How Your Hearing Is Impacted By Quinine
You know what quinine is if youve ever had a gin and tonic. Quinine is the key ingredient that gives tonic its bitter taste and is sometimes used to treat people with restless leg syndrome or malaria. While research that investigates the correlation between hearing loss an quinine arent that widespread. Reversible loss of hearing has been observed in certain malaria patients.
A Genetic Look At Hereditary Hearing Loss
Congenital hearing loss can be the result of genes passed down from the parent. In some cases, a baby may not be born with DNA that will lead to hearing loss, but a mutation occurs in a babys DNA while theyre developing in the womb.
Researchers at the University of Iowa Laboratory of Human Molecular Genetics have previously been able to locate the LMG2 family of genes, which are responsible for deafness passed down through the family. Later the same team was able to further narrow the culprit to a mutation in a certain part of the chromosome called DFNA27.
The final stage was to isolate the specific gene causing the hearing loss. Its known as the REST gene. Once isolated, these scientists began looking for possible drug therapies to alter this gene.
How Quinine Affects Your Ears
You are aware of what quinine is if youve ever had a gin and tonic. Quinine is utilized to treat malaria and has also been employed to help people who suffer from restless leg syndrome while also being the essential ingredient in tonic that gives the drink its bitter flavor. While research that investigates the correlation between hearing loss an quinine arent that widespread. Reversible loss of hearing has been observed in certain malaria patients.
What Can I Do
You can form one habit right away to minimize your exposure to ear-damaging effects. Keep yourself aware of the possible side effects of any medication you take by reading the label or asking your pharmacist. Then, if you start to notice a ringing in your ears after being prescribed an antibiotic with ototoxic side effects, you may already know the potential cause. At this point, you should consult your doctor or pharmacist for possible substitutions. Similarly, if you already experience hearing problems or your family has a history of them, tell your doctor or pharmacist before beginning an ototoxic medication.
Medications For Chronic Conditions Can Help Tinnitus
High blood pressure and unmanaged diabetes can make tinnitus worse. Keeping these under control with diet, exercise, and medication can reduce tinnitus symptoms. This is because the underlying issues of these conditions all relate to blood flow, which can severely impact your hearing and tinnitus symptoms. You should speak to your doctor about taking iron supplements and other medications that can get these conditions under control and return your hearing to normal.
Is Hearing Loss Permanent
For most people affected by ototoxicity, the damage is reversible, at least to some degree. Unfortunately, for some people, the damage can be permanent. Sadly, ototoxicity is often a trade-off for the treatment of a more severe condition, like cancer.
Whether ototoxicity can be reversed often depends on the dosage, duration, and type of medication. Damage caused by cisplatin is usually permanent. Aspirin, on the other hand, is temporary.
This is another reason why it is vital to be aware of the phenomenon of ototoxicity. If you are about to begin treatment with one of the known ototoxic agents, you can consult with your doctor on ways to avoid damage to your ears.
Ways To Protect Yourself
1. Be sure your doctor knows exactly what medications you take. Combinations of over-the-counter products and herbal supplements may damage your hearing. “Some people take several medications, all prescribed by different doctors,” notes Ross J. Roeser, executive director emeritus of the audiology program at the University of Texas at Dallas Callier Center for Communication Disorders. “Unless you’re clear about what you’re taking, a doctor has no way of knowing if any new drug will increase the possibility for the hearing loss.”
2. Ask about side effects. Many medications have benefits with short-term use under medical supervision. Some are lifesaving. “Still, it can’t hurt to ask if another drug might work just as well,” says Roeser.
3. Recognize early signs of trouble. Ringing or buzzing in your ears or a worsening of tinnitus if you already have it is the first sign. Other symptoms include hyperacusis, a condition in which loud noises are extremely painful; dizziness; or difficulty hearing in a crowded room. Once the drugs are stopped, tinnitus may recede over time. However, never stop taking a drug before first checking with your physician.
Chemo And Other Drugs To Fight Cancer Can Damage Your Hearing
You know there will be side effects when you go through chemo. Doctors are filling the body with toxins in an effort to kill cancer cells. These toxins cant often tell the difference between healthy cells and cancer.
