativeenthealth.com/sinus-reset-program Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. sinus headache, integrative ent, eustachian tube dysfunction, chronic dizziness, vestibular migraine, vestibular disorder symptoms, vestibular group fit, symptom tracking, phases of vestibular migraine, holistic approach, lifestyle changes, nervous system regulation, allergies

Men’s health in the vestibular space? Yes, we’re finally talking about it! I get so many questions about this especially from men with vestibular migraine, Ménière’s disease, and other vestibular disorders who feel like all the health content out there is geared toward women. So I brought in Dr. Mark Heisig, naturopathic physician and creator of the Healthy on Purpose framework, to help us navigate the topic of men’s health. In this episode, we’re covering how men age hormonally, what’s behind the global decline in testosterone, the labs you should be requesting, and why mindset is such a foundational principle of health. Whether you’re a man with a vestibular disorder, or you just love one—this one’s for you. In this episode, we’ll dig into: What is driving the global drop in testosterone in men under 40 How to determine what is “normal” aging and what may require medical evaluation How testosterone impacts the vestibular system Why men should reconsider holding off on going to the doctor Healthy living basics refresher Labwork Dr. Mark recommends for all men and options for where to get yours done What the “dad belly” is a warning sign of The insurance vs. cash-pay reality Nutritional deficits Dr. Mark sees most often in men How mindset contributes to our overall health The BAMs (Bare Ass Minimums) framework The importance of physical and emotional health for men Whether you’re healthy on purpose or unhealthy by accident, the good news is that the levers to pull are the same ones we talk about every week on the podcast and in group. The better news? It’s never too late to start making changes. Related Episodes: #153 Hormones, Histamine, and Your Vestibular Disorder w/ Dr. Saru Bala: https://thevertigodoctor.com/podcast/153-hormones-histamine-and-your-vestibular-disorder/ Meet: Dr. Mark Heisig Dr. Mark Heisig, ND is a naturopathic doctor licensed in Arizona and Washington, with 8 years in personal training, nutrition coaching, and exercise physiology before that. Through his practice, Healthy on Purpose, he helps men and women in their 30s and 40s who are doing “everything right” but still hitting a wall. He’s also a husband, dad, and still lacing up for BJJ and hockey. Connect w/ Dr. Mark Heisig Instagram: https://www.instagram.com/drmarkonpurpose/  Substack: https://drmarkheisig.substack.com/p/welcome-to-healthy-on-purpose  Website: https://www.drmarkonpurpose.com/  Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Membership is 30% off from September 4th-8th! Included in your membership is a Full Script link (VGFit members only). Good for 30% off all supplements (for US customers) and 10% off (for Canadian customers). Why Zebras Don’t Get Ulcers by Robert Sapolsky: https://amzn.to/45YuFoQ Rupa Health: https://www.rupahealth.com/ Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. naturopathic doctor, vestibular migraine, chronic dizziness, men’s health, nervous system regulation, PPPD, living with vestibular migraine, vestibular disorders, optimal lab values, hormone health, gut issues, lifestyle changes, mindset and chronic illness, holistic approach

If you’ve been to a million and one doctors and still don’t have a clear diagnosis—you are not alone, and you are not crazy.  Dizziness is notoriously undertreated, and a lot of providers just don’t like dealing with it.  So in this episode, I’m giving you a comprehensive resource guide: which providers to see, what to ask when you call, and what tests are available so you’re better prepared for what you’re walking into. This is the episode I wish existed when people first started experiencing dizziness. Share it and save it so you can refer back to it.  And remember, finding the right provider can make all the difference! A willing-to-learn provider beats a dismissive expert every single time. In this episode, we’ll dig into: Why dizziness is so often undertreated The difference between an ENT, neurotologist, and otologist Medical providers you may want to reach out to for support Why you’ll want to make sure to call the office first What a board-certified headache specialist is Questions to ask any provider before booking A full overview of vestibular testing What to expect after most tests are run The Bárány Society as a resource Additional resources available inside Vestibular Group Fit Getting the right diagnosis starts with knowing who to see, what to ask, and what to expect. And now, you have a roadmap to help you get started. Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Trusted Providers Worksheet (available inside Vestibular Group Fit under the community tab) The Bárány Society: https://www.thebaranysociety.org/ How to find a provider Searching local health systems for types of providers/departments based on the area you’re looking to schedule American Neurotology Society (ENT with special focus on neurological disorders of inner ear and other related structures) American Migraine Foundation Find a Doctor National Headache Foundation Find a Provider UK National Migraine Centre Migraine Canada Find a Headache Specialist Neurahealth national headache medicine clinic Binocular vision dysfunction provider directory Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. dizziness diagnosis, vestibular migraine, living with vestibular disorder, ENT, neurotologist, otologist, chronic dizziness, medical provider, vestibular disorder diagnosis, vestibular disorder treatment, vestibular rehabilitation therapy, vestibular group fit, occupational therapist, neuro-optometrist, vertigo

