Hearing Loss Help  

Sudden Hearing Loss—What Happens Next?

by Neil Bauman, Ph.D.

A man explained:

I am a 37 year old male who has experienced sudden hearing loss in my right ear. Unfortunately, the problem was not treated right away. Prednisone therapy, which didn’t help, was initiated 13 days after the loss. In hearing tests I could not understand any speech, though I hear tones and some low register sounds. I’m curious to know the possibility, if any, of the hearing returning. My MRI came out negative and I experienced very little, if any, vertigo. It has now been four weeks since the loss. If my hearing does not recover, does the ringing, at least, eventually die down? Do hearing aids assist in reducing the ringing?

Sudden hearing loss typically strikes without warning. The standard treatment is Prednisone. Beginning it as soon as possible after the sudden hearing loss gives the best chances of recovery. Just remember that sometimes Prednisone works and sometimes it doesn’t. Also, sometimes hearing comes back on its own without, or in spite of, any treatment.

In your case, it seems the Prednisone didn’t work. Even though you began it after 13 days, that is not necessarily too late—but the sooner you begin, typically the better results you have.

Unfortunately, it seems that neither the Prednisone, nor time, has restored your hearing. Typically, the worse the sudden loss, the less chance there is of full, or even any, recovery.

The way it usually works is that the hearing you have at the end of 30 days or so is what you will be left with—unless your hearing has been returning a bit at a time all along, in which case it could continue to improve after the 30 days. Since you haven’t had any significant hearing returning during this time, I think the chances that more will return are slim.

You ask, “If my hearing does not recover, does the ringing, at least, eventually die down?”

It may, or may not. In any case, you can learn to habituate to your tinnitus so it no longer bothers you—no matter how loud or soft it is. The thing to do is not dwell on, or focus on, your tinnitus. Totally ignore it, and act like it isn’t there. When you do this, you will notice that your tinnitus tends to fade into the background and not be so intrusive. Not easy to do, I know, but it does work for many people. I’ve had tinnitus for 40 plus years now, and although my ears are ringing away as I write this, I do not let my tinnitus bother me. It is just “there”. (Of course, if I had by “druthers”, I’d rather it wasn’t there at all!)

Conversely, if you dwell on your tinnitus, it will get even worse. That is why it is so important, right from the start, to learn to focus on other things and thus ignore your tinnitus.

Since people typically perceive their tinnitus as louder when there is no sound around, enriching your sound environment helps mask your tinnitus. That is why wearing hearing aids help a lot of people cope with their tinnitus. Hearing aids bring in lots of real sounds for your brain to process so it doesn’t concentrate on your tinnitus as much. Thus, your tinnitus seems to fade into the background to some degree. However, when you take your hearing aids off at night, the lack of real sounds allows your tinnitus to come back until the next morning when you put your aids in again.

One trick to help you manage your tinnitus during the night is to set your clock radio to stay on for an hour or so, so your brain has real sounds to listen to while you fall asleep. Other people find that having a fan running in their bedroom does the same thing. Still others listen to CDs of environmental sounds—rain, waves on the seashore, birds, etc. and have good results with that. Do what works best for you. Hopefully your tinnitus will only be a minor annoyance in your life, not a major problem.

If this doesn’t work, my book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How” teaches you a number of things you can do to help yourself successfully live with your tinnitus.

by Neil Bauman, Ph.D.

A lady explained:

I find that my tinnitus is worse if I am stressed about something. Sometimes the pitch changes and sometimes I can hear more than one sound at a time. My tinnitus is always worse when I’m trying to get to sleep and that’s when I get anxious. I can hear it in the day too, so it’s there all the time. When I wake up in the morning it can be very loud and I have to get up straight away or I can become panicky. I have always been noise phobic from when I was a small child. I just can’t handle fireworks or loud noises. When I was very young I became very upset by the scratching of the needle on a record. Is this part of the profile of someone with tinnitus?

Very much so. Stress and anxiety are two triggers of tinnitus. If you are a high-strung, anxious type of person, often you will find that not only do you hear tinnitus, but you also may have hyperacusis—where you hear some/all sounds louder and more intrusive than normal.

I was helping a lady recently that had much the same experiences as you—she was high-strung, anxious and had just gone through a very stressful situation. Her tinnitus was now much louder than normal, and she was worried that it would stay that way. In the past when she would stress over something, her tinnitus would get louder, but subside in a day or two. This time it wasn’t—hence her call to me for help.

I explained to her that when we are anxious, this puts our bodies in the “fight or flight” mode. Extra adrenaline surges through our arteries giving us more strength to fight or flee. At the same time, our senses become more acute. Thus we actually hear better than normal during such events—especially fainter sounds.

