Vitamin deficiency vertigo. Vitamin D Supplementation and Benign Paroxysmal Positional Vertigo: A Comprehensive Analysis

28.07.202308.07.2023 by alexxlab

How does vitamin D deficiency affect benign paroxysmal positional vertigo. What are the benefits of vitamin D supplementation for BPPV patients. How can vitamin D improve balance and reduce fall risk in the elderly. What is the relationship between vitamin D levels and BPPV recurrence rates. How does vitamin D influence muscle strength and function in older adults. What are the seasonal variations in vitamin D levels and their impact on BPPV.

Содержание

The Link Between Vitamin D Deficiency and Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder characterized by brief episodes of vertigo triggered by changes in head position. Recent studies have uncovered a significant relationship between vitamin D deficiency and the occurrence and severity of BPPV. This connection has sparked interest in the potential therapeutic role of vitamin D supplementation in managing this condition.

Research has shown that individuals with BPPV often have lower serum vitamin D levels compared to healthy controls. A study by Jeong et al. found decreased serum vitamin D levels in patients with idiopathic BPPV, suggesting a possible causal relationship. This finding raises an important question: Can vitamin D deficiency contribute to the development of BPPV?

The answer appears to be yes. Vitamin D plays a crucial role in calcium metabolism and bone health, which are essential for the proper functioning of the vestibular system. The otoconia, small calcium carbonate crystals in the inner ear, are particularly sensitive to changes in calcium metabolism. Vitamin D deficiency may lead to abnormalities in otoconia formation or maintenance, potentially increasing the risk of BPPV.

Vitamin D Supplementation: A Promising Approach to BPPV Management

Given the established link between vitamin D deficiency and BPPV, researchers have begun investigating the potential benefits of vitamin D supplementation in managing this condition. The results have been encouraging, suggesting that vitamin D supplementation may offer significant advantages for BPPV patients.

A longitudinal clinical study examined the influence of supplemental vitamin D on the intensity of BPPV. The findings revealed that patients who received vitamin D supplementation experienced a reduction in the severity and frequency of vertigo episodes. This improvement was particularly notable in patients with severe vitamin D deficiency.

How does vitamin D supplementation benefit BPPV patients? Several mechanisms have been proposed:

Improved calcium metabolism and otoconia stability
Enhanced vestibular function
Increased muscle strength and balance
Reduced inflammation in the inner ear

These mechanisms work together to alleviate BPPV symptoms and potentially reduce the risk of recurrence. However, it’s important to note that vitamin D supplementation should be considered as part of a comprehensive treatment approach, which may include other interventions such as the Epley maneuver.

Vitamin D and Balance: Implications for Fall Prevention in the Elderly

The benefits of vitamin D extend beyond BPPV management. Numerous studies have highlighted the role of vitamin D in maintaining balance and reducing fall risk, particularly in older adults. This connection is especially relevant given that BPPV is more common in the elderly population.

A meta-analysis by Bischoff-Ferrari et al. demonstrated that vitamin D supplementation can significantly reduce the risk of falls in older adults. The study found that higher doses of vitamin D (700-1000 IU per day) were more effective in fall prevention than lower doses.

How does vitamin D improve balance and reduce fall risk? The mechanisms are multifaceted:

Enhanced muscle strength and function
Improved neuromuscular coordination
Better postural stability
Increased bone density

These effects are particularly important for older adults with BPPV, as the condition can significantly increase the risk of falls and related injuries. By addressing vitamin D deficiency, healthcare providers may be able to improve overall balance and reduce fall risk in this vulnerable population.

Vitamin D Levels and BPPV Recurrence Rates: A Closer Look

One of the most intriguing findings in recent research is the potential impact of vitamin D levels on BPPV recurrence rates. BPPV is known for its tendency to recur, with some patients experiencing multiple episodes over time. Could vitamin D supplementation help reduce these recurrences?

A study by Talaat et al. provided compelling evidence in this regard. The researchers found that treatment of severe vitamin D deficiency led to a significant reduction in the recurrence rate of BPPV. This finding has important implications for long-term management of the condition.

