Hearing Loss Help  

by Neil Bauman, Ph.D.

A lady wrote:

Would you explore the question of medications that affect hearing loss. My hearing gets noticeably worse every year. I’ve asked my doctor about which of my many medications (I’m 81) might cause deterioration of my hearing. He doesn’t seem to know.

Here is the list of what I am taking.

Ventolin HFA inhaler (Albuterol)
Vytorin (a combination of Ezetimibe and Simvastatin)
Klor-Con (Potassium chloride)
Vitamin D3, 2000 unit
Calcium+D 500mg
Veramyst nasal spray (Fluticasone)
Pataday eye drops
Lisinopril
Warfarin (Coumadin)
Advair diskus (Fluticasone)
Omeprazole (brand name Prilosec)
Fosamax (Alendronate)
Furosemide (Lasix)
Claritin
Centrum Silver
Tylenol Arthritis Pain
Tylenol PM

It can be hard to pin down exactly what is causing your hearing to drop each passing year. There could be any number of factors including aging and various health issues in addition to the drugs you are taking.

However, when I looked at the above list of drugs and vitamins you are taking, one drug instantly jumped out at me.

First, the good news. Of the 17 things you are taking, 16 of them are not known to cause hearing loss. (Some of these cause other ototoxic side effects such as tinnitus or vertigo so they can still damage your ears, but they are not known to cause hearing loss.)

Now for the bad news. One drug is well-known for causing hearing loss, namely Furosemide (brand name Lasix).

Your doctor has no excuse for not knowing that Furosemide is ototoxic because it has been known to cause hearing loss for 39 years now! It’s not a secret. Furthermore, Furosemide is listed as being ototoxic in his PDR.

Incidentally, Furosemide causes hearing loss in about 6.4% of the people taking it. Furthermore, the greater the dose and the faster you take it, the greater the incidence and severity of the resulting hearing loss. For example, in one study, 67% of the people taking Furosemide at the rate of 25 mg per minute ended up with noticeable hearing loss.

I would not be at all surprised if you find that your progressive hearing loss is largely caused by the Furosemide you are taking. You should ask your doctor if you could take another diuretic instead. For example, if it will do the job, Hydrochlorothiazide is much less ototoxic than Furosemide and is not known to cause hearing loss.

by Neil Bauman, Ph.D.

Americans take a lot of prescription drugs. Doctors in the USA in 2008 prescribed a total of 1,505,200,000 prescriptions for just the 50 top prescription drugs. (And they prescribed untold millions more prescriptions for the hundreds of other drugs.) The retail value of these 1.5 billion prescriptions was a whopping $53,186,000,000.00 according to the October, 2009 AARP Bulletin.

The scary thing for us is that 44 of these top 50 prescription drugs (88%) can be ototoxic and damage your ears in some way (and all of them also have numerous other side effects).

Therefore, you want to be sure that any drug that you take is absolutely necessary before you take it if you truly value your health. Drugs should be your last resort, not the first thing you turn to.

I try to keep my drug usage to a minimum. For example, in the last 30 years, I can only remember getting two prescriptions—one was an antibiotic for an infection that I couldn’t control any other way, and the other was for a bad case of sciatic pain, and even then, I only took 2 of the pills. Apart from that, the only drug I take is the pain-killer the dentist gives me before working on a live tooth. I never take over-the-counter medications either.

I use other means to stay healthy. In my opinion, most prescription drugs are not necessary. There are many alternative ways of achieving the same results without drugs and their numerous side effects. Avail yourself of the various kinds of alternative medicine practitioners—for example, naturopathic doctors, herbalists, chiropractors, acupuncturists, massage therapists and so on. These practitioners have a wealth of knowledge in helping your body get and stay healthy.

It’s tragic that we ignore the basic things that will help the most to keep us healthy such as getting lots of exercise, eating a healthy diet, watching our weight and getting plenty of rest. We refuse to do these things because they take effort and we want effortless health—hence we pop pills instead of doing those things that really make a difference.

Build some exercise into your daily routine. For example, when I take my daily trip to the post office to ship my orders, I take my dog along. Afterward, we go into the country (only a mile away) and walk for a couple of miles in the fresh air. It doesn’t take us long. We typically cover two miles in just half an hour. That gets the blood circulating again before I return to my desk.

Follow the above basic health principles, and not only will you save a bundle that you now spend on drugs, but you will likely feel ever so much better, and incidentally, you’ll never have to worry about drugs damaging your ears either.

by Neil Bauman, Ph.D.

A lady wrote:

One thing I am concerned about is the new swine flu and flu vaccines in general. I’ve heard that they contain a lot of mercury. Do these vaccines have a negative effect on hearing? I have not ever had any kind of flu shot and will not if there is any question of damaging my hearing further. I already have lost almost all hearing in my right ear and some in the other one.

