Joy Victory Managing Editor Healthy Hearing
Joy Victory has extensive experience editing consumer health information. Her training in particular has focused on how to best communicate evidence-based medical guidelines and clinical trial results to the public. She strives to make health content accurate, accessible and engaging to the public.Read more about Joy.
Tinnitus: Difficult To Treat
The exact path of tinnitus is hard to trace, which makes this condition difficult to treat. While tinnitus is thought to be caused by hearing loss when cochlear hair cells are damaged, pinpointing the exact region of the damage has proved elusive.
Vitamin B12 may help because cochlear function depends on good vascular supply and the normal functioning of nerve tissue. Low levels of vitamin B12 may cause damage to the protective myelin sheath around neurons in the cochlear nerve. The protective myelin sheath surrounds nerve fibers in the brain, optic nerves and spinal cord. When it’s damaged, nerve impulses can slow or stop, causing neurological problems.
So the damaged myelin sheath around the cochlear nerve neurons may cause the degeneration and death of the neurons. The longer the condition goes without treatment, the more chance there is of permanent damage.
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When Should You Seek Immediate Medical Care
If you think you or a loved one has experienced an aspirin overdose, seek immediate medical attention.
You can also call Poison Control at 800-222-1222. Theyre open 24 hours a day, seven days a week.
If you arent sure if you took enough to be considered an overdose, its best to go to the emergency room anyway. You could otherwise miss valuable time to begin treating the poisoning.
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Identifiable Causes Of Ssnhl
Identifiable causes are found for 7% to 45% of patients with SSNHL . The differential diagnosis for SSNHL includes more than a hundred potential etiologies . Cases with a potentially discoverable etiology fall into one of several broad categories including infectious, autoimmune, traumatic, vascular, neoplastic, metabolic, and neurologic . In a meta-analysis of 23 studies of SSNHL, the most frequent causes identified were infectious followed by otologic , traumatic , vascular or hematologic , neoplastic , and other . Other causes, such as malingering, conversion disorder, and ototoxic drug administration, were not examined in this study, and should be added to the list of identifiable etiologies of SSNHL . For many of these etiologic agents, hearing loss results from damage to hair cells or other cochlear structures and is irreversible. Further damage can occasionally be prevented if the underlying etiology is identified and treated promptly. More rarely, SSNHL resulting from known causes can be reversed. However, many of these identifiable causes of SSNHL have broader health implications for the patient. Thus, identification of conditions underlying SSNHL can be justified in terms of overall patient health rather than simply in terms of hearing outcomes.
Protective Mechanisms Of Nsaids In Cochlear Injury
Little is known regarding the protective mechanisms of NSAIDs against inner ear injury. However, given that NSAIDs exhibit both anti-inflammatory and anti-oxidant actions, these actions might also be related to their protective effects in the inner ear.
Regarding the anti-inflammatory actions of NSAIDs, several products of the arachidonic cascade are related to inflammation. For example, PGs are very well-known inflammatory agents, which have potent effects on vasodilatation and vascular permeability . Additionally, it has been demonstrated that the over-production of TXs and LTs induces inner ear injury . Based on these findings, there is a possibility that NSAIDs are able to protect against inner ear injury by inhibiting the over-production of these metabolites.
Another possible mechanism of cochlear protection is the anti-oxidant actions of NSAIDs. It has been reported that reactive oxygen species are involved in several inner ear injuries including drug-mediated ototoxicity , loud sound , ischemia , and aging . Dinis et al. firstly demonstrated that salicylate was a radical scavenger. In regard to ROS production via the arachidonic cascade, ROS are produced during the conversion of PG-G2 to PG-H2 in the COX pathway and hydroperoxy-eicosatetraenoic acid to hydroxy-eicosatetraenoic acid in the LOX pathway . COX and LOX inhibitors, namely NSAIDs, can therefore block ROS production.
