1210 - Buying over-the-counter supplements: are you witty or woozy?

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

EC

Enrique Cruz, MD

Resident
Westchester Medical Center
Caguas, Puerto Rico, United States
JT

Jeffrey Tang, BS

medical student
New York Medical College
Valhalla, New York, United States
MS

Manuel Sargen, BS

medical student
New York Medical College
Valhalla, New York, United States

Corresponding Author(s)

AL

Anusha Lekshminarayanan, MD

Attending
Westchester Medical Center
Valhalla, New York, United States

Submitter(s)

EC

Enrique Cruz, MD

Westchester Medical Center
Caguas, Puerto Rico, United States

Case Diagnosis: 66-year-old male with neck pain and vertigo.

Case Description: The patient reported a 4-month history of vertigo and neck pain which had been getting better in the past few weeks. He was evaluated by an otorhinolaryngologist and a vestibular therapist. Dix Hallpike test was negative. During his PM&R sports clinic visit, the patient revealed he had purchased an over-the-counter online Vitamin supplement (D3+K2) brand based on social media recommendations. A thorough review revealed the timing of symptom onset coincided with starting the supplement. After stopping it, his symptoms gradually improved, with vertigo occurring only once or twice a week. His Vitamin D level was obtained. Vitamin D insufficiency was detected and prescription Vitamin D3 ordered. During 2-week follow up, the patient reported almost complete resolution of the vertigo.

Discussions: This case underscores the risks of self-prescribed supplements, often influenced by social media, without understanding their contents or regulation. Although the product listed only two ingredients, supplement oversight is limited. Patient-reported reviews on the vendor website revealed similar experiences of dizziness and paradoxical decrease in Vitamin D level with the same product. Careful history-taking and medication reconciliation were key to identifying the supplement as a likely contributor. While there’s evidence showing Vitamin D deficiency could result in residual dizziness after treatment for benign paroxysmal peripheral vertigo, our patient had a negative Dix-Hallpike test.

Conclusions: This case illustrates the importance of clinician vigilance in uncovering hidden causes of vertigo. It also raises broader concerns about supplement safety and regulation. A thorough evaluation—including review of over-the-counter products—can significantly alter diagnosis and guide effective treatment.