Most of us take our ears for granted.
We only really notice them when we get 'swimmers ear' after a day at the pool, or are squirming under a hot water bottle during an ear infection.
Some of us may pack some gum on an airplane to get through that unpleasant few moments between the feeling of pressure in our inner ear and the reassuring pop when it finally opens up.
But for thousands for others, there is a constant feeling of fullness in one or both ears or even a complete blockage by fluid that does not go away.
Complex Ear Congestion
Your case will be unique - your ear congestion may come with nausea, nasal drip, a bad taste in your mouth, migraines, balance issues, tinnitus, fatigue and motion sickness.
Your ear congestion may have happened during an ear infection and never went away, or may get worse when eating certain foods, or they may have become plugged at the onset of an autoimmune condition.
In this article, we will use an example case to show that chronic ear congestion can signal a deeper imbalance. Finding the root cause is the key to getting rid of ear congestion for good.
Rule Out Obvious Causes
Your first step should be to visit your doctor's office to rule out physical blockages and acute infection.
If your case is not resolved there, you will be referred to an ear, nose and throat specialist (an ENT).
Ideally, your ear problem is solved by either of these two visits. If it isn't, you likely have been told that it may go away on its own and it may not - and there is nothing that you can do but wait.
Fortunately, there are many ways to find out what exactly is causing your chronic ear congestion and - depending on your case - ways to make it go away fast.
Get Better Testing
Typically, blood tests are not ordered in cases of chronic ear congestion. A conventional doctor will usually look into structural causes of hearing impairment - like certain genetic conditions, wax buildup or inflammation-based fluid.
If no surgery is recommended and no medication is needed and the fluid affecting your inner or middle ear appears to be clear (uninfected) then a 'wait and see' approach will likely be recommended.
Tests are often just used for diagnosis, often additional testing can reveal the underlying cause of mysterious symptoms
I practice functional medicine, which seeks to address the cause of complex symptoms and conditions.
'Idiopathic' is the label given conditions that have 'no known cause.'
Often, however, idiopathic conditions are simply those that have not been properly investigated.
It may be that the only blood tests you've had is a cholesterol test or a complete blood count (CBC) at your annual checkup.
When something changes - like the onset of severe allergies or new symptoms or a health condition like rheumatoid arthritis, chronic fatigue or depression - more thorough testing is warranted to see what is happening on a deeper level in your body.
Functional Range And Why It Matters
It helps to know just how blood testing results are assessed before we go further. You may assume that when a doctor orders testing and says that your results are 'normal' that it means that you are 'well'.
Results that are in a 'normal' range just mean that you are in the average range of all the patients that have got 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 be in an advanced diseased state, or on the brink of organ failure.
'Functional range' on the other hand, is a range of the optimal function of the value we are testing.
Based on a functional medicine model, 'mysterious' symptoms begin to make sense, and 'idiopathic' diseases can sometimes be traced to a specific cause.
During your care we can also assess how well you are responding to treatment based on your bloodwork - you will not only feel your symptoms improve, you will see evidence of your overall function improve as well.
For my patients, I don't just want you to be 'not sick,' I want you to be healthy.
From 'Idiopathic' to Diagnosis
In cases of ear congestion of unknown origin it is helpful to assess the function of your internal organs (especially your liver), the overall health of your immune system, if you have any latent infections, if you have markers that indicate a parasite or fungal infection or if you are showing traces of autoimmunity activity.
Often, ear pain or congestion is just one of many symptoms you may experience
These tests should be tailored to your medical situation.
A 65 year old with diabetes, weight gain and a feeling of fullness in her ears will have different tests ordered than a 31 year old with Crohn's disease whose eustachian tubes have been filled with clear fluid for 2 years.
This functional medicine testing can be done at my clinic, or can be arranged at a hospital near you if you are out-of-state. This testing is usually covered by your insurance.