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Diagnosis Of Salicylate Poisoning
Usually, ABGs show primary respiratory alkalosis Respiratory Alkalosis Respiratory alkalosis is a primary decrease in carbon dioxide partial pressure with or without compensatory decrease in bicarbonate pH may be high or near normal…. read more during the first few hours after ingestion later, they show compensated metabolic acidosis Metabolic Acidosis Metabolic acidosis is primary reduction in bicarbonate , typically with compensatory reduction in carbon dioxide partial pressure pH may be markedly low or slightly… read more or mixed metabolic acidosis/respiratory alkalosis. Eventually, usually as salicylate levels decrease, poorly compensated or uncompensated metabolic acidosis is the primary finding. If respiratory failure occurs, ABGs suggest combined metabolic and respiratory acidosis, and chest x-ray shows diffuse pulmonary infiltrates. Plasma glucose levels may be normal, low, or high. Serial salicylate levels help determine whether absorption is continuing ABGs and serum electrolytes should always be determined simultaneously. Increased serum CK and urine myoglobin levels suggest rhabdomyolysis.
Ototoxicity Induced By Nsaids
NSAIDs are used in the clinical practice of various departments e.g., in the otolaryngological department, they are used as analgesic agents for otitis media, sinusitis, tonsillitis, and other diseases. Although no problem occurs due to their usage in most cases, side effects of NSAIDs do occur in some cases. Common side effects are gastric mucosal injury, renal function impairment, allergic reactions, and cardio-vascular complications. In addition to these side effects, high-dose treatments of NSAIDs, especially aspirin and its active metabolite salicylate, occasionally induce ototoxicity, including tinnitus, and hearing loss . In such cases, tinnitus is often the first subjective symptom. Subsequently, mild to moderate hearing loss, usually reversible tends to occur. The severity of hearing loss is reportedly correlated with the plasma salicylate level .
In addition to the reports that an excessive amount of salicylate induces the dysfunction of hair cells, as described above, recent studies have demonstrated that high doses of salicylate also induce the degeneration of cochlear spiral ganglion neurons , and impair auditory neural activity of the cochlea . It has been demonstrated that arachidonic acid potentiates NMDA receptor currents . The spiral ganglion neurons express NMDA receptors . Although fast excitatory synaptic neurotransmission is predominantly mediated by AMPA receptors in the cochlea ,
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Frequent Use Of Aspirin Advil Or Tylenol Associated With Higher Risk Of Tinnitus
- Frequent use of NSAIDs or acetaminophen or regular use of COX-2 inhibitors was associated with an almost 20 percent higher risk of tinnitus
- Frequent use of moderate-dose aspirin was associated with a 16 percent higher risk among women under 60, but frequent low-dose aspirin use did not elevate risk
Our findings suggest that analgesic users may be at higher risk for developing tinnitus and may provide insight into the precipitants of this challenging disorder, said lead author Sharon Curhan, MD, ScM, of the Brighams Channing Division of Network Medicine. Even though these analgesics are widely available without a prescription, these are still medications, and there are potential side effects. For anyone who is considering taking these types of medications regularly, it is advisable to consult with a health care professional to discuss the risks and benefits and to explore whether there are alternatives to using medication.
Millions of Americans experience tinnitus, often to a disabling degree. Tinnitus is the perception of sound when no actual external noise is present. Commonly described as ringing in the ears, tinnitus can also be experienced as many different perceptions of sound, such as buzzing, hissing, whistling, swooshing, and clicking. Tinnitus can be transient or temporary, or it can be a persistent, long-term condition.
The team found:
Distortion Product Otoacoustic Emissions
Schematic of mean DPOAE amplitudes plotted as a function of L1 intensity pre- salicylate treatment, 1 h post-salicylate treatment, and 2 h post salicylate treatment . Frequencies indicated above each panel represent 2f1-f2. Acute systemic salicylate administration significantly reduced DPOAE amplitudes in low and high frequencies but not at mid frequencies. .
Chronic salicylate treatment also influences the motor protein prestin. Chronic treatment with SS enhanced DPOAE amplitudes and caused an up-regulation in prestin mRNA and protein expression 531. Rats were chronically treated over two time periods consisting of four days, with a two day rebound period in between. During each period, the animals were treated with a systemic injection of SS and DPOAEs were measured 2-hours post administration. Changes in DPOAE amplitudes were normalised to pre-treatment amplitudes. During both treatment periods, DPOAE amplitudes were significantly reduced. However, each treatment period was followed by a significant rebound enhancement of DPOAE amplitudes compared to pre-treatment amplitudes 5. There was no change in DPOAE amplitudes after a long duration treatment with salicylate at moderate levels 5.
