Hearing Loss Help  

by Neil Bauman, Ph.D.

One of the reasons I have not published this eZine for the past three months is that I have been enormously busy working on several projects with unmovable deadlines. (I hope to get back to a regular publishing schedule for this eZine now.)

One project that took a lot of my time was researching the latest information concerning Meniere’s disease for some presentations I was to make on this subject.

In the process, I completely revised and greatly expanded my book, The Agony of Meniere’s Disease—Please! Make My World Stop Spinning.

If you are suffering from this mysterious condition—I say mysterious because researchers still don’t know what Meniere’s disease really is, don’t know exactly what causes it, and thus, don’t know how to effectively treat it—you might want to check out the new third edition of this book.

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.

In the March, 2008 issue, I reported on an interesting treatment for hearing loss. There has been a fair bit of interest in this treatment as evidenced by the various comments on the HearingLossHelp blog. You can read the original article and comments here.

In part, here is Rick Walter’s comment (#15) on what has been happening with his ears since he began taking Aldosterone two months ago. He writes:

I’ve been taking Aldosterone therapy for about 2 months now. My hearing loss came from many things. Much came from loud noise over my lifetime, but I came down with Meniere’s disease about a year ago, and the hearing loss greatly accelerated.

The Aldosterone gave me back clarity of hearing, but only a little volume. Make no mistake any improvement is huge when your ears are as bad as mine are. Also my drop attacks and weird dizziness are completely gone!

Obviously, Aldosterone is not a complete cure for hearing problems, but just improving clarity of hearing (improved discrimination) is a wonderful blessing in itself.

Also, it seems that Aldosterone can help fix a damaged balance system. For example, reducing the frequency of, or totally eliminating, drop attacks is certainly another blessing. (Drop attacks are where, without warning, you suddenly lose your balance and fall to the floor. This typically happens in people with severe cases of Meniere’s disease.)

If you are interested in Aldosterone therapy either contact Dr. Jonathan Wright (see above link) or work with your doctor while you are on this therapy so bad things don’t happen to you. With Aldosterone, as with other body hormones, too much of a good thing can quickly become a bad thing.

by Neil Bauman, Ph.D.

I get some very interesting email at times. A man wrote:

I’m under the care of Dr. Jonathan Wright of the Tahoma Clinic in Renton WA. He’s been working with Professor Dennis Trune (U of OR Hearing Sciences Center) on an aldosterone therapy trial on a human patient. His previous research demonstrated that aldosterone added to mouse drinking water restores damaged hearing. Their first human patient has experienced cessation of further hearing loss plus a total stop of his vertigo (from Meniere’s).

I’ve been on the same treatment—125 mcg twice a day of compounded aldosterone for seven months. (I get the compounded aldosterone from a Canadian pharmacy.) To date, although my balance is still poor, I have recovered 30 dB (at 250Hz) in my nearly-deaf left ear, and about 20 dB each in the rest of the test frequencies. On my still “sort of functioning” right ear, I got back 20 dB across the test frequencies. My discrimination came up to 95% on my right ear (from 70%), while the discrimination in my left ear rose from 20% to 65%. Also, it stopped my serious recruitment!

This is great news for people with hearing loss from AIED (autoimmune inner ear disease), people with Meniere’s disease and people who are losing their hearing as a result of aging (presbycusis)!

Aldosterone is a naturally-occurring hormone (technically a mineralocorticoid [steroid]) made in our adrenal glands. It plays an important part in regulating our sodium and potassium levels—both critical for normal hearing. Unfortunately, as we age (that means you and me brother), not only do our potassium levels drop, but so do our aldosterone levels. This results in some hearing loss. Furthermore, some people have below normal levels of aldosterone in the first place, and thus, they too have hearing problems.

Researchers have discovered there is a direct link between blood levels of aldosterone and our ability to hear normally. Thus, for people with lower than normal aldosterone levels, taking bio-identical aldosterone supplements can help restore their hearing, and even help with related issues (balance, recruitment, discrimination, etc.).

If you want to know more about aldosterone therapy and where you can get bio-identical aldosterone, check out the easy-to-read article “Take Control of Your Hearing Loss Before It’s Too Late” by Dr. Jonathan Wright.

by Neil Bauman, Ph.D.
 

Meniere’s Disease is actually a syndrome (collection of symptoms) including a fluctuating hearing loss, vertigo, tinnitus and a feeling of fullness or pressure in the affected ear. Meniere’s Disease affects in excess of 2.6 million people in North America and Europe. For most people with Meniere’s, the vertigo is the most debilitating aspect of the disease.

Meniere’s Disease is thought to be caused by excessive fluid (called endolymph) in the inner ear. (The fancy name for this is endolymphatic hydrops.) Therefore, typical treatments have focused on things to reduce fluid retention in the body such as a very low sodium diet, eliminating or greatly reducing both caffeine and alcohol consumption and typically also taking a diuretic (water pill).

