Headaches, Tinnitus, and Dizziness in Anorexia Recovery

Livia answers a listener question about how to get rid of headaches, tinnitus, and dizziness in anorexia recovery.

Want more? Find my books, courses, and coaching programs at livlabelfree.com

Episode transcript:

Hello my friends, well today is another Q&A episode and today’s question comes from jellyfish1093 on YouTube and they asked if I could do an episode on physical and mental symptoms no one talks about when in anorexia. And obviously there are an infinite number of things no one talks about – or rather, not enough people are talking about – when it comes to eating disorders, especially when said eating disorders intertwine with autism and LGBTQ+ identity and chronic illness and all the other things that well, no one talks about!

And by this point, I do hope you know that a huge goal of mine with this podcast and with my books and my courses is to shed light on these underserved topics because they’re things I wish I had known during my own recovery. They’re the things my family wished they’d known because they would have been better able to support me. They’re things that all healthcare professionals SHOULD know so that they can help individuals unleash their full potential rather than trying to treat a “disorder” that’s merely a manifestation of, again, everything no one talks about.

Anyways, all that being said, because we’ve of course gotta have some direction, I replied to jellyfish1093 asking if they could elaborate on what stage of recovery they’re in and specifically what symptoms they wanted me to talk about. And here’s what they replied: 

“I’m currently in quasi recovery. My weight is very low and I am still exercising every day and struggling immensely. I am eating 4 meals a day but have been experiencing headaches, dizziness, tinnitus, and other symptoms like brain fog, extreme anxiety and depression. I also have Autism. Just looking to find hope that if I can fully recover that these symptoms can go away. For 4 years I have been trying to find out why these symptoms are happening but now I am wondering if they are all related to anorexia? Just trying to find hope. Thank you.”

Well we’ve got a lot to get into and I am super excited to get into it because, as you may have guessed, I did some research (which basically means I went into multiple research rabbit holes, a very autistic trait, I might add) and I paired my findings with my own lived experience and those of my clients to now bring you this podcast! So buckle up because I’m going to take you on a journey to what I’ve learned so that hopefully, jellyfish1093, this gives you hope, and to anyone else with similar experiences, I hope this gives YOU hope as well. So without further ado, let’s dive in!

Alright so we need to establish the facts first. Based on what jellyfish1093 (I freaking love saying that username so thank you for gifting me this opportunity to have a laugh), we’re going to establish as a fact that you are malnourished. Your weight is low, you’re engaging in exercise that you probably shouldn’t be, and you’re not eating enough. So, you’re in a state of energy deficit. Quasi recovery aside, the fact is that your body is depleted. And the fact that I’m really hammering this down right now is because when the body is in a state of energy deficit, nothing can function correctly. And I mean nothing.

Because the truth is that the human body is nothing more than a living organism that uses energy and requires that energy to be replenished. And if that energy replenishment – AKA eating and drinking – is hard for you, trust me, I am right there with ya my friend. The amount of times that I have wished that I could photosynthesize, the amount of times I have wished this body didn’t even have needs. The amount of times I have wished I didn’t have to drink or eat or sleep or shower or clean or whatever it is that we have to do on a daily basis just because we have bodies…my god, it’s fucking exhausting. But all those feelings aside, the bottom line is that we do have bodies. And these bodies do have needs.

So what happens when we don’t give our body what it needs? What happens is that the body goes into energy conservation mode. It does everything humanly possible (no pun intended) to not use up its limited resources. Now, I’m not going to elaborate on the science behind this too deeply because I literally wrote an entire book called How to Beat Extreme Hunger explaining energy deficit and how this leads to energy debt and why extreme hunger is your body’s attempt at getting you back into homeostasis, and of course, in that book I also share my lived experience around all my recovery fears including mental hunger just being a bad habit, that I would become addicted to food and develop binge eating disorder if I gave into my extreme hunger, and of course, I share how to make peace with weight gain because I’m autistic and philosophical and the whole “oh just love your body and appreciate what it can do for you” NEVER resonated with me because to be honest my friends, I still feel hella trapped in this body. I mean for real, it’s too freaking constraining and demanding. But we’re not gonna go there right now because we were gonna talk about headaches and dizziness and tinnitus and all the things jellyfish1093 has asked about. But yeah, shameless plug for all my books right now because they’re awesome and I worked really hard on them and you can find them all at livlabelfreebooks.com or on Amazon.