“Progesterone will hold up the mirror for you and show you about your habits. Estrogen is forgiving—progesterone is not.” For so many women with vestibular disorders, symptoms get dramatically worse right before their period or around ovulation, and the answer they’re usually given is “take birth control” or “drink more water.”  That, of course, is not enough. I brought in Dr. Saru Bala, Naturopathic Doctor and Women’s Hormonal Health Specialist, to break it all down. Get ready to nerd out on all things hormones! In this episode, we’re talking about what hormones actually are, how your cycle phases impact your vestibular symptom, why your liver is way more important than you think, the estrogen-histamine-MCAS loop, and what bloodwork you should be asking for. In this episode, we’ll dig into: What are hormones What to pay attention to with women’s hormones The phases of your cycle What progesterone is reflecting back about your habits  The basics that impact your hormones the most Bloodwork Dr. Saru recommends for her clients Why you want to get a full thyroid panel The liver’s role in hormone metabolism How to support your liver The estrogen-histamine loop How MCAS plays a role here Why gut & liver support are essential for histamine, MCAS, and hormone issues Why women are taking much longer to feel better than even 5 years ago If you take nothing else away from this, remember your hormones, liver, gut, and nervous system are all talking to each other. When you start supporting them, things are able to start changing. Meet: Dr. Saru Bala Dr. Saru Bala is a licensed Naturopathic Doctor with a degree from Bastyr University in Seattle, WA. Prior to attending medical school, she graduated from University of Texas at Austin where she received her bachelor’s degree in Neurobiology. She’s done extra training in women’s health and naturopathic endocrinology and wants to talk to you about all things women’s health. Connect w/ Dr Saru Bala Website: https://www.drsarubala.com/ Instagram: https://www.instagram.com/drsarubala Facebook: https://www.facebook.com/periodpractice Period Solutions Academy: https://www.drsarubala.com/periodsolutionsacademy Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Rise Centered Alarm Clock: https://risecentered.com?sca_ref=7113075.4mnDvPsCZ8H Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. hormonal health, women’s health, naturopathic doctor, vestibular migraine, chronic dizziness, birth control, vestibular disorders, PMDD, what is optimal bloodwork, optimal lab values, thyroid panel, lifestyle changes, period problems, understand your period, gut liver and hormone connection

Having a list or “menu” of ideas for what to do on those higher symptom days can be helpful to have before you actually need it. This could be a time when you’re riding out an attack and looking for things to do that are gentle but stimulating to help pass the time.  Of course, what will be the best fit will depend on the person and the symptoms on a given day. Save this episode to come back to because I’m walking through a whole list of low-demand activities that can be enjoyable on higher symptom days. In this episode, we’ll dig into: Why you need a go-to activity list before a high symptom day hits A reminder to always reach for your toolkit first on harder days A variety of gentle indoor and outdoor activities to note An upcoming MCAS webinar you won’t want to miss Having a list of things your brain already trusts on a hard day isn’t just self care, it’s part of your toolkit. Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit MCAS Webinar (August 14, 2026): https://resolvinghistamine.heysummit.com/ Seek App: https://www.inaturalist.org/pages/seek_app Petals and Profanity coloring book: https://amzn.to/49VMBTC The 15 Puzzle (slider game): https://amzn.to/4vjoZ40 Sagrada board game: https://amzn.to/4fMGN2l Carcassonne board game: https://amzn.to/4ejqbgk Flip 7 card game: https://amzn.to/4vHK5su Five Crowns card game: https://amzn.to/44bNuUw Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. activity list, MCAS webinar, living with vestibular disorder, vestibular group fit, vestibular migraine, chronic dizziness, PPPD, vestibular disorder symptoms, manage vestibular disorder, migraine toolkit, vestibular disorder flare, gentle movement, what to do during migraine

