The Relationship Between Disorders of Bone Metabolism and Benign Paroxysmal Positional Vertigo: A Systematic Review

Ear Hear. 2021 Nov-Dec;42(6):1462-1471. doi: 10.1097/AUD.0000000000001063.


Objectives: Several studies have reported an association between benign paroxysmal positional vertigo (BPPV) and bone mineral density or serum vitamin D levels. The aim of this review is to provide further clarification regarding the relationship between BPPV and calcium metabolism.

Design: PubMed and MEDLINE databases were systematically reviewed to identify all English language papers regarding the relationship between BPPV and the following terms: osteoporosis, osteopenia, bone mineral density, serum vitamin D levels, and bone metabolism.

Results: Of the 456 identified records, 28 studies were eligible for this review. Most were retrospective studies with inherent limitations and often conflicting results. While the literature is not conclusive, osteoporosis in patients of at least 50 years old appears to have an association with BPPV. Similarly, an association was observed between recurrent BPPV and vitamin D deficiency.

Conclusion: There is only weak evidence to support the relationship between BPPV and osteoporosis or low serum 25-hydroxyvitamin D levels. Further prospective studies with more robust methodologies are needed to clarify the association between BPPV and disorders of bone metabolism.

Publication types

  • Systematic Review

MeSH terms

  • Benign Paroxysmal Positional Vertigo* / complications
  • Humans
  • Middle Aged
  • Osteoporosis*
  • Prospective Studies
  • Retrospective Studies
  • Vitamin D


  • Vitamin D