Some of the drugs under scrutiny are:
- Cisplatin commonly known as Platinol
- Carboplatin commonly known as Paraplatin
- Bleomycin commonly known as Blenoxane
Unfortunately, chemo-induced hearing loss is a necessary tradeoff when fighting cancer. You may want to speak with a hearing specialist about monitoring your hearing while youre going through cancer treatments or find out if there are any recommendations the specialist can make that can help in your individual situation.
How To Prevent Damage To Your Hearing
When it comes to protecting your hearing, there are several simple steps you can take. Here are three things you should keep in mind when you visit your doctor.
Medications That Can Cause Ringing In The Ears
Tinnitus, or ringing in the ears, is a perception of sound in one or both ears in the absence of an external source. Its often described by patients as buzzing, ringing, or whooshing. While there is often no known cause for tinnitus, there are a handful of medications that may contribute to it. Though rare, tinnitus is a debilitating complication with limited treatments.
Medications known to cause tinnitus or hearing loss are considered ototoxic medications. Discontinuing these medications can prevent tinnitus and hearing loss progression, though the ringing may not always go away. Check with your doctor before stopping the use of any medication.
Here are some commonly prescribed medications known to cause tinnitus and some options and alternative medications to consider.
Drugs Can Affect Your Hearing
Pharmaceuticals is a nearly $500 billion industry and the United States accounts for almost half of that consumption.
Are you buying medications over-the-counter? Or are you taking ones that your doctor prescribes? All medications carry risk, and while side effects and risks may be listed in the paperwork, no one ever thinks theyll be affected. Thats why emphasizing that some medications may increase your risk of hearing loss is so important.
On a more positive note, some medications, like tinnitus medications, can actually help your hearing. But how do you know which drugs are safe and which are the medications that hurt your hearing? And what do you do if a doctor prescribes drugs that cause hearing loss? Heres the good, the bad, and the ugly on medications.
Drugs That Can Cause Hearing Loss
Its a fact of life that, at some point, you may be prescribed certain medications to treat specific medical conditions. Unfortunately, some drugs can lead to ototoxicity, which relates to medications and supplements that can cause hearing loss. These drugs are good for treating certain conditions, but can damage cilia, the fine hairs inside the ear that control hearing and balance. In some cases, hearing loss is only temporary, but sometimes, a person can be left with permanent damage.
These are some drugs that can cause hearing loss:
Other Substances That Can Cause Hearing Loss
Caffeine and Hearing Loss
caffeine may play an indirect role in sensorineural hearing loss
Alchohol and Hearing Loss
Alcohol has long been villainized for causing a host of health problems including liver damage, high blood pressure and heart disease. If alcohol makes a frequent appearance in your routine, youll need to add hearing loss to the list of potential health consequences.
Alcohol damages the central auditory cortex, the part of your brain responsible for deciphering sounds brought to it by your ear. So while your ears may be in perfect working order, your brain may have trouble understanding what its hearing. Alcohol intake seems to most often affect a persons ability to process lower frequency sounds.
In a study out of London, participants usually regained their normal hearing abilities once they stopped drinking. However researchers hypothesize that repeated alcohol induced hearing loss can permanently damage hearing abilities over time.
Nicotine and Hearing Loss
In a recent study out of Japan, researchers spent 8 years tracking the hearing abilities of over 50,000 participants. Researchers concluded that smoking is in fact associated with an increased risk for hearing loss, with the number of cigarettes impacting the level of risk.
Amazingly the risk of hearing loss declined for those who quit smoking even as few as 5 years before the start of the study. The findings are encouraging for those wishing to improve their health by ending a nicotine habit.
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.
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.
Some Medications That Commonly Cause Hearing Loss
Its natural to check out the side effects of a medication when you begin taking it. Can you expect to feel Nauseous or to get a dry mouth? A more severe side effect that can potentially occur is hearing loss. Ototoxicity is the term medical professionals give to this condition. Broken down, ototoxic means ear poisoning.
Its still not known how many drugs lead to this problem, but there are at least ototoxic medications on record. What are some of the common ones you should watch out for and why?
