Hearing Loss Help  

by Neil Bauman, Ph.D.

A lady asked:

Can Amlodipine cause roaring in the ears? I have only been taking it for 6 weeks. Can I stop without a problem? My doctor doesn’t think that is the cause of the roaring. I would like to stop for a period and see if the roaring stops.

Roaring in your ears is one of the many tinnitus sounds. According to the PDR, Amlodipine (Norvasc) causes tinnitus in between 1 person in 1,000 and one person in 50, so tinnitus is a relatively common side effect of this drug. Also, realize that the “official” figures are always low by their very nature, as not all tinnitus occurrences are reported, and thus included in the “official” figures.

You need to talk it over with your doctor about whether you can stop cold turkey, or need to taper down or what. Then together you can make the decision what you want to do.

If you stop taking this drug for a couple of weeks or so, and if your tinnitus goes away, that is strong circumstantial evidence that this drug is causing your tinnitus in spite of what your doctor says. (Doctors typically know little about ototoxicity.) Don’t expect the tinnitus to stop immediately after stopping the drug. It may take some days or weeks or longer.

Then, if/when your tinnitus stops, and you decide to begin taking this drug again—if the roaring comes back, that is proof that this drug is the culprit. If that happens, I’d suggest you ask your doctor for a different drug that will do the same job.

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.

Millions of people take anti-inflammatory drugs (typically Non- Steroidal Anti-Inflammatory Drugs [NSAIDS]) to reduce pain and inflammation in their bodies. Unfortunately, these drugs can also damage their ears.

Non-steroidal anti-inflammatory drugs include drugs in the following drug classes. Note: in order to give you an idea of the drugs we are talking about, I’ve listed one or two representative drugs under each class (generic drug name first followed by a brand name in brackets).

Acetic acids (12 ototoxic drugs in this class)

• Diclofenac (Voltaren)
• Ketorolac (Toradol)

Cox-2 inhibitors (5 ototoxic drugs in this class)

• Celecoxib (Celebrex)
• Valdecoxib (Bextra)

Fenamates (3 ototoxic drugs in this class)

• Mefenamic acid (Ponstel)

Oxicams (5 ototoxic drugs in this class)

• Meloxicam (Mobic)

Propionic acids (13 ototoxic drugs in this class)

• Ibuprofen (Advil)
• Naproxen (Aleve)

Salicylates (13 ototoxic drugs in this class)

• Acetylsalicylic acid (Aspirin)
• Mesalamine (Asacol)

These NSAID drugs can have numerous ototoxic side effects. Some of the more common ototoxic side effects include ear pain, hearing loss, tinnitus, and vestibular (balance) side effects such as ataxia (staggering gait), dizziness and vertigo (spinning sensation).

People have asked me how they can both control the pain/inflammation they have, and yet not suffer from these ototoxic side effects.

The good news is that changes in diet go a long way towards reducing inflammation (and thus the need for such drugs).

Incidentally, inflammation is not a minor problem, but is a “well- known contributor to chronic health conditions such as heart disease, diabetes, cancer and dementia.”

In order to reduce inflammation you need to greatly reduce your intake of foods that cause inflammation. According to nutrition expert Dr. Andrew Rubman, ND, the 10 worst inflammatory foods include (1):

• “Desserts made with lots of sugar (cookies, candy, ice cream and so on).
• Sweetened cereals.
• “White” carbohydrates (white bread, white rice, white potatoes, English  muffins, etc.).
• Non-diet soft drinks.
• Anything containing high-fructose corn syrup.
• Processed meats (bologna, salami, hotdogs, sausage and others made with preservatives and additives).
• French fries, potato chips and other fried snack foods.
• Fast foods, most specifically the ones that are high-fat, high-calorie, high simple carbohydrate—which describes most of the inexpensive offerings at quick-serve restaurants.
• Margarine, because it contains processed sterols called stanols that have been implicated in both atherosclerosis and various fatty-deposit diseases.
• Organ meats such as liver, because these often contain undesirable products including antibiotics, fertilizer and other unwanted residues.”

At the same time, you want to include (greatly increase) your intake of the 10 best anti-inflammatory foods. These include:

• “Wild salmon, mackerel and other omega-3-fatty-acid-rich fish.
• Berries.
• Green, leafy vegetables (e.g., spinach and kale).
• Cruciferous vegetables (broccoli, Brussels sprouts, cabbage, etc.).
• Deeply pigmented produce, such as sweet potatoes, eggplant and pomegranate…along with carrots, plums, oranges, peppers, peas and red grapes.
• Nuts.
• Whole grains.
• Tea—specifically black, green and white teas.
• Cold-pressed fresh oils, including avocado, flaxseed and olive oils in particular.
• Spices (specifically, garlic, ginger, turmeric, saffron).”

