Seasonal Vertigo: The Overlooked Role of Vitamin D
Are you experiencing more vertigo this autumn? There is a scientifically proven link between reduced sunlight, vitamin D deficiency, and increased seasonal vertigo. International studies reveal that the risk of vertigo can be up to 23 times higher in people with vitamin D deficiency. Here are our practical tips, prevention strategies, and solutions to help you regain your balance.
Why do more people seek treatment for vertigo in autumn?
If you've noticed an increase in vertigo symptoms with the arrival of autumn, 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 peak incidence during winter months and early spring [1,2,3].
In Switzerland, this phenomenon takes on particular significance. From September onwards, daylight hours begin to decrease dramatically: we go from over 13 hours of daylight at the beginning of autumn to less than 9 hours by late November—a loss of more than 4 hours of sunlight in just three months [4]. This dramatic reduction in sun exposure has significant consequences for our bodies and our vestibular system.
The scientific link between vitamin D and vertigo
Understanding the mechanism
BPPV results from the 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 become dislodged and move into the semicircular canals, causing that unpleasant sensation of the room spinning around us.
Vitamin D plays a crucial role in calcium metabolism and the health of our inner ear. Produced primarily by our skin when exposed to ultraviolet rays from the sun, 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 the research shows
Scientific research has established a remarkable link between vitamin D levels and the frequency of vertigo:
A Korean study of nearly 300 people showed that 80% of patients with BPPV had vitamin D levels below 20 ng/ml, compared to 60% in the control group [5]
The risk of vertigo is 3.8 times higher in people with levels between 10 and 20 ng/ml
Remarkably, this risk is 23 times higher 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 some Swiss regions, researchers confirmed that most 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 factors contribute to increased vertigo in autumn and winter:
Viral infections: Colds, flu, and ENT infections, more common 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 known as vestibular neuritis.
Sedentary lifestyle: We naturally spend more time indoors during Swiss autumn and winter. This reduction in physical activity can promote bone demineralisation and, consequently, affect the otoliths in the inner ear [3].
Atmospheric pressure and humidity: Rapid weather changes, particularly common in our alpine country, can also play a role in triggering vertigo episodes.
Recognising signs of vitamin D deficiency
Vitamin D deficiency can manifest through various symptoms, often subtle at first:
Chronic fatigue and persistent lack of energy
Vertigo or sensations of dizziness
Muscle weakness, particularly in the legs
Bone or joint pain
Weakened immune system with frequent infections
Low mood or depressive symptoms
Slow wound healing
If you recognise several of these symptoms, especially combined with episodes of vertigo, it may be wise to speak with your doctor and consider having your vitamin D levels tested.
What to do: practical solutions and prevention
1. Maximise sun exposure (even in autumn)
Even as days grow shorter, every ray of sunlight counts. Specialists recommend approximately 15 to 30 minutes of exposure per day, with face, arms, and hands uncovered when weather permits. In Switzerland, aim for the hours around midday when the sun is at its highest, particularly during the months from October to March.
At weekends, take advantage of a mountain walk: sunshine is often better at altitude than in the lowlands, where autumn fog can drastically limit sun exposure. In Geneva, for example, sunshine in November can be half that at La Dôle.
2. Adjust your diet
Certain foods can help maintain adequate vitamin D levels:
Oily fish: salmon, mackerel, sardines, herring (excellent sources)
Cod liver oil (the richest dietary source)
Egg yolk
UV-exposed mushrooms (shiitake, chanterelles)
Fortified dairy products available in Switzerland
However, we must be realistic: diet alone can rarely meet vitamin D requirements during the Swiss winter.
3. Consider supplementation
Clinical studies are clear: vitamin D and calcium supplementation can significantly reduce BPPV recurrence. A randomised study of nearly 1,000 patients showed a 24% to 45% reduction in annual recurrence rate, with the effect being particularly pronounced in those with the most severe deficiencies [8,9].
The protocol studied involved a daily intake of 400 international units of vitamin D and 500 mg of calcium, twice daily. However, before starting any supplementation, it is essential to consult your GP, who can, if necessary, prescribe a blood test and tailor recommendations to your personal situation.
4. The importance of vestibular rehabilitation
If you suffer from vertigo, the good news is that BPPV responds remarkably well to treatment. Otolith repositioning manoeuvres, such as the Epley manoeuvre, can often resolve the problem in a single session. At Activate Centre in Thun, our vestibular rehabilitation specialists are trained in these techniques and can help you to:
Obtain an accurate diagnosis of the type of vertigo you're experiencing
Perform the appropriate repositioning manoeuvres
Learn exercises to practise at home in case of recurrence
Establish a tailored rehabilitation programme to strengthen your balance system
Vestibular rehabilitation is most effective when started early. Don't wait until vertigo becomes a daily handicap.
5. When to seek emergency care
BPPV is benign in itself. However, if you experience other symptoms alongside vertigo, 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 impaired coordination
Confusion or behavioural changes
These symptoms may indicate a central (neurological) condition requiring urgent care. If in doubt, call emergency services or your GP without delay.
A message of hope
While autumn and winter in Switzerland create conditions favourable to the onset or recurrence of vertigo, our scientific understanding of this phenomenon now offers concrete and effective solutions. The combination of attention to vitamin D levels, an adapted lifestyle, and early recourse to vestibular rehabilitation allows for effective prevention and treatment of these balance disorders.
BPPV is not inevitable, even during the darker months of the year. With the right strategies and appropriate professional support, you can regain your balance and navigate autumn with confidence.
Jean-Jacques Lagarde – our vestibular physiotherapist is available to help with your BPPV and balance issues associated with vestibular dysfunction.
Book an appointment with Jean-Jacques Lagarde for a vestibular assessment
Activate Centre – Vestibular Rehabilitation Specialists For any questions or to book an appointment: www.vestibulaire.ch
This article is provided for informational purposes and does not replace medical consultation. If you experience 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. Consulté sur 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
