Is the vitamin D deficiency a cause of intractable BPPV?

Background This study investigated the association between treatment resistance in benign paroxysmal positional vertigo (BPPV) and various risk factors, including vitamin D deficiency, age, gender, and comorbidities. Methods A retrospective review of medical records was conducted on 122 patients diagnosed with BPPV at a tertiary care hospital between January 2020 and January 2023. The diagnosis of BPPV was confirmed using clinical history and positional tests, while serum 25-OH vitamin D levels were measured using chemiluminescence immunoassay. Patients who required three or more canalith repositioning maneuvers were considered treatment-resistant. Logistic regression analysis was employed to assess the impact of demographic and clinical factors on BPPV treatment resistance, and recurrence rates were evaluated over a one-year follow-up period. Results. Logistic regression revealed that male gender, comorbidities, and betahistine use were significantly associated with BPPV resistance (p < 0.05), while no significant relationship was found between vitamin D levels and treatment resistance or recurrence (p > 0.05). Recurrence was observed in 22.1% of patients during the follow-up period, though this was not significantly related to vitamin D status. Conclusions While previous studies suggested a potential link between vitamin D deficiency and BPPV recurrence, this study found no significant association between vitamin D deficiency and intractability along with the recurrence of BPPV. Instead, male gender, comorbidities (notably hypertension), and betahistine use were identified as risk factors for requiring multiple maneuvers. The study raises questions about the role of vitamin D in BPPV pathophysiology and suggests that other clinical factors may have a greater influence on treatment outcomes.