Note: wolfing your food down also increases the inflammation index of the foods you eat, so slow down, chew your food completely before swallowing.

Since making drastic lifestyle changes is difficult, and prone to failure, start by choosing to make wiser decisions. Thus, consciously choose to substitute one of the foods in the “worst” list with one of the foods in the “best” list. As you continue to do this, over time you will realize you have almost eliminated the worst inflammatory foods from your diet—and surprise—you’ll notice you feel ever so much better in the process, and thus likely won’t need to take anti-inflammatory drugs anymore.

(1) The above information was extracted from the article “10 Best and Worst Foods for You” contained in the April 22, 2010 issue of Bottom Line Secrets “Daily Health News” newsletter. I find this newsletter an excellent source of information on a variety of topics including health issues. If you’d like to sign up for this free newsletter from Bottom Line Secrets, click here.

by Neil Bauman, Ph.D.

Today it seems that more and more people have allergies, sinus infections and middle ear infections than ever before. Typically doctors prescribe antibiotics and other drugs to treat these conditions. Unfortunately, these drugs often can be ototoxic.

To make matters worse, these conditions tend to recur so these drugs are prescribed over and over again.

As people are becoming more aware of the ototoxic properties of antibiotics and other drugs, they ask me what they can do/take to get rid of these infections/conditions without the risk of ototoxic side effects such as hearing loss and tinnitus.

Recently I came across information on a natural therapy that is not ototoxic and apparently works for many people. It goes by various names such as “salt therapy”, “halotherapy” and “speleotherapy”.

Did you ever notice when you go to the beach, especially when the wind is blowing and thus the waves are pounding the surf, the invigorating salt air really cleans out your sinuses? That is the essence of salt therapy.

Although known in ancient and medieval times, salt therapy had its modern beginnings in the mid 18th century when Dr. Feliks Boczkowski noticed that workers in the Polish salt mine at Wielezka did not suffer from lung diseases. As a result, he wrote a book about the benefits of salt dust back in 1843. His successor, M. Poljakowski set up a salt spa at Velicko, near Krakow, (that is still in operation) based on these observations. From this beginning, salt spas soon sprung up throughout many eastern European countries.

The original spas were actually salt caves or grottos and salt rooms in working salt mines. Treatment consisted of spending some time in these salt rooms breathing the salt-laden air. This form of salt therapy is called speleotherapy from the Greek word “speleos” – “cave”.

Since not everyone lived near salt mines or salt caves, some entrepreneurs mined big blocks of salt and set up artificial salt caves (rooms) where people could come and breathe the salt-laden air given off from these blocks of salt.

A later development were salt rooms—rooms that were coated in several layers of salt—plus a salt-dust generator that blew finely crushed dry salt dust into the air. This treatment is called halotherapy from “halos” the Greek word for salt.

To be effective the salt particles in the air must be exceedingly small (0.3 – 0.5 microns) so they can reach the deepest/smallest recesses in the lungs, sinuses and other parts of the respiratory tract.

Salt therapy works because salt is a natural preservative and disinfectant. When you breathe in this microscopic natural salt dust it dries up and disinfects the mucous membranes in your sinuses and lungs, and even in your Eustachian tubes and middle ears.

Not only does salt therapy kill the pathogens causing your sinus infections, it also shrinks the mucous membranes so you can breathe easier. Thus, it can be a boon to people with sinus problems, allergies, asthma, middle ear infections and related conditions.

Although salt therapy is quite common in eastern Europe, it has been slow to catch on here in the USA, but that is changing. For example, there are now salt rooms in Encino, CA and Naples, FL (and in Kitchener and London, Ontario for Canadians) to name some of them.

If you want to learn more about salt therapy and how it might help you, here are some links to get you started.

General articles on salt therapy:

Salt therapy is like a breath of fresh air

Benefits of halotherapy

Introduction and background on speleotherapy and halotherapy

Ukrainian mine helps asthmatics

Ukrainian salt mines reinvented as a haven for asthma sufferers

Locations of some “Salt Rooms” in the USA and Canada

Salt “cave” in Naples, FL

Salt “chalet” in Encino, CA

Iris Wellbeing salt therapy “room” in Kitchener, ON

Salt therapy “room” in London, ON

by Neil Bauman, Ph.D.