Vestibular disorders (particularly vestibular migraine) and POTS are often talked about in our practice and in Vestibular Group Fit as they overlap quite a bit. In this episode, I’m digging into one of the most common co-occurring conditions I see in my practice alongside vestibular migraine: POTS (Postural Orthostatic Tachycardia Syndrome). I’m also introducing something called the pentad super syndrome (almost every single person I see in my clinic has all five). You’ll learn what it is and what I believe is missing from the list. Discover everything from how POTS is diagnosed, to helpful resources, and why your basics matter more than ever when you’re managing both POTS and vestibular disorders at the same time. In this episode, we’ll dig into: What POTS is The diagnostic criteria for POTS Why there is overlap between POTS and vestibular  What the pentad super syndrome is Why histamine and MCAS are a huge piece of the puzzle The tilt table test vs. active stand test What conditions can sometimes mimic POTS What the CHOP POTS protocol is Why heat is a major POTS and MCAS trigger What tools to keep in your toolkit for heat Lifestyle changes that are beneficial for POTS and vestibular conditions How VGF members apply the threshold and bucket theory to manage both conditions The good news is that the toolkit for your vestibular disorder and your POTS have a LOT of overlap, which means you’re already building the right foundation. Related Episodes: Build Your Migraine Threshold: https://thevertigodoctor.com/podcast/74-build-your-migraine-threshold-to-reduce-vestibular-migraine-attacks/ Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Standing Up to POTS podcast: https://www.standinguptopots.org/podcast dysautonomiaproject.org  Santosha Spirit on YouTube (Rachel): https://www.youtube.com/channel/UC0ROkm_8Bjk0qOQ13XYOebg Compression socks: https://sockwellusa.com/ NEWZILL Calf Compression Sleeve: https://www.amazon.com/NEWZILL-Calf-Compression-Sleeve-Footless/dp/B0DRYS7KBD/ Doc Miller Calf Compression Sleeves: https://www.amazon.com/Doc-Miller-Compression-20-30mmHg-Fashionable/dp/B012E1B5P6/ LMNT electrolytes: https://www.amazon.com/LMNT-Zero-Sugar-Electrolytes/dp/B084HQ4DYQ/ Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Citations “Research Summary: Postural Orthostatic Tachycardia Syndrome (POTS)….” American Headache Society, 2022, americanheadachesociety.org/research/library/research-summary-postural-orthostatic-tachycardia-syndrome-pots-and-migraine-a-narrative-review. Cleveland Clinic. “Postural Orthostatic Tachycardia Syndrome (POTS).” Cleveland Clinic, 9 Sept. 2022, my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots. POTS and vestibular disorders, vestibular migraine, histamine and MCAS, chronic dizziness, PPPD, nervous system regulation for vestibular migraine, migraine management, stress relief, vestibular disorders, vestibular group fit, nervous system regulation, vestibular disorder treatment

