Ototoxicity: Chemically-Compromised Hearing Loss

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Hearing function is a chain of very vulnerable and weak links. Hearing, and especially understanding speech, depends on the smallest bones and the tiniest muscles in the body, stimulating perfectly frequenced responses in one of your body’s most complicated nerve branches. This chain of weak links is not like a Timex watch — it won’t just “take a lickin’ and keep on tickin’.”

These organs need the care and feeding of a healthy blood supply — blood that can carry in nutrition and oxygen and carry out waste. If that blood supply gets “poisoned,” it stops supporting the cells involved in hearing and it starts harming them. Poison-loaded blood leading to hearing loss is called ototoxicity.

Ototoxicity can be caused by medications that dull, weaken, stiffen or slow the sound transmission pathways. When the pathways are compromised, hearing ability declines and tinnitus (ear ringing) can occur. Ototoxic medications range all the way from simple aspirin to the harshest chemotherapies.

Doctors and pharmacists are usually careful in tracking the largest known ototoxic medications, but Patients need to do their part by reporting related symptoms to their doctors including:

  • Any loss in hearing or balance
  • Ringing in the ears or an increase in tinnitus
  • Hallucinations (visual or auditory)
  • Fullness or pressure in the ears

There are many other toxins besides medicines that can damage hearing and lead to tinnitus or balance problems. Some toxins include the usual suspects like nicotine, alcohol, recreational drugs and environmental pollutants. Others are more location- or profession-specific like solvents, insecticides, aerosols, adhesives, fungi, petrochemicals, carcinogens, heavy metals and animal venoms.

Read how Rich and Sharon, two very different people, met hearing loss head on.
Rich, age 65, is a typical patient dealing with toxicity-induced hearing loss with tinnitus. Rich recently retired from a lifetime of shop work. He had his fair share of time cleaning parts with solvents, being exposed to all of a shop’s petrochemicals and triggering a paint gun. For a typical man of his age, these three exposures may have been enough to cause a mild to moderate loss. Add to that, however, that Rich never wore hearing protection while using the air wrenches and impact guns. Rich had enough ototoxic exposure, combined with noise exposure, to expect a 65-year-old to experience moderate hearing loss. However, Rich also smoked until he was 55, he reports two to three drinks a day and his wood stove has leaked for years. All of these things contribute to making Rich a hearing patient who, without his high-power, tinnitus-masking hearing aids, would be miserably isolated.

Sharon, age 55, has endured a lot of pain from a car accident 20 years ago. She’s had many surgeries and lots of pain medication. Several times after a surgery, she thought her hearing had diminished. This wasn’t an illusion. Anesthesia puts the nerves to sleep and some people, on some occasions, never fully recover. Pain medications work in a similar way. Anything that affects the nervous system can affect hearing. Sharon has also endured years and years of pain stress. Constant bathing of her cells in stress-induced cortisol and other stress hormones has been toxic to her entire body. A vision impairment is tracking right along with her hearing loss — something often seen in patients with ototoxicity. Hearing health care with hearing aids is fundamental to Sharon’s quality of life. She has less stress now that she can hear better and there is hope that her hearing loss (and associated maladies) may stop worsening if she’s able to stop or counteract ongoing toxic stress.

When ototoxicity diminishes hearing and balance, other body functions are often compromised as well. Typical co-morbidities include poor kidney function, neuropathy, reduced cognition and exacerbated immunodeficiencies (especially thyroid imbalance, arthritis and diabetes). Patients often try to deal with the painful symptoms of these conditions with medications and other available chemicals. However, this just further poisons the blood and adds more harmful stress hormones.

Hearing patients exhibit ototoxicity in dozens of ways. Some patients can claim toxic exposure as the sole cause of their hearing loss. Most have been dealt a mixed-hand of hearing loss risk factors. The risks of hearing loss from toxic exposures are heightened when a patient already has a genetic predisposition, prenatal illness, early childhood high fever, chronic infections, excessive exposure to cold or wind, head trauma, sinusitis, stroke, immunodeficiencies, thyroid, diabetes, and noise exposure (sudden or long-term).

Nearly all of us will have age-related hearing loss at some point and many of us will eventually benefit from some level of hearing correction. Those of us with a history of toxic exposure are most at risk. It’s important to understand how delicate our hearing actually is — both to avoid ototoxicity and to respect the need for treatment if it’s happened. Ototoxicity can be ignored, its poisons compounding their effects though the miseries of untreated hearing loss — or toxic exposures can be faced and dealt with by those who gracefully seek the highest quality of life possible. If you would like to know more about ototoxicity in Montrose, Colorado, and to discuss your options for treating it, call Colorado Hearing at 970-318-2010 to schedule your visit with our Hearing Aid Specialist, Brian Bennett.

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