Until the mid 1990s, Acetaminophen (known as Paracetamol in Europe) was not thought to be ototoxic at all. Thus in the second edition of my book, “Ototoxic Drugs Exposed” I do not even mention Acetaminophen.

All that has changed. New research has revealed that rather than not being ototoxic at all, Acetaminophen (Tylenol) is actually quite ototoxic.

Thus people who take high doses of Vicodin (a combination of Acetaminophen and Hydrocodone) for a number of months can develop almost total hearing loss.

Since Acetaminophen was “not ototoxic”, I assumed that it was the Hydrocodone that caused the massive hearing losses being reported. Not so according to research conducted at the House Ear Institute. They found, to their surprise, that it was the Acetaminophen that was ototoxic and not the Hydrocodone.

You see, in high doses, Acetaminophen kills the liver, thus you die before massive hearing loss has a chance to develop. However, the researchers found that when taking Hydrocodone with Acetaminophen, somehow the Hydrocodone protected the liver. Thus you lived to tell the tale, but massive hearing loss could be a result.

Now, another study, reported in the American Journal of Medicine (Vol. 123, Issue 3, March, 2010), reveals that even just taking low doses of Acetaminophen over several years results in increased risk of hearing loss.

For example, in a study of 26,917 men between the ages of 40 and 75 at the beginning of the study, men that used Acetaminophen at least twice a week had a 22% increased risk of hearing loss. However, when only men under the age of 50 were considered, the increased risk factor skyrocketed to 99%.

This reveals that Acetaminophen, when taken regularly over as few as 1 to 4 years can slowly and insidiously destroy your hearing without your even being aware of it. You have been warned.

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 asked:

Could you tell me if my sleeping pills, Amitriptyline, are ototoxic? I’ve become very concerned because my hearing loss was caused by prescription medicines after treatment for prostate cancer. The otolaryngologist kept on insisting it was coincidence, but then I did find out that the medicines, in fact, can cause hearing loss, although not for everybody. The effect was very gradual and not very noticeable until it was too late.

Yes, Amitriptyline can be quite ototoxic to some people. Most complaints I receive concern loud tinnitus from taking Amitriptyline, although some people have also reported problems with distorted hearing and hyperacusis. If you notice any of these kinds of problems, it is quite possible that Amitriptyline is the culprit.

Many doctors try to shift the blame for ear problems away from the drugs they prescribe. If a given drug gave every last person a hearing loss, then the doctors would have to admit that drug was the culprit, but when a drug only causes hearing loss in 10% or 1% or 0.1% of the people they see, they ignore it and say it must have been a coincidence. However, you now know that tinnitus (and other ear problems) do happen to numbers of people who take Amitriptyline.

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 asked:

I take Glyburide and Glucophage for Diabetes Type II. Is there any evidence that prolonged use of Glyburide or Glucophage XL is ototoxic?

I have no information indicating that Glucophage is ototoxic, so you shouldn’t have to worry about that drug.

Glyburide can be mildly ototoxic. It has been reported to cause tinnitus and dizziness in some people. However, if it is not making you dizzy, or making your tinnitus worse, then you likely don’t have to worry about this drug either.

At the same time, don’t let your guard down. Glyburide belongs to the class of drugs called Sulfonylureas, and other drugs in this class have reported ototoxic side effects such as hearing loss, tinnitus, ataxia, dizziness and vertigo. Since drugs in the same class tend to have the same side effects, it is still in the realm of possibility that Glyburide might also cause these side effects in some people.

If you notice any of these ototoxic side effects developing, talk to your doctor. You may want to consider switching medications if this happens.

by Neil Bauman, Ph.D.

A lady wrote:

I came across your extremely informative articles on the Internet, and I wanted to ask you a question. I was recently prescribed Aleve 220 mg and Soma 250 mg for a neck injury. I was instructed to take the two pills together in the evening for 7 days. I took the pills together (1 Aleve and 1 Soma) for 2 evenings, and then stopped because my ear was ringing very loudly, and I feel a significant loss in my hearing on my left side.

I always have tinnitus in my left ear due to damaging my ear in college from listening to a Walkman radio. However, since I took these medications the ringing is much louder, and I feel that I cannot hear as well.

It has been one week since I stopped the medicines, and the increased tinnitus and hearing loss has persisted. Is this permanent damage to my hearing? I am really worried, and regret having taken these medicines in the first place.

The good news is that Carisprodol (Soma) is not known to cause tinnitus or hearing loss. So Soma is off the hook.

