Association of Vitamin D Deficiency in Patients with Benign Paroxysmal Positional Vertigo - A Retrospective Study

Abstract

Background: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder and is characterized by recurrent episodes of positional vertigo. Emerging evidence suggests that vitamin D deficiency may contribute to the development and recurrence of BPPV through its role in calcium metabolism and otoconial homeostasis.

Objective: To evaluate the prevalence of vitamin D deficiency in patients with BPPV and determine its association with disease recurrence.

Methods: This retrospective observational study was conducted at the Department of Otorhinolaryngology, Sri Ramkrishna Institute of Medical Sciences and Sanaka Hospitals, West Bengal, India. Medical records of adult patients diagnosed with BPPV between January 2023 and December 2025 were reviewed. Patients with documented serum 25-hydroxyvitamin D [25(OH)D] levels and complete follow-up records were included.

Results: Eighty-two patients were included, of whom 38 (46.3%) experienced recurrence. Recurrent patients were significantly older than non-recurrent patients (54.1 ± 9.8 vs. 45.5 ± 7.3 years, p<0.001). Mean serum vitamin D levels were significantly lower in the recurrent group (23.7 ± 7.1 ng/mL) compared with the non-recurrent group (29.7 ± 6.0 ng/mL, p<0.001). Recurrence occurred in 75.0% of vitamin D-deficient patients, 72.4% of insufficient patients, and 19.5% of patients with sufficient vitamin D levels (p<0.001). Multivariable analysis identified increasing age (aOR 1.10, 95% CI 1.03–1.17, p=0.004) and lower vitamin D levels (aOR 0.91, 95% CI 0.84–0.99, p=0.029) as independent predictors of recurrence.

Conclusions: Lower serum vitamin D levels and advancing age are independently associated with recurrent BPPV. Assessment and correction of vitamin D deficiency may represent a simple and potentially effective strategy for reducing recurrence in susceptible patients.