Broadly classified, vertigo is usually either physiologic or pathologic. Physiologic vertigo is normal and occurs when there is a conflict between the signals sent to the brain by the vestibular system and by the other balance-sensing systems of the body. It can also occur when the head is subjected to unfamiliar movements, such as the rolling motion associated with seasickness, spinning for an extended period, or when the head is held in an unusual position (such as when you tilt your head and neck back for an extended period). Physiologic vertigo is usually easily corrected, either by moving the head and neck into a more normal position or by focusing on an external reference point to give the vestibular system an opportunity to stabilize. This is why a person with motion sickness is advised to look into the distance and focus on some faraway point, such as the horizon.
Benign paroxysmal positional vertigo (BPPV) occurs after a sudden movement of the head. It is one of the most common types of vertigo (Crespi V 2004). Women are affected twice as often as men, and the average age of onset is the middle 50s (Salvenelli F et al 2004).
The conventional treatment of vertigo depends on its underlying cause. In the case of BPPV, the most common therapy is repositioning exercises that redistribute the calcium carbonate back throughout the inner ear. There are various forms of repositioning exercises, including the Epley maneuver. In the Epley maneuver, the person lies down and the head is moved from side to side, with each position being held about 20 seconds. This has been shown to redistribute the calcium deposits in the inner ear, thus re-establishing normal function (Epley JM 1994).
If you have vertigo, it is important to see a physician, who will try to uncover any underlying conditions that may be causing the vertigo. In some kinds of vertigo (for example, BPPV), patients may be taught the Epley maneuver and other positional exercises that have been shown to help relieve vertigo.
In other forms of vertigo, particularly Ménière’s disease, the following supplements may help improve symptoms:
- Vitamin C—1000 to 6000 mg daily with food with 500 to 1000 mg of N-acetylcysteine daily
- Vitamin B6—150 mg with food, while vertigo persists
- Ginkgo biloba—120 mg daily
- CoQ10—50 to 200 mg daily with food
- Ginger—As directed on label (especially for motion sickness).
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