From the Guidelines
Vitamin B12 deficiency is the most significant vitamin deficiency associated with vertigo, as it can damage the myelin sheath that protects nerves, affecting balance and causing dizziness or vertigo. According to the British Obesity and Metabolic Surgery Society guidelines 1, vitamin B12 deficiency with possible neurological involvement, such as unexplained sensory and/or motor and gait symptoms, should be treated immediately with hydroxocobalamin 1 mg intramuscularly administered on alternate days until there is no further improvement.
Some key points to consider when treating vitamin B12 deficiency include:
- Hydroxocobalamin 1 mg intramuscularly should be administered every 2 months after initial treatment 1
- For people with vitamin B12 deficiency and no neurological involvement, hydroxocobalamin 1 mg intramuscularly should be administered three times a week for 2 weeks, followed by maintenance treatment with 1 mg intramuscularly every 2–3 months for life 1
- Folic acid deficiency may also be present and should be treated with oral folic acid 5 mg daily for a minimum of 4 months, but only after excluding vitamin B12 deficiency 1
It is essential to note that while other vitamin deficiencies, such as vitamin D, E, and A, may also contribute to vertigo, the current evidence 1 primarily supports the association between vitamin B12 deficiency and vertigo. Therefore, treating vitamin B12 deficiency should be the primary focus when addressing vertigo related to vitamin deficiencies.
From the Research
Vitamin Deficiencies Associated with Vertigo
- Vitamin D deficiency has been linked to benign paroxysmal positional vertigo (BPPV) in several studies 2, 3, 4, 5, 6
- Research suggests that patients with BPPV who have low vitamin D levels may benefit from supplementation 2, 3, 4, 5, 6
- Studies have shown that vitamin D supplementation can reduce the recurrence of vertigo episodes in patients with BPPV and vitamin D deficiency 3, 4, 5, 6
Key Findings
- A retrospective pilot study found that patients with idiopathic positional vertigo had low average serum levels of 25-hydroxyvitamin D, and vertigo attacks did not recur after supplementation with vitamin D 2
- A case-control study found that patients with BPPV who received vitamin D supplementation had significantly lower recurrent episodes than those who did not receive supplementation 4
- A systematic review and meta-analysis found that vitamin D supplementation can significantly lower recurrence in BPPV and vitamin D deficiency 5, 6