When you are anxious all the time, your body becomes stuck in this fight or flight mode, which includes the increased acute hearing. The result is that you perceive certain sounds to be annoyingly loud such as your phonograph needle. At the same time, loud sounds are then much too loud (such as fireworks).

The usual reaction to this increased sensitivity to sound is to avoid all noisy places and wear ear protectors most of the time. This actually proves counterproductive because when you wear ear protectors all the time, you brain becomes “starved” for normal sounds. As a result, it cranks up its internal volume control. This just makes the situation even worse—because when you take the noise protectors off, sounds are louder and even more annoying than before.

On top of this, your tinnitus is also louder because, with the increased internal volume, your brain is now hearing more of the random firings of the neurons in your auditory system—which some researchers think we hear as tinnitus.

The way to resolve this problem is not to overprotect your ears. Yes, clap your hands to your ears if there is a sudden loud sound around you (a siren going past you, or a truck blasting his air horn), but otherwise do not overprotect your ears so your auditory system will always have adequate stimulation. This will cause your brain to turn down the internal volume.

At the same time, you need to learn how not to be so anxious. You need to learn to be calm and “hang loose”. That will get you out of the “fight or flight” mode. This alone will let your brain turn down its internal volume.

When you do this, you will find that your tinnitus often becomes less intrusive and fades into the background. You will also find hat those sounds you found annoying before now don’t bother you much, or at all.

I’m not saying this is easy to accomplish, but it is necessary. There are a number of books available that teach you how to relax and calm down. If you need further help, see a therapist that specializes in helping people work through their anxiety problems without using drugs.

The end result will be reduced tinnitus, reduced hyperacusis and more enjoyment in your life. That makes it all worthwhile, doesn’t it?

If you have tinnitus, my book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How” teaches you a number of things you can do to help yourself successfully live with your tinnitus.

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.

by Neil Bauman, Ph.D.

A lady wrote:

Dr. Timothy Hain has written an article about low-dose Gentamicin treatment. What do you have to say about this treatment?

I respect Dr. Hain and his work, although, in my opinion, he is too conservative when it comes to the side effects of ototoxic drugs. By this I mean that he doesn’t think the ototoxic side effects are as common and severe as they really are.

Gentamicin, as a treatment for Meniere’s disease, has been around for quite a while. As the above article explains, in the past, high-dosage Gentamicin treatments have resulted in pretty significant ear problems including hearing loss.

This new low-dose protocol seems to cause far less damage to the inner ear than the high-dose one, and that is all to the good.

However, there are a few things this article doesn’t mention of which I think anyone contemplating this procedure should be aware.

First, a significant portion of the population have a genetic variant that leaves them very susceptible to aminoglycoside ototoxicity—much more so than the general population. Since Gentamicin is one of the aminoglycosides, it would seem wise to be tested to see if you have the 1555A-G variant of the 12S rRNA gene (see page 109 in my book “Ototoxic Drugs Exposed for more information), and if you have it, really consider whether the supposed benefit will be worth the greatly increased risk.

Second, this treatment can work great and “kill” the balance system in one ear, hopefully eliminating the severe vertigo. But what happens if later your Meniere’s switches to your other ear, as it does in approximately 20% to 25% of the people with Meniere’s?

With your balance system dead in one ear, you don’t dare do the same procedure on your other ear, or you will be left without any inner ear balance function at all. Among other balance problems, this will almost certainly result in such conditions as oscillopsia (bouncing vision), ataxia (staggering gait like you were drunk), blurred vision and other problems with your eyes. If this happens to you, you will never be able to drive again. You will likely find movement such as riding in a car, or even just watching action movies on your TV can make you “sick”.

Third, there are no guarantees that even in low doses, the Gentamicin will not affect your hearing. Gentamicin typically damages the balance system (a good thing in this case) more than it damages the hearing system (a bad thing)—but this is not always the case. Are you prepared to lose some or all of your remaining hearing in that ear? It can and does happen.

If you have severe vertigo with your Meniere’s, (and I can’t even imagine what that must be like) and nothing else works, you may want to try this treatment. Remember, this is a treatment of “last resort”—one not to be taken lightly.

If you have considered the above points, read the above referenced article carefully, done your own research and talked it over with your ear doctor, you are ready to make an informed choice. What you choose is up to you.

To learn more about Meniere’s Disease and some of the things you can do to help bring it under control, check out “Please Make My World Stop Spinning—The Agony of Meniere’s Disease“.

by Neil Bauman, Ph.D.

