Seasonal Vertigo: The Unknown Role of Vitamin D
Do you suffer more from vertigo in autumn? Know that there is a scientifically proven link between decreased sunlight, vitamin D deficiency and increased seasonal vertigo. International studies reveal that vertigo risk can be multiplied up to 23 times in deficient individuals. Our practical advice, prevention and solutions to regain your balance.
Why do we consult more for vertigo in autumn?
If you've noticed an increase in your vertigo symptoms with autumn's arrival, you're not alone. This observation, shared by many patients and healthcare professionals, is now confirmed by scientific research. Several international studies demonstrate significant seasonal variation in benign paroxysmal positional vertigo (BPPV), the most common type of vertigo, with an incidence peak during winter months and early spring [1,2,3].
In Switzerland, this phenomenon takes on a particular dimension. From September onward, daylight duration begins to decrease drastically: we go from more than 13 hours of daylight at the beginning of autumn to less than 9 hours at the end of November, a loss of more than 4 hours of sunshine in just three months [4]. This spectacular reduction in sun exposure has consequences for our organism and our vestibular system.
The scientific link between vitamin D and vertigo
Understanding the mechanism
BPPV results from displacement of small calcium crystals called otoliths in the inner ear. These crystals, which normally play an essential role in our perception of balance, can detach and move into the semicircular canals, causing that unpleasant sensation that everything is spinning around us.
Now, vitamin D plays a crucial role in calcium metabolism and the health of our inner ear. Produced mainly by our skin when exposed to the sun's ultraviolet rays, this vitamin naturally becomes deficient during autumn and winter in Switzerland, where sunshine can drop to less than 50 hours per month in December in some regions.
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What studies reveal
Scientific research has established a remarkable link between vitamin D levels and vertigo frequency:
A Korean study of nearly 300 people showed that 80% of patients with BPPV had vitamin D levels below 20 ng/ml, versus 60% in the control group [5]
Vertigo risk is multiplied by 3.8 in people with levels between 10 and 20 ng/ml
Spectacularly, this risk is multiplied by 23 in those with levels below 10 ng/ml [5]
A six-year study conducted in Shanghai observed an inverse correlation between serum vitamin D levels and the number of consultations for BPPV, with particularly low levels during winter months [6]. In Austria, where the climate is comparable to that of some Swiss regions, researchers confirmed that the majority of symptoms occur in winter, followed by spring, with a negative correlation with sunshine hours [1].
Other seasonal factors at play
Beyond vitamin D, several other elements contribute to increased vertigo in autumn and winter:
Viral infections: Colds, flu and ENT infections, more frequent during the cold season, are closely associated with BPPV [3,7]. Sometimes, the immune system, after fighting a respiratory infection, can mistakenly attack the inner ear, causing what is called vestibular neuritis.
Sedentary lifestyle: We naturally spend more time indoors during Swiss autumn and winter. This reduction in physical activity can promote bone demineralization and, in turn, affect inner ear otoliths [3].
Atmospheric pressure and humidity: Rapid weather changes, particularly frequent in our Alpine country, can also play a role in triggering vertigo attacks.
Recognizing signs of vitamin D deficiency
Vitamin D deficiency can manifest through various symptoms, often subtle at first:
Chronic fatigue and persistent lack of energy
Dizziness or sensations of spinning head
Muscle weakness, particularly in the legs
Bone or joint pain
Weakened immune system with frequent infections
Gloomy mood or depressive symptoms
Slow wound healing
If you recognize several of these symptoms, especially combined with vertigo episodes, it may be wise to discuss with your doctor and consider a blood vitamin D test.
What to do: practical solutions and prevention
1. Maximize sun exposure (even in autumn)
Even as days shorten, every ray of sunshine counts. Specialists recommend exposure of about 15 to 30 minutes per day, exposing face, arms and hands when weather permits. In Switzerland, favor the hours around noon, when the sun is highest, particularly during October to March months.
On weekends, enjoy a mountain walk: sunshine is often better there than in the plains, where autumn fogs can drastically limit sun exposure. In Geneva, for example, November sunshine can be half that of La Dôle.
2. Adapt your diet
Certain foods can help maintain adequate vitamin D levels:
Fatty fish: salmon, mackerel, sardines, herring (excellent sources)
Cod liver oil (the richest food source)
Egg yolk
UV-exposed mushrooms (shiitake, chanterelles)
Fortified dairy products available in Switzerland
However, let's be realistic: diet alone barely covers vitamin D needs during Swiss winter.
3. Consider supplementation
Clinical studies are clear: vitamin D and calcium supplementation can significantly reduce BPPV recurrences. A randomized study of nearly 1000 patients showed a 24% to 45% reduction in annual recurrence rate, with the effect being particularly marked in the most deficient individuals [8,9].
