BPPV and low Vitamin D

BPPV is one of the most common causes of vertigo. Resent evidence shows a possible link between the recurrence of BPPV and low Vitamin D levels. Benign paroxysmal positional vertigo (BPPV) is often encountered in private practice.

BPPV and low Vitamin D
BPPV due to loose crystals in the semicircular canal.

The likelihood of occurrence increases with age and it is estimated that 3 to 4% of the population above the age of 60 years has BPPV every year. BPPV causes 20% of all dizziness and is responsible for 50% of dizziness in older people. Although the symptoms of BPPV include dizziness, lightheadedness and imbalance it is most often characterized by the sudden onset of rotational and spinning vertigo induced by certain changes in position and movement of the head. Patients often complain that they experience short lasting intense vertigo when rolling over in bed. Tying shoe laces, washing hair and hanging up laundry become problematic.

BPPV is believed to be caused by loose displaced crystals (otoconia) in the inner ear. Some experts feel that a virus infection of the inner ear may be responsible. The calcium carbonate crystals or otoconia can become loose after trauma, surgery, infections but in many cases a cause is not established. In 40% of patients BPPV can recur. This is problematic as the onset is often abrupt and intense. It may be so bad that nausea and vomiting occur. Patient’s often become scared to move and prefer to sleep in certain positions, avoiding the side eliciting the vertigo.

In a recent study BPPV and low Vitamin D levels were linked in patients with recurrence of BPPV. Vitamin D plays a role in the calcium metabolism in the otoconia and low levels may lead to otholitic disturbance. It is therefore advised to have Vitamin D levels checked if suffering from recurrent BPPV.

A word of caution though is that care should be taken not to take too much Vitamin D as this may lead to Vitamin D toxicity which can cause abnormal high levels of blood calcium, a potential dangerous situation.