Research published August 2020 in Neurology, the journal of the American Academy of Neurology, describes the benefit of taking both vitamin D and calcium twice a day to decrease a recurrence of vertigo for individuals predisposed to experiencing this disconcerting and sometimes dangerous physiologic symptom.  

Ji-Soo Kim, MD, PhD, of Seoul National University College of Medicine in Korea and colleagues examined nearly 1,000 individuals in Korea who were diagnosed with benign paroxysmal positional vertigo and who were subsequently successfully treated with therapeutic head movements. The authors describe benign paroxysmal positional vertigo as one of the most common types of vertigo (or dizziness), occurring when the position of the head changes and results in a “sudden spinning sensation.” Treatment involves performing a series of head movements that are intended to shift particles in the ears that cause the vertigo; however, despite initial improvement, vertigo frequently recurs. The authors note that roughly 86% of people with this form of vertigo miss days at work and find that it interrupts their daily life.

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

The 348 people of the 445 in the intervention group had vitamin D levels below 20 nanograms per milliliter (ng/mL) and received vitamin D supplementation of 400 international units of vitamin D and 500 milligrams of calcium twice daily. The remainder had levels equal to or greater than 20 ng/mL and were not given supplements. The observation group included 512 people who did not receive supplements and did not have their vitamin D levels monitored. The authors wrote that the intervention group showed a reduction in the absolute risk reduction [0.83 (95% CI, 0.74-0.92) vs. 1.10 (95% CI, 1.00-1.19) recurrences per one-person year with an incidence rate ratio of 0.76 (95% CI, 0.66-0.87, P <.001) and an absolute rate ratio of -0.27 (-0.40 to -0.14) from intention to treat analysis. The number needed to treat was 3.70 (95% CI, 2.50-7.14). The proportion of patients with recurrence was also lower in the intervention than in the observation group (37.8 vs. 46.7%, P = .005).

“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,” said Dr. Kim. “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.”

The authors observed a greater improvement in vertigo for patients who exhibited a greater vitamin D deficiency at the beginning of the study, with individuals starting at a level lower than 10 ng/mL experiencing a 45% reduction in annual recurrence rate. Comparatively, individuals with levels between 10 and 20 ng/mL experienced only a 14% reduction. A total of 38% of the people in the interventional group had another episode of vertigo, compared with 47% of those in the observation group. The authors noted that many subjects dropped out of study before it was completed, a limitation to the trial.

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