You’ve probably heard the words ‘biofeedback’ and ‘neurofeedback’ floating around the internet. And you’re also probably wondering what they mean and if they’re worth your time and money when you have a vestibular disorder. I’m answering all of that in this episode! Biofeedback is a type of mind-body technique to control some of the body’s function. And neurofeedback is a type of biofeedback that measures and records brainwaves. As always, I’ve got research and scenarios for us to talk through to help this really land. They’re probably not the first thing you want to invest in and there are even less expensive options that are equally or more effective which I share more about in the episode. Buckle up and let’s get a little nerdy with this one! In this episode, we’ll dig into: What biofeedback is and how it works What the main types of biofeedback are What neurofeedback is and how it relates to biofeedback The difference between active and passive neurofeedback The two main models of biofeedback that exist What to expect in a biofeedback session What biofeedback is considered effective for Types of neurofeedback and biofeedback sessions, devices, and apps available How to find a qualified biofeedback provider What questions to ask before committing to either option If you want to go even deeper with what you heard in this episode, we have coaching calls specifically about biofeedback and neurofeedback available in Vestibular Group Fit. Biofeedback is a tool, not a cure. But if you’re curious, informed, and financially comfortable exploring it, it absolutely can have a place in your vestibular toolkit. Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Certification from the Association for Applied Psychophysiology and Biofeedback (AAPB) site has an option to find a practitioner: https://aapb.org/Find_a_Practitioner  Hearthmath: https://www.heartmath.com/  Resperate (FDA approved for blood pressure and stress): https://resperate.com  Leva (FDA approved for pelvic floor): https://levacares.com/  Prism (FDA approved for PTSD): https://www.graymatters-health.com/prism-for-ptsd  Finding a provider International society for neuroregulation and research: https://isnr.org/ Biofeedback certification international alliance: https://www.bcia.org/ Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Citations Frank, D. L., Khorshid, L., Kiffer, J. F., Moravec, C. S., & McKee, M. G. (2010). Biofeedback in medicine: who, when, why and how?. Mental health in family medicine, 7(2), 85–91. Mayo Clinic. “Biofeedback – Mayo Clinic.” Mayoclinic.org, 18 Mar. 2023, www.mayoclinic.org/tests-procedures/biofeedback/about/pac-20384664. Marzbani, H., Marateb, H. R., & Mansourian, M. (2016). Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications. Basic and clinical neuroscience, 7(2), 143–158. https://doi.org/10.15412/J.BCN.03070208 Bazzana, F., Finzi, S., Di Fini, G., & Veglia, F. (2022). Infra-Low Frequency Neurofeedback: A Systematic Mixed Studies Review. Frontiers in human neuroscience, 16, 920659. https://doi.org/10.3389/fnhum.2022.920659 Duke, G., Yotter, C. N., Sharifian, B., Duke, G., & Petersen, S. (2024). The effectiveness of microcurrent neurofeedback on depression, anxiety, post-traumatic stress disorder, and quality of life. Journal of the American Association of Nurse Practitioners, 36(2), 100–109. https://doi.org/10.1097/JXX.0000000000000945 Cleveland Clinic. “Biofeedback: What Is It & Procedure Details.” Cleveland Clinic, 21 Dec. 2020, my.clevelandclinic.org/health/treatments/13354-biofeedback. biofeedback and neurofeedback, biofeedback vs neurofeedback, vestibular group fit, VGF, vestibular disorders, chronic dizziness, PPPD, nervous system regulation, migraine management, stress relief, alternative therapies, holistic approach, living with vestibular migraine, living with vertigo, migraine toolkit, vestibular disorder treatment

One thing that a lot of people with vestibular disorders notice is how fatiguing or challenging different tasks become over time.  What’s happening is your brain is trying to process multiple inputs (or even tasks) at the same time.  For those with vestibular disorders, it becomes more difficult because your body is trying to process more information—and it’s also now having to work double time to keep you upright. Multitasking and task switching are a part of daily life, but it comes with costs. And those with vestibular disorders often notice this more but aren’t quite sure how to make it go away. But this episode is here to help! In this episode, we’ll dig into: Why tasks feel manageable alone but become overwhelming when combined How multitasking and task switching are similar and different What the “switch cost” is and how it adds up over time for those with vestibular disorders What percentage of people with vestibular conditions experience cognitive symptoms like brain fog How the central nervous system and cerebral cortices matter for cognitive symptoms Why spatial awareness demands extra resources when you have a vestibular disorder How balance exercises in VRT are designed to gradually scale up task demands Why errors are actually part of healing with a vestibular condition Why rest and recovery are essential when you’re adding in more cognitive or physical tasks Task switching and multitasking are hard for everyone! A vestibular disorder just adds an extra layer—it doesn’t mean things can’t improve, but it does take time, space, and grace. You’re doing more things than you think and certainly doing more than you take credit for. Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Citations  McGrath, Kim. “The “Switch Cost” of Multitasking.” Wake Forest News, 16 Apr. 2024, news.wfu.edu/2024/04/16/the-switch-cost-of-multitasking/. Asuako, P. A. G., Stojan, R., Bock, O., Mack, M., & Voelcker-Rehage, C. (2025). Multitasking: does task-switching add to the effect of dual-tasking on everyday-like driving behavior?. Cognitive research: principles and implications, 10(1), 5. https://doi.org/10.1186/s41235-025-00611-y Smith, L. J., Wilkinson, D., Bodani, M., & Surenthiran, S. S. (2024). Cognition in vestibular disorders: state of the field, challenges, and priorities for the future. Frontiers in neurology, 15, 1159174. https://doi.org/10.3389/fneur.2024.1159174 ————————————— task switching and multitasking, things to help with brain fog, vestibular migraine brain fog, what causes brain fog and dizziness, vestibular disorders, vestibular group fit, living with vestibular migraine, living with chronic dizziness, sensory overload, spatial awareness, cognitive abilities