A man asked:

What can you tell me about Neuromonics. Is it for real? Does it really work?

“Neuromonics Tinnitus Treatment is a relatively new treatment for tinnitus. Developed by audiologist, Paul Davis, Ph.D. of Australia to reduce the disturbing effects of tinnitus, Neuromonics opened for business in Australia in 2001. It came to the USA in late 2005. More and more tinnitus treatment centers are adding it to their arsenal of tinnitus treatments.

You see, no one tinnitus treatment protocol works for everyone. Some tinnitus treatment protocols work for some people and not for others depending on the kind and cause of their tinnitus. Neuromonics is the same—it works for some people but not for all….”

This is the beginning of my article on Neuromonics. It explains what Neuromonics is, what you need to know about it, how well it works and whether it might work for you. Read the rest of this article here.

by Neil Bauman, Ph.D.

“When “Jonathan” took a course of Erythromycin prescribed by his doctor, the last thing on his mind was that this drug would cause him to lose hearing in one ear, give him hyperacusis and balance problems, and result in “horrific bilateral tinnitus.”

No one warned “Eunice” that taking the anti-depressant drug Amitriptyline would result in “screaming tinnitus”, a condition much worse than her original depression.

Without warning, drugs that were prescribed for Jonathan and Eunice to treat other health issues resulted in loud, intrusive tinnitus, making their lives almost unbearable. (These stories are true, although I’ve changed their names.)

Ototoxic (OH-toe-TOKS-ik) drugs are those medications that can cause ototoxic (ear damaging) side effects to your ears. Such drugs can cause hearing loss, hyperacusis (normal sounds now too loud), tinnitus and other phantom sounds, and a whole host of balance problems. This does not happen to everyone who takes drugs by any means, but it does happen to a significant number of unfortunate people.

Note this well. Even though a drug’s description lists tinnitus as a side effect, it does not mean that you will develop tinnitus if you take it. Some people do. Many don’t. The problem is that you don’t know into which class you will fall. Therefore, you should learn about the side effects of any drug before you begin taking it. Be particularly cautious until you know that any given drug won’t adversely affect your ears….”

This is the beginning of my article on drugs and tinnitus that the American Tinnitus Association published in their April 2009 edition of Tinnitus Today. Read the the rest of this article here.

 by Neil Bauman, Ph.D.
A man wrote:

I was browsing on a website and want to know whether what it said about sound therapy is true. The website said that:

‘The Sound Therapy Program is a rehabilitation of the inner ear muscles, thanks to high frequencies.

It can help in all ear disorders as:
· Hearing loss
· Tinnitus
· Meniere’s disease, vertigo and dizziness
· Cocktail party syndrome (difficulty hearing in noisy places)
· Noise sensibility (hyperacusis)
· Short term memory loss
· Language disorders (dyslexia, stuttering)
· Learning (ADD, ADHD, autism, Down’s syndrome)
· Sleep disorders
· Brain damage (accident, stroke, Alzheimer’s, Parkinson’s)’

The above “blurb” came from near the bottom of this web page. It’s quite an impressive list of conditions that sound therapy is supposed to cure, isn’t it?

You are right to be cautious, and want to know whether it is real, or just a bunch of hype.

I’m not an expert in sound therapy, but I have investigated and written about it in the past, and even have the sound therapy tapes myself so I know a bit about it.

First, let me say that the above blurb is somewhat misleading (just like much of the advertising today is). Yes, sound therapy does work for all those conditions to some degree or other for some people, but no, is is not the cure for all those conditions for everyone.

If sound therapy did indeed work for everyone and cure hearing loss or tinnitus, then everyone would be using it, As a result, no one would need hearing aids or have tinnitus anymore—and we know that is not true. Thus, you have to
understand what sound therapy realistically can and cannot do for you.

Sound therapy is indeed a valid treatment for certain conditions, especially for children with learning disabilities, ADD, autism and related conditions. In fact, this is where sound therapy excels.

One lady just wrote me and stated, “I have seen incredible results in all 3 of my children with special needs from listening [to sound therapy music using an] 80 GB iPod with bone conduction headphones.”

This lady is now herself a sound therapy practitioner. When I asked her how it had helped her tinnitus, she told me that although she had been using sound therapy on herself for the past 9 months, she hadn’t seen any difference in her tinnitus. This reinforces my point that sound therapy does not work for everyone, not even for some firm believers in the program. On the other hand, it does work miracles for some people. Thus, you really can’t know if it will work for you unless you try it.

I found, that with my particular reverse slope hearing loss, listening to the tapes grated on my nerves, so this therapy isn’t for me either.

