At Equilibrium Audiology, we know that when it comes to dizziness, especially Benign Paroxysmal Positional Vertigo (BPPV), the solution often begins with precision: repositioning tiny inner ear crystals through specific maneuvers like the Epley, Semont, or Gufoni. These Canalith Repositioning Maneuvers (CRMs) are the gold standard and should always be your first step with a qualified vestibular professional.

But what if you’re doing all the right things, yet your BPPV keeps coming back?

For some individuals, lifestyle factors, especially nutrition, might be playing a less obvious, but very real role in the recurrence or persistence of BPPV. In particular, we’ve noticed a pattern emerging in patients who follow strict low-carbohydrate or ketogenic-style diets. Could your well-intentioned eating plan be affecting the health of your inner ear?

Let’s take a closer look at the science behind this intriguing connection.

 

A Quick Recap: What Is BPPV?

BPPV is a mechanical disorder of the inner ear, caused by tiny calcium carbonate crystals (otoconia) that become dislodged and migrate into one of the semicircular canals. When this happens, head movements can send confusing signals to your brain about balance, resulting in short bursts of vertigo, dizziness, or unsteadiness.

The solution? Reposition those crystals using tried-and-tested CRMs. But when BPPV is recurrent, it’s worth asking: why are those crystals breaking off in the first place?

 

Could Your Diet Be Weakening Your Inner Ear Crystals?

 

1. Your Inner Ear Runs on Glucose

The inner ear is metabolically demanding, relying on glucose for consistent energy. A severely carb-restricted diet may disrupt blood sugar stability, affecting the fluid balance and nerve signaling inside your vestibular system. Think of it as destabilizing the “glue” that keeps the otoconia where they belong.

 

2. Low-Carb Diets and Inflammation

Many popular low-carb diets inadvertently cut out antioxidant-rich fruits, vegetables, and whole grains – foods that help reduce chronic inflammation. When inflammation affects the delicate tissues surrounding your otoconia, those crystals may become more prone to dislodging.

 

3. Key Nutrients That Protect Your Inner Ear

If you’re eating low-carb and also missing out on essential nutrients, you could be unintentionally weakening your vestibular system:

• Vitamin D3: Critical for calcium absorption and inner ear health. Deficiency is strongly linked to BPPV recurrence.
• Vitamin K2: Helps guide calcium into bones and away from soft tissues. It may prevent abnormal calcification in the inner ear.
• Magnesium: Regulates nerve and muscle function, supports vestibular hair cells, and activates Vitamin D. A deficiency can impact balance, energy metabolism, and increase dizziness.

These nutrients work synergistically to maintain the structural integrity of your inner ear. If you’re low in one, the others can’t do their jobs properly.

 

4. Acidity and Crystal Fragility: A Speculative But Noteworthy Link

Some theories suggest that an overly acidic internal environment, influenced by dietary patterns (especially protein-heavy, plant-light diets), may degrade otoconia over time. Though speculative, it’s worth considering if you’re experiencing recurrent episodes and consuming an imbalanced diet.

 

Recurrent BPPV? Your Diet May Be the Missing Piece

To be clear – diet is not the direct cause of BPPV, and repositioning maneuvers remain the frontline treatment. However, in recurrent or chronic cases, nutrition and systemic health can influence the terrain in which those crystals live.

If you’ve been experiencing:

• Recurrent BPPV episodes despite treatment
• Fatigue, low energy, or blood sugar fluctuations
• A highly restrictive or low-carb eating pattern

… then it may be time to evaluate whether your diet is supporting or stressing your vestibular system.

 

The Equilibrium Audiology Approach

At Equilibrium, we go beyond symptom management—we take a root-cause, functional medicine-informed approach to dizziness and balance disorders.

We combine:

• Advanced diagnostics
• Targeted vestibular rehabilitation
• Nutritional insight
• Mind-body coaching support

Our goal is to not only treat your BPPV but to understand what might be causing it to return, so you can take empowered steps toward lasting relief.

 

Final Thoughts

If you’re following a low-carb diet and experiencing recurrent BPPV, this is your invitation to pause and reflect. Nutritional choices matter, not just for your metabolism or weight, but for your inner ear health too.

Before making any major dietary changes or starting supplements, always speak with your audiologist, doctor, or a registered dietitian who understands the intersection of balance, biochemistry, and brain health.

Your inner ear is whispering. Are you listening?

 

Want to learn more or book a vestibular consultation?
Contact us at Equilibrium Audiology—where balance begins with understanding.