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Are TB Drugs Ototoxic?

by Neil Bauman, Ph.D.

A lady wrote:

I am writing to you as I am trying to find out the reason for my hearing loss. I am 28 (female) with a mild—moderate—severe hearing loss (at low—middle—high frequencies). My hearing loss was first noticeable at age 20. I had my first audiogram at age 26, so do not have any records of the loss before that.

My parents have perfect hearing and we have no record of hearing loss in their generation of the family. We do not have much information about previous generations.

I was infected with Tuberculosis at age 10 and was treated with an 8 months daily course of Isoniazid/Rifampin. The treatment started at age 11. By the time I was 12, I had stopped taking the medications. I can say for sure that I had perfect hearing at least till age 16-17. But sometime after that my hearing started to degrade (was noticeable only at age 19-20).

My question is, “Could the drugs taken at that point of time (age 11-12) trigger an onset of progressive hearing loss which became obvious after 6 to 7 years? Or, does hearing loss due to ototoxicity show up immediately or within a couple of years? Will the loss caused due to ototoxic drugs be progressive?”

I’m sure anything is possible, but I would have expected your hearing loss to show up in the weeks and months after you took these drugs—not years later— if these drugs were responsible for your hearing loss.

Both Isoniazid and Rifampin are ototoxic and have caused hearing loss and tinnitus in some people. They can also cause ataxia (staggering gait), dizziness and vertigo (spinning sensation). However, I don’t know what percentage of the people taking either of these drugs have a resulting hearing loss. Nor am I aware of these drugs being implicated in progressive hearing loss.

If indeed these drugs did cause your hearing loss, my question to you is, “How do you know you had ‘perfect’ hearing until 16?” Is it possible that the drugs had already killed the very high frequencies by that time? Typically, ototoxic drugs begin their damage at the highest frequency you can hear and work their way down the frequency spectrum. I doubt many people would even notice if they had lost hearing above 16,000 Hz for example.

Another factor to consider is whether you had balance problems associated with taking these drugs. If you had ataxia or dizziness or vertigo and now have hearing loss, then I could see that there might be a connection. This is because often drugs that affect hearing also affect balance—so if the drug damages one, often you will also see some damage in the other.

Also, there may have been other medications you have taken over the years, particularly antibiotics, that could have caused your hearing loss. Therefore, from the limited information you have given, there is not enough evidence that the above drugs were responsible for your hearing loss.

To learn more about such drugs, see my book Ototoxic Drugs Exposed 4th edition. This book contains information on the ototoxicity of 1,604 drugs, 64 herbs and 144 chemicals.

Reader Interactions

Comments

  1. Another Lady says

    March 30, 2009 at 7:03 PM

    I had a very similar experinece except that I had to take isoniazid for two years, since I skipped too many times the first year. Unfortunately, in my case I didn’t even need it – the TB test was positive because I had BCG immunization in Europe.

    Due to ignorance on the clinic’s part and my not being able to speak english well enough, they blew off my telling them that I had a “special shot that made the TB test positive”.
    Anyway, several years later, I too, started losing my hearing. By the time I was 27, I needed to wear a hearing aid. The hearing loss is mainly the medium tones. As with your first posting, no one in my family has any hearing problems and I did’t suffer from any unusal ear problems as a child. All was normal until my mid-twenties, about 10 years after my Isoniazid treatment.

    Reply
    • Susan says

      November 10, 2020 at 6:59 PM

      Yes I also was given the drug as a one year old every day for a year. And at age 20 began a gradual decline I am deaf without hearing aids. I also get dizzy easily

      Reply
  2. Wayne Morgan says

    November 17, 2009 at 9:52 PM

    I was on streptomycin and paraminosalcilicacid two doses per week for one year for TB. This was some years back. I now have a hearing loss. Could it be caused by
    the treatment?

    Reply
  3. Dr. Neil says

    November 18, 2009 at 9:24 AM

    Hi Wayne:

    As I said in the above article anything is possible, but I would have expected the hearing loss to show up much sooner, not years later. There could have been any number of factors that can hearing loss that have occurred in the intervening years.

