Dr. Richel L. Cavas, ENT

30/05/2026

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25/05/2026

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01/05/2026

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08/03/2026

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02/03/2026

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Blood Investigations in Vertigo

Blood investigations are indicated in atypical, recurrent, persistent, or systemic presentations.Blood tests are to rule out metabolic, vascular,autoimmune, and systemic causes of dizziness, not positional vertigo.BPPV is a clinical diagnosis and does NOT require routine blood tests.

1. Blood Count (CBC)
Parameter Possible Cause of Vertigo
-Low Hb Anemia → Reduced cerebral oxygenation
-High TLC Infection (labyrinthitis, systemic infection)
-Polycythemia Hyperviscosity → Cerebellar/brainstem hypoperfusion

2. Glucose (Fasting / Random / HbA1c)
Abnormality Cause
-Hypoglycemia Acute dizziness, presyncope
-Hyperglycemia Diabetic neuropathy, microvascular ischemia affecting vestibular system

3. Function Tests (TSH, T3, T4)
Disorder Mechanism
-Hypothyroidism Vestibular dysfunction, delayed central compensation
-Hyperthyroidism Autonomic instability, palpitations with dizziness

4. Electrolytes (Na⁺, K⁺, Ca²⁺, Mg²⁺)
Abnormality Clinical Correlation
-Hyponatremia Cerebral edema → dizziness
-Hypokalemia Cardiac arrhythmia → presyncope
-Hypocalcemia Neuromuscular irritability
-Hypomagnesemia Neurological instability

5. B12 Level
Deficiency Effect
-Low B12 Posterior column dysfunction → imbalance, ataxia

6. D Level
Finding Association
-Low Vitamin D Associated with recurrent BPPV (otoconial degeneration)

7. Profile
Abnormality Risk
-Hyperlipidemia Vertebrobasilar insufficiency, stroke risk

8. / CRP
Elevated Suggests
-High ESR/CRP Vasculitis, autoimmune inner ear disease

9. Markers (ANA, RF)
Positive Possible Condition
-ANA Autoimmune inner ear disease
-RF Rheumatological disorders

10. Profile
Abnormality Risk
-Hypercoagulable state Posterior circulation stroke

When to Order Blood Tests in Vertigo?
-Recurrent unexplained vertigo
-Bilateral vestibular involvement
-Associated neurological signs
-Suspected metabolic/endocrine disorder
-Elderly with vascular risk factors
-Recurrent BPPV (check Vitamin D)

07/02/2026

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15/04/2025

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22/02/2025

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