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Effects Of Drugs Used For Treating Cancer On Hearing Loss
Drugs that are used for treating cancer are called cytotoxic drugs.
Cytotoxic drugs destroy cells or prevent their regrowth. This usually happens through chemotherapy.
These drugs attack healthy cells as well as cancerous ones, so they can cause a number of side effects.
Types of cytotoxic drugs that can cause hearing loss are:
- carboplatin, which is mainly used to treat ovarian and lung cancer
- cisplatin, which is mainly used to treat ovarian, testicular, lung or bladder cancer
- oxaliplatin, which is mainly used to treat bowel cancer.
Cytotoxic drugs are often used in combination with other drugs, which can affect how much hearing loss you experience.
If you are prescribed cytotoxic drugs, the effects will be carefully monitored. You should tell your doctor immediately if you are taking them and you:
- develop tinnitus
Any of these can be the first sign of hearing loss caused by ototoxic drugs.
You Can Develop Ringing In Your Ears By Taking These Everyday Medicines
You wake up in the morning, and theres ringing in your ears. This is weird because they werent doing that last night. So you start thinking about possible causes: you havent been working in the shop , you havent been listening to your music at an excessive volume . But your head was aching yesterday, and you did take some aspirin before bed.
Might it be the aspirin?
Youre thinking to yourself maybe its the aspirin. And you remember, somewhere in the deeper recesses of your mind, hearing that certain medications were connected to reports of tinnitus. Is one of those medications aspirin? And does that mean you should quit taking aspirin?
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Local Applications Of Ss
To identify the central effects of salicylate independent of peripheral changes, SS was locally applied to the AC or the cochlea. Figure 8 shows the sound-driven LFP I/O functions in the AC before and after local application of SS to the cochlear round window or to the AC. When salicylate was locally applied to the round window both the CAP and AC sound-driven responses were significantly reduced and the threshold was increased approximately 25 dB 13 . However, when salicylate was applied locally to the auditory cortex there was a significant enhancement of the sound-driven response in the AC, but no change in threshold 13. Figure 6-D shows the sound-driven response from the AC when salicylate was systemically administered the threshold shift in AC observed with systemic treatment largely originates in the cochlea whereas the hyperactivity in the AC originates in the CNS.
Mean percent correct WRS in noise as a function of SNR. After a high dose of aspirin there was a significant reduction in word discrimination ability at a SNR of -8 dB HL. Individual WRS in noise as a function of SNR. When averaged together aspirin appears to have a significant reduction in word discrimination ability in noise however, when observed individually it appears that aspirin’s effect on word discrimination has large variability.
Ototoxicants In The Environment And Workplace
Ototoxic effects are also seen with quinine, pesticides, solvents, asphyxiants, and heavy metals such as mercury and lead. When combining multiple ototoxicants, the risk of hearing loss becomes greater. As these exposures are common, this hearing impairment can affect many occupations and industries. Examples of activities that often have exposures to both noise and solvents include:
- Weapons firing
- Pesticide spraying
Ototoxic chemicals in the environment or in the workplace interact with mechanical stresses on the hair cells of the cochlea in different ways. For mixtures containing organic solvents such as toluene, styrene or xylene, the combined exposure with noise increases the risk of occupational hearing loss in a synergistic manner. The risk is greatest when the co-exposure is with impulse noise.Carbon monoxide has been shown to increase the severity of the hearing loss from noise. Given the potential for enhanced risk of hearing loss, exposures and contact with products such as fuels, paint thinners, degreasers, white spirits, exhaust, should be kept to a minimum. Noise exposures should be kept below 85 decibels, and the chemical exposures should be below the recommended exposure limits given by regulatory agencies.
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How To Find Relief
Experts have long known that taking high doses of aspirin can lead to reversible tinnitus in other words, stop taking the aspirin and the tinnitus subsides. But Curhans team found that frequent use of moderate-dose aspirin and typical doses of other over-the-counter painkillers is independently associated with the risk of developing chronic persistent tinnitus.