    Neil

    Reply
  4. Seenxii says

    November 10, 2010 at 7:19 AM

    I am a 26 years old boy.I got hearing problem soon after i was put on TB Drug which were given as injection and tablet form together for two months. Currently,i have got partially difficulty in balance,i could hear hissing sound continously for the last 12 years,partially my facial muscles are rigid. What i am asking u now is 1)Is this sound permanent?2)what can i do for the Partial rigidity of my neck,face and skull muscles,Is there any medicament?I am socially and Psychologically affected.What could u advise me regarding the above things. I had got my ear checked up and my Doctor advised me to use hearing aid.But i am not psychologically ready to use it.sincerly,

    Reply
  5. post plueral tb says

    November 8, 2011 at 1:35 PM

    I am a 36year old female. I started taking tb medcation 3years ago for a period of 8months. I did not have perfect hearing prior to beginning my course , but, my hearing loss has deteriorated noticeably & rapidly ever since ! I now have tinnitus & terrible problems with my balance & nausea as well . I am convinced this is as a result of the medication unfortunately !

    Reply
  6. Adarsh says

    February 22, 2012 at 12:59 AM

    Hi,

    Well I have a smiliar question. My uncle is suffering with TB and Kanamycin injection was given regularly due to this he suffering from hearing loss.

    my question is will the hearing loss can be cured? or is there any solution for this?

    looking forward for your response.

    Thanks,
    Adarsh

    Reply
  7. grietzi says

    December 12, 2015 at 7:12 PM

    When I came to the US it was discovered that I once had TB. I was put on a 2 year regimen of Isoniazid. A couple of years later a bout with idiopatic sudden hearing loss wiped out my left ear. 10 years later the right ear followed, leaving me barely functional with one high power hearing aid. I still wonder if the Isoniazid had something to do with that.

    Reply
    • Neil Bauman, Ph.D. says

      December 12, 2015 at 7:30 PM

      Hi Grietzi:

      Who knows if the Isoniazid caused your hearing loss that many years after you stopped taking it. But it does cause hearing loss in some people–no doubt about it.

      Cordially,

      Neil

      Reply
  8. Artthur McCall says

    October 27, 2016 at 12:30 PM

    I had weak lungs when I was a teen. In my early 20s I was misdiagnosed for TB. My lungs were weak but it wasn’t TB,so for about a year I was ordered to swallow Isoniazid 1 or 2x daily. After a little over four months, I started having tinnitus, but only the right ear was affected. I also began hearing anomalies in my right ear, and today my hearing loss in my right ear is 98%. Fortunately, my left ear remains clear but I know its going to fail soon as I grow old.

    Is isoniazid the culprit? YES ABSOLUTELY! How can one reject this dangerous cheap TB drug as the cause of someone’s hearing problems without having tried the drug himself/herself even if he/she is a doctor?

    Reply
  9. Caryn Payne says

    March 15, 2017 at 10:44 AM

    I have been taking Isoniazid for 6 months and have terrible ringing in my ears and now mild to moderate hearing loss. The Dr told me to stop the Isoniazid immediately. Will the ringing in my ears clear up? Will the hearing loss improve with time or is the loss permanent? Thank you so much for your response

    Reply
    • Neil Bauman, Ph.D. says

      March 15, 2017 at 10:59 AM

      Hi Caryn:

      Isoniazid is listed as causing both hearing loss and tinnitus in some people–but I don’t think it is too common. When it happens to you, you don’t care whether it is common or not, you have it 100%.

      I don’t have any information as to whether the tinnitus or hearing loss will be temporary or permanent. Only time will tell. You can always be hopeful it will prove to be temporary, but for this drug, I really don’t have a clue what will ultimately happen. Sorry.

      In the meantime, try not to focus on your tinnitus. Instead, focus on the loves of your life and thus ignore your tinnitus. When you do this, you have a much better chance of your tinnitus fading into the background. For this to happen, you need to remain totally neutral emotionally towards your tinnitus.

      Cordially,

      Neil

      Reply
  10. Felicia says

    November 24, 2018 at 3:50 PM

    ALSO took tb treatment in 2012 up until April 2013. By the end of that hear I noticed a whooshing sound in my right ear that went along to the beating of my heart. took me by surprised and I was completely freaked out. I thought it was just head rush because I got up too fast and thought it would go away . But it didn’t. It got worse when I turned my head to the left and stopped completely if I held / pressed on the right side of my neck. In 2017 ,last year I got an auditory exam and turns out my hearing is fine. Even though the titinus is very constant and distracting . I was put on amitriptyline for a while as some forms of treatment- it worked only because it highly sedated me and was asleep for more time than I was awake. I stopped taking them because they really didn’t help anything. 2018 – Titinus is still just as bad and have just stopped hoping for it to go away. Music helps drown it out , so listening to music is my way of coping. It’s a bit sad to think I won’t be getting a moment of silent for the rest of my life. I’m like “whatever” and “it’s fine at least I haven’t had any loss of hearing” but it still disturbs me and I don’t think I’ll ever really be okay about it.

    25, Female

    Reply

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