For some, keeping vertigo at bay could be as easy as falling off a rock
Certain vitamins can help keep a level head at heights, experts find
The world started to spin when I looked up while climbing in the Cederberg recently. I felt as if I was falling, though I hadn’t left the ground. (Falling off the rock higher up is expected, but not this sensation.)
I had a common type of vertigo that day and a new study shows that the risk of another attack can be reduced by taking vitamin D and calcium twice a day.
“Benign paroxysmal positional vertigo, or BPPV, is a very common reason for vertigo, which originates in the ear,” said Dr Louis Hofmeyr, an ear, nose and throat specialist who has super-specialised in disorders of the inner ear.
“We have no real drug at the moment that can prevent it or cure it.”
The latest research, with about 900 participants, found that taking a vitamin D and calcium supplement was a “simple, low-risk way to prevent vertigo from recurring”.
“It is especially effective if you have low vitamin D levels to begin with,” said the lead author, Dr Kim Ji-soo, of Seoul National University College of Medicine in Korea.
BPPV happens when a changing head position gives a sudden spinning sensation, he noted in the online journal of Neurology in August.
“About 86% of people with this form of vertigo find that it interrupts their daily life or causes them to miss days at work.”
That weekend I didn’t want to miss out on climbing and was with two doctor friends who diagnosed it as BPPV and treated it on the spot with the Epley manoeuvre — like a magic trick.
This exercise involved my lying down, moving my head side to side so they could identify which ear was the problem by watching my eyes and then sharply turning my head to shift the loose crystals in my ear that caused the mechanical disorder.
Even in their expert hands the dizziness didn’t disappear 100%, probably because I was repeatedly tilting my head up (not advised) after they had done it.
Hofmeyr treats only complex and intractable ear cases and he sees about 10 to 20 patients a month with recurrent BPPV in his rooms in Cape Town and Johannesburg.
He sees younger patients with BPPV, but research has shown that about 10% of people experience this type of vertigo after 65 years old.
“If you get BPPV once, there is a 50% chance you will get it again,” said Hofmeyr, who tests patients for low vitamin D and recommends those with low levels take supplements.
“There is a misconception that you have normal vitamin D if you are in the sun. I am seeing more and more cases of people who are in the sun, including a professional cyclist and a farmer, with low vitamin D.
“The sun is only one part of the whole metabolic process to make vitamin D,” he said.
A meta-analysis of 18 studies on BPPV and vitamin D found that supplementation diminished the chance of recurrence, he said. This allows sufferers to avoid the Epley manoeuvre and surgery, for the worst cases that don’t respond to treatment.
“About half of the patients with chronic dizziness conditions eventually end up with secondary psychological problems,” he said. “They feel bad, but they don’t look ill and the people (close to them) don’t understand how they feel. They avoid certain activities because they are scared of injuring themselves.”
He said that about 95% of patients can get their BPPV fixed with exercises, manoeuvres and supplements, and, for the less than 5% who need surgery, the results are excellent.
Calcium is regulated in the body with vitamin D, so it is not surprising they work together for BPPV, Hofmeyr said.
“The crystals in the inner ear are calcium carbonate crystals, so it makes sense that vitamin D can influence them.”
Increasingly, researchers and local GPs are reporting vitamin D deficiency and supplementation is becoming popular.
But international scientists recently warned against people taking high doses of vitamin D supplementation to prevent Covid-19. “There is currently insufficient scientific evidence to show vitamin D can be beneficial in preventing or treating Covid-19,” the authors said of the latest research, countering unverified reports that it could reduce the risk of getting coronavirus and successfully treat Covid-19.
But those results could change, as everything does continually under the pandemic. As poet Lord Tennyson wrote: “Let the great world spin for ever down the ringing grooves of change.”