But now back to the episode and why it’s so important to understand that energy deficit AKA restriction causes the body to try and conserve energy is that this energy conservation causes all kinds of symptoms that, to put it bluntly, fucking suck. You weaken your digestive system which means that when you start eating again in recovery you’ll feel really sick and bloated. You starve your brain which means that there will be imbalances in ALL the neurotransmitters, so hello anxiety and depression.

And if you compound energy deficit with being autistic, which I’m just gonna go off on a limb here and say you probably feel permanently burnt out just trying to navigate a world not built for you, well when you take all these factors into account, well no wonder you’re in so much pain all the time. But here is the plot twist: You’re not broken. You don’t need to be fixed. What you need is to create safety within yourself and your environment. But that’s of course just the overarching message of all of this. Because essentially, the trauma caused by being autistic in a non-accommodating world compounded with the trauma of an eating disorder, while ironically being the ED being a trauma response in and of itself, well all of this just creates a never-ending spiral of fight-or-flight mode, which is incredibly energetically demanding, and thus not sustainable. 

So how does all of this connect to anorexia symptoms, specifically headaches and tinnitus? Well, there are a lot of different kinds of headaches, but for me personally, my headaches were always tension headaches. This might sound kinda weird, but I felt my headaches from the front of my head all the way down to my lower back and this is because I carry so much stress with me all the time, and honestly, I still do. But when you are malnourished, your body is way more fragile so everything you experience is going to be experienced on infinitely high volume. This is why we have zero flexibility when we have eating disorders. The body and brain simply do not have enough energy to consider other options. So hello black and white thinking and what is often termed as “rigid” thinking.

Now of course there’s nuance to this because autistic people often already have difficulty with change. So again, add malnutrition to that, and you’ve practically just turned that autism dial up a few notches. This is also why many people who are not autistic can actually display autistic traits during active eating disorders. But again, that’s a whole nother topic which you can learn more about in my Autistically ED-Free Academy at livlabelfree.com/group or you can book a 1-1 coaching session with me at livlabelfree.com/coaching if you’d like to work with me privately. 

So, jellyfish1093 and anyone else listening, I don’t know what kinds of headaches you’re experiencing or if there’s anything that makes them worse or better, but what I do know is that restriction is fueling your fight-or-flight response, which scientifically speaking can cause headaches! Why? Well, your body perceives restriction, so energy deficit, as a famine. When you’re not eating enough, your nervous system believes there aren’t enough resources. I mean, why else would you be starving yourself?

As I’m sure I don’t have to tell you, a lack of resources is one of the greatest threats to human survival! But because your body is designed to do everything in its power to ensure your survival, it’s going to activate that fight-or-flight mode so you can fight or flee whatever is causing you to be malnourished. Of course, your nervous system that obviously doesn’t have a logical thinking organ cannot know that you’re not actually in a famine environment, and it doesn’t know that you’re purposely restricting for other reasons, including fear of weight gain, autistic masking, and all the other things I talk about on this podcast and in my books and courses.

Now, why is this relevant? Because when you’re in a permanent state of fight-or-flight mode, your body is literally tensing up ALL the time! Your neck muscles, your shoulder muscles, your scalp muscles, everything is constantly clenched and ready for battle. And, well, can you guess what happens when those muscles stay contracted for weeks, months, perhaps even years? Hello tension headaches! Of course, tension headaches aren’t the only type of headaches that restriction causes. Now, let’s talk about what happens when your brain is literally running on empty.

