The Relation Between Vertigo And Osteoporosis
What is BPPV?
Benign Paroxysmal Positional Vertigo (BPPV) is a disorder caused due to complications in the inner ear. It is the most common cause of vertigo, which triggers the sudden feeling or sensation in a person that their head is spinning. This can prove dangerous when the person is in physical situations that can cause serious harm or injury. BPPV can cause mild or severe periods of dizziness. Other symptoms may include blurred vision, loss of balance, light-headedness, and nausea.
Causes of BPPV
BPPV is commonly triggered due to sudden changes in movements of the head. This could mean sudden jerking, tipping the head up and down, getting out of bed, etc. It can develop when otoconia, or calcium carbonate crystals, shift to get trapped in the semi-circular canals of the utricle of the ear. These deposits interfere with the cilia within the canals that help in identifying any movements of the head. This then sends false messages to the brain regarding head motion and balance.
The link between BPPV and Osteoporosis
A Korean study has proven the existence of a link between BPPV and osteoporosis. The latter is a bone disease where the body’s bone density is low. The study also correlated BPPV to osteopenia, which is the first stage of osteoporosis and results in milder loss of bone density. Vertigo, osteoporosis, and osteopenia are conditions found more often in older men and women.
The study by Dr. Ji Soo Kim of Seoul National University College of Medicine was published in the journal Neurology. It revealed that people with osteoporosis or osteopenia are more inclined to suffer from vertigo. It was conducted on 209 subjects who suffered from BPPV with no known cause of head trauma or surgery. The subjects were compared to 202 other persons who had no history of vertigo. After testing the bone density of all subjects, Dr. Kim observed that in both men and women, a significant percentage of those with vertigo also suffered from osteoporosis. He found similar findings for patients suffering from osteopenia.
The study revealed gender differences among those suffering from BPPV and osteoporosis. Twenty-five percent of women suffering from vertigo episodes also had osteoporosis, compared to 9 percent of women who did not have vertigo. In men, it was found that 12 percent of those with vertigo had osteoporosis, compared to the 6 percent of men who did not. According to Dr. Kim, this difference is attributed to the loss of bone mass and low estrogen levels in women aged more than 50 years. Estrogen is one of the key hormones that help to regulate bone mass. However, the link between osteoporosis and vertigo holds true for men as well; therefore, other factors are also at play.
It is also noted that vertigo is related to the wrong alignment in the upper part of the neck or column vertebrae. In the C1 and C2 vertebra, a misalignment may result in pressure on the brain stem and subsequent inhibition in blood flow. This could further mean that false signals are sent to the brain, triggering an episode of vertigo.
Relief from BPPV
Dr. Ji Soo Kim claimed that restoring calcium metabolism could prevent any recurrences of idiopathic BPPV in patients. Other studies have made attempts at correlating problems in calcium metabolism and vitamin D levels to BPPV. Byun, Bhung, Lee, Park, Kim & Kim concluded in a South Korean study that osteoporosis patients were exposed to greater risks of occurrence and recurrence of BPPV. Sen, Padiyar, and Arora in 2018 examined that postmenopausal women with BPPV who also suffer from osteoporosis may find relief with sufficient intake of vitamin D. Other modalities of treatment can also be sought, such as canalith repositioning, which involves a series of head movements that the patient has to hold for a few seconds. In rare cases, surgical procedures are also performed.