In this article, I answer two BPPV questions.

BPPV Questions:

Q. After one episode of BPPV resolved with vestibular therapy, is it possible that BPPV never returns?

Well, if you are an optimist, of course!

But in terms of recurrence rates, it’s about a 35% rate of recurrence for the general population. For people with migraines, it’s a 50% recurrence rate. So, if you’re somebody that gets migraines, you’re more likely to get it again.

There are other risk factors for BPPV. For example, Meniere’s disease is a risk factor, as well as osteoporosis, osteopenia, high blood pressure, high cholesterol, obesity, tobacco smoking, dehydration, low vitamin D, etc. There are more risk factors, but these are some examples of certain health conditions that predispose people to a higher likelihood that they are going to get BPPV and that they may get it again.

But yes, there is a chance that you never get it again and that is my hope for everyone!

If you do get it again, the key thing is to go back to whoever treated you the first time and ask them to fix it for you again. Do this as quickly as possible so that you don’t fall and you don’t get injured and you get through the recurring episode as quickly and efficiently as possible.

Q. What is the connection between osteoporosis and BPPV?

There is a research team in South Korea that is studying the prevalence of BPPV in people with osteoporosis and osteopenia and they are finding a higher rate of BPPV in people with those conditions.

While there is limited research published on this right now, their theory is that it has something to do with the calcium metabolism within the body because BPPV crystals are made out of calcium carbonate.

They researched if taking Vitamin D could help reduce the rate of recurrence of BPPV crystals and they did show preliminarily that it may reduce the rate of recurrence.

So there is some evidence that potentially supplementing Vitamin D if you are deficient (meaning your level of Vitamin D is below 30) may reduce the risk of recurrence of the BPPV crystals.

Let’s keep a close watch for more research to come out regarding the potential link between Vitamin D, calcium, and BPPV recurrence.


This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.

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