Hearing Loss Help  

by Neil Bauman, Ph.D.

I received this email from a young man in his 20s. He writes:

I have experienced ototoxicity, following an application of Neomycin on a large, deep cut on my leg. I covered the cut completely with Neosporin and soon thereafter experienced tinnitus and dizziness. In the months following, my hearing has slightly worsened on the audiogram. (Self test) and I have experienced a dramatic change in the way I perceive sounds.

My parents refuse to believe that one application of this drug could affect my hearing to such a degree.I have no way to prove it to them. They sent me to a psychiatric hospital because they think I’m making it up. Would you let them know that this is possible and I am not crazy. Thanks.

Neomycin, the chief ingredient in Neosporin, is most definitely ototoxic. You just have to read the fine print that comes with Neomycin preparations to know that. Here is a quote from my book “Ototoxic Drugs Exposed” regarding Neomycin, “Do not use large amounts in the treatment of…open wounds… In these cases, serum concentrations are comparable to, and often higher, than those attained following oral and parenteral (injections and intravenous) therapy.” This information was taken from the Physicians’ Desk Reference (PDR).

Also, “You may end up with permanent hearing loss following topical application of minute amounts of Neomycin to both small and large surgical sites” (which includes deep cuts such as you had). This comes from the Canadian equivalent to the PDR, called the Compendium of Pharmaceuticals and Specialties (CPS).

Unfortunately, it seems too few people read and heed those warnings,

As you have just discovered, even one application of Neomycin to a large open cut could certainly cause the dizziness, tinnitus, hearing loss and distorted hearing you describe. (From your description, I take it you applied the Neosporin liberally.) You are just lucky it wasn’t even worse!

All the Aminoglycoside antibiotics, of which Neomycin is one, can damage your ears. (Neomycin, in particular, goes after your hearing.) You may be surprised to learn that between 250,000 and 1,000,000 Americans each year have resulting hearing loss from taking one of these drugs. That is a lot of people. You are definitely not alone.

One of the more insidious things about Neomycin is that the hearing loss doesn’t necessarily appear right away, but can surface several months later, and/or the hearing can continue to get worse for several months and up to a year later.

You are certainly not crazy–nor making it up–thinking that one dose of Neomycin did all this damage to your ears. Your parents are way off base here. The only “dumb” thing you did was to use such a potent antibiotic in the first place.

A word of caution. Since you now know that your ears are sensitive to the aminoglycoside antibiotics, you have to be very careful in the future. You can expect that every time you take aminoglycoside antibiotics in the future, you will further damage your ears. Therefore, only take them in life-threatening situations. (Better to be deaf than dead!)

by Neil Bauman, Ph.D.

Perhaps the greatest emotion we have when we lose some (or more) of our hearing is fear.

One otologist (Otologists are doctors that specialize only in ears.) with rare insight wrote on a patient’s card, “progressive hearing loss,” adding “the record might more accurately read, Diagnosis: fear. Fear of failure. Fear of ridicule. Fear of people. Fear of new situations. Fear of chance encounters. Fear of sudden noises. Fear of imagined sounds. Fear of being slighted. Fear of being avoided. Fear of being conspicuous.”

These are just a few of the many fears that haunt us.

When my wife, Diane, was first losing her hearing, fear was the first emotion that impacted her. She was afraid. At that time, four fears immediately jumped into her mind.

1. Will I be able to still function? (How will I be able to function if I can’t hear?)

2. Will I lose my job? (How can I do my job if I can’t hear?)

3. Will I still be able to drive? (Can hard of hearing people even drive?)

4. Will I be able to look after my children? (How will I be able to care for my children when I can’t hear them?)

Since we fear the unknown, the way to overcome fear is by learning about our hearing losses. Following each of the above fears is a “how” question. With more knowledge about hearing loss, we will soon begin to find solutions to these questions. As we do this, we find that hope begins to replace our fears.

Apart from reading articles and books on the subject of hearing loss–such as are on this website (http://www.hearinglosshelp.com), one of the best ways to learn how to successfully cope with hearing loss is to join hearing loss support groups. That way, you will learn how others successfully cope with their hearing losses. You can then incorporate these ideas into your own life.

