Common cause of dizziness (BPPV) reduced 5 X by several doses of 50,000 IU of vitamin D – 2015, 2016

BPPV reduced 4.5 X by Vitamin D: loadng dose then 100,000 monthly - 2015

Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin D deficiency - 2015
Auris Nasus Larynx, Available online 16 September 2015. doi:10.1016/j.anl.2015.08.009
Hossam Sanyelbhaa Talaata, Sanyelbhaa at yahoo.com , Abdel-Magied Hasan Kabela, 1, Lobna Hamed Khalielb, 2, Ghada Abuhadiedc, 3, Heba Abd El-Rehem Abo El-Nagad, 4, Ahmed Sanyelbhaa Talaate, 5

Objective: Several studies correlated between vitamin D deficiency and the development, and the recurrence of benign positional paroxysmal vertigo (BPPV), but none of them proved that treatment of vitamin D deficiency would reduce the recurrence rate of BPPV. This study aims to detect the effect of treatment of severe vitamin D deficiency on the recurrence rate of BPPV.

Methods: The inclusion criteria of the study group were: (1) Unilateral, idiopathic, posterior canal BPPV with no history suggestive of secondary BPPV and (2) 25-hydroxyvitamin D3 level ≤10 ng/ml. All subjects enrolled in the current study underwent detailed clinical history, audiovestibular evaluation consisting of pure-tone audiometry, Immittancemetry, Videonystugmography, serum 25-hydroxyvitamin D3 assessment, and Dual-energy X-ray absorptiometry (DXA). Vitamin D therapy was prescribed for the study group. Serum 25-hydroxyvitamin D3 level was evaluated twice, on recruitment into the study group and 3 months after commencing vitamin D therapy. According to the results of the second evaluation of serum 25-hydroxyvitamin D3, the study group was subdivided into two subgroups: Subgroup (I): including 28 subjects who disclosed elevation of serum 25-hydroxyvitamin D3 level; improvement ≥10 ng/ml. Subgroup (II): including 65 patients who disclosed elevation of serum 25-hydroxyvitamin D3 levels <10 ng/ml. The study group was followed up for 18 months in order to observe the recurrence of BPPV.

Results: The differences between both study subgroups (I) & (II) regarding age, sex distribution, and bone mineral density were insignificant. The number of subjects who had recurrence of BPPV in subgroup (I) was 4 (14%) versus 28 subjects (43%) in subgroup (II).
The mean values for recurrent attacks/subject in subgroups (I) & (II) were 0.18, and 0.66 attack/subject respectively; these differences between both subgroups were of high statistical significance (p < 0.01). The Odds Ratio for development of recurrence of BPPV in subjects with severe vitamin D deficiency was 4.54 (95% CI: 1.41–14.58, p < 0.01). The relapse attacks of BPPV affected both ears irrespective of the ear showing the original BPPV attack.

Conclusion: The present study indicates that improvement of serum 25-hydroxyvitamin D3 levels is associated with substantial decrease in recurrence of BPPV.
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BPPV reduced 5X by 50,000 IU of vitamin D - first weekly, then monthly - 2016

Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: A longitudinal clinical study
Caspian J Intern Med. 2016 Spring; 7(2): 93–98. PMCID: PMC4913711
Mahboobeh Sheikhzadeh, MSc,1 Yones Lotfi, MD,2,* Abdollah Mousavi, MD,3 Behzad Heidari, MD,4 Mohsen Monadi, MSc,5 and Enayatollah Bakhshi, PhD6

Background: Benign paroxysmal positional vertigo (BPPV) is linked to vitamin D deficiency. This clinical trial aimed to determine the influence of vitamin D supplementation on intensity of BPPV.

Methods: The study population was selected consecutively and the diagnosis of BPPV was made by history and clinical examination and exclusion of other conditions. Intensity of BPVV was assessed based on VAS score (0-10). Serum 25-hydroxyvitamin D (25-OHD) was measured using ELISA method and levels < 20 ng/ml was considered a deficiency. All patients received rehabilitation treatment using Epley's maneuver one time per week for one month. Serum 25-OHD deficient patients were classified as treated and non-treated groups (rehabilitation with or without 50.000 IU cholecalciferol weekly for two months).The results of treatment were compared with vitamin D sufficient group as control. All patients were followed-up for 6 months.

Results: After two months of treatment, in both vitamin D treated and non-treated groups the intensity of BPPV decreased significantly as compared with control (P=0.001 for both groups) but at endpoint, the intensity of BPPV aggravated and regressed to the baseline value in vitamin D deficient non-treated group (P=0.001) whereas, in vitamin D treated group, improvement of BPPV remained stable and unchanged over the study period.

Conclusion: This study indicates that correction of vitamin D deficiency in BPPV provides additional benefit to rehabilitation therapy (Epley maneuver) regarding duration of improvement. These findings suggest serum 25-OHD measurement in recurrent BPPV.

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Study described at Vitamin D Council

See also PubMed

• Seasonality of benign paroxysmal positional vertigo Feb 2015 free full text online
• Low bone mineral density and vitamin D deficiency in patients with benign positional paroxysmal vertigo Sept 2015
  "Moreover, low levels of vitamin D were related to development of BPPV while very low levels were associated with recurrence of BPPV."
• Vitamin D deficiency and benign paroxysmal positioning vertigo Medical Hypothesis Feb 2013]
  free full text online