Chemo Drugs Can Harm Your Hearing
You know there will be side effects when going through chemo. Doctors are filling the body with toxins in order to destroy cancer cells. Healthy cells and cancer are often indistinguishable by these toxins. These medications are being analyzed:
- Bleomycin commonly known as Blenoxane
- Carboplatin commonly known as Paraplatin
- Cisplatin commonly known as Platinol
Unfortunately, chemo-induced loss of hearing is a required trade off when fighting cancer. While youre going through chemo, a hearing care professional could help you monitor your hearing. Or you might want to look into whether there are any recommendations we can make that may help in your individual situation.
Side Effects Are Unpredictable
Just because you need to take one of these medications doesn’t always mean you will lose your sense of hearing. Everyone reacts to medications differently, and side effects can range from temporary tinnitus and hearing loss to permanent hearing damage. Or, in some cases, it could mean no hearing loss at all. It’s best to be prepared with questions for your physician about hearing concerns. If they are prescribing these medications, it’s because you have a health condition that requires it and your hearing health is a secondary concern.
How Medications Can Affect Your Hearing
Rex Banks, Au.D., Doctor of AudiologyDirector of Hearing Healthcare
When medications result in hearing loss, ringing in the ears, or balance disorders, they are known as ototoxic. There are more than 200 prescription and over-the-counter ototoxic medicines on the market. In some instances, the problems caused by these drugs can be reversed when usage is discontinued. Other times, the damage is permanent.
Ringing in the ears is often the first sign that a medication is ototoxic. If hearing loss develops, you may not immediately notice it until your ability to understand speech is affected. You could also experience a loss of balance or unsteadiness. Feeling dizzy or difficulty in hearing conversations may cause you to stop participating in your usual activities and affect your quality of life.
So which medications are ototoxic? Common medications that can cause hearing loss include:
Contributing factorsThe factors that affect ototoxicity are dose, course of treatment, cumulative effects over time, genetics, age, dehydration, and kidney and liver functions. In some instances, exposure to loud noise while taking certain drugs will increase their damaging effects. Toxins found in heavy metals , solvents and gases can also affect your hearing. These toxins can be found in occupational settings such as shoe or battery manufacturing and dry cleaning, or in household items such as adhesives, spot removers, insecticides and paint/varnishes.
What Are The Symptoms Of Ototoxicity
Because ototoxicity impacts the inner ear, the symptoms are primarily related to hearing and balance.
The symptoms typically start off as mild and may get worse over time if left undiagnosed or untreated. The severity of symptoms also depends on the individual and their risk factors, as well discuss below.
Here are some of the symptoms of ototoxicity:
- Ringing in the ears
- Hereditary factors
Depending on how many of these factors are relevant, specific drugs may cause different symptoms for different people.
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What Is The Risk Level For Each Drug
The list of drugs which can cause temporary or permanent hearing loss may surprise you. You probably take some of these drugs when you are in pain and you might have some of them in your medicine cabinet right now.
Over the counter pain relievers are at the top of the list of ototoxic drugs:
Salicylates, better recognized as aspirin, can be added to this list. The hearing issues caused by these drugs are normally correctable when you quit taking them.
Antibiotics are a close second for well known ototoxic drugs. Not all antibiotics are ototoxic, however. You might have heard of some of these that arent:
The problem goes away once you stop taking the antibiotics just like with painkillers. The common list of other drugs include:
Substances That Trigger Tinnitus
Diamox, Bumex, Lasix and Edecrin are diuretics that trigger tinnitus but there are bigger offenders in this category:
- Tonic water
When you get up every morning and drink your morning coffee you expose yourself to a substance that might cause tinnitus. After the drug is out of your system it will pass and thats the good news. Some drugs, ironically, that doctors prescribe to treat tinnitus are in fact on the list of offenders.
Why Ototoxix Medications Are Used
SNHL side effects are likelier to increase when more than two ototoxic medications are taken at the same time. This is very common when a patient is diagnosed with cancer. For instance, a patient may be prescribed one form of ototoxic medication for chemotherapy, and another to prevent inflammation or infection.
For patients who have been diagnosed with a life-threatening disease, it often seems their only solution involves taking ototoxic medications. Ask your primary doctor if there is alternative treatment available for your diagnosis.