If you want to join a face to face support group, join SHHH (Self Help for Hard of Hearing People) in the US (http://www.hearingloss.org) or CHHA (The Canadian Hard of Hearing Association) in Canada (http://www.chha.ca). If you’d rather join an on-line support group for hard of hearing people, the SayWhat Club (SWC) is one of the best (http://www.saywhatclub.com).

by Neil Bauman, Ph.D.

When asked, “In your view, what features of hearing aids are most positively correlated to customer satisfaction?” Sergi Kochkin, Executive Director of the Better Hearing Institute replied, “In all my experience in conducting market research in the hearing health care industry, I’ve never come across a factor as strongly correlated with customer satisfaction as the directional feature in hearing aids.”

He further explained, “When you combine advanced digital–which can be taken to mean ‘better hearing comfort in noise’–with a quality directional system–which means ‘better hearing in noise’–you arrive at a pretty good solution for hearing loss.” (Reported in The Hearing Review, October, 2005 p. 30.)

Therefore, if you are going to get new hearing aids, insist on hearing aids that both effectively reduce background noise and also have good directional microphones for use in noisy situations. You will be much happier with your new hearing aids if you do so. At the same time, don’t forget to insist that your hearing aids have good t-coils in them too.

by Neil Bauman, Ph.D.

A young man (25 years old) wrote:

I typically listen to loud music in my car on my ride to work and home for a period of 45-60 minutes each day. Usually after listening to the music my ears feel blocked and muffled for a few minutes. Occasionally my ears ring, maybe 3 times a month.

Ten days ago I was riding in my friend’s car that is equipped with two subwoofers and an amplifier located in the trunk. I was sitting in the back seat close to the subwoofers listening to loud bass that was vibrating my ear drums to the point that it was giving me pain. I don’t know the exact sound level, but it must have been at least 100 dB since it was shaking and vibrating my ear drums as well as the whole car.

The next morning I woke up with the feeling that my ear was plugged. My ears rang briefly, but I haven’t heard the ringing since. I noticed that I could not make out some words during normal conversation. When I listen to the radio, I can only hear it with one of my ears, and it seems that I can’t hear high pitched sounds in the affected ear any more. I have trouble hearing conversation in my left ear in a crowded area like a mall. I have to constantly tell people to repeat themselves to make out certain words. It feels like my ear is constantly plugged up.

It has been 10 days now and it has not improved. I fear that I now have a unilateral hearing loss. Is there any way I can regain my hearing, or will I have to deal with this for the rest of my life?

I hope there can still be treatment other than a hearing aid. Do you think steroid treatment is still an option or have my hair cells been permanently destroyed? These past 10 days have been very difficult for me. It is starting to affect my personal life from music to talking on the telephone to watching television.

After your ride to work each day, you noticed your ears felt plugged up and sounds were muffled. This is called a temporary threshold shift. This is a warning to you that you are damaging your ears from loud sounds. Listening to music at this volume is not a smart thing to do.

After the episode in your friend’s car 10 days ago, the excessive sound levels (I figure more like 120 dB or higher) has left you with a permanent threshold shift. In other words, I fear you now have permanent hearing loss—likely in both ears—but obviously worse in your left ear.

Unfortunately, you’ve wasted 10 precious days without getting effective treatment. The window for effective treatment for noise-induced hearing loss is only a day or two, so likely there isn’t much that can be done now.

You need to protect your ears from loud sounds in the future as they are now going to be even more sensitive to noise damage than they were in the past. Wear ear plugs if the sound is going to be louder than 85 dB or so. I wouldn’t be surprised if the sound you were listening to–at the point of pain–would have been up around 120 to 130 dB. At 120 dB, the safe time exposure is only 4 seconds. At 130 dB, that drops to a minuscule 1/4 of a second!

I’d suggest you go to an audiologist and have a complete audiological evaluation. That way you will know how bad your hearing is–and it may be in both ears too–although one is obviously worse than the other.

When you expose your ears to loud sounds, free radicals are formed in your inner ears. These free radicals zap the cells in your inner ears. Any cells that are fatally damaged go into a process called apotosis—in which they systematically shut down and die. Thus, you have to zap the free radicals before they do their dastardly deeds.

The best way to zap free radicals is with powerful antioxidants. Glutathione is considered the most powerful natural antioxidant there is. Your body makes this antioxidant naturally from compounds such as N-acetyl-cysteine and D-methionine which in turn are made from three amino acids–cysteine, glycine and glutamic acid.

