Does supplemental vitamin D help reduce the intensity of benign paroxysmal positional vertigo?. This longitudinal study explores the influence of vitamin D on the severity of this common vestibular disorder.

The Prevalence of Vitamin D Deficiency in Musculoskeletal Conditions

Numerous studies have highlighted the high prevalence of vitamin D deficiency in various musculoskeletal conditions. One study found that vitamin D deficiency is common among patients presenting to rheumatology clinics, with an inverse relationship between age and vitamin D levels. Vitamin D deficiency has also been linked to increased severity of knee osteoarthritis and reduced muscle strength. These findings suggest the importance of addressing vitamin D status in the management of various musculoskeletal disorders.

Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder characterized by brief episodes of vertigo triggered by changes in head position. BPPV can have a significant impact on the quality of life and long-term outcomes, with some individuals experiencing recurrent episodes. Understanding the potential factors that influence the severity and recurrence of BPPV is crucial for improving patient management.

The Role of Vitamin D in Muscle Function and Balance

Vitamin D is known to play a crucial role in muscle function and performance. Several studies have demonstrated the positive effects of vitamin D supplementation on muscle strength, gait, and balance in older adults. This suggests that vitamin D deficiency may contribute to impaired balance and increased fall risk, which could potentially exacerbate the symptoms of BPPV.

Canalith Repositioning Maneuvers for BPPV

The Epley maneuver is a commonly used repositioning technique for the treatment of BPPV. This procedure aims to relocate the displaced otoconia (calcium crystals) back into the appropriate chamber of the inner ear, reducing the severity of vertigo episodes. While the Epley maneuver is often effective, the long-term outcomes and recurrence rates of BPPV remain a concern.

Vitamin D Deficiency and BPPV

Recent studies have suggested a potential link between vitamin D deficiency and the development or recurrence of BPPV. One study found that patients with idiopathic BPPV had significantly lower serum vitamin D levels compared to healthy controls. Another study reported that treating severe vitamin D deficiency in BPPV patients led to a reduction in the recurrence rate of the condition.

The Impact of Supplemental Vitamin D on BPPV Intensity

This longitudinal clinical study aimed to investigate the influence of supplemental vitamin D on the intensity of BPPV symptoms. By monitoring BPPV patients over time and assessing the changes in vertigo intensity with vitamin D supplementation, the researchers sought to provide insights into the potential therapeutic role of vitamin D in the management of this vestibular disorder.

Key Findings and Implications

The study findings demonstrate that supplemental vitamin D can effectively reduce the intensity of BPPV symptoms. Patients with vitamin D deficiency who received vitamin D supplementation experienced a significant decrease in the severity of their vertigo episodes compared to those who did not receive the supplement. These results suggest that addressing vitamin D status may be a valuable strategy in the management of BPPV, potentially reducing the need for more invasive interventions and improving the long-term outcomes for affected individuals.

The study’s longitudinal design and focus on the influence of vitamin D supplementation on BPPV intensity provide valuable insights into the potential therapeutic applications of this widely available and well-tolerated nutrient. By understanding the interplay between vitamin D status and BPPV, healthcare professionals can optimize the management of this common vestibular disorder and improve the quality of life for affected patients.

Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: A longitudinal clinical study

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Two Common Nutrients Might Keep Vertigo at Bay

WEDNESDAY, Aug. 5, 2020 (HealthDay News) — Taking in extra vitamin D plus calcium might cut your odds of getting a debilitating form of vertigo, new research shows.

The Korean study focused on benign paroxysmal positional vertigo (BPPV), a sudden spinning sensation that’s commonly triggered by changing your head position. According to the study authors, about 86% of people who have this type of vertigo find that it affects their life, even resulting in missed days at work.

Often, the condition can be remedied by undergoing a specific type of head movement under a doctor’s supervision, according to researcher Dr. Ji-Soo Kim, of Seoul National University College of Medicine.

But the new findings now suggest that for folks with BPPV, “taking a supplement of vitamin D and calcium is a simple, low-risk way to prevent vertigo from recurring,” he said in a news release from the American Academy of Neurology.

Kim added that the treatment “is especially effective if you have low vitamin D levels to begin with.”

One U.S. expert said the study adds to prior data supporting the therapy.

The study “represents the best evidence to date that a simple over-the-counter treatment of this common condition affecting adults over the age of 50 is safe and effective,” said Dr. Anthony Geraci. He directs neuromuscular medicine for Northwell Health in Great Neck, N.Y.

In their study, Kim’s team recruited more than 900 people with BPPV. Participants were divided into two groups. In the first group, those with low vitamin D levels (below 20 nanograms per milliliter) were given supplements with 400 international units of vitamin D and 500 milligrams of calcium, twice daily, while those with healthier vitamin D levels (equal to or greater than 20 ng/mL) were not given supplements.

The second group was not given supplements regardless of their vitamin D levels.

The result: People taking the supplements experienced a 24% reduction in their rate of vertigo compared with those not taking supplements, the researchers found.

The greatest benefit was seen in those who were more deficient in vitamin D to begin with. People whose vitamin D levels were lower than 10 ng/mL saw a 45% reduction in vertigo recurrence, while those with vitamin D levels of 10 to 20 ng/mL saw only a 14% reduction, the researchers found.

In all, 38% of people who took vitamin D/calcium experienced another episode of vertigo, compared with 47% of those who weren’t taking them.

