Should I take Vitamin D if I have BPPV?

Should I take Vitamin D if I have BPPV?

Benign paroxysmal positional vertigo (BPPV) is the most common type of peripheral vestibular vertigo. Known predisposing factors for BPPV include gender, advanced age, head trauma, vestibular neuritis, Meniere’s disease, migraines, otologic surgery, and prolonged bed rest.

In many cases, a clinical diagnosis and bedside treatment by a Vestibular Physical Therapist with canalith repositioning manuevers — also known as manual reduction procedures — is highly successful in 1-3 sessions! It is quite amazing that we can achieve ~90% success rate with these techniques work if the correct diagnosis is made.

However, the recurrence rate of BPPV is ~70% and therefore, this makes healthcare clinicians wonder what else can be done to prevent BPPV from happening again.

What about taking Vitamin D for BPPV?

Vitamin D deficiency and its relationship with BPPV continues to be controversial in the medical field.  With that said, most patients who exhibit recurrent BPPV and medial professionals (including physical therapists) who treat this note lower vitamin D level is a risk factor for BPPV.

Research has gone back and forth over the years but here are two recent publications by the same author, but I think can finally put the debate to rest.

In 2020 , Jeong et al performed an investigator-initiated, blinded-outcome-assessor, parallel, multicenter, randomized controlled trial examining the effect of vitamin D and calcium supplementation in preventing recurrences of BPPV. The authors concluded,

This study provides Class III evidence that for patients with BPPV, vitamin D and calcium supplementation reduces recurrences of BPPV.

A meta-analysis (which is a top notch research from all other research studies!) in 2020 by same authors, Jeong et al. The authors examined the therapeutic effects of vitamin D supplementation, with or without calcium, for preventing recurrences of BPPV. Here is the conclusion:

Vitamin D supplementation provides a benefit for secondary prevention of BPPV. Supplementation of vitamin D should be considered in patients with frequent attacks of BPPV, especially when serum vitamin D is subnormal.

Therefore, if you have recurrent BPPV and subnormal Vitamin D levels, unless medically authorized not to, it can help to supplement with Vitamin D to reduce your recurrence of BPPV.

We also do recommend you have a team of professionals, including your general practitioner, ENT and Vestibular Physical Therapist, that you know and trust to help you through the good and bad times with dizziness and vertigo. We find our patients find that they can contact us when need for quick appointments or advice (if on vacation or away from town) for any reoccurrences.

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