The other problem is that I’m allergic to egg yolks, according to the doctor who did the blood allergy test for me. My internist doesn’t think this is a true allergy. I only have five foods that came up as problems, but avoiding them has improved my health; eating them does cause problems. So I am not anxious to ingest even a flu shot because it is made from egg yolk. I am most concerned about the effect on my hearing though.

What is your take on vaccines?

I have been asked a number of times recently for my opinion on flu shots—whether they are ototoxic, or even necessary.

In general, I’m against vaccines. Apart from the fact that they have a number of side effects—some as serious as death, they seem to mess up the immune system so it can’t do its job properly. This may be one reason for the proliferation of immune system diseases that are so prevalent today.

A number of vaccines can be ototoxic, including the influenza vaccines. I have two anecdotal reports in my files of children having significant hearing losses after getting flu shots.

I wouldn’t take a flu shot unless the situation was life-threatening, and there weren’t any alternatives available. The good news is that there are alternatives.

I was just reading Dr. David Williams newsletter (1) and he addressed this issue. He says keep your immune system robust by doing two things to help prevent yourself from getting the flu—whether the swine flu or any other strain.

First, he suggests taking Vitamin D supplements (adult dose at 4,000 to 5,000 IU a day). You see, adequate amounts of Vitamin D are essential for your immune system to function properly. In the wintertime, when colds and the flu are common, we typically don’t get adequate Vitamin D through our skin from the sun. Therefore, we need to take Vitamin D supplements.

Second, make sure your beneficial gastrointestinal (GI) flora are present and healthy. In fact, the beneficial bacterial flora in your GI tract are so important they are often called your second immune system.

If your GI flora are depleted from taking antibiotics for example, you are much more vulnerable to all sorts of “bugs” including flu bugs. Therefore, eat fermented foods with live cultures such as live yogurt and kindred foods, and/or take probiotic supplements containing bacteria such as Lactobacillus acidophilus and Bifidobacterium bifidus to maintain adequate numbers of the beneficial bacterial flora in your intestinal tract.

Dr. Williams ends his article with this admonition. “If you want to avoid the flu and other epidemics, live longer, stay healthier, and minimize the chronic problems associated with aging, make sure you’re getting enough vitamin D, start taking probiotics, and routinely add fermented food to your diet.”

I couldn’t have said it better myself! When you do this, you likely won’t have any problems with the swine flu or any other similar infections.

(1) “Keeping Up With the Flu”. Dr. David Williams. October, 2009. In: Alternatives, Vol. 13, No. 4.

by Neil Bauman, Ph.D.

A lady asked:

Have you heard about potassium gluconate having ototoxic effects? I have been diagnosed with Meniere’s Disease. My ENT put me on a diuretic and a daily dose of 550 mg of potassium gluconate, Almost as soon as I started on it, my tinnitus started to roar and I was hearing very little. I experienced slight to severe vertigo at least two out of every three days during that time. When I stopped taking the potassium gluconate, I noticed an improvement in my tinnitus after only one day. After 2-3 days it was back to its familiar hiss. The vertigo stopped completely the first day, and has not come back in the week I have been off the potassium gluconate. Also, my hearing rebounded almost back to normal in the week I have been off the potassium, but an audiogram confirmed I have lost a bit more hearing. My ENT doesn’t think there’s a connection. Do you know if there is any evidence beyond my anecdotal experience that potassium gluconate could be the cause?

This same lady, a few weeks later, wrote,

I recently decided (again) that it was time to lose weight, and though I’d use SlimFast to get a jump start on it. I immediately experienced extreme tinnitus and hearing loss. When I checked the label, I found that it is high in potassium—in fact it contains 550 mg—the same amount I was taking in the supplement that caused me trouble before. I stopped the SlimFast and the problems decreased again. I have not gotten back to where I was before the 30 days on potassium, but at least it’s no longer getting worse.

One reference says that taking potassium gluconate can cause ringing in the ears (tinnitus) and sudden hearing loss so obviously you are not alone. (1)

Also, in the same article it explains “Potassium gluconate can decrease blood flow to the optic nerve of the eye, causing sudden vision loss.”

If potassium gluconate can do this to our eyes, it seems likely that it also does the same to the tiny arteries in our inner ears. This would starve the hair cells of oxygen, causing them to be “sick” (to use a fancy medical term). The result could be instant tinnitus and a temporary sudden hearing loss, as well as balance problems such as vertigo when taking potassium gluconate in higher doses.

When you stop taking potassium gluconate, inner-ear blood flow (hopefully) returns to normal. As a result, some/all hearing returns and the tinnitus goes away or decreases. However, this is only true if the hair cells were “sick” from lack of oxygen. If they actually died (and some may die) then you would be left with some degree of permanent hearing loss. I think the longer you take this medication, the weaker the hair cells become and some begin to die—thus resulting in permanent hearing loss. That is why the sooner you stop taking the drug, the better your chances are for near-normal recovery.

