Vitamin deficiency vertigo. Vitamin D Supplementation for Benign Paroxysmal Positional Vertigo: Impact on Intensity and Recurrence

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. Can vitamin D reduce the intensity and recurrence of vertigo symptoms. How does vitamin D impact muscle function and balance in relation to BPPV.

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Understanding Benign Paroxysmal Positional Vertigo (BPPV)

Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder characterized by brief episodes of vertigo triggered by specific changes in head position. It occurs when calcium carbonate crystals (otoconia) become dislodged from the utricle and migrate into the semicircular canals of the inner ear, causing a false sense of motion.

The prevalence of BPPV increases with age, affecting approximately 10% of individuals over 60 years old. While the condition is generally considered benign, it can significantly impact quality of life and increase the risk of falls, particularly in older adults.

Common Symptoms of BPPV

Sudden onset of spinning sensation
Dizziness triggered by head movements
Nausea and vomiting
Loss of balance
Visual disturbances

Are there any underlying factors contributing to the development of BPPV? Recent research has uncovered a potential link between vitamin D deficiency and the occurrence and severity of BPPV symptoms.

The Role of Vitamin D in Vestibular Health

Vitamin D, often referred to as the “sunshine vitamin,” plays a crucial role in various physiological processes, including calcium metabolism, bone health, and muscle function. Emerging evidence suggests that vitamin D may also have a significant impact on vestibular health and balance control.

Studies have shown that vitamin D receptors are present in the inner ear, including the vestibular system. These receptors are involved in calcium homeostasis and the regulation of otoconia formation. Vitamin D deficiency may disrupt this delicate balance, potentially contributing to the development of BPPV.

Vitamin D Deficiency and BPPV: The Connection

Research has revealed a higher prevalence of vitamin D deficiency among patients with BPPV compared to the general population. A study by Jeong et al. (2013) found that serum vitamin D levels were significantly lower in patients with idiopathic BPPV than in healthy controls.

Can vitamin D deficiency increase the risk of developing BPPV? While more research is needed to establish a causal relationship, the current evidence suggests that low vitamin D levels may be a contributing factor to the onset and recurrence of BPPV.

Impact of Vitamin D Supplementation on BPPV Intensity

The influence of vitamin D supplementation on the intensity of BPPV symptoms has been the subject of recent clinical studies. A longitudinal study examined the effects of vitamin D supplementation on patients with BPPV and concurrent vitamin D deficiency.

The results of this study demonstrated a significant reduction in the intensity of vertigo symptoms following vitamin D supplementation. Patients who received vitamin D supplements reported less severe and less frequent episodes of vertigo compared to those who did not receive supplementation.

Measuring BPPV Intensity

To assess the impact of vitamin D supplementation on BPPV intensity, researchers used various methods, including:

Dizziness Handicap Inventory (DHI) scores
Frequency of vertigo episodes
Duration of symptoms
Subjective patient-reported outcomes

How much can vitamin D supplementation reduce BPPV intensity? While individual responses may vary, the study reported an average reduction of 30-40% in vertigo intensity among patients who received vitamin D supplements.

Vitamin D and BPPV Recurrence Rates

One of the challenges in managing BPPV is the high recurrence rate, with up to 50% of patients experiencing a relapse within a year of initial treatment. Recent research has explored the potential of vitamin D supplementation in reducing BPPV recurrence rates.

A study by Talaat et al. (2015) investigated the effect of treating severe vitamin D deficiency on BPPV recurrence. The researchers found that patients who received vitamin D supplementation had a significantly lower recurrence rate compared to those who did not receive supplementation.

Potential Mechanisms of Vitamin D in Reducing BPPV Recurrence

Several mechanisms have been proposed to explain how vitamin D supplementation may help reduce BPPV recurrence:

Improved calcium metabolism in the inner ear
Enhanced otoconia stability
Strengthened vestibular hair cells
Improved overall balance and muscle function

Does vitamin D supplementation completely prevent BPPV recurrence? While it may not eliminate the risk entirely, current evidence suggests that maintaining adequate vitamin D levels can significantly reduce the likelihood of BPPV relapse.

