Vitamin deficiency vertigo. Vitamin D Supplementation for Benign Paroxysmal Positional Vertigo: A Comprehensive Analysis
How does vitamin D supplementation affect benign paroxysmal positional vertigo. What are the implications of vitamin D deficiency on BPPV intensity and recurrence. Can vitamin D supplementation reduce BPPV symptoms and improve patient outcomes.
Understanding 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 occurs when calcium carbonate crystals (otoconia) become dislodged from the utricle and migrate into the semicircular canals of the inner ear. This displacement causes an abnormal sensation of movement, resulting in vertigo, dizziness, and imbalance.
BPPV predominantly affects older adults, with a higher prevalence in women. The condition can significantly impact quality of life and increase the risk of falls, especially in the elderly population. While BPPV is generally considered benign, its recurrent nature and associated symptoms can be debilitating for many patients.
Symptoms and Diagnosis of BPPV
The hallmark symptoms of BPPV include:
- Sudden onset of vertigo with changes in head position
- Dizziness and a spinning sensation
- Nausea and vomiting
- Loss of balance or unsteadiness
- Visual disturbances (nystagmus)
Diagnosis of BPPV typically involves a thorough medical history and physical examination. The Dix-Hallpike test is commonly used to provoke and observe characteristic nystagmus associated with BPPV. In some cases, additional vestibular function tests may be performed to rule out other causes of vertigo.
The Role of Vitamin D in BPPV
Recent research has highlighted a potential link between vitamin D deficiency and the occurrence and severity of BPPV. Vitamin D plays a crucial role in calcium metabolism and bone health, which are closely related to the function of the vestibular system. The inner ear, including the otolith organs and semicircular canals, relies on proper calcium homeostasis for optimal function.
Studies have shown that individuals with BPPV often have lower serum vitamin D levels compared to healthy controls. This association has led researchers to investigate the potential benefits of vitamin D supplementation in managing BPPV symptoms and reducing recurrence rates.
Vitamin D Deficiency and BPPV Risk
Several factors contribute to the increased risk of vitamin D deficiency in BPPV patients:
- Age-related decline in vitamin D synthesis and absorption
- Reduced sun exposure, especially in older adults
- Dietary insufficiency of vitamin D
- Certain medical conditions affecting vitamin D metabolism
Is there a direct correlation between vitamin D levels and BPPV severity? Studies have shown that patients with lower serum vitamin D concentrations tend to experience more severe BPPV symptoms and higher recurrence rates. This observation suggests that addressing vitamin D deficiency may be a valuable adjunct to conventional BPPV treatments.
Vitamin D Supplementation in BPPV Management
The potential benefits of vitamin D supplementation in BPPV patients have garnered significant attention in recent years. Clinical studies have explored the effects of vitamin D supplementation on various aspects of BPPV, including symptom intensity, recurrence rates, and overall patient outcomes.
Impact on BPPV Intensity
Research has demonstrated that vitamin D supplementation can lead to a reduction in the intensity of BPPV symptoms. Patients receiving vitamin D supplements often report less severe vertigo episodes and improved balance compared to those not receiving supplementation. This improvement may be attributed to the role of vitamin D in maintaining proper calcium homeostasis within the inner ear.
Recurrence Rate Reduction
Can vitamin D supplementation decrease the likelihood of BPPV recurrence? Evidence suggests that correcting vitamin D deficiency through supplementation may significantly reduce the recurrence rate of BPPV. A study by Talaat et al. (2015) found that treating severe vitamin D deficiency in BPPV patients led to a notable reduction in symptom recurrence compared to patients who did not receive vitamin D supplementation.
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
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- 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.