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“.