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Health Protocols

Vertigo and Dizziness

Conditions Associated With Vertigo and Dizziness

Vertigo and dizziness are associated with several systemic disorders. While the connections between some particular health conditions and vertigo or dizziness are well understood (eg, orthostatic hypotension and dizziness) (Kim 2015), other associations remain the subject of intriguing ongoing research. Some of these associations will be reviewed here.

Abnormal Glucose Metabolism

Vertigo, particularly that caused by Ménière’s disease, is associated with abnormalities of glucose and insulin metabolism (Kraft 1998; Kirtane 1984; D'Avila 2005; Mangabeira Albernaz 1984; Lehrer 1986; Serra 2009). In fact, people with diabetes may have up to 70% higher risk of a balance disorder (Agrawal 2013), and high glucose and insulin levels have been associated with increased risk of positional vertigo recurrence (Webster 2015).

It has been proposed that chronic blood glucose elevation damages the blood vessels and nerves that supply the vestibular system, leading to degeneration of vestibular tissues. At the same time, the inner ear is rich in insulin receptors and therefore sensitive to insulin levels. Chronically elevated insulin levels may affect inner ear blood flow, disrupting the complex chemical balance of inner ear fluids and resulting in vestibular dysfunction (Webster 2015). More information about diabetes and glucose control is available in Life Extension’s Diabetes protocol.


There is some evidence that low bone mineral density (osteopenia) and osteoporosis are associated with positional vertigo (Yu 2014). In one study, women with osteoporosis and positional vertigo were more than three times as likely to have recurrent vertigo than women without osteoporosis, and the rate of recurrence increased as bone mineral density decreased (Yamanaka 2013). In another study, osteoporosis treatment correlated with a lower risk of positional vertigo in women 51‒60 years old (Mikulec 2010). Some researchers have proposed that the association between positional vertigo and bone loss may be related to vitamin D deficiency (Talaat, Abuhadied 2015). For more information about bone health see Life Extension’s Osteoporosis protocol.

Sleep Apnea

In a preliminary study, adults with dizziness of unknown origin were more likely to report symptoms suggestive of sleep apnea than people without dizziness (Sowerby 2010). In other research, individuals with moderate-to-severe obstructive sleep apnea reported greater vertigo-related disability than those with mild sleep apnea (Kayabasi 2015). And patients with sleep apnea and Ménière’s disease experienced a reduction in Ménière’s disease symptoms when their sleep apnea was treated with a continuous positive airway pressure (CPAP) device (Nakayama 2015). New evidence suggests repeated bouts of low oxygen levels that accompany sleep apnea may damage the vestibular system (Kayabasi 2015; Gallina 2010), which could increase risk of peripheral vertigo. Refer to Life Extension’s Sleep Apnea protocol for more information.

Depression and Other Mental Health Issues

There is a high prevalence of anxiety, depression, and other emotional, psychiatric, and cognitive disorders in people with vertigo (Peluso 2015; Bigelow 2015; Ketola 2015; Lahmann 2015). Some researchers have proposed that the vestibular system, in addition to supporting balance control, may participate in perception, cognition, and consciousness. Vestibular dysfunction may therefore play an important role in psychiatric and cognitive disorders, even in the absence of vertigo (Gurvich 2013). For more information, refer to Life Extension’s protocols on anxiety, depression, and obsessive-compulsive disorder.