Analysis of cortisol and other stress-related hormones in patients with Meniere's disease

Objective: To evaluate cortisol and catecholamine levels in patients with Meniere's disease.

Study Design: Prospective, controlled study.

Setting: Tertiary referral center.

Patients: Thirty patients with Meniere's disease and 18 healthy controls.

Main Outcome Measures: Serum and saliva cortisol, serum cortisol after the dexamethasone suppression test, urine free cortisol, and urine catecholamines.

Results: The serum and saliva cortisol levels were higher in Meniere's patients compared with their control group: 440 +/- 127 (n = 28) versus 366 +/- 90 (nmol/L) (n = 18) and 17.2 +/- 6.1 (n = 18) versus 11.6 +/- 4.6 (nmol/L) (n = 9), respectively. Both differences were significant (P <0.05). There were no dissimilarities in urine cortisol or urine catecholamines for either group. Twenty-eight Meniere's patients were divided into two subgroups, namely, high- and low-cortisol groups, using a serum cortisol level cutoff point of 465 nmol/L (median). The total Meniere's disease time and the duration of tinnitus tended to be longer in the high-cortisol group (p = 0.07, two-tailed). The total Meniere's disease time was 13.5 +/- 9.9 years in the high-cortisol group and 7.1 +/- 7.4 years in the low-cortisol group (n = 14 for both). The subgroups were matched for age, gender, and unilaterally or bilaterally affected ears.

Conclusion: Patients with Meniere's disease have higher serum cortisol levels. It is suggested that these higher cortisol levels are rather the result than the cause of this chronic disease, because patients affected longer seem to have higher cortisol levels. The exact impact of these higher cortisol levels on the inner ear and endolymph homeostasis is yet unknown.