For a number of medications that are taken short-term, discontinuation of use can lead to relief from tinnitus symptoms, says Curhan. Based on the findings in our study, it will be informative to examine whether avoidance of analgesics, or discontinuation of regular use, may help alleviate tinnitus symptoms.
The study also found that taking COX-2 inhibitors such as celecoxib two or more days a week was associated with a 21 percent higher risk of developing tinnitus.
The takeaway message? For anyone who is considering taking these types of medications regularly, it is advisable to consult with a health care professional to discuss the risks and benefits and to explore whether there are alternatives to using medication, Curhan says.
Kimberly Goad is a New Yorkbased journalist who has covered health for some of the nations top consumer publications. Her work has appeared in Womens Health, Mens Health and Readers Digest.
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Other Medicinal Ototoxic Drugs
At high doses, quinine, aspirin and other salicylates may also cause high-pitch tinnitus and hearing loss in both ears, typically reversible upon discontinuation of the drug. Erectile dysfunction medications may have the potential to cause hearing loss. However the link between erectile dysfunction medications and hearing loss remains uncertain.
Previous noise exposure has not been found to potentiate ototoxic hearing loss. The American Academy of Audiology includes in their position statement that exposure to noise at the same time as aminoglycosides may exacerbate ototoxicity. The American Academy of Audiology recommends people being treated with ototoxic chemotherapeutics avoid excessive noise levels during treatment and for several months following cessation of treatment. Opiates in combination with excessive noise levels may also have an additive effect on ototoxic hearing loss.
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If You Have Tinnitus Try Avoiding These 10 Things
For those who dont suffer from tinnitus, there arent many conditions more difficult to understand. Thats because unless youre afflicted with tinnitus, you wont see, feel or hear the symptoms in the same way you might other ailments.
But for the nearly 50 million Americans who suffer from some form of tinnitus, the problem is very real and is often very difficult to manage. Tinnitus is best classified as ringing in the ears, but according to the American Tinnitus Association, it can present sufferers with clicking, whistling, hissing, swooshing, and buzzing. Maybe the most frustrating part of tinnitus is that these sounds arent detectable by others, which can lead to confusion, disorientation, depression and delayed diagnosis.
While that 50 million number is huge, its even more staggering when put in the context that it means about 15 percent of the overall public struggles with tinnitus. A report released by the U.S. Center for Disease Control says that 2 million of those people experience symptoms that are debilitating and severe while another 20 million have whats known as burdensome and chronic tinnitus.
If you have tinnitus here are 10 things to avoid:
Aspirin Can Cause Ringing In Your Ears
It is feasible that the aspirin you took is causing that ringing. But heres the thing: Dosage is once again extremely significant. Generally speaking, tinnitus starts at extremely high doses of aspirin. Tinnitus symptoms usually wont be produced by standard headache doses. The good news is, in most situations, when you quit taking the huge doses of aspirin, the tinnitus symptoms will go away on their own.
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Aspirin Hearing Loss And Tinnitus
Aspirin is most likely to cause hearing loss and tinnitus at the higher daily doses often taken for chronic pain, such as arthritis. Some people may take 8 to 12 tablets a day for arthritic pain. Aspirins potential effect on hearing was first recognized soon after the drug was synthesized more than a century ago. In fact tinnitus and hearing loss are among the side effects sometimes listed in tiny print on the label.
A very recent study, published in the Jan. 2015 issue of Otolaryngology Head and Neck Surgery consisted of a systematic review of other studies involving 185,155 participants who were regular users of aspirin. It found that those taking 6 full strength aspirin or more per day was associated with worse audiometric results. Participants lost between 4 and 112 dB in hearing. The effect was dose dependent and reversible in the short term.
A large Harvard study of middle-aged female nurses, the Nurses Health Study II, published in the American Journal of Epidemiology, found that those who took ibuprofen or acetaminophen on most days of the week had a 20% increased risk of hearing loss and tinnitus.
So, if no over-the counter pain medications are totally safe to use, especially by those who already have tinnitus, what is one to do to relieve pain? What about prescription pain medication?