Vitamin D and Hearing Loss
Vitamin D and calcium metabolism are relevant to inner-ear function in three specific ways: benign paroxysmal positional vertigo (BPPV) recurrence, sudden sensorineural hearing loss (SSNHL), and age-related presbycusis. Evidence is strongest for BPPV.
BPPV — the calcium otoconia link
BPPV is caused by dislodged otoconia — calcium carbonate crystals — floating into the semicircular canals. Vitamin D and calcium metabolism affect otoconia formation and stability. A 2020 South Korean randomised trial (Jeong) of 957 BPPV patients showed vitamin D 400 IU + calcium 500 mg reduced BPPV recurrence rate by ~24% over 12 months (annualised recurrence 0.83 vs 1.10 episodes). Reasonable adjunct in recurrent BPPV.
Sudden sensorineural hearing loss (SSNHL)
Small observational studies find vitamin D-deficient SSNHL patients have poorer recovery than replete patients. Corticosteroids remain the standard early treatment. Vitamin D correction is not established as changing outcomes but is reasonable general care.
Presbycusis and age-related hearing loss
Cross-sectional studies find modest correlation between low 25(OH)D and hearing threshold in older adults, but Mendelian randomisation and supplementation trials do not consistently support causation. Age-related hearing loss is multifactorial (noise exposure, ototoxic medications, vascular changes, genetics).
Practical guide
- Recurrent BPPV: check 25(OH)D and calcium; consider 800 IU vitamin D + 500 mg calcium daily as adjunct to Epley/Semont maneuvers.
- SSNHL: prompt otolaryngology evaluation (steroids are time-sensitive within days); vitamin D adjunct is reasonable.
- General age-related hearing changes: get audiology assessment; vitamin D unlikely to reverse but useful for general health.