Why does my BPPV keep coming back? Vitamin D, bone health, head injury and recurrence

What is the link between vitamin D and BPPV?

The crystals in the inner ear are made of calcium carbonate, and vitamin D helps regulate calcium metabolism. Lower vitamin D levels are linked to more BPPV. In a randomized trial of people with recurrent BPPV, those with low vitamin D who took vitamin D and calcium supplements had fewer recurrences than those who did not². Ask your physician whether checking your level makes sense; we do not prescribe supplements.

Can a head injury or car accident cause BPPV?

Yes. A blow to the head, a fall or the jolt of a collision can shake crystals loose. Post-traumatic BPPV is more likely to affect both ears or more than one canal, so it can take more treatment sessions¹. Dizziness after a car accident also needs the neck and a possible concussion checked.

What can lower the chance of BPPV returning?

• Talk with your doctor about vitamin D and bone health if you have had more than one episode
• Stay active, since long periods lying flat are linked to BPPV
• Learn your own early warning signs so you can book quickly
• Use home maneuvers only for the canal and side we have confirmed and taught you

Where can I get fast treatment when BPPV returns in Alpharetta or Cumming?

Returning patients can usually be seen within 48 hours at our Alpharetta or Cumming clinic. We confirm the canal under infrared video goggles, because a new episode can affect a different canal or ear than last time. Patients come from Johns Creek, Milton, Suwanee, Sugar Hill and Forsyth County.

Where can I get help in Alpharetta, Cumming and nearby?

Dr. Manan Patel, PT, DPT, TPS and our team of physical therapists see patients from Alpharetta, Johns Creek, Milton, Roswell, Cumming, Suwanee, Sugar Hill, Buford, Duluth and Forsyth County at two North Atlanta clinics. Every visit is 60 minutes, one-on-one, and urgent appointments are available within 48 hours. We are in-network with Traditional Medicare, BCBS / Anthem and Tricare, and offer a $129 rate per visit for self-pay and out-of-network plans. Not sure where to start? Take the free symptom self-check, or visit our Alpharetta clinic or Cumming clinic page.

Related care

Related questions

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References

1. Bhattacharyya N, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngology–Head and Neck Surgery. 2017.
2. Jeong SH, et al. Prevention of benign paroxysmal positional vertigo with vitamin D supplementation: a randomized trial. Neurology. 2020.

Answered by Dr. Manan Patel, PT, DPT, TPSDoctor of Physical Therapy, Certified Vestibular Specialist and one of the few certified Therapeutic Pain Specialists in North Atlanta, with 15+ years of outpatient care. About Dr. Patel

This answer is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor. Call 911 for sudden severe dizziness with trouble speaking, weakness, numbness, double vision or a severe headache.