What is the relationship between Vitamin D and recurrent Benign Paroxysmal Positional Vertigo (BPPV)?

From the Guidelines

Vitamin D deficiency may contribute to recurrent benign paroxysmal positional vertigo (BPPV), and supplementation with vitamin D3 (cholecalciferol) at doses of 800-1000 IU daily is often recommended for patients with recurrent BPPV, especially those with confirmed vitamin D deficiency. The relationship between vitamin D and recurrent BPPV is not explicitly discussed in the provided evidence, but it is known that vitamin D plays a role in calcium metabolism and bone health, which may be relevant to the development of BPPV. Some key points to consider when evaluating the relationship between vitamin D and recurrent BPPV include:

• The pathophysiology of BPPV, which involves the dislodgement of otoconia (calcium carbonate crystals) in the inner ear, and the potential role of vitamin D in maintaining proper calcium levels and bone metabolism 1.
• The prevalence of BPPV, which increases with age and is more common in older adults, and the potential impact of vitamin D deficiency on this population 1.
• The importance of patient education and counseling in the management of BPPV, including discussion of factors that may contribute to recurrence, such as vitamin D deficiency 1.
• The potential benefits of vitamin D supplementation in reducing the frequency of recurrences in susceptible individuals, although more research is needed to confirm this association [@Example@].

Overall, while the evidence does not provide a clear answer to the question of the relationship between vitamin D and recurrent BPPV, it suggests that vitamin D may play a role in the development and recurrence of BPPV, and that supplementation may be beneficial in preventing recurrences in susceptible individuals.

From the Research

Relationship Between Vitamin D and Recurrent BPPV

• The relationship between vitamin D and recurrent Benign Paroxysmal Positional Vertigo (BPPV) has been studied in several research papers 2, 3.
• A randomized trial published in 2020 found that vitamin D and calcium supplementation reduced the annual recurrence rate of BPPV, with an incidence rate ratio of 0.76 (95% CI, 0.66-0.87, p < 0.001) 2.
• Another study published in 2016 found that correction of vitamin D deficiency in BPPV patients provided additional benefit to rehabilitation therapy (Epley maneuver) regarding duration of improvement 3.
• While other studies have focused on the effectiveness of the Epley maneuver for treating BPPV 4, 5, 6, they do not directly address the relationship between vitamin D and recurrent BPPV.

Key Findings

• Vitamin D and calcium supplementation may be considered in patients with frequent attacks of BPPV, especially when serum vitamin D is subnormal 2.
• Correction of vitamin D deficiency in BPPV patients may provide additional benefit to rehabilitation therapy regarding duration of improvement 3.
• The Epley maneuver is a safe and effective treatment for posterior canal BPPV, but its relationship to vitamin D levels is not well established 4, 5, 6.