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Vitamin D Supplements May Improve Benign Paroxysmal Positional Vertigo


(Reuters Health) – Some patients with benign paroxysmal positional vertigo (BPPV) may have fewer recurrences if they take vitamin D and calcium supplements, new trial results suggest.

Study participants had completed successful treatment with canalith repositioning maneuvers. Among the 445 people randomized to the intervention group, 348 with vitamin D levels <20 ng/mL were started on daily vitamin D supplements of 400 IU as well as 500 mg of calcium carbonate twice daily. The 512 people in the observation group didn’t have vitamin D levels evaluated or take supplements.

The average recurrence rate of vertigo episodes was lower in the supplement group than in the observation group (ARR 0.83 vs 1.10 times per person-year). This translates into a 24% reduction in the annual recurrence rate.

“Our study suggests that for people with benign paroxysmal positional vertigo, taking a supplement of vitamin D and calcium is a simple, low-risk way to prevent vertigo from recurring,” said study co-author Dr. Ji-Soo Kim of Seoul National University College of Medicine in Korea.

“It is especially effective if you have low vitamin D levels to begin with,” Dr. Kim said.

When researchers looked just at people in the intervention group who had baseline vitamin D levels <10 ng/mL, these participants experienced a 45% reduction in the annual recurrence rate, while participants with baseline vitamin D levels from 10 to 20 ng/mL experienced only a 14% reduction.

Overall, 38% of the people in the intervention group had another episode of vertigo, compared to 47% of participants in the observation group.

“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,” Dr. 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.”

One limitation of the study is that there was a high dropout rate, with fewer people completing the study in the intervention group than in the observation group, the study team notes in Neurology. It also wasn’t a placebo-controlled trial.

Even so, the results suggest supplements may be one effective way to treat people with BPPV, said Dr. Bela Buki of the department of otolaryngology at Karl Landsteiner University Hospital Krems in Austria.

“The take home message is that, apart from treating the primary symptoms in BPPV, doctors also should think of a possible vitamin D deficiency, measure the blood-levels of vitamin D, and correct it, if necessary,” Dr. Büki, who wasn’t involved in the study, said by email. “This even in countries with high levels sun radiation, because in these countries patients frequently suffer from vitamin D deficiency due to their clothing which is designed to shield them from sunlight.”

SOURCE: https://bit.ly/33yW1Tx Neurology, online August 5, 2020.

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