As I’ve talked about before on this podcast, your brain requires glucose – so, sugar! – to function. This is why during extreme hunger, we crave so much sugar. We’re not becoming “addicted to sugar,” we’re not developing binge eating disorder, our brain is literally screaming for us to help it heal! But because restriction depletes your brain of the glucose it needs to function, you experience not only headaches caused by blood sugar spikes and crashes, but you experience that brain fog, anxiety, depression, and other mental health struggles jellyfish1093 mentioned.

So you may be wondering, how the heck does this blood sugar stuff work? Well, when you’re engaging with an eating disorder, your blood sugar is basically on a constant roller coaster ride because energy deficit makes it harder for the body to properly regulate blood sugar. Why? Because regulating blood sugar costs energy, and well, you don’t have enough of that, remember?! Your liver, which normally stores glucose and releases it when needed, doesn’t have enough reserves to keep your levels stable. So even if you do eat something, your blood sugar might spike too high and then crash even harder, creating this vicious cycle of glucose instability that leaves your brain in constant distress.

And then there’s electrolyte imbalances. When you’re malnourished, your sodium, potassium, and magnesium levels get thrown off. These minerals fuel the electrical system of your body – they’re what allow your nerves to send signals properly. So when those levels are imbalanced, which they absolutely will be during restriction, your nervous system starts misfiring. And where do you feel that neurological chaos? Yep, in your head!

So moral of the headache story before we move onto tinnitus is that yes, absolutely anorexia can cause headaches and they’re probably not some mysterious separate condition that you need to worry about on top of everything else you’re already dealing with. Your headaches are your body’s completely predictable response to being in energy deficit – whether that’s from your nervous system being stuck in fight-or-flight mode, your brain running on fumes, or your electrical system going haywire from electrolyte imbalances.

The really important thing I want you to hear, jellyfish1093, is that these headaches aren’t permanent. They’re not a sign that you’ve broken your body beyond repair. They’re actually proof that your body is still fighting for you! When you give your body consistent, adequate nutrition – which is probably more than just four meals a day and probably less exercise and yes, weight gain – these systems can and do heal. Your nervous system can calm down, your blood sugar can stabilize, and your electrolytes can rebalance. It takes time, and to be honest, it often gets worse before it gets better. This is where coaching can be so helpful because you have someone who’s been there supporting you every step of the way! So if you are interested in working with me, do schedule a discovery session because I would love to meet you and create your freedom plan. And now, onto tinnitus!

So jellyfish1093 I’m actually so happy you mentioned this because I used to have really bad tinnitus during my anorexia and in quasi recovery and I had never even connected the dots to malnutrition until your comment, so thank you for enlightening me! And before we get into the science behind how malnutrition can cause tinnitus, it’s worth saying what tinnitus is because it can kinda sound like a fancy word! So tinnitus is a condition where a person perceives ringing, buzzing, hissing, or other noises in their ears, even when there is no external sound source. It can be caused by several factors, including aging, ear infections, and can be a side effect of certain medications. But what’s not talked about ANYWHERE is how tinnitus can be caused by anorexia!

But here comes Reddit to the rescue! Yep, that’s right. As I was doing my research for this episode, I googled “tinnitus and anorexia,” and the top hit was a Reddit post! Which is saying a lot about there not being information on this connection. Anyways, maybe you already saw this Reddit post in your own research, jellyfish1093, but I want to read it aloud just in case it’s helpful and because it of course provides another lived experience story about how eating enough truly is the only way to heal yourself!