In general, for the average person with conditions such as hearing loss, hyperacusis, tinnitus and Meniere’s disease, I don’t think sound therapy by itself has a very high success rate. However, if you have certain particular variations of the above conditions, for example, certain conductive hearing losses rather than sensorineural hearing losses, then sound therapy can do amazing things.

Sound therapy is simple to use. It consists of listening to special tapes/CDs/iPods of classical music that have been specially electronically altered to give your ears a “workout”. You can listen while you are working or relaxing.

Sound therapy was developed by French ENT, Dr. Alfred Tomatis in the early 1970s, so it has been around for about 40 years.

Another doctor, Guy Berard made some modifications to the sound therapy program and called it “Auditory Integration Training”. He brought this program to the USA in 1992.

The mother and daughter team of Patricia and Rafaele Joudry made yet another variation to the sound therapy program and explain it in their book, “Sound Therapy: Music to Recharge Your Brain”. It explains how to listen, and what benefits you can expect for conditions such as tinnitus, fatigue, insomnia, stress and anxiety, hearing loss, sound sensitivity (hyperacusis), dizziness, Meniere’s syndrome, jet lag and learning, memory and concentration problems.

Rafaele also authored, “Triumph over Tinnitus”. This book explains sound therapy’s role in helping people with tinnitus. You can get these books through her Sound Therapy International website.

Sound therapy is one of the many tools you should have in your “ear repair” toolbox, and take it out and use it when appropriate. If it works for you, great. If not, put in back in your toolbox and try another “tool”.

You can read more about Sound Therapy, Auditory Integration Training and Biomental Home-Retraining Therapy and how they specifically apply to tinnitus in my book, “When Your Ears Ring! Cope With Your Tinnitus—Here’s How“.

If you have tried sound therapy or one of its variations, I’d love to hear how it worked for you.

by Neil Bauman, Ph.D.

A man wrote:

Is it possible that Nexium has caused my sudden bouts of tinnitus, first in my left ear, and a week later in my right ear? I was taking 40 mg twice daily for about 6-8 weeks. Is there a chance that it will go away after I discontinue the medication? I think I’m going crazy with 2 different tones that will not stop!

Yes, it’s certainly possible to get tinnitus from taking Esomeprazole (Nexium). Tinnitus is listed as one of the side effects listed for Nexium, but it doesn’t appear to be all that common.

Although there is not much information on the permanence of tinnitus from this drug, I think there is a good chance that your tinnitus will go away a week or two after you stop taking the Esomeprazole. However, a lot depends on you, and how you are handling your tinnitus now. If you dwell on your tinnitus all the time, it will be much harder for it to go away, than if you treat it as a “non-person” and pretend it doesn’t exist—in other words remain totally emotionally neutral to it.

I’ve had tinnitus for 40 years or so. It never goes away, but I don’t let it bother me either. It is just “there”.

Any advice for a desperate man?

If I were in your shoes and knew a drug was causing me horrible tinnitus, I’d dump the drug in a heartbeat. I encourage you to either get your doctor to prescribe another medication that doesn’t cause tinnitus, or investigate alternate treatments for your condition. Here are a few to get you started.

Sometimes acid reflux is caused by certain vertebrae in your back being “out”. A chiropractic treatment can quickly fix it. (That happened to my brother so I know it works.) Sometimes acid reflux results because you don’t have enough hydrochloric acid (HCL) in your stomach and thus you need to take HCL supplements. (I know it seems wrong to treat acid with acid, but this works for many people). Another thing to consider is what you eat. Some foods cause problems and others don’t. So eating correctly can solve it easily. (My wife has problems at night with acid reflux whenever she eats certain foods for supper— especially if we have a late supper. The better part of valor is to avoid them altogether or eat them early in the day.) Finally, being obese can cause such problems. Simply reducing your weight can fix the problem.

So those are some of the things I’d consider. You might find your problems stem from a combination of several of the above and possibly others I haven’t mentioned.

If you are interested in learning more about what you can do to help bring your tinnitus under your control, you would do well to read my book, “When Your Ears Ring! Cope With Your Tinnitus—Here’s How“.

by Neil Bauman, Ph.D.

A man wrote:

I have a question regarding alcohol. I recently visited an audiologist about my tinnitus after it got worse from a clubbing experience (first time it happened due to a club). I wore ear plugs and figured I’d be safe. She seemed convinced it was due the copious amounts of alcohol I consumed. She said that alcohol is very bad for my ears and that I should limit my drinks.