The study revealed that patients with vitamin D levels below 10 ng/mL had a higher recurrence rate of BPPV compared to those with higher levels. After vitamin D supplementation, the recurrence rate decreased significantly in the treatment group. This suggests that maintaining adequate vitamin D levels may be a key factor in preventing BPPV recurrence.

Why does vitamin D supplementation reduce BPPV recurrence? Several theories have been proposed:

Stabilization of calcium metabolism in the inner ear
Improved otoconia resorption and formation
Enhanced vestibular adaptation
Reduced inflammation and oxidative stress

These mechanisms collectively contribute to a more stable vestibular environment, potentially reducing the likelihood of BPPV recurrence. However, more research is needed to fully elucidate the long-term effects of vitamin D supplementation on BPPV recurrence rates.

The Impact of Vitamin D on Muscle Strength and Function in Older Adults

The relationship between vitamin D and muscle function is particularly relevant in the context of BPPV and balance disorders. Numerous studies have demonstrated the positive effects of vitamin D on muscle strength and performance, especially in older adults.

A review by Rejnmark examined the evidence from randomized controlled trials on the effects of vitamin D on muscle function. The findings consistently showed that vitamin D supplementation can improve muscle strength and performance, particularly in individuals with low baseline vitamin D levels.

How does vitamin D enhance muscle function? The mechanisms are complex and involve both genomic and non-genomic pathways:

Increased protein synthesis in muscle cells
Enhanced calcium uptake and utilization in muscles
Improved mitochondrial function
Activation of specific vitamin D receptors in muscle tissue

These effects translate into improved muscle strength, better balance, and enhanced overall physical performance. For BPPV patients, particularly older adults, these improvements can be crucial in managing symptoms and reducing the risk of falls.

A study by Mastaglia et al. focused specifically on the effect of vitamin D nutritional status on muscle function and strength in healthy women aged over 65 years. The results showed a positive correlation between vitamin D levels and muscle strength, highlighting the importance of maintaining adequate vitamin D status in this population.

Seasonal Variations in Vitamin D Levels: Implications for BPPV Management

An often-overlooked aspect of vitamin D’s role in BPPV is the impact of seasonal variations on vitamin D levels. Studies have shown that serum vitamin D concentrations can fluctuate significantly throughout the year, with levels typically being lower in winter months due to reduced sun exposure.

A study by Heidari and Haji Mirghassemi examined seasonal variations in serum vitamin D according to age and sex. The researchers found notable differences in vitamin D levels between summer and winter, with the most pronounced variations observed in older adults.

How do these seasonal fluctuations affect BPPV? Several potential implications have been identified:

Increased risk of BPPV onset during winter months
Potential exacerbation of symptoms in vitamin D-deficient individuals
Need for adjusted supplementation strategies based on seasonal changes
Importance of regular monitoring of vitamin D levels throughout the year

These findings suggest that healthcare providers should consider seasonal variations when assessing vitamin D status and designing treatment plans for BPPV patients. Proactive vitamin D supplementation during winter months may help maintain optimal levels and potentially reduce the risk of BPPV onset or recurrence.

Vitamin D Supplementation Strategies for BPPV Patients: Dosage and Duration

While the benefits of vitamin D supplementation for BPPV patients are becoming increasingly clear, questions remain about optimal dosage and duration of treatment. The appropriate supplementation strategy may vary depending on factors such as baseline vitamin D levels, age, and overall health status.

Current research suggests that higher doses of vitamin D may be more effective in managing BPPV and related symptoms. The study by Talaat et al. used a dosage of 50,000 IU weekly for two months, followed by 50,000 IU monthly for four months in patients with severe vitamin D deficiency. This regimen resulted in significant improvements in BPPV recurrence rates.