Adequate potassium intake is necessary to a healthy body. However, it seems that the potassium dose you were taking was too high for you. From what I can gather, 500 mg a day is about the safe upper limit. After that, ear damage can begin. A more conservative dose is 100 mg, 3 times a day as the maximum.

You may find you can take potassium gluconate, but at a lower dose. It is something you might want to try if you think the potassium gluconate was helping your body (apart from your ears).

In any case, whenever your tinnitus suddenly increases when you start taking a drug, consider it a warning that the drug is causing ear damage at that dose. You need to pay attention to that warning before other ear damage also becomes apparent. Either reduce the dose or stop taking the drug, but run this by your doctor first of course.

(1) Potassium gluconate.

by Neil Bauman, Ph.D.

A lady explained:

Because of high blood pressure, some previous mini-strokes and a family history of high cholesterol, I have been taking Lipitor [Atorvastatin]. My doctor feels my cholesterol needs to be under better control and has switched me to Crestor. I cannot find Crestor in your Ototoxic Drug book. Could you give me some information on it’s side effects? I would certainly appreciate any help.

Crestor (Rosuvastatin) is fairly new and not a lot of information about its ototoxic properties is readily available. The PDR lists dizziness as the only ototoxic side effect.

I suspect it has other ototoxic side effects that will become apparent in the future. This is because all the “statin” drugs belong to the same general drug family—i.e. they have similar chemical compositions. Thus you would expect them to have similar (not identical, but similar) ototoxic side effects.

On page 502 of my drug book, in the comparison table (section 11.3.2) you can see that all 6 “statins” listed there have dizziness as a side effect, just like Crestor has. However, 5 of the 6 also have vertigo listed, 2 have tinnitus, 2 have hearing loss and 1 has ataxia listed. So those are the most likely ototoxic side effects that Crestor may have.

Therefore, you might experience dizziness and/or possibly vertigo if you take Crestor, but only time will reveal whether Crestor will also cause side effects such as hearing loss and tinnitus in some people.

To learn which drugs are (or can be) ototoxic, see “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs, 30 herbs and 148 chemicals.

by Neil Bauman, Ph.D.

A concerned daughter wrote:

My dad is 74 years old, in great physical condition, slim and active. Within the past 5 months he has developed a loss of hearing, ringing in his ears and balance impairment. He has been taking Prozac for the past 20 years. He adjusts the dose to his own liking. He also has been taking blood thinners because of a heart bypass operation. Might the Prozac be guilty?

Fluoxetine (Prozac) might be guilty, but I really wouldn’t expect it since he has been taking it for 20 years without previous side effects (unless now he has suddenly upped the dose significantly). To be sure, Fluoxetine (an SSRI) can, and does, cause hearing loss, tinnitus and/or balance problems in some people.

On the other hand, I’m sure he was given lots of drugs at the time of his heart bypass operation, and they could have caused his hearing loss, tinnitus, etc. Also, maybe the blood thinners are the problem.

Look at any other drugs he is taking, or has been taking, for the past 6 months or so. I’m always suspicious when side effects show up in the weeks/months after beginning a new medication or upping the dose on an existing one. If you can correlate his ototoxic side effects with a drug he began taking shortly before they occurred, that is the likely culprit.

by Neil Bauman, Ph.D.

A lady asked:

Do you have an opinion on which antidepressants are the safest for our ears—e.g. Pamelor, Desipramine, Zoloft, Lexapro, Celexa, etc. Is there one that is significantly less ototoxic than the others?

For my money, I wouldn’t use any of the above. Why? Because there is a much safer alternative—St. John’s Wort. You see, this herbal is not ototoxic at all. Furthermore, according to numerous studies, it works as well as the above drugs for mild to moderate depression. In addition, it doesn’t have all the other bad side effects the above drugs have either.

If you decide to take St. John’s Wort, do two things. First, run it by your doctor or pharmacist. You want to make sure it won’t interfere with any of the other drugs you are currently taking. Second, be sure it says on the bottle that it is standardized to 0.3% to 0.5% hypericin. (Hypericin is the active ingredient.) When you use a standardized formulation, you know exactly how much of the active ingredient you are getting. Otherwise, the active ingredient may vary all over the place, and you don’t want that.

by Neil Bauman, Ph.D.

A lady wrote:

I have a question regarding Restasis (for dry eyes). I have dry eyes and used to use Restasis, which was very successful. When my tinnitus increased a year and a half ago, I stopped everything that I was using including Restasis because I was not sure what was causing it, although at that time, I became very congested and felt that I had some type of sinus condition going on that lasted for months. I had been using Restasis for a few years at that point.

