Table 2.

Treatments proposed for recurrent BPPV based on hormones and other factors.

Estrogens	Lesser episodes of vertigo in women who need estrogen hormone replacement therapy. Not recommended to treat the recurrence of positional vertigo exclusively. Consider the short-term use of phytoestrogens in women with low estrogen levels.
Vitamin D	Use in population with recurrent vertigo and low levels of vitamin D. Given the safety of this treatment, as well as the high prevalence of this vitamin deficit, it is pending to evaluate in new studies its standardized use in the entire population.
Osteoporosis Treatment	Fewer recurrences in patients with vertigo and osteoporosis. Standardized use not recommended.
Corticosteroids	Approach treatment with caution. Use the intratympanic injection technique once confirmed positional vertigo and other therapeutic options had been ruled out.
Thyroid hormones	Not recommended given the association of BPPV with autoimmunity, not with metabolic disorders of the thyroid itself.
Growth Hormone	Although it regulates bone metabolism, studies with human patients are needed.