However, it’s important to note that vitamin D supplementation should be tailored to individual needs and monitored closely. Factors to consider when determining the appropriate supplementation strategy include:

Baseline vitamin D levels
Age and sex
Presence of comorbidities
Seasonal variations in vitamin D status
Individual response to supplementation

Healthcare providers should aim to achieve and maintain optimal vitamin D levels, typically considered to be above 30 ng/mL. Regular monitoring of serum vitamin D concentrations is crucial to ensure safe and effective supplementation.

The duration of vitamin D supplementation for BPPV patients remains an area of ongoing research. While some studies have shown benefits with short-term supplementation (e.g., 2-6 months), others suggest that long-term maintenance of adequate vitamin D levels may be necessary for optimal results. Further research is needed to establish definitive guidelines for supplementation duration in BPPV management.

Potential Synergies: Vitamin D and Traditional BPPV Treatments

As research on vitamin D supplementation in BPPV continues to evolve, it’s important to consider how this approach may complement traditional treatments. The Epley maneuver, for instance, remains a cornerstone of BPPV management. Could combining vitamin D supplementation with repositioning maneuvers lead to enhanced outcomes?

Preliminary evidence suggests that there may indeed be synergistic effects. Patients receiving both vitamin D supplementation and standard BPPV treatments have shown improved outcomes compared to those receiving standard care alone. This combination approach may offer several advantages:

Faster resolution of acute symptoms
Reduced risk of recurrence
Improved long-term management of BPPV
Enhanced overall balance and vestibular function

Future research should focus on optimizing combination therapies, determining the ideal timing of interventions, and identifying patient subgroups that may benefit most from this approach.

Beyond BPPV: Vitamin D’s Role in Other Vestibular Disorders

The emerging evidence on vitamin D’s role in BPPV has sparked interest in its potential effects on other vestibular disorders. While research in this area is still in its early stages, preliminary findings suggest that vitamin D deficiency may be associated with a range of balance and vestibular problems.

Some areas of ongoing investigation include:

Ménière’s disease and vitamin D status
Vestibular migraine and potential benefits of vitamin D supplementation
Age-related vestibular dysfunction and vitamin D’s protective effects
Vitamin D’s role in central vestibular disorders

As our understanding of vitamin D’s impact on the vestibular system continues to grow, it may open up new avenues for treatment and prevention of a wide range of balance disorders. This expanding body of knowledge underscores the importance of considering vitamin D status in the evaluation and management of patients with vestibular complaints.

The Future of Vitamin D Research in Vestibular Health

The growing body of evidence supporting the role of vitamin D in BPPV and vestibular health has opened up exciting new avenues for research. Future studies will likely focus on several key areas:

Long-term effects of vitamin D supplementation on BPPV recurrence
Optimal dosing strategies for different patient populations
Genetic factors influencing vitamin D metabolism and BPPV susceptibility
Potential interactions between vitamin D and other nutrients in vestibular health
Development of targeted therapies based on vitamin D pathways

These research directions hold promise for improving our understanding of BPPV pathophysiology and developing more effective treatment strategies. As we continue to unravel the complex relationship between vitamin D and vestibular function, we may be on the cusp of a paradigm shift in how we approach the management of BPPV and related disorders.

In conclusion, the emerging evidence on the role of vitamin D in BPPV represents a significant advancement in our understanding of this common vestibular disorder. From its influence on symptom intensity to its potential in reducing recurrence rates, vitamin D has shown promise as a valuable tool in BPPV management. As research progresses, integrating vitamin D assessment and supplementation into standard care protocols for BPPV may become increasingly common, potentially leading to improved outcomes and quality of life for patients affected by this challenging condition.