When your ears need extra help, taking N-acetyl-cysteine and D-methionine helps your body quickly make more glutathione.

Note: you don’t want to overdose on N-acetyl-cysteine, as it can actually work “backwards” and cause more ear damage. I’ve seen figures that if you take more than 2,800 mg of N-acetyl-cysteine a day it can reverse its activity and become a pro-oxidant rather than the beneficial antioxidant. Your ears need some N-acetyl-cysteine, but too much can be dangerous.

You may want to consider taking glutathione and N-acetyl-cysteine to help protect your ears. Incidentally, Vitamins E and C are also good antioxidants.

You can buy both glutathione and N-acetyl-cysteine in health food stores or on-line. This will give your body the boost it needs to zap all these free radicals.

In addition, researchers now know that the mineral magnesium plays an important part in hearing. Scientists have found that a magnesium deficiency increases susceptibility to noise damage. One of the things that happens is the lack of magnesium causes the tiny blood vessels in your ears to constrict, thus depriving them of an adequate supply of oxygen. At the same time, loud noise depletes your ears of magnesium–so loud noise actually causes a double-whammy. There is evidence that high doses of magnesium taken soon after a sudden hearing loss can sometimes help restore hearing.

You may still want to try the above. Since they are all natural substances, they won’t harm your body or your ears (unless you overdose on them).

by Neil Bauman, Ph.D.

A man recently wrote:

I’ve been having sporadic bouts of tinnitus lasting roughly a day at a time. I’ve now had two such episodes. I was curious if there is any information supporting that NSAIDS like Naproxen can cause permanent tinnitus or hearing loss. Also, is this dose related?

Yes, it is true that Naproxen can cause both hearing loss and tinnitus. In fact, the Physicians’ Desk Reference (PDR) shows that up to 9% of the people taking Naproxen get tinnitus and up to 3% result in hearing loss. (Personally, I think these figures are low!)

Hearing loss from taking Naproxen is sometimes temporary and sometimes permanent. I think this is also the case with tinnitus–although I don’t have any hard figures to prove it.

Also, be aware that tinnitus is often dose related. For example, if you cut the dose in half, you may find that your tinnitus goes away. Or saying it another way, if you increase your dose after having been on Naproxen for some months, you may suddenly find you have tinnitus.

This man continues:

I’m just looking for peace of mind. I’m extremely prone to anxiety and stress. The bout with tinnitus that I’m dealing with now struck me right after taking 2 Naproxen. I can only deduce that it has been brought on by the Naproxen because I have, to the best of my knowledge, very few triggers other then that which could bring about the persistant tinnitus. Fortunately, up to now, I have not had this for any period longer than 10 hours.

Be aware that just anxiety and/or stress can cause tinnitus and can certainly make existing tinnitus worse–so you want to learn to relax and not worry so much. As they used to say “hang loose.”

I tend to agree that very likely your tinnitus is being brought on by taking the Naproxen. You might try reducing the dose to 1 Naproxen at a time and see if you still get tinnitus. If so, the sooner you dump the Naproxen, the less likely your tinnitus will become permanent.

by Neil Bauman, Ph.D.

A man recently wrote:

I recently read your article on AIED. I was diagnosed with AIED a few months ago, and I’ve been through most of the treatments, prednisone, methotrexate. and cortisone injections through a tube. My doctor wants me to try Remicade, a new biological type drug. What do you think about this drug and AIED?

Personally, I think that with AIED the cure can be worse than the disease, especially for some people. I was just talking to a man yesterday who took Prednisone and Methotrexate and ended up with kidney cancer because of them. Not a good trade off in my opinion.

I don’t know much about Inflixmab (Remicade) and its long term effects on our bodies. After reading about the serious side effects it can have, including immune problems, cancer and death, I must say I don’t like the odds, especially since I haven’t seen any data that proves it will cure AIED. Personally, I wouldn’t be in any rush to take it.

In regards to your ears, Inflixmab can cause dizziness and vertigo. Three other drugs in this same family can cause hearing loss so this drug may be found to do the same.

To learn more about Autoimmune Inner Ear Disease (AIED), point your browser to http://www.hearinglosshelp.com/articles/aied.htm.