Role of thyroid metabolism in vestibular vertigo


  • Anisa . Department of ENT, Yenepoya Medical College and Hospital, Derlakatte, Mangalore, Karnataka, India
  • Sheetal Rai Department of ENT, Yenepoya Medical College and Hospital, Derlakatte, Mangalore, Karnataka, India



Thyroid hormones, Vertigo, Inner ear


Background: Thyroid hormones play a role in the development and functioning of the inner ear.  Therefore, it was hypothesized that a derangement in the thyroid hormone levels can affect the cochleo-vestibular system.

Methods: The present study included 64 cases and 64 controls. All patients diagnosed with peripheral vertigo were enrolled into the study. All the subjects underwent thyroid function tests- serum T3, T4 and thyroid stimulating hormone (TSH). Free hormone levels were obtained in patients with subclinical hypo or hyperthyroidism. The data was analyzed using Independent sample t test.  

Results: Out of 64 cases only 10 patients showed altered thyroid values. Fifty-nine cases were diagnosed with benign paroxysmal positional vertigo (BPPV) out of which 9 (15%) had altered thyroid hormone levels. Among the control group, 12 were found to have deranged thyroid hormone levels.

Conclusions: There is no association between functional thyroid hormone levels and BPPV. Therefore, altered thyroid metabolism has no role in the causation of vestibular dysfunction due to BPPV. However, in case of Meniere’s disease and Vestibular neuronitis further studies with large sample size are required to ascertain the role of functional thyroid hormones in producing vestibular symptoms.


Santos MD, Bittar RS. Vertigo and metabolic disorders. Int Tinnitus J. 2012;17(1):16-20.

Rybak LP. Metabolic disorders of the vestibular system. Otolaryngol Head Neck Surg. 1995;112(1):128-32.

Brevern MV. Epidemiology of BPPV: a population based study. J Neurol Neurosurg Psychiatry. 2007;78(7):710-5.

Lopez-Escamez JA, Cary J, Chung WH, Goebel JA, Magnusson M, Mandala M et al. Diagnostic criteria of Meniere’s disease. J Vestib Res Equilib Orientat. 2015;25(1):1-7.

Cooper CW. Vestibular neuronitis: a review of common cause of vertigo in general practice. Br J Gen Pract. 1993;43(369):164-7.

Sari K, Yildrim T, Borekci H, Akin I, Aydin R, Ozkiris M. The relationship between benign paroxysmal positional vertigo and thyroid autoimmunity. Acta Otolaryngol. 2015;135(8):754-7.

Lindell E, Karlsson T, Johansson M, Magnusson M, Finizia C. Investigation of self-reported dizziness in the elderly when lying down or turning over in bed, and possible benign paroxysmal positional vertigo. J Laryngol Otol. 2019;133(4):275-80.

Chiarella G, Russo D, Monzani F, Petrolo C, Fattori B, Pasqualetti G, et al. Hashimoto’s thyroiditis and vestibular dysfunction. Endocr Pract. 2017;23(7):863-8.

Evren C, Demirbilek N, Elbistanli MS, Kokturk S, Celik M. Diagnostic value of repeated dix-hallpike and roll manoeuvre in benign paroxysmal positional vertigo. Braz J Otorhinolaryngol. 2017;83(3):243-8.

Bradley DJ, Towle HC, Young WS. Alpha and beta thyroid hormone receptor (tr) gene expression during auditory neurogenesis: evidence for tr isoform-specific transcriptional regulation in vivo. Proct Natl Acad Sci USA. 1994;91(2):439-43.

Meza G, Acuiqa D, Escobar C. Development of vestibular and auditory function: effects of hypothyroidism and thyroxine replacement therapy on nystagmus and auditory evoked potentials in the pigmented rats. Int J Dev Neurosci. 1996;14(4):515-22.

Weber T, Zimmermann U, Winter H, Mack A, Kopschall I, Rohbock K, et al. Thyroid hormone is a critical determinant for the regulation of the cochlear motor protein prestin Proct Natl Acad Sci USA. 2002;99(5):2901-6.

Papi G, Corsello SM, Milite MT, Zanni M, Ciardullo AV, Donato CDI, et al. The association between benign paroxysmal positional vertigo and autoimmune chronic thyroiditis. Clin Endocrinol (Oxf). 2009;70(1):169-70.

Papi G, Guidetti G, Corsello SM, Di Donato, Pontecorvi. The association between benign paroxysmal positional vertigo and autoimmune chronic thyroiditis is not related to thyroid status. Thyroid. 2010;20(2):237-8.

Modugno GC, Pirodda A, Ferri GG, Montana R, Rasciti L, Ceroni AR. A relationship between autoimmune thyroiditis and benign paroxysmal positional vertigo? Med Hypotheses. 2000;54(4):614-5.

Vassiliou A, Vlastarakos PV, Maragoudakis P, Candiloros D, Nikolopoulos TP. Meniere’s disease: Still a mystery disease with difficult differential diagnosis. Ann Indian Acad Neurol. 2011;14(1):12-8.

Santhosh UP, Rao MS. Incidence of hypothyroidism in Meniere’s disease. J Clin Diagn Res. 2016;10(5):1-3.

Powers WH. Metabolic aspects of Meniere’s disease. Laryngoscope. 1978;88(1):122-9.

Evans KL, Baldwin DL, Bainbridge D, Morrison AW. Immune status in patients with Meniere’s disease. Arch Otorhinolaryngol. 1988;245(5):287-92.

Yoo TJ, Floyd RA, Sudo N, Ishibe T, Takeda T, Tomoda K, et al. Factors influencing collagen-induced autoimmune ear disease. Am J Otolaryngol. 1985;6(3):209-16.

Gunes A, Karakus MF, Telli TA, Gunes NA, Mutlu M. The effect of thyroid autoantibody positivity on the functions of internal ear. Eur Arch Otorhinolaryngol. 2017;274(11):3853-8.

Fattori B, Nacci A, Dardano A, Dallan I, Grosso M, Traino C, et al. Possible association between thyroid autoimmunity and Meniere’s disease. Clin Exp Immunol. 2008;152(1):28-32.

Nacci A, Dallan I, Monzani F, Dardano A, Migliorini P, Riente L, et al. Elevated antithyroid peroxidise and antinuclear antibody titers in Meniere’s disease patients: more than a chance association? Audiol Neurootol. 2009;15(1):1-6.






Original Research Articles