Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of peripheral dizziness.  Commonly referred to as “a problem with the crystals,” BPPV occurs when tiny pieces of calcium carbonate, otoconia (often called crystals) move into the wrong area of the inner ear (the semi-circular canals).  When otoconia are in the canals, people experience the sensation of “room spinning” dizziness, often severe, when they change their head position relative to gravity.  Some common movements that cause this severe spinning are: lying down in bed, rolling over, sitting up from lying flat, bending over, or tipping one’s head back to look up.

     The good news is, despite these symptoms being very unpleasant to say the least, this condition is very treatable with an appropriate physical therapist (me!).  Even better news- sometimes BPPV is resolved in as little as 1 visit, and on average in 2-4 visits.

     Some people who get BPPV will have a resolution of their condition, only to have it return months later.  In my experience these people often report BPPV coming back perhaps every 6 months or every 12 months.  This return of symptoms in a cyclical manner may be caused by chronically low vitamin D.  Why is this?

     Just like the cycle of producing new skin cells and getting rid of the old, our bodies create and dispose of our otoconia.  Since these otoconia are made out of Calcium Carbonate, our bodies use vitamin D rich fluid to dispose of excess otoconia.  If a person has chronically low vitamin D, they have a waste disposal problem and are at risk to have excess otoconia buildup.  This excess logically makes it more likely for otoconia to overflow into the semicircular canals… therefore causing BPPV.

     Does this mean everyone should start self medicating with vitamin D?  Probably not.  I always strongly encourage people to touch base with their physicians with this question, as blood testing and then treating deficiencies based on data, is a much better approach.  Some people are very very low in vitamin D, in which case their medical team may recommend a higher or prescription dose, and some people aren’t low in vitamin D to begin with so they risk levels going too high.

     In summary: if you have BPPV, and especially if you’ve had it several times, ask your primary care team to look into this possible solution.