The studied protocol consisted of a daily intake of 400 international units of vitamin D and 500 mg of calcium, twice daily. Nevertheless, before starting any supplementation, it's essential to consult your treating physician who can, if necessary, prescribe a blood test and adapt recommendations to your personal situation.
Quality vitamin D3+K2 supplements are available at the Activate Center Geneva reception.
4. The importance of vestibular rehabilitation
If you suffer from vertigo, the good news is that BPPV can be treated remarkably well. Otolith repositioning maneuvers, like the Epley maneuver, often resolve the problem in a single session. At the Activate Center in Thun, our vestibular rehabilitation specialists are trained in these techniques and can support you to:
Make a precise diagnosis of the type of vertigo you're experiencing
Perform appropriate repositioning maneuvers
Teach you exercises to practice at home in case of recurrence
Implement an adapted rehabilitation program to strengthen your balance system
Vestibular rehabilitation becomes even more effective when undertaken early. Don't wait for vertigo to become disabling in daily life.
5. When to consult urgently?
BPPV is benign in itself. However, if in addition to vertigo, you notice other symptoms such as:
Vertigo accompanied by severe headaches
Vision problems (double vision, visual field loss)
Difficulty speaking or swallowing
Weakness or numbness on one side of the body
Loss of consciousness
Difficulty walking or disturbed coordination
Confusion or behavioral changes
These symptoms may indicate central (neurological) involvement requiring urgent care. If in doubt, call emergency services or your treating physician without delay.
A message of hope
If autumn and winter in Switzerland create favorable conditions for the appearance or recurrence of vertigo, scientific understanding of this phenomenon now offers us concrete and effective solutions. The combination of attention to vitamin D levels, adapted lifestyle and early recourse to vestibular rehabilitation allows us to effectively prevent and treat these balance disorders.
BPPV is not inevitable, even during the dark months of the year. With the right strategies and appropriate professional support, you can regain your balance and navigate autumn with serenity.
Jean-Jacques Lagarde - our vestibular physiotherapist is at your disposal for your BPPV problems and instabilities associated with vestibular deficit.
Make an appointment with Jean-Jacques Lagarde for a vestibular assessment
Activate Center – Vestibular Rehabilitation Specialists For any questions or to make an appointment: www.vestibulaire.ch
This article is provided for informational purposes and does not replace medical consultation. In case of vertigo, always consult a healthcare professional for an accurate diagnosis.
Scientific references
[1] Seo, T., Miyamoto, A., Saka, N., et al. (2024). Seasonality of benign paroxysmal positional vertigo: A retrospective study from Central Europe. Wiener Klinische Wochenschrift, 136, 85-90. https://doi.org/10.1007/s00508-023-02237-w
[2] Jeong, J., Kim, J. S., Shin, J. W., et al. (2024). Seasonal variation in peripheral vestibular disorders based on Korean population data. Laryngoscope Investigative Otolaryngology, 9(2), e1254. https://doi.org/10.1002/lio2.1254
[3] Cao, Z., Zhao, X., Ju, Y., Chen, M., & Wang, Y. (2020). Seasonality and Cardio-Cerebrovascular Risk Factors for Benign Paroxysmal Positional Vertigo. Frontiers in Neurology, 11, 259. https://doi.org/10.3389/fneur.2020.00259
[4] MétéoSuisse. (2023). L'automne météorologique. Consulted on https://www.meteosuisse.admin.ch
[5] Jeong, S. H., Kim, J. S., Shin, J. W., et al. (2013). Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. Journal of Neurology, 260(3), 832-838. https://doi.org/10.1007/s00415-012-6712-2
[6] Wu, Y., Chen, W., Zhou, J., et al. (2019). Seasonal variation of idiopathic benign paroxysmal positional vertigo correlates with serum 25-hydroxyvitamin D levels: a six-year registry study in Shanghai, China. Scientific Reports, 9, 17429. https://doi.org/10.1038/s41598-019-52803-4
[7] Gacek, R. R. (2003). Pathology of benign paroxysmal positional vertigo revisited. Annals of Otology, Rhinology & Laryngology, 112(7), 574-582.
[8] Kim, J. S., Oh, S. Y., Lee, S. H., et al. (2020). Randomized clinical trial for prevention of benign paroxysmal positional vertigo recurrence: vitamin D and calcium supplementation. Neurology, 95(9), e1117-e1125. https://doi.org/10.1212/WNL.0000000000010343
[9] AlGarni, M. A., Mirza, A. A., Althobaiti, A. A., Al-Nemari, H. H., & Bakhsh, L. S. (2018). Association of benign paroxysmal positional vertigo with vitamin D deficiency: a systematic review and meta-analysis. European Archives of Oto-Rhino-Laryngology, 275(11), 2705-2711. https://doi.org/10.1007/s00405-018-5146-6