Vitamin D’s Impact on Muscle Function and Balance

Beyond its direct effects on the vestibular system, vitamin D plays a crucial role in muscle function and balance control. These factors are particularly important in the context of BPPV, as improved muscle strength and balance can help mitigate the risk of falls and injuries associated with vertigo episodes.

Research has shown that vitamin D supplementation can lead to improvements in muscle strength, particularly in older adults and individuals with vitamin D deficiency. A meta-analysis by Muir and Montero-Odasso (2011) found that vitamin D supplementation had positive effects on muscle strength, gait, and balance in older adults.

Vitamin D and Fall Prevention

The relationship between vitamin D and fall prevention is particularly relevant for BPPV patients, who are at increased risk of falls due to balance disturbances. A meta-analysis by Bischoff-Ferrari et al. (2009) demonstrated that vitamin D supplementation could reduce the risk of falls in older adults by up to 19%.

How does vitamin D contribute to fall prevention? The mechanisms include:

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

Optimal Vitamin D Levels for BPPV Management

Determining the optimal vitamin D levels for BPPV management is an area of ongoing research. While there is no universally agreed-upon target level specifically for BPPV patients, general recommendations for vitamin D sufficiency can serve as a guideline.

The Endocrine Society defines vitamin D sufficiency as serum 25-hydroxyvitamin D levels of at least 30 ng/mL (75 nmol/L). However, some experts suggest that levels between 40-60 ng/mL (100-150 nmol/L) may be optimal for overall health and disease prevention.

Vitamin D Testing and Supplementation

For individuals with BPPV, especially those with recurrent episodes, vitamin D testing may be recommended. The most common test is the 25-hydroxyvitamin D blood test, which measures the circulating form of vitamin D in the body.

If deficiency is detected, vitamin D supplementation may be prescribed. The dosage and duration of supplementation will depend on various factors, including:

Severity of deficiency
Age and overall health status
Presence of other risk factors
Individual response to supplementation

What is the recommended daily intake of vitamin D? The Institute of Medicine suggests a daily intake of 600-800 IU for adults, but higher doses may be necessary for individuals with deficiency or specific health conditions.

Integrating Vitamin D Supplementation with Traditional BPPV Treatments

While vitamin D supplementation shows promise in managing BPPV, it should be considered as a complementary approach to traditional treatments. The mainstay of BPPV management remains canalith repositioning procedures, such as the Epley maneuver.

Integrating vitamin D supplementation with established BPPV treatments may offer a comprehensive approach to managing the condition. This combined strategy aims to address both the immediate symptoms and potential underlying factors contributing to BPPV.

Potential Benefits of Combined Approach

A holistic treatment plan that includes both vitamin D supplementation and traditional BPPV therapies may offer several advantages:

Faster symptom resolution
Reduced recurrence rates
Improved long-term outcomes
Enhanced overall balance and muscle function
Decreased risk of falls and related injuries

How should vitamin D supplementation be incorporated into BPPV treatment plans? It is essential to consult with a healthcare provider to develop an individualized approach based on specific needs and vitamin D status.

Future Directions in Vitamin D and BPPV Research

The emerging evidence supporting the role of vitamin D in BPPV management opens up exciting avenues for future research. Several areas warrant further investigation to enhance our understanding of this relationship and optimize treatment strategies.

Potential Research Topics

Long-term effects of vitamin D supplementation on BPPV outcomes
Optimal vitamin D levels specifically for BPPV prevention and management
Genetic factors influencing the relationship between vitamin D and BPPV
Combination therapies incorporating vitamin D with other nutrients or interventions
Impact of vitamin D on different subtypes of BPPV

As research in this field progresses, it may lead to more personalized and effective approaches to managing BPPV, potentially improving the quality of life for millions of individuals affected by this common vestibular disorder.

In conclusion, the growing body of evidence suggests that vitamin D plays a significant role in the management of Benign Paroxysmal Positional Vertigo. From reducing symptom intensity to lowering recurrence rates and improving overall balance, vitamin D supplementation offers promising benefits for BPPV patients. As research continues to evolve, integrating vitamin D assessment and supplementation into BPPV treatment protocols may become an essential component of comprehensive care for individuals suffering from this challenging condition.

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.

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.