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Vertigo appears associated with osteoporosis

New research suggests that having a bone mineral density below normal ("osteopenia") or having an even greater loss of bone density resulting in fragile porous bones ("osteoporosis"), which are both caused by a lack of calcium, are more common in men and women who also have benign positional vertigo than in their peers without this condition.
"These findings suggest a problem with calcium metabolism in people with vertigo," senior author Dr. Jim Soo Kim, from Seoul National University College of Medicine in Korea, said in a statement. "Women most often have their first case of vertigo in their 50s, when they are also having a drop in bone mass due to loss of estrogen. Estrogen is one of the main hormones that influence calcium and bone metabolism."

According to the report in the journal Neurology, the cause of benign positional vertigo is largely unknown. Prior research, however, has suggested that calcium deposits and, therefore, bone metabolism may play a role in benign positional vertigo. The condition is characterized by the onset of vertigo that occurs following a change in body position, such as going from a seated to a standing position.

In the present study, which featured 209 benign positional vertigo patients and 202 comparison subjects, the results of bone mineral density testing showed that benign positional vertigo patients were at greater risk for both osteopenia and osteoporosis.

After adjusting the findings for the effects of age, gender, alcohol use, smoking, and abnormally high phosphate levels, the authors found that osteopenia and osteoporosis doubled and tripled the risk of benign positional vertigo, respectively.

In women 45 years of age or older, bone loss was greater in those with recurrent benign positional vertigo than in those with a first episode, the report indicates.

The findings, the authors conclude, suggest that calcium metabolism is disturbed in subjects with benign positional vertigo. The results are also consistent with those from an earlier, smaller study showing that bone mineral T scores are lower in older women with the condition than in their unaffected counterparts.

Vertigo is an inner ear disorder that's a common cause of dizziness. It's believed to be caused by loose calcium carbonate crystals in the sensing tubes of the inner ear.

The researchers compared 209 people with benign positional vertigo with no known causes -- such as ear surgery or head trauma -- with 202 people with no history of dizziness. Compared to participants with normal bone density, those with osteoporosis (low bone density) were three times more likely to have vertigo and those with osteopenia (the stage before osteoporosis) were two times more likely to have vertigo.

Among women, 25 percent of those with vertigo had osteoporosis, compared to 9 percent of those without vertigo, and 47 percent of those with vertigo had osteopenia, compared to 33 percent of those without vertigo. Among men, 12 percent of those with vertigo had osteoporosis, compared to 6 percent of those without vertigo, and 40 percent with vertigo had osteopenia, compared to 27 percent of those without vertigo.

The study will be published in the March 24 issue of Neurology.

"These findings suggest a problem with calcium metabolism in people with vertigo," Dr. Ji Soo Kim, of the Seoul National University College of Medicine, said in a journal news release.

"Women most often have their first case of vertigo in their 50s, when they are also having a drop in bone mass due to loss of estrogen. Estrogen is one of the main hormones that influence calcium and bone metabolism," Kim said.

The role that estrogen plays in vertigo hasn't been determined. Since this study also found an association between osteoporosis and vertigo in men, other factors must also play a role, Kim noted. The first thing to do if you have any problems, ask the doctor, because only he can to you at the pharmacy to pick up the necessary medicines for treatment.