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

1. Heidari B, Heidari P, Samari E, Jalali MR. Frequency of vitamin D deficiency in common musculoskeletal conditions. J Babol Univ Med Sci. 2014;16:7–15. [in Persian] [Google Scholar]

2. Heidari B, Heidari P, Hajian-Tilaki K. High prevalence of vitamin D deficiency in women presenting to rheumatology clinic in north of Iran: An inverse relation with age. J Women’s Health Care. 2013;2:123. [Google Scholar]

3. Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian J Intern Med. 2011;2:205–12. [PMC free article] [PubMed] [Google Scholar]

4. Heidari B. Muscle strength, vitamin D deficiency and knee osteoarthritis. J Babol Univ Med Sci. 2012;14:84–91. [Google Scholar]

5. Heidari B. Knee osteoarthritis diagnosis, treatment and associated factors of progression: Part II. Casp J Intern Med. 2011;2:249–55. [PMC free article] [PubMed] [Google Scholar]

6. Heidari B, Heidari P, Tilaki KH. Relationship between unexplained arthralgia and vitamin D deficiency: a case control study. Acta Med Iran. 2014;52:400–5. [PubMed] [Google Scholar]

7. Heidari B, Javadian Y, Babaei M, Yousef Ghahari B. Restorative effect of vitamin D deficiency on knee pain and quadriceps muscle strength in knee osteoarthritis. Acta Med Iran. 2015;53:460–70. [PubMed] [Google Scholar]

8. Heidari B, Monadi M, Asgharpour M, et al. Efficiency of supplemental vitamin D in patients with chronic obstructive pulmonary disease. Br J Med Med Res. 2014;4:3031–41. [Google Scholar]

9. Silva C, Amorim AM, Paiva A. Benign paroxysmal positional vertigo–a review of 101 cases. Acta Otorrinolaringol Esp. 2015;66:205–9. [PubMed] [Google Scholar]

10. Lopez-Escamez JA, Gamiz MJ, Fernandez-Perez A, Gomez-Fiñana M. Long-term outcome and health-related quality of life in benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol. 2005;262:507–11. [PubMed] [Google Scholar]

11. Iwasaki S, Yamasoba T. Dizziness and Imbalance in the Elderly: Age-related Decline in the Vestibular System. Aging Dis. 2014;6:38–47. [PMC free article] [PubMed] [Google Scholar]

12. Rejnmark L. Effects of vitamin D on muscle function and performance: a review of evidence from randomized controlled trials. Ther Adv Chronic Dis. 2011;2:25–37. [PMC free article] [PubMed] [Google Scholar]

13. Muir SW, Montero-Odasso M. Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc. 2011;59:2291–300. [PubMed] [Google Scholar]

14. Hilton M, Pinder D. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. 2004;2:CD003162. [PubMed] [Google Scholar]

15. Nunez RA, Cass SP, Furman JM. Short- and long-termoutcomes of canalith repositioning for benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2000;122:647–52. [PubMed] [Google Scholar]

16. West N, Hansen S, Møller MN, Bloch SL, Klokker M. Repositioning chairs in benign paroxysmal positional vertigo: implications and clinical outcome. Eur Arch Otorhinolaryngol. 2015 Mar 7; [Epub ahead of print] [PubMed] [Google Scholar]

17. Heidari B, Haji Mirghassemi MB. Seasonal variations in serum vitamin D according to age and sex. Caspian J Intern Med. 2012;3:535–40. [PMC free article] [PubMed] [Google Scholar]

18. Talaat HS, Kabel AH, Khaliel LH, Abuhadied G, El-Naga HA, Talaat AS. Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin D deficiency. Auris Nasus Larynx. 2015 Sep 16; pii: S0385-8146(15)00203-5. doi: 10.1016/j.anl.2015.08.009. [Epub ahead of print] [PubMed] [Google Scholar]

19. Jeong SH, Kim JS, Shin JW, et al. Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. J Neurol. 2013;260:832–8. [PubMed] [Google Scholar]

20. Suzuki T. Frontiers in vitamin D; basic research and clinical application Vitamin D and falls. Clin Calcium. 2011;21:71–9. [PubMed] [Google Scholar]

21. Mastaglia SR, Seijo M, Muzio D, et al. Effect of vitamin D nutritional status on muscle function and strength in healthy women aged over sixty-five years. J Nutr Health Aging. 2011;15:349–54. [PubMed] [Google Scholar]

22. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, et al. Fall prevention with supplemental and active forms of vitamin D: A meta-analysis of randomised controlled trials. BMJ. 2009;339:b3692. [PMC free article] [PubMed] [Google Scholar]