Heading somewhere with a big elevation change? Good news! Most people living with vestibular disorders actually do really well at altitude. But that doesn’t mean you just show up unprepared and hope for the best. In this episode, I’m breaking down everything you need to know about navigating altitude changes with a vestibular disorder.  From quick pressure shifts like takeoff and landing, to extended stays at higher elevations, I’m sharing what to keep on standby, what to avoid, and why slower adjustments make all the difference. In this episode, we’ll dig into: Why most people with vestibular disorders actually feel good at altitude Tools for quick pressure changes like takeoff, landing, and steep elevation drives The difference between earplanes & WeatherX earplugs Why slower ascents make a huge difference and how to pace your elevation Medications to ask your doctor about before travel Why you most definitely want to rethink alcohol at elevation What self-care tips still apply at altitude The research behind nature being great for your nervous system My thoughts on oxygen bars and vestibular disorders Altitude changes don’t have to derail your trip! With the right prep, the right toolkit, and a slower ascent, you absolutely can enjoy the mountain tops. Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit WeatherX Earplugs: https://amzn.to/4h7Py7N Earplanes: https://amzn.to/4aQji5b Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Citations “Mountain Vacation? 5 Tips to Cope with Your Altitude Sickness.” Cleveland Clinic, health.clevelandclinic.org/understanding-altitude-sickness-5-best-tips-for-your-next-mountain-trip. ————————————— vertigo and altitude changes, altitude and vertigo, travel and vestibular disorders, vestibular group fit, VGF, living with vestibular disorder, weather & vestibular disorder, change in pressure, inner ear, manage migraine, weatherx earplanes, meniere’s disease, nervous system regulation, chronic dizziness, PPPD

If you’ve ever tried to do too much, crashed hard, and then felt like you were back at square one—this episode is for you. I’m talking about two of the most important concepts we teach in Vestibular Group Fit: scaling and pacing. It cannot be stressed enough how important this is and how much we talk about it in VGF. Scaling and pacing aren’t about doing less forever. They’re about building capacity strategically so you can eventually do MORE without paying for it for days afterward. I’m walking you through real-life examples of how to scale movement, exercise routines, walking, driving, and other daily activities — plus what to do on higher symptom days and post-attack so you can recover faster and get back to living your life. In this episode, we’ll dig into: What scaling and pacing actually mean and how they’re different Why you should never increase more than 10% at a time How to scale things like strength training, walking, and driving The difference between “immediate” responders and “hangover” responders Real-life pacing strategies you can add into your day-to-day life How to scale down on post-attack or high symptom days The 30-day to 30-minute return to walk program results from VGF Summer consistency challenge details for Vestibular Group Fit members Whether it’s exercise, grocery shopping, driving, or attending your nephew’s graduation—the same principles apply. Scaling and pacing are skills. As with any skill, it takes time, practice, and a whole lot of grace and patience with yourself. Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Inside VGF, we have two helpful lessons: Visualization exercises for return to driving, and a 30-day to 30-minute return to walk program Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. physical activity intensity, scaling and pacing, activity pacing, scaling physical activity, vestibular disorder management, chronic dizziness, living with vestibular disorder, migraine attacks, nervous system regulation, exercises to improve balance, return to walking, driving with vestibular disorder, vestibular exercises

