Unless you have experienced benign paroxysmal positional vertigo (BPPV), you cannot appreciate how distressing it is. I know first-hand because I have experienced it periodically over the last several years. The dizziness and/or spinning are both disorienting and disruptive! Trying to think clearly when the world is not quite stable is challenging. Is it possible to treat or prevent BPPV?
Symptoms of Benign Paroxysmal Positional Vertigo:
People describe this sensation in various ways. When I roll over in the bed the world starts spinning. The first time it happened I was trying to get out of bed. The intense dizziness and spinning made me sit right back down on the side of the bed. I started sweating profusely and I thought I would throw up.
Others say BPPV happens when they tip their head up to look at the ceiling or look down at their feet. Bending down to pick up something that has fallen to the floor can be extremely challenging as the spinning and dizziness take over.
BPPV often interferes with quality of life or the ability to carry out normal tasks. Playing tennis, for example, can be tough when you throw the ball up to serve and the spinning starts.
What Causes BPPV?
This condition apparently occurs when crystals inside the ear get out of place and end up in one of the semicircular canals. BPPV can be treated with a series of head movements (the Epley Maneuver) designed to get the crystals back where they belong.
Not all health professionals are familiar with BPPV and the strategy to “cure” it. The ENT technician who first diagnosed and treated me admitted that she frequently helps people who have suffered with this condition for years without a proper diagnosis. Several minutes with a trained professional who can perform the Epley Maneuver can make a world of difference.
Readers Describe BPPV and Treatment:
Jerry was one of the fortunate ones:
“I’m lucky enough to have three sources of healthcare: A great PCP doctor, a wonderful cardiologist, and a caring Veterans Administration (VA) team. On my last routine visit to the VA, I offhandedly mentioned that I have had minor headaches for years, so the doctor immediately thought, “brain problems.”
“She did an in-office test for balance and said she would feel better to schedule me for a CT scan. A week or so later, I received word that the CT scan did not reveal anything that she thought would contribute to my imbalance, so she requested approval for physical therapy (PT) sessions. I started to just ignore that, believing that PT couldn’t do anything about balance. I couldn’t have been more wrong. After an initial evaluation meeting with the therapist, our second session consisted of a series of tests for BPPV, after which she performed the Epley Maneuver. Performing it twice that same day, the vertigo was gone!
“She told me of the rapid eye movement during the vertigo, but naturally I didn’t know this was happening. I’ve been tested in subsequent PT sessions, and I haven’t experienced the vertigo again. She did tell me that it would probably return some time later, but that she would teach me how to take care of this at home. My first thought after this was that it was akin to magic! I never would have expected this result after years of putting up with this problem.”
Mike describes it this way:
“I also experienced BPPV. I went to my ENT and he had me see a therapist. After doing the Epley maneuver I was able to keep the world from spinning. Thank you Dr. Epley!”
How to Prevent BPPV from Coming Back:
Many people who suffer from this condition have recurrences. Is there any way to prevent BPPV from coming back?
Researchers in South Korea recruited more than 900 people who had been treated successfully (Neurology, Aug. 5, 2020). They wondered whether vitamin D and calcium would prevent recurrence.
About half of the people were chosen at random to have their vitamin D levels tested. Those with low levels took supplements of 400 IU vitamin D and 500 mg of calcium twice a day. The remainder of the individuals were in the control group. Those taking supplements were 24% less likely to have another attack during the following year.
The authors conclude:
“Supplementation of vitamin D and calcium may be considered in patients with frequent attacks of BPPV, especially when serum vitamin D is subnormal.”
Vitamin D to Prevent BPPV Recurrences:
This is not the first time we have heard about vitamin D to prevent BPPV.
Several years ago we received this story from a reader:
“I have been diagnosed with vertigo (BPPV) and it’s the worst. Any time I move my head the world spins.
“But I recently found a study linking vitamin D deficiency to BPPV. My level was really low and so I started taking a supplement.
“I haven’t had a vertigo attack since then, but I still have some residual dizziness that is slowly fading. I hope I don’t get any more vertigo attacks.”
No Drugs for BPPV:
There is no medication that works for BPPV. We do encourage people to ask about the Epley Maneuver, a manipulation technique that can help get the crystals back where they belong. It does not work for other causes of dizziness, but can be quite helpful for BPPV.
Although it is possible to learn how to do the Epley Maneuver at home, it can be quite useful to have a well-trained professional do it the first time. Audiologists and ear, nose and throat specialists are a good place to turn for expert assistance.
Drugs that Cause Dizziness:
Many people do not realize that a surprising number of medications can actually trigger dizziness. This is sometimes perceived by health professionals as a “minor” side effect. We consider it a potentially deadly drug complication. If someone falls because of dizziness, it can lead to a head injury or a hip fracture. And dizziness can ruin the quality of a person’s life. Here is a link to an article we wrote titled “Dizziness is Driving Her Towards Suicide.”
Vitamin D to Prevent BPPV:
We were interested in your reference to low vitamin D contributing to this condition, and found that there has been some research (Journal of Neurology, March, 2013). More recently, a systematic review also recognized that low levels of vitamin D are a risk factor for BPPV (Frontiers in Neurology, June 23, 2020).
Another reader also tried this approach:
“After months of dealing with vertigo attacks several times a week, I finally tried supplementing with vitamin D. It has worked wonders over the last month and a half, as I’ve had only one attack a few weeks after starting vitamin D, and none afterwards. Vertigo is horrible: I have no balance or sense of equilibrium, everything spins and I suffer nausea, vomiting and exhaustion.”
We think that the Epley Maneuver is the first step in overcoming benign paroxysmal positional vertigo. There are other maneuvers that can also be helpful. A health professional can assist in determining the best approach. It is also important to prevent BPPV from coming back. Having blood levels of vitamin D assessed would be a good start. If they are low, adding vitamin D and possibly calcium might be helpful.
Please let us know how you have dealt with BPPV in the comment section below. Have you found the Epley Maneuver helpful. What about vitamin D? Share your experience. If you know someone with BPPV, please share this article by scrolling to the top of the page and sending it via email, Facebook or Twitter by using the icons you will find there.