Low Vitamin D Levels Linked to Higher BPPV Risk and Recurrence, Supplementation Offers Relief: Study Finds

The analysis found that patients with BPPV had notably lower vitamin D levels (WMD −2.84), with recurrent cases showing even greater deficiency (WMD −5.01). Drawing from 60 studies, the researchers observed that vitamin D supplementation nearly halved the recurrence rate (RR 0.45). Moreover, higher vitamin D levels were linked to a reduced incidence of BPPV (RR 1.36), suggesting that vitamin D deficiency could be a modifiable risk factor in both the onset and recurrence of the condition.

Benign paroxysmal positional vertigo, a common peripheral vestibular disorder, presents with symptoms like dizziness and vertigo that can significantly disrupt daily functioning and diminish quality of life. Emerging evidence has suggested a potential link between BPPV, particularly its recurrent form, and vitamin D deficiency. Some studies propose that addressing severe vitamin D insufficiency may help lower the recurrence of BPPV, although findings across individual studies have varied and lacked consistency.

To explore this relationship more conclusively, researchers conducted the present meta-analysis to assess the association between vitamin D levels and the occurrence and recurrence of BPPV. Yanyan Li, Department of Neurology Ward, Chaoyang Central Hospital of China Medical University, Chaoyang, China, and colleagues aimed to evaluate the effectiveness of vitamin D supplementation in preventing BPPV relapses, offering a clearer understanding of whether vitamin D could serve as a modifiable factor in managing this condition.

For this purpose, the researchers conducted a comprehensive search of electronic databases, including PubMed, EMBASE, SCOPUS, and the Cochrane Library, to identify relevant studies on vitamin D or vitamin D supplementation and its association with the incidence or recurrence of benign paroxysmal positional vertigo. The search spanned from the inception of these databases to December 22, 2024. A total of 60 studies, encompassing 16,368 participants, were included in this meta-analysis.

The findings of the meta-analysis are as follows:

• In the BPPV cohort, there was a significant reduction in vitamin D levels compared to the control group, with a weighted mean difference (WMD) of −2.84.
• Recurrent BPPV groups showed notably lower vitamin D levels than non-recurrent groups, with a WMD of −5.01.
• Vitamin D levels were significantly lower in the cupulolithiasis BPPV group compared to the canalolithiasis BPPV group, with a WMD of 5.09.
• Increased vitamin D levels were inversely associated with BPPV incidence, as indicated by a multivariable-adjusted relative risk (RR) of 1.36. However, there was no significant relationship between vitamin D and recurrence (RR = 0.95).
• The vitamin D supplementation group showed a significantly lower recurrence rate than the control group that did not receive vitamin D supplementation, with a relative risk (RR) of 0.45.

The meta-analysis highlights a significant association between lower vitamin D levels and the incidence and recurrence of benign paroxysmal positional vertigo, particularly in recurrent cases.

"The study indicates that vitamin D deficiency may play a role in the occurrence of BPPV episodes, with significantly lower vitamin D levels observed in patients with canalolithiasis compared to those with cupulolithiasis," the authors noted. They further emphasized, "Additionally, vitamin D supplementation in patients with deficiency or insufficiency significantly reduced the recurrence of BPPV."

"However, due to the limited quality and quantity of the studies included, further research with larger sample sizes is necessary to confirm these findings and validate the role of vitamin D in managing BPPV," they concluded.

Reference:

Li Y, Gao P, Ding R, Xu Y, Wang Z, Pei X and Li L (2025) Association between vitamin D, vitamin D supplementation and benign paroxysmal positional vertigo: a systematic review and meta-analysis. Front. Neurol. 16:1560616. doi: 10.3389/fneur.2025.1560616