So the post is in the subreddit /tinnitus and it’s titled “For those with malnutrition/eating disorders…” and here’s what the OP writes:

“Hey, I just wanted to share that my intense and persistent tinnitus was resolved through recovery from my eating disorder (anorexia). I thought I was getting enough nutrition, however, I was not. Also, you cannot simply take enough vitamins/supplements. I was attempting to do that but it didn’t make up for the food I was supposed to be ingesting. The tinnitus for me was like the sound of white noise, particularly in one ear. Machine sounds, such as the low hum of a refrigerator in a store could further intensify it, and I had been to a great ENT doctor that ruled out anything structure-wise on their end. I did not connect the dots, that tinnitus could be caused by malnutrition…but I am SO glad to be free from it. I want you to be free from it too. So I figured I’d share what helped me.”

Honestly, this is why I love Reddit. The amount of validation I have felt on there is kind of unmatched. But because I want this podcast to be unmatched as well, I’m gonna give you more than lived experience and hope because I also want to explain WHY tinnitus is a symptom of anorexia. And here’s what I discovered:

First off, remember those electrolyte imbalances we just talked about with headaches? Well, your inner ear is incredibly sensitive to changes in fluid balance. When your sodium, potassium, and magnesium levels are all over the place, it messes with the fluid in your inner ear. This can create pressure changes and affect how sound waves are processed, which your brain might interpret as ringing or buzzing.

But there’s also a blood flow component. When you’re malnourished, your blood pressure often drops because you’re dehydrated and your blood volume is low. But then sometimes your body tries to compensate and your blood pressure spikes. These blood pressure fluctuations affect circulation to your inner ear, and poor blood flow to those tiny, delicate structures can absolutely cause tinnitus.

And remember how we talked about your brain being starved of glucose? Well, your auditory system requires a ton of energy to function properly. When your brain doesn’t have enough fuel, it can start misfiring, and sometimes that misfiring gets interpreted as sound when there isn’t any. It’s like your brain is so desperate for stimulation that it starts creating its own – which honestly makes so much sense for those of us with neurodivergent brains that are already seeking stimulation all the freaking time!

To bring this full circle with that chronic fight-or-flight state I keep coming back to, sympathetic nervous system activation makes your brain hypervigilant to everything, including sounds that would normally be filtered out. And if you’re autistic, you already know how overwhelming auditory processing can be even when we do feel regulated. So imagine how much worse that gets when malnutrition has your nervous system completely dysregulated.

Now before we wrap up here, what’s worth emphasizing is that none of this is happening in isolation. It’s probably not just one thing causing your tinnitus. The mechanisms I just described – so your inner ear fluid being off, your blood flow being chaotic, your brain misfiring from lack of fuel, and your nervous system being hypervigilant – this is all happening simultaneously.

This same concoction of mechanisms is likely what’s causing your dizziness as well. Your vestibular system, which is a sense that plays a crucial role in balance and spatial orientation – lives right there in your inner ear alongside your hearing. So when malnutrition messes with your inner ear fluid and blood flow, it’s not just affecting how you hear, but it’s also going to affect your sense of balance and where you are in space. Add in those blood pressure fluctuations and blood sugar crashes we talked about, well, you guessed it, hi there dizziness!

So I know this is a lot, but jellyfish1093, you did say in your original comment that you were looking for hope, so that’s exactly what I want to leave you with. Your body is so wise, wiser than our mind could ever be. Your body knows exactly what it needs, and it is doing everything in its power to support you and your healing. All the symptoms you’re experiencing – the headaches, tinnitus, dizziness, brain fog, anxiety, depression, and I’m sure so much more – these aren’t actually separate parts that need individual targeting to heal. In reality, these are all your body’s way of saying “Hey, I need consistent fuel to function properly.” And I can promise you that when you give your body what it actually needs, it will take all that energy and utilize it to fully recover. Of course, if you want my help on that journey, you can schedule a consultation call for 1-1 coaching or enroll in my extreme hunger course or join me and other neurodivergent aliens in the existential autistic membership! You can find all the different ways to work with me on my website livlabelfree.com. I hope to chat with you in real-time, and otherwise, I’ll talk to you in the next episode. Bye bye for now!