“Our results are exciting because, so far, going to the doctor to have them perform head movements has been the main way we treat benign paroxysmal positional vertigo,” Kim said. “Our study suggests an inexpensive, low-risk treatment like vitamin D and calcium tablets may be effective at preventing this common, and commonly recurring, disorder.”

Geraci noted there are already good reasons to get more vitamin D and calcium into your diet.

“The beneficial effects of vitamin D and calcium supplementation have previously been shown to improve cardiovascular health, bone health and reduction in fractures due to falls in the elderly,” he noted.

Dr. Sami Saba is a neurologist at Lenox Hill Hospital in Great Neck, N.Y. He said that “the standard treatment for BPPV is a repositioning maneuver that puts the crystals in the inner ear that have been displaced back where they belong.”

However, Saba added, “the symptoms often recur after such a maneuver, and until now there hasn’t been any proven treatment to prevent recurrence.”

Vitamin D plus calcium might change all that, Saba said — and there’s logic behind the treatment.

“The inner ear crystals, or otoconia, are partially made of calcium carbonate, and vitamin D is essential for calcium metabolism, so the mechanism of the treatment makes sense,” he said.

The report was published online Aug. 5 in the journal Neurology.

More information

For more on vertigo, head to the U.S. National Library of Medicine.

SOURCES: AnthonyGeraci, MD, director, neuromuscular medicine, Northwell Health, Great Neck, N.Y.; Sami Saba, MD, neurologist, Lenox Hill Hospital, New York City; American Academy of Neurology, news release, Aug. 5, 2020

Vitamin D deficiency can cause dizziness attacks

• Health

To find out, Egyptian scientists conducted a study on 40 patients diagnosed with benign paroxysmal positional vertigo. Translated into human – dizzy with a sharp change in posture.

August 24, 2021

Source:

iStock/Getty Images

About 20 percent of adults complain of dizziness. Many of them are not due to problems with neurology, but with disorders in the vestibular apparatus. Calcium carbonate crystals (otoconia) enter the semicircular canals and cause benign paroxysmal positional vertigo (BPPV). It occurs most often due to a change in the position of the head, tilting, turning when you get out of bed or lie down in it. Therefore, the disease has another name – positional vertigo. It can be accompanied by mild nausea, even vomiting, and does not last long – a few minutes. Scientists have suggested that the process may be affected by a lack of vitamin D.

“We set out to evaluate the association between recurrent BPPV attacks and vitamin D deficiency,” Aida Ahmed Abdelmaqsoud, co-author of the ENT department at the University of the South Valley School of Medicine, Egypt, explained the purpose of the study in the journal Nature.

Read also

40 patients who had already been diagnosed with BPPV were selected for the study. All had low levels of vitamin D – this was a prerequisite for participation in the study. Among them were 14 men and 26 women, they were divided into two groups – receiving an additional dose of vitamin D, and those who were treated in the usual way. The therapy was repeated six months later. It was found that vitamin D directly affects the mechanism of formation of otoconial particles in the vestibular system.

“Vitamin D deficiency has been associated with BPPV severity and recurrence,” said Aida Ahmed Abdelmaqsoud. “And adding vitamin D to therapy may reduce the frequency of recurrent seizures.”

Adequate levels of vitamin D can be maintained through skin photosynthesis and oral intake. According to Egyptian scientists, about a billion people around the world suffer from a deficiency or lack of vitamin D even in summer: somewhere there is not enough sun, somewhere bad weather conditions, air pollution, too much sunscreen is used, clothes get dirty.

Text author:Alena Bezmenova

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Vitamin D and benign paroxysmal positional vertigo

PUBLICATIONS

Relevance

Benign paroxysmal positional vertigo (BPPV) is one of the most common diseases of the peripheral part of the vestibular analyzer. The main clinical manifestation of BPPV is intermittent short-term attacks of dizziness when the head position changes. It is believed that BPPV is the most common cause of dizziness (18-25% of all cases of dizziness).

Despite the benign nature of the disease, the presence of BPPV is associated with a decrease in the quality of life. However, there are no effective methods to prevent BPPV. Several observational studies have found that BPPV patients are more likely than the general population to have vitamin D deficiency and decreased bone mineral density. In this connection, the purpose of the study under discussion was to evaluate the effectiveness of vitamin D in the prevention of BPPV.

Methods

The randomized trial was performed in 8 hospitals in South Korea between December 2013 and May 2017.

Its participants were patients with BPPV. All of them were randomized into two groups: vitamin D therapy 400 IU in combination with 500 mg calcium carbonate twice a day (if the concentration of vitamin D was less than 20 ng/ml) and standard observation.

The primary end point was the annual recurrence rate. The mean follow-up period for participants was 1 year.

Results

• The study participants were 1050 patients with BPPV.

• It was found that, on average, during the study period, relapses of dizziness were observed with a frequency of 0.83 cases per year in the vitamin D group and 1.1 cases per year in the standard observation group (hazard ratio 0.76; 95% confidence interval 0.66-0.87; p<0.001. In addition , in the active therapy group, BPPV relapses were reported in fewer patients (37.8% vs. 46.7%; p=0.005).

• The estimated number of patients who needed to be treated with vitamin D to prevent recurrence of BPPV was 3.7 (95% CI 2.5-7.14).

Conclusion

Thus, the results of the present study demonstrate that in patients with BPPV, vitamin D and calcium supplementation reduces the frequency of relapses.