Like an idiot, I ignored her advice the next week and my tinnitus did get worse despite wearing some new, more powerful ear plugs (32 db of protection)! According to her, it was the combination of loud music + daily, noisy city life + alcohol that did it.

However, after reading your web log link to the Norway study of pre-school teachers having hearing damage from loud kids, I figured that may be why. I’m a newly-minted elementary teacher. I was hired to focus on the conversation aspect of English education here, so day in and out it’s 30 kids speaking loudly and screaming for at least 3+ hours a day. So now I’m wearing 10 dB ear protection!

Nevertheless, I wonder if the audiologist was still right. I’m gonna lay off the drinks anyway. I would like to know if alcohol can lower the threshold for hearing damage or lead to permanent damage. Is the fact that I’m drinking in a club that much more dangerous and could possibly lead to more tinnitus?

Just so you know, alcohol alone can cause tinnitus. Noise alone can cause tinnitus. So can many other factors. You were wise in wearing ear protection. However, I don’t know the sound levels in the clubs you visited. Ear protectors can only help about 30 dB or so. After that, the sound travels through your skull via bone conduction and assaults your inner ears in spite of any ear protection you may be wearing.

Thus for example, if the sound level in the club was way up there at 120 dB. Your inner ears were still being exposed to around 90 dB of sound. In this case the ear protectors were bringing it down 30 dB, but 90 dB is still too loud and can cause damage given enough time.

You would not expect 90 dB to cause much damage in just one long evening at a club. However, there were other less known factors coming into play too. For example, I’m assuming that the club was also filled with smoke, right? Breathing in that second hand smoke (or first hand if you were smoking too) exposes you to significant amounts of nicotine.

One of nicotine’s nefarious characteristics is that it works together with loud noise in a synergistic fashion to cause more damage to your ears than you would expect from noise alone or nicotine alone. Thus, even with wearing ear protectors, the presence of smoke could make your ears more sensitive to noise damage at the reduced level of noise that you thought wouldn’t damage your ears.

Carbon monoxide has the same nefarious characteristic, and in smoke filled rooms, there is more carbon monoxide than normal too.

In addition, for example, maybe you get headaches from all the noise at the club so you take a couple of aspirin. Guess what? Aspirin lowers the noise tolerance that your ears can stand before damage, just like nicotine and carbon monoxide do.

Thus you have the effects of alcohol, noise, nicotine and carbon monoxide, and maybe some pain killers—each of them ototoxic in their own right and causing damage to your ears. Then you have the synergistic effects of noise and nicotine and the synergistic effects of noise and carbon monoxide, etc. That is just some of the things your ears are dealing with in the clubs. All these little things can add up to cause big problems for your ears.

On top of that you have all the noise and exposure to drugs and chemicals that also can damage your ears in your day to day living apart from clubs. And on top of that still is all the noise you are exposed to as a pre-school teacher. (Can’t you get the kids to pipe down? It shouldn’t be that noisy or the kids are going to have hearing problems too!)

So putting it all together, I’m not surprised that your ears have taken a beating. If you value your health and your ears, you’ll cut way down on your alcohol consumption and noisy clubbing too.

If you are interested in learning more about what you can do to help bring your tinnitus under your control, you would do well to read my book, “When Your Ears Ring! Cope With Your Tinnitus—Here’s How“.

by Neil Bauman, Ph.D.

A lady wrote:

Some drugs, such as Neurontin [Gabapentin] or Xanax [Alprazolam] have been recommended as treatments for tinnitus. Is not this contradictory since they can also cause tinnitus? Xanax does lower it for me, temporarily; and Neurontin does lower it while the drug is in my system.

The above drugs are ototoxic—they can damage your ears. One of their side effects is tinnitus as you know. Although, some doctors still prescribe these drugs for tinnitus control, the truth is, the FDA has not approved a single drug as being effective for tinnitus—so that should tell you something right there—that these drugs have not been proven to reduce tinnitus.

In my opinion, what these drugs do is not affect the tinnitus as such, but change your response to your tinnitus. In other words when you take such drugs, you don’t worry about your tinnitus as much, even though it is still there. Thus, it doesn’t seem so loud and intrusive.

The proof that these drugs don’t really do anything to “cure” your tinnitus is that when you stop taking them, your tinnitus is just as loud as it was before.

Thus, if you take one of these drugs for tinnitus, it may give you a bit of apparent temporary relief—but that is it. You need to begin practicing the various tinnitus treatments that will help you get your tinnitus under control in the long term.

If you are interested in learning more about what you can do to help bring your tinnitus under your control, you would do well to read my book, “When Your Ears Ring! Cope With Your Tinnitus—Here’s How“.