23. Boersma D, Demontiero O, Mohtasham Amiri Z, et al. Vitamin D status in relation to postural stability in the elderly. J Nutr Health Aging. 2012;16:270–5. [PubMed] [Google Scholar]

24. Cangussu LM, Nahas-Neto J, Orsatti CL, et al. Effect of isolated vitamin D supplementation on the rate of falls and postural balance in postmenopausal women fallers: a randomized, double-blind, placebo-controlled trial. Menopause. 2015 Nov 2; [Epub ahead of print] [PubMed] [Google Scholar]

25. Parham K, Leonard G, Feinn RS, et al. Prospective clinical investigation of the relationship between idiopathic benign paroxysmal positional vertigo and bone turnover: a pilot study. Laryngoscope. 2013;123:2834–9. [PubMed] [Google Scholar]

26. Talaat HS, Abuhadied G, Talaat AS, Abdelaal MS. Low bone mineral density and vitamin D deficiency in patients with benign positional paroxysmal vertigo. Eur Arch Otorhinolaryngol. 2015;272:2249–53. [PubMed] [Google Scholar]

27. Yu S, Liu F, Cheng Z, Wang Q. Association between osteoporosis and benign paroxysmal positional vertigo: a systematic review. BMC Neurol. 2014;14:110. [PMC free article] [PubMed] [Google Scholar]

28. Heidari B, Heidari P, Nourooddini HG, Hajian-Tilaki KO. Relationship between parity and bone mass in postmenopausal women according to number of parities and age. J Reprod Med. 2013;58:389–94. [PubMed] [Google Scholar]

29. Heidari B, Hoshmand S, Hajian K, Heidari P. Comparing bone mineral density in postmenopausal women with and without vertebral fracture and its value in recognizing high-risk individuals. East Mediterr Health J. 2010;16:868–73. [PubMed] [Google Scholar]

30. Heidari B, Javadian Y, Monadi M, Dankob Y, Firouzjahi A. Vitamin D status and distribution in patients with chronic obstructive pulmonary disease versus healthy controls. Caspian J Intern Med. 2015;6:93–7. [PMC free article] [PubMed] [Google Scholar]

31. Hajian-Tilaki K, Heidari B, Firouzjahi A, et al. Prevalence of metabolic syndrome and the association with socio-demographic characteristics and physical activity in urban population of Iranian adults: a population-based study. Diabetes Metab Syndr. 2014;8:170–6. [PubMed] [Google Scholar]

32. Prasad P, Kochhar A. Interplay of vitamin D and metabolic syndrome: A review. Diabetes Metab Syndr. 2015 Mar 6; pii: S1871-4021(15)00027-2. doi: 10.1016/j.dsx.2015 .02.014. [Epub ahead of print] [PubMed] [Google Scholar]

33. Hajian-Tilaki K, Heidari B. Prevalence of obesity, central obesity and the associated factors in urban population aged 20-70 years, in the north of Iran: a population-based study and regression approach. Obes Rev. 2007;8:3–10. [PubMed] [Google Scholar]

34. Hajian-Tilaki K, Heidari B. Childhood obesity, overweight, sociodemographic and life style determinants among preschool children in Babol, Northern Iran. Iran Public Health. 2013;42:1283–91. [PMC free article] [PubMed] [Google Scholar]

35. Hajian-Tilaki K, Heidari B. Prevalence of overweight and obesity and their association with physical activity pattern among Iranian adolescents aged 12-17 years. Public Health Nutr. 2012;15:2246–52. [PMC free article] [PubMed] [Google Scholar]

36. Waringhoff JC, Bayer O, Ferrari U, Straube A. Co-morbidities of vertiginous disease. BMC Neurol. 2009;9:29. [PMC free article] [PubMed] [Google Scholar]

37. Yamanka T, Fukuda T, Shirota S, et al. The prevalence and characteristics of metabolic syndrome in patients with vertigo. Plos One. 2013;8:e80176. [PMC free article] [PubMed] [Google Scholar]

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.

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.