Benign paroxysmal positional vertigo: is hypothyroidism a risk factor for recurrence?

Area of Science:

• Endocrinology
• Neurology
• Otolaryngology

Background:

• Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of vertigo.
• Hypothyroidism is a prevalent endocrine disorder often managed with hormone replacement therapy (HRT).
• The relationship between hypothyroidism, particularly when treated, and BPPV recurrence remains an area of investigation.

Purpose of the Study:

• To investigate the association between hypothyroidism treated with HRT and the risk of BPPV recurrence.
• To explore the role of specific thyroid antibodies and conditions like Hashimoto thyroiditis in BPPV recurrence.

Main Methods:

• A cohort of 797 patients with idiopathic BPPV was divided into recurrent (R-BPPV) and non-recurrent (NR-BPPV) groups.
• Serum levels of TSH, f-T3, f-T4, TG-Ab, and TPO-Ab were analyzed in patients with thyroid disease on HRT.
• Statistical analysis was performed to compare hypothyroidism prevalence and antibody levels between R-BPPV and NR-BPPV groups.

Main Results:

• Hypothyroidism on HRT was significantly more prevalent in the R-BPPV group (24.4%) compared to the NR-BPPV group (14.4%).
• Hashimoto thyroiditis (HT) was strongly associated with BPPV recurrence (p < 0.0001).
• Recurrence showed a significant correlation with serum TPO-Ab and TG-Ab levels, but not with TSH, f-T3, or f-T4.

Conclusions:

• Hypothyroidism treated with HRT may increase the risk of BPPV recurrence.
• The findings suggest a potential link between autoimmune thyroid disease, positive thyroid antibodies, and recurrent vertigo.
• Autoimmunity may play a role in the pathophysiology of recurrent BPPV.