When alternative treatment is not available, our specialists can record a baseline of your hearing and balance in order to monitor any changes. It is also vital that you notify your physician immediately of any changes in your hearing when they occur. The key to reversing side effects is catching issues early.
What Medications Cause Hearing Loss
Depending on the person, ototoxicity can be caused by a wide variety of medications .
While there are hundreds of medications that may contribute to hearing loss, heres a list of the more common ones that we will expand on below.
Ototoxic Medications that can cause hearing loss
- Antibiotics: Gentamicin, Streptomycin, Tobramycin & Erythromycin
- Loop diuretics: Furosemide
Antibiotics that fall within the aminoglycoside class may cause ototoxicity. The reasons are not well understood. Some common antibiotics in this class are gentamicin, streptomycin, and tobramycin.
Erythromycin, a macrolide antibiotic, can also cause damage to the ear .
Loop diuretics are medications used to treat hypertension in people with chronic kidney disease. Furosemide is a loop diuretic medicine that may cause ototoxicity, especially at higher doses .
Certain medications designed to stop the growth of cancer cells can be responsible for ototoxicity. The drugs cisplatin and carboplatin may cause tinnitus or hearing loss .
Aspirin may also cause hearing loss at higher doses. But the symptoms typically stop once aspirin is discontinued .
For a full list of ototoxic drugs, check out this list from the American Tinnitus Association .
Your Hearing Can Be Affected By Drugs
The United States accounts for almost half of the $500 billion dollar pharmaceutical industry. Do you regularly take over-the-counter medication? Or perhaps your doctor has prescribed you with some type of medication. It commonly happens that people ignore the warnings that come along with almost all medications because they assume they wont be impacted. Thats the reason why emphasizing that certain medications might raise your chance of having loss of hearing is so important. But on the plus side, some medicines, like tinnitus medications, can in fact, help your hearing. But how can you know which medicines are ok and which ones are the medications will be harmful? But if you get prescribed with a medication that is recognized to lead to hearing loss, what can you do? A little knowledge on the subject can go a long way.
What Drugs Put You At Risk
You may be surprised by the list of medications which can cause temporary or permanent hearing loss. Many of them you probably have in your medicine cabinet right now, and chances are you take them before bed or when you are in pain.
At the top of the list for ototoxic drugs are over-the-counter pain relievers such as:
Salicylates, better recognized as aspirin, can be added to this list. The hearing issues caused by these drugs are generally reversible when you quit taking them.
Antibiotics come in as a close second for well known ototoxic medications. Not all antibiotics are ototoxic, though. You may have heard of some of these that arent:
The problem disappears when you quit taking the antibiotics just like with painkillers. Other drugs on the ordinary list include:
Tinnitus Can be Triggered by Several Common Compounds
Diamox, Bumex, Lasix and Edecrin are diuretics which result in tinnitus but there are greater culprits in this category:
- Tonic water
When you get up every morning and have your morning coffee you subject yourself to a substance that could cause tinnitus. After the drug is out of your system it will pass and thats the good news. Ironically, some drugs doctors give to deal with tinnitus are also on the list of potential causes such as:
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.
Ototoxic Medications: What Are They
Are you in the habit of checking the side effects of your medications?
In todays world, medical experts have provided us with a multitude of life-improving, often lifesaving, medications. Sometimes, we take them to relieve simple ailments like headaches or fever. Other times, we rely on them to treat more serious problems, such as cancer or malaria.
The word ototoxic can be broken down into two parts: oto, a medical prefix indicating the ear, and toxic, a word meaning poisonous or harmful. Therefore, ototoxic medications are those that may have ear-damaging side effects. The term otoxicity describes the tendency of a given drug to cause adverse effects to a persons hearing.
You might experience the following symptoms if you have been exposed to ototoxic medication:
- Hearing loss, temporary or permanent
- Hyperacusis, or increased sensitivity to certain frequencies or volumes
- Tinnitus, or a ringing in the ears
- Perception of phantom sounds
- Disequilibrium, or balance problems such as vertigo or ataxia
- Physical damage to the hair cells of the inner ear, the cochlea, or the vestibular apparatus