Testing For Congested Ears
In general, there are a few markers that are particularly helpful to test for in cases of chronic ear congestion:
hs-CRP - which tests for general inflammation
Food sensitivity testing - ELISA/ACT testing tends to be the most accurate
Comprehensive stool analysis - checks for viral, bacterial, fungal and parasitic infection. It also assesses the health of your microbiome and digestive capability
Nasal culture - for fungal or antibacterial resistant staph infections
CBC - complete blood count - to evaluate general immune system activity, from these results we can more deeply assess your immune function. This test is often done but is rarely interpreted from a functional perspective.
Plasma Histamine - evaluates systemic histamine levels which is important for any type of congestion and environmental/food allergies. This can indicate that your body is reacting to something even though other testing is negative.
Keep in mind this is a very general starting point. After a new patient appointment or online consultation I would know your medical history, other conditions you may have, any other testing you have had, and family history - based on that information I could order testing personalized to your specific situation.
Infection Causing Ear Congestion
Let's look at the example patient 'Kevin' to see how chronic ear congestion could be addressed with the application of functional medicine.
In our initial appointment, Kevin tells me he has a feeling of fullness in both ears, headaches, tinnitus, digestive upset and a general feeling of fatigue - these symptoms have been steadily worsening over the past year.
He now feels like he is reacting to certain foods he is eating and never really feels 'well'.
He has been to other doctors who have him on long-term antibiotics. We order testing similar to that listed above.
We find a fungal infection confirmed both in the nasal culture and in the comprehensive stool analysis as well as a few severe nutrient deficiencies.
Multiple tests are useful in cases of complex or chronic conditions, if the nasal culture is not done correctly it may come back as a false negative, but both tests provide additional confirmation.
This example patient has only got worse in the last few months despite aggressive treatment by his doctors - and no wonder - by continually wiping out beneficial bacteria with antibiotic use, the acute fungal infection has become chronic.
With each round of antibiotics the fungal infection has become stronger and has spread to his gastrointestinal tract via nasal drip.
Now, in addition to ear congestion, he is experiencing digestive upset, constipation, and stomach cramping after meals.
Two major factors that cause fungal infections to thrive are excessive use of antibiotics and a suppressed immune system. Antibiotics are used far too much and often in cases where they do more harm than good.
Stress is the number one cause of an impaired immune system. Your body's ability to handle stress is like the battery capacity of your phone. The only time your phone's battery actually impacts you is when your phone battery about to reach 0% and it shuts off.
The same is true with your body and how it handles stress - you only really feel the full effects of stress is when your body can no longer keep up and you develop symptoms.
An overtaxed immune system also drains the nutrient reserves of your body to the point of deficiency, further compounding symptoms.
This is what happened to Kevin.
'Gut Healing' Or 'Condition Based' Diets
A quick note on diets. Diet alone is usually not enough to completely kill off a severe infection despite the claims of gut healing or fungal infection diets.
A good indicator of the efficacy of these diets is to assess how you feel after a 'cheat' meal.
If you have been on a strict diet aimed at killing an infection but when you have one or two 'cheat' meals with refined sugar (or whatever else is forbidden) and your symptoms come back - then the infection is still active, it is just being kept at a lower level than before.
Your diet is a fantastic tool for healing quickly - but it is one tool of many that we can utilize.
Your diet is an incredibly powerful and necessary tool in your recovery. When used in conjunction with treatment, it is extremely effective.
Before you self-treat with a strict diet, get confirmation testing to determine what is wrong and work with a functional medicine doctor to naturally treat your underlying condition so that your diet can be at its most effective.
Our priorities in Kevin's case is to weaken and kill the fungal infection through targeted treatment and dietary and lifestyle changes.
We will also replete his deficiencies using high grade supplementation.
Kevin had a pretty standard American diet, lots of coffee, fast food, too much sugar and not enough vegetables and fruits.
Our first step is to cut out refined sugar and fast food from his diet. I help him swap out his favorite foods with healthier versions.
After a few days the stomach cramping is gone and he can sleep better. Excited at his progress, he adds more vegetables and cuts out refined flour from his diet.
Once he received his pharmaceutical grade supplementation, his body was able to recover and start to heal.
Through targeted nutritional medicines his energy drastically increased and his stress dissipated. We were able to verify that his immune system capacity was now healthy and able to protect him from fu