I recently got a certificate in functional nutrition and I have thoughts. Starting with the fact that staying hydrated and fueling your body with nutrients will be—not can be, will be—a game-changer for your vestibular disorder. In this episode, I’m breaking down something that comes up over and over again in Vestibular Group Fit: how much what you eat (and drink!) actually matters when you have a vestibular disorder. This isn’t about going on a perfect diet or never eating processed foods again. It’s about understanding how blood sugar regulation, hydration, inflammation, gut health, and hormones are all connected to your dizziness. And what small, manageable steps you can take to start feeling better. In this episode, we’ll dig into: Why diet & hydration are foundational basics for managing a vestibular disorder How blood sugar crashes — including overnight ones — can trigger dizziness & attacks Why skipping meals is practically a guaranteed migraine trigger The role of key nutrients like iron, vitamin D & B vitamins in managing chronic dizziness How inflammation connects to vestibular disorders — and how food either fuels or fights it Perimenopause & menopause: how hormonal changes affect metabolism, muscle mass, insulin sensitivity & dizziness Endocrine-disrupting chemicals (plastics, pesticides, PFAs) & how low-tox swaps can make a real difference Why your gut microbiome might be the reason your medications aren’t working Practical, accessible ways to start improving your nutrition without overhauling everything at once You don’t have to eat perfectly! You just have to start somewhere because the better your nutrition and hydration are, the better you will feel. Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Optimal Bloodwork Link: https://thevertigodoctor.myflodesk.com/yt2ko79vaq  Detoxify by Alli Cohen: https://www.amazon.com/dp/1668033534/ref=cm_sw_r_as_gl_api_gl_i_TYFM23HJFGM1JPQW5671?linkCode=ml1&tag=thevertigodoc-20&linkId=1700598d13c22416e1837eb71940139d  EWG Dirty Dozen list: https://www.ewg.org/foodnews/dirty-dozen.php Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Citations Patelarou, E., & Giakoumidakis, K. (2025). Nutrition and Quality of Life for Patients with Chronic Disease. Nutrients, 17(13), 2170. https://doi.org/10.3390/nu17132170 Paramasivam, A., Murugan, R., Jeraud, M., Dakkumadugula, A., Periyasamy, R., & Arjunan, S. (2024). Additives in Processed Foods as a Potential Source of Endocrine-Disrupting Chemicals: A Review. Journal of xenobiotics, 14(4), 1697–1710. https://doi.org/10.3390/jox14040090 Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S. (2023). The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients, 16(1), 27. https://doi.org/10.3390/nu16010027 Yu, X., Pu, H., & Voss, M. (2024). Overview of anti-inflammatory diets and their promising effects on non-communicable diseases. The British journal of nutrition, 132(7), 898–918. https://doi.org/10.1017/S0007114524001405 Kang, H. S., Kim, S. Y., Kim, J. H., Kim, E. S., Choi, H. G., Lim, H., Kim, J. H., Park, H. Y., Kim, N. Y., Hong, S., Choi, K. C., & Kwon, M. J. (2022). Association between Migraines and Prior Proton Pump Inhibitor Use: A Nested Case-Control Study Using a National Health Screening Cohort. Pharmaceuticals (Basel, Switzerland), 15(11), 1385. https://doi.org/10.3390/ph15111385 Zhang P. (2022). Influence of Foods and Nutrition on the Gut Microbiome and Implications for Intestinal Health. International journal of molecular sciences, 23(17), 9588. https://doi.org/10.3390/ijms23179588 importance of nutrition, functional nutrition, nutrition and lifestyle, living with vestibular migraine, diet and nutrition, treatment for vestibular disorders, diet for vestibular migraine, food and diet for vestibular disorder, migraine management, chronic dizziness, PPPD, vestibular group fit

If you’ve ever started a new medication and immediately felt worse—you’re not broken, and you’re definitely not alone.  In this episode, I’m diving into one of the most common and most frustrating experiences in the vestibular world: medication sensitivity. And more importantly, what to actually do about it. I’m breaking down why so many people with vestibular disorders struggle to tolerate new medications, how to wean on and off gradually to give yourself the best shot at success, and why going slow is actually the fastest way to feel better. We’re also talking about the nocebo effect—because what you expect from a medication can literally shape what you experience. Plus, I’m making a case for the most underutilized resource in your healthcare team: your pharmacist. Seriously, use them. They know things your doctor might miss. In this episode, we’ll dig into: Why medication sensitivity is SO common in the vestibular community The case for weaning onto medications gradually What compounding pharmacies are & how they can be a game changer for hypersensitive people Why you need to understand the nocebo effect before starting a new medication How to tell the difference between “dizziness as a side effect” vs your chronic dizziness How to set yourself up for success when starting a new medication A tool you can use to take the guesswork out of medications Starting a new medication doesn’t feel like as much of a gamble when you know how to prepare, advocate for yourself, and you go slow. Following these tips, you give yourself the very best shot at finally feeling better. Related Episodes: How to Wean Off Your Preventative Medications: https://thevertigodoctor.com/podcast/54-how-to-wean-off-your-preventative-medications/ Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Golden Genetics (mention Dr. Madison for a discount!): https://www.goldengeneticshealth.com/ Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email [email protected] Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. ————————————— vestibular medication, medication for vestibular disorder, placebo and nocebo effect, side effects, vestibular migraine, VM, vestibular disorders, chronic dizziness, mindset and the nocebo effect, increased anxiety and depression, nervous system and dizziness, vestibular group fit, migraine management, compounding pharmacies