I am having a lot of eye problems, and very little of the over-the-counter drops really work as well as Restasis. Would you suggest that I try using it again (even with my history of tinnitus and some mild high frequency hearing loss, although that may be age related—I am 56—and not medication related, but who knows)? What I need to know is does the description in your book about Cyclosporine causing hearing loss and tinnitus also apply to drops in the eye, or does it refer to internal ingestion. I really would like to start using it again.

Cyclosporine (Restasis) is known to cause tinnitus, hearing loss and other ear problems in a number of people. That’s the bad news.

However, what you really want to know is whether the Cyclosporine is causing your tinnitus and hearing loss or not. I can’t answer that, but I can give you some pointers to help you make up your own mind whether you want to start taking it again or not.

You had been taking Restasis for a number of years in the past. Did your tinnitus get worse after you started taking it? If not, then your tinnitus likely was related to other things, not the Cyclosporine.

What happened when you quit all the drugs you were taking? Did your tinnitus go away, reduce to a lower level, or stay the same? If it reduced in volume or went away, then you can assume your tinnitus was related to one of the drugs you were taking, including the Cyclosporine. If there was no change, then its unlikely your tinnitus was caused by any of your medications, including Cyclosporine.

You can try taking the Cyclosporine again and see if your tinnitus increases. If it does, then you have to decide whether you’d rather have more problems with your eyes, or put up with increased tinnitus.

Regarding using eye drops vs. taking a drug internally, I don’t make any distinction. Who is to say that eye drops don’t cause the same side effects as ingesting the drug does? Some people are more sensitive to any given drug. Thus, what may affect one person may not affect another. That is why I just list the drug and its ototoxic side effects and let each person make up their own mind what they choose to do.

Since Restasis eye drops only contain 0.05% Cyclosporine, I’d think that such a small amount wouldn’t damage your ears—but anything is possible. Therefore, if you decide to take the Cyclosporine again, just watch for your tinnitus. If it gets worse, you know Cyclosporine affects your ears (and could also affect your hearing). If there is no change in your tinnitus, then there is a good chance it isn’t affecting your ears.

To learn which drugs are (or can be) ototoxic, see “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs, 30 herbs and 148 chemicals.

by Neil Bauman, Ph.D.

A man explained:

A year ago, I took a single dose of Paxil, obtained from a friend; I (foolishly) wanted to see what effect it would have on me. Two days later, while sitting at my desk at work, I suddenly went deaf in one ear, and my hearing never recovered. The otologists at the University of Washington say it is permanent idiopathic sudden sensorineural hearing loss, suggesting perhaps a vascular, viral, or autoimmune event. In your anecdotal experience, how likely is it that this was related to my single dose of Paxil?

I don’t have any anecdotal reports of Paroxetine (Paxil) causing sudden hearing loss like that. To be sure I wasn’t missing something, I looked at all the other drugs in the same SSRI class. For two of the SSRIs I have anecdotal reports of people losing some (not total) hearing after taking them for long periods—ranging from a number of weeks and up to several years. However, I couldn’t find any sudden hearing loss episodes like you experienced.

Paroxetine is listed as causing hearing loss, so some degree of hearing loss can and does happen, but there is no mention of the speed or degree of the resulting hearing loss.

In your case, based on what I know, and what you have said, I don’t think it very likely that your sudden hearing loss was caused by the Paroxetine (but I suppose anything is possible). It does seem coincidental, though, doesn’t it?

I’m with your doctors on it possibly being vascular or viral in origin. Typically, autoimmune hearing loss doesn’t happen quite so suddenly—but the other two certainly can.

To learn which drugs are (or can be) ototoxic, see “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs, 30 herbs and 148 chemicals.

by Neil Bauman, Ph.D.

A man explained:

I have had rheumatoid arthritis for 35 years. About a year ago I was put on 40 mg shots of Adalimumab (brand name Humira) every two weeks. My tinnitus was bad during the last few years and I attributed it to stress.

This past Saturday I took a shot after not having had one for about a month. Coincidentally, my tinnitus was getting better during that period. A few hours after the shot, my tinnitus acted up again, and has been very loud 24/7 ever since.

Do you have any information that would indicate that Adalimumab should be on your list of ototoxic drugs?

Interestingly enough, the current Physicians’ Desk Reference (PDR) does not list a single ototoxic side effect for Adalimumab. However, a number of other sources list tinnitus, hearing loss, dizziness, vertigo and ear pain as side effects of this drug.

Therefore, it is very likely that your tinnitus flared up because of getting the Adalimumab shot. I have no reason to believe otherwise.

I’ll add this drug to the 3rd edition of “Ototoxic Drugs Exposed” which should be coming out in another year or so, depending on how much time I can devote to that project.

To learn which drugs are (or can be) ototoxic, see “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs, 30 herbs and 148 chemicals.