The bad news is that Naproxen (Aleve) is known to cause both hearing loss and tinnitus (and a bunch of other ototoxic side effects as well). In fact the “official” figures (which I think are much too low) indicate that Naproxen causes hearing disorders in up to 3% of the people taking it, and tinnitus in up to 9% of the people taking it. It looks like you are one of the “fortunate few”.

It’s hard to know whether the damage will be temporary or permanent. In one study 40% recovered their hearing and 60% had permanent hearing loss after taking Naproxen. Tinnitus results are mixed too. In some people it is permanent, and in others it goes away after some hours or days.

As a very rough rule of thumb, the level of hearing you have a month after stopping the Naproxen will likely be your new “normal” hearing level.

If you remain emotionally neutral to your tinnitus, and ignore it by focusing on other things, hopefully it will fade into the background as you habituate to it.

I hear from numbers of people who say much as you have said, “I am really worried and regret having taken these medicines in the first place.”

The problem with any drug side effects is that you never know whether they will hit you or not, so you don’t know which drugs you need to avoid. For myself, I don’t take any drugs—not even an Aspirin. I use herbals and alternate medicine instead. That way, I never have to worry about ototoxic (or any other) side effects of drugs.

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 asked:

Can HCTZ cause the constant roar I now hear in my ears?

Hydrochlorothiazide (HCTZ) is about the least ototoxic of all the diuretics. It is listed as sometimes causing dizziness or vertigo, but is not listed (as far as I have ever seen) as causing tinnitus.

However, one lady told me that whenever she takes HCTZ, her tinnitus gets louder. Thus, it could be the cause your constant roar (tinnitus) too.

Think back to when you started taking HCTZ. If you didn’t have the loud roar before you began this drug, and your tinnitus started soon after (in the following 14 days or so), then this is strong circumstantial evidence that Hydrochlorothiazide is indeed causing your tinnitus.

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 firefighter wrote:

I am a 42 year old man. I was driving today at 10:00 AM and all of a sudden I felt like I was in a plane changing altitudes. I waited for my ears to pop like they usually do, but they didn’t, and I realized quickly that I had a dramatic loss of hearing in my right ear. I tried to find a physician, but to no avail. At about 2:00 PM I went to an audiologist and she confirmed my fears that I had a dramatic sudden hearing loss in my right ear. I finally got to an ENT and she said that I should start on steroids right away. I am a firefighter and within the past week got the N1H1 (swine flu) vaccine. Could this be a possible cause?

That was quite the unexpected experience, wasn’t it? They don’t call it sudden hearing loss for no reason!

If your hearing loss is thought to be caused by a virus, some doctors prescribe an antiviral drug such as Methotrexate (Rheumatrex) or Oseltamivir (Tamiflu) along with the steroid Prednisone. Sometimes these drugs work and sometimes they don’t, but you might think it worth a try.

No one seems to mention it, but sudden hearing loss can and does occur in some people from taking viral vaccines. I have received two such reports in the past few years. One boy lost significant hearing after getting a flu shot, while a girl’s hearing suddenly dropped 30 dB one week to the day after receiving her flu shot.

To be sure, these were not swine flu shots, but it seems that flu viruses can get into the inner ear and cause sudden hearing loss. I don’t see why the swine flu should be any different.

I wouldn’t be surprised if, in your case, the swine flu virus was the culprit, unless you have had a cold, other virus or flu in the past week or so.

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.

As prescription drugs proliferate, so do their weird and seemingly unpronounceable names. New drug brand names are bad enough, but some of the newer generic drug names are real enigmas to pronounce.

For example, how do you pronounce drug names such as “Abciximab” or “Ixabepilone” or “Pioglitazone” or “Zafirlukast”? Is “Abciximab” pronounced as “aye-bee-cee-icks-mab” or what?

If you have a hearing loss, your chances of correctly hearing these names being pronounced by anyone is almost nil. That’s the bad news.

Now for the good news. You don’t have to try to come up with your own pronunciations and embarrass yourself in the process.

For your convenience (mine too), I have put up a web page that shows the proper pronunciations of more than 700 generic prescription drug names.

You can access it on the Center for Hearing Loss Help’s website, then click on the third link down the left side: “Generic Drug Pronunciation Guide”.

In case you are interested, you pronounce “Abciximab” as “ab-SIX-ih-mab”. “Ixabepilone” is pronounced “ex-ah-BEH-pill-own”. “Pioglitazone” comes out as “pie-oh-GLIT-ah-zohn” and “Zafirlukast” as “zah-FLUR-luh-kast”.

This pronunciation guide is largely based on pronunciations given in the 2010 Nursing Drug Handbook.