Why does dizziness recur?
Dr. Berg points out that most sudden, spinning dizziness is actually related to otoliths in the inner ear. Otoliths are extremely small calcium carbonate crystals that are supposed to adhere to a layer of gel membrane in the inner ear, acting like a "paperweight" to help the body perceive direction and gravity. When otoliths detach and drift into the semicircular canals, interfering with capillaries, the illusion of "the world is spinning even though you're not moving" occurs, accompanied by discomfort such as nausea and chest tightness.
The study also found that people with high calcium concentrations in their endolymph and those with osteoporosis are more prone to this type of dizziness; and vitamin D deficiency is also quite common.
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First, determine if it is "postural vertigo" ( BPPV ).
Benign paroxysmal postural vertigo ( BPPV ) has three key characteristics:
1 ) Paroxysmal: Triggered by a certain posture (e.g., turning the head, tilting the head back to stand up).
2 ) Spinning sensation: feeling like the environment is spinning, accompanied by nausea.
3 ) Nystagmus: Involuntary twitching of both eyes during an attack.
A Dix-Hallpike test that can be done at home (it's best to have a family member observe the nystagmus): Sit on the edge of the bed, turn your head to one side about 45° , quickly lie down with your shoulder blades resting on a pillow, and then tilt your head back about 30° . Observe whether it induces dizziness and nystagmus; test each side once to identify which side is the "problem side". If you have cervical spondylosis, recent head injury, or are unsure about your condition, consult a healthcare professional first.
Self-help at home: Epley instructions (using the right side as an example)
The goal is to gradually "remove" the free otoliths from the semicircular canals . Hold each step for 30–60 seconds or until the vertigo subsides.
1 ) Sit on the edge of the bed and turn your head 45° to the right .
2 ) Lie down quickly with your shoulder blades on the pillow, tilt your head back about 30° and still 45° to the right .
3 ) Slowly turn your head 45° to the left .
4 ) Roll your body to the left side to lie on your side, keeping your head down at about 45 degrees (with your chin slightly tucked towards your left shoulder).
5 ) Maintain the position and sit up, then return your head to the center.
Perform this treatment once daily for several days until symptoms subside; if the left side is affected, the direction is reversed. If the dizziness is severe, accompanied by hearing loss, persistent headache, or neurological signs (slurred speech, weakness in the limbs), seek medical attention immediately .
Nutrition and Metabolism: Why are otoliths prone to "loosening"?
High calcium levels in the inner ear lymph fluid can make it more difficult for shed crystals to be redissolved and absorbed. Multiple studies have shown a significantly increased proportion of individuals with BPPV who have low vitamin D levels ; the risk is higher for older individuals, those with less sun exposure, darker skin, or those who work indoors for extended periods.
Dr. Berger's key recommendations:
- Vitamin D3 : You may consider starting with a higher dose (the video mentions a combined dose once a week, such as a total of 50,000 IU as an example; a common daily regimen is also 3,000–4,000 IU ), but it is essential to adjust the dose according to individual blood levels and medical history under the supervision of a healthcare professional .
- Vitamin K2 : Works in conjunction with D3 to help transport calcium to bones and reduce soft tissue deposition. A common ratio is 100 μg K2 for every 10,000 IU D3 .
- Magnesium : It is a cofactor in multiple enzyme steps of D3 and also helps maintain the dynamic balance of calcium.
- Daily routine : adequate protein, resistance training, and sun exposure (pay attention to sun protection and skin safety), while managing other factors contributing to osteoporosis (vitamin D/K2/ calcium / magnesium, weight-bearing exercise, and reducing smoking and alcohol consumption).
Tips for Hong Kongers
- Prolonged exposure to air conditioning and insufficient sunlight is common, and low D levels are more likely to occur from late winter to spring. It is recommended to have 25(OH)D , calcium, and parathyroid hormone ( PTH ) tested annually for personalized dosage reference.
- People with osteoporosis, a long-term sedentary lifestyle, and a low calcium / protein diet have a relatively higher chance of developing BPPV ; taking Epley supplements and supplementing with D/K2/ magnesium can help reduce the recurrence rate.
- Before performing any exercises at home, make sure you do not have any acute cervical spine problems , recent falls , or signs of a stroke . If you have had ear surgery or have chronic middle ear disease, consult your doctor first.
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Summary: A two-pronged approach to stop dizziness and prevent relapse.
For short-term acute attacks, Epley can be used, while long-term treatment involves vitamin D3 + K2 + magnesium and bone management, addressing both calcium metabolism and otolith stabilization to reduce recurrence. If symptoms are abnormal, accompanied by hearing changes or neurological signs, do not try to tough it out; consult an ENT specialist or internist as soon as possible.
YouTube source: https://www.youtube.com/watch?v=jGxWOIhekv0
YouTube Column: Dr. Berger's Chinese Health Knowledge