If these measures don’t work, then doctors have a number of other things they can try, but all of them can have nasty side effects and may not work. Some of these include intratympanic corticosteroids (injecting steroids through the eardrum), endolymphatic sac shunt (invasive and not found to be very effective) and intratympanic Gentamicin (injecting Gentamicin through the ear drum which can result in hearing loss while controlling the balance problems). If all else fails, doctors may cut the vestibular nerve to totally destroy balance on the one side (vestibular nerve section) or surgically remove the whole balance system on one side (labyrinthectomy). These are rather drastic measures and leave the person with a weakened balance system as the other ear’s balance system has to do all the work.

In recent years, there has been another treatment that has proven to cut the frequency and severity of Meniere’s attacks way down, yet is only minimally invasive (tube in eardrum) and has not shown other negative side effects. This is called Meniett Therapy.

With Meniett Therapy, the person first has a tube placed in the eardrum on the affected side. Then, 3 times a day for 5 minutes at a time, the person uses the Meniett device (a digitally- controlled, pager-sized low-pressure pulse generator) to deliver low-pressure pulses to the middle ear via a clear plastic tube with a special ear tip that you put in your ear. These low- pressure pulses act on the round window membrane. Doctors believe that the energy of the low-pressure pulses displaces the perilymph (the other inner ear fluid), which in turn stimulates the flow of the endolymph, and results in a reduction of the endolymphatic fluid, thus relieving the symptoms of Meniere’s Disease.

If you have Meniere’s Disease and are having problems keeping the attacks under control, you might want to investigate whether Meniett Therapy will help you. The doctor best able to help you is an ear specialist called an otologist.

To learn more about Meniere’s Disease and how you can help bring it under control click on the above link.

by Neil Bauman, Ph.D.

A lady asked:

I was just diagnosed with bi-lateral LVAS [large vestibular aqueduct syndrome] AND Meniere’s disease, moderate- profound loss. Does the fact that I have both, increase my chances for further hearing loss? Can I expect my hearing to deteriorate further? I know no one can say for certain, I’d just like to know some odds or statistics.

As far as I know, these two conditions do not affect each other. Therefore, look at each of these conditions independently. People who have a hearing loss from LVAS typically have some kind of trauma that results in more hearing loss each time it occurs. Some people with LVAS never seem to have any hearing loss, or are only susceptible to pretty major trauma, so they lose some hearing at one point and then it stays at that level for a long time.

With Meniere’s disease, typically you lose more hearing with every attack you have. Then, after the attack, your hearing returns somewhat, but not to its previous level. So think of your hearing loss typically as going down two steps, then back up one step—then down two steps and back up one with each succeeding attack.

This isn’t written in stone, but the people that I know with Meniere’s typically have this kind of loss, and eventually they lose most of their hearing in the affected ear.

The good news is that Meniere’s typically affects only one ear—but about 20% of the people with Meniere’s have it in both ears or it switches to the other ear later.

You can learn more about LVAS here.

Learn more about Meniere’s Disease and what you can do to help yourself.

by Neil Bauman, Ph.D.

A lady wrote:

I’ve been reading your books with interest and read that eventually the balance system is irreversibly damaged in most people with Meniere’s disease. I was wondering how people cope with mobility at this point. Is a cane or walker still helpful or does it mean a wheelchair? What do most people do?

Meniere’s disease can indeed damage the balance system in your ears. However, even totally destroying this balance system (called the vestibular system) doesn’t leave you flopping around on the floor like a jellyfish. This is because we have, not one, but three separate balance systems. Thus when one quits working properly, our brains rely more on the other two to help keep us balanced.

You can read about our three balance systems (vestibular system, visual system and proprioceptive system) and how they all work together to keep us upright in my article at http://www.hearinglosshelp.com/articles/balancesystem.htm.

Furthermore, each of these balance systems consist of two (redundant) subsystems. For example, there is a separate vestibular (balance) system in each of our inner ears. Thus, if one side is damaged or destroyed, the other side takes over and allows us to keep our balance.

In fact, this is exactly what happens in the vast majority of people with Meniere’s disease. Meniere’s disease typically only attacks one ear. Thus, most people with Meniere’s, unless they are having a severe vertigo attack where they can’t even sit up, use whatever balance systems are still working and manage to get around reasonably well. Their brains learn to adapt and pay more attention to any balance system information that is still reliable.

However, people with damaged vestibular systems are not as steady on their feet as they once were. In fact, if the damage is severe in both ears, they may lurch and stagger–much like the proverbial “drunken sailor.” Such people often use canes or walking sticks to help steady themselves. Even so, I don’t know of any that are confined to wheelchairs solely because of their Meniere’s.

If you have damaged both vestibular systems, you will have a much more difficult time when it is dark (when you can’t use your eyes effectively) or when walking on uneven or soft ground (which messes up your proprioceptive system). Under such conditions you may have to “hang on” to a wall or another person.

To learn more about Meniere’s disease and what you can do about it, point your browser to http://www.hearinglosshelp.com/products/books.htm#menieres_disease.