Retinopatía Diabética

Vertigo and dizziness are listed in the NIH ODS Black Cohosh Health Professional Fact Sheet as menopausal symptoms for which black cohosh is commonly used and studied. Clinical trials of black cohosh for the broad menopausal symptom cluster include vertigo as a subscale item on validated rating tools.

Calcium supplementation combined with vitamin D3 has RCT-level evidence for reducing BPPV recurrence. In the landmark Jeong et al. 2020 multicenter RCT (n=1050, Neurology), calcium carbonate 500 mg twice daily with vitamin D3 400 IU for 1 year significantly reduced BPPV annual recurrence rate (IRR 0.76, p<0.001). Calcium is essential for otoconia integrity in the inner ear, the structural basis of BPPV pathophysiology.

Gastrodin is the primary bioactive phenolic glycoside of Gastrodia elata (Tianma), used in Chinese medicine for vertigo for over 1,000 years. It has demonstrated vestibular-modulating, neuroprotective, and anti-vertigo pharmacological properties. Retrospective cohort data from China confirms positive clinical effects for dizziness and vertigo, and a comparative animal study shows vestibular improvement comparable to betahistine.

Ginger (Zingiber officinale) has documented anti-vertigo and motion-sickness-reducing properties supported by multiple RCTs and systematic reviews. A controlled clinical study (Grøntved & Hentzer, 1986) demonstrated a statistically significant vertigo-reducing effect of ginger root. A systematic review of 12 RCTs in 2,630+ subjects and a 2026 PRISMA systematic review of 4 RCTs (469 participants) support ginger's efficacy for motion sickness symptoms including nausea, dizziness, and vertigo.

Standardized Ginkgo biloba extract EGb 761 has demonstrated efficacy for vertigo and balance disorders in multiple randomized controlled trials and a 2023 meta-analysis. It improves vestibular compensation, reduces dizziness severity, and enhances balance training outcomes in age-related vestibular dysfunction. A 12-week multicenter RCT in 120 patients aged 60+ found clinically relevant improvement in vertigo and dizziness when EGb 761 was combined with balance training.

Magnesium supports inner ear fluid homeostasis and has been investigated in migraine-associated vertigo given its established role in migraine prophylaxis. A meta-analysis in cardiac patients found magnesium orotate supplementation reduced dizziness risk by 78%. Magnesium is also a required co-factor for vitamin D activation, linking it indirectly to the BPPV-otoconia pathway. Direct evidence for vertigo reduction in isolation is limited but present in migraine-related dizziness contexts.

N-acetyl leucine (N-acetyl-DL-leucine, Tanganil) has been used in clinical practice for over 50 years as a symptomatic treatment for acute vertigo, particularly in France. It accelerates vestibular compensation following unilateral labyrinthine lesions by normalizing abnormal vestibular neuronal membrane potentials and activating the vestibulocerebellum. A clinical study in post-labyrinthectomy patients and multiple animal models confirm its antivertiginous efficacy.

Vinpocetine, a semisynthetic alkaloid derived from Vinca minor, has been clinically used to treat vertigo and dizziness for over 30 years via cerebral blood flow enhancement and neuroprotection. A clinical study (n=44, 15 mg/day) showed improvement of vertigo in 100% and dizziness in 71% of patients. The EDELWEISS open-label parallel-group study (n=139, 8 months) demonstrated significant reduction in vertigo/dizziness severity and improved statodynamic function with vinpocetine plus vestibular exercises.

Vitamin B12 deficiency causes peripheral and central neuropathy manifesting as dizziness, vertigo, and gait instability. The US NHLBI recognizes B12 deficiency as a cause of dizziness. Clinical and observational studies demonstrate B12 repletion resolves dizziness in deficient patients, and a study in 100 neurologically symptomatic patients found 15% had deficient or borderline-low B12 with vertigo among their symptoms.

Vitamin D3 deficiency is associated with increased occurrence and recurrence of benign paroxysmal positional vertigo (BPPV). A landmark multicenter RCT (Jeong et al., 2020, Neurology, n=1050) demonstrated vitamin D3 400 IU plus calcium carbonate 500 mg twice daily for 1 year significantly reduced BPPV annual recurrence rate (IRR 0.76, p<0.001). A meta-analysis of five studies confirmed significant BPPV recurrence reduction (fixed-effects RR=0.68, p<0.0001) with vitamin D supplementation.

Dizziness and vertigo are documented traditional indications for feverfew, listed in the PMC systematic review and NCCIH. The herb has been used alongside tinnitus in folk medicine for vestibular complaints. No clinical trials address this use.

The Chinese Pharmacopoeia explicitly lists dizziness (vertigo) among Fu Ling's primary indications, particularly dizziness arising from fluid accumulation and phlegm obstruction. Classical TCM formulas like Wu Ling San address fluid-related dizziness. No modern clinical trials support this indication.

Gastrodia elata (Tianma in TCM) has been used in Chinese traditional medicine for over 1,000 years to treat vertigo, dizziness, headaches, and convulsions, classified as a liver-Yang-subduing and interior-wind-extinguishing herb. It is a key ingredient in classical TCM formulas for vertigo due to liver Yang rising. Its bioactive constituent gastrodin has modern scientific support for vestibular modulation.

Dizziness and vertigo are among the most consistently documented traditional indications for Shi Jue Ming (abalone shell) in TCM. It is a key herb for the Liver Yang rising pattern that includes vertigo, tinnitus, and balance disturbances.

Dizziness and vertigo are among the four primary traditional TCM indications for Ligustrum lucidum, attributed to yin deficiency of the liver and kidney. MSKCC acknowledges this use but states clinical evidence is lacking. The indication is documented in the Chinese Pharmacopoeia and multiple ethnobotanical sources.