Prevention of Chemically-Compromised Hearing

Your 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 lick’n and keep on tick’n”.

These organs need the care and feeding of a healthy blood supply, blood that can carry in nutrition and oxygen, then carry out waste.

If that blood gets poisoned, it stops supporting the cells and it starts harming them. Poison-loaded blood leading to hearing loss is called ototoxicity. In the halls of health care, ototoxicity typically has a narrow semantic. Medical doctors tend to think strictly of pharmacological ototoxicity. Indeed, many medications can dull, weaken, stiffen, and/or slow the sound transmission pathways — often breaking down hearing ability (especially speech discrimination) and causing tinnitus (ear ringing). 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:

  • any loss in hearing or balance
  • increase in tinnitus
  • hallucinations (visual or auditory)
  • increases in fullness or pressure in the ears
  • or any other side effects that may indicate a poor pharmacological match.

You also need to be aware that there are many other toxins besides medicines that can damage hearing, lead to tinnitus, or even cause balance problems. Some toxins are the usual suspects: 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 venom.

Rich, age 65, is one of my typical patients dealing with toxicity induced hearing loss with tinnitus. Rich has 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 (he says he always wore a mask while painting). On a typical man of 65, these three exposures may have been enough to cause a mild to moderate hearing loss. Add in, however, that Rich never wore hearing protection while using the air wrenches and impact guns and now we’ve got a patient whose had enough ototoxic exposure combined with noise exposure for me to expect a moderate to severe hearing loss. But add in even further that he smoked until he was 55, that he reports 2-3 drinks a day, and that his wood stove has leaked for years. Now I have a patient who, without his super-power, tinnitus-masking hearing aids, would be miserably isolated.

Sharon, age 55 is challenged with different ototoxicities. Sharon has endured a lot of pain from a car accident twenty years ago. She had many surgeries that included lots of pain medications. Several times after a surgery, she thought her hearing had decreased and I assured her that this wasn’t an illusion. Anesthesia puts the nerves to sleep and some people 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; this constant bathing of her cells in stress-induced cortisol and other stress hormones has been toxic to her entire body. Her vision impairment is tracking right along with her hearing loss — something I often see in patients with ototoxicity. Sharon has less stress now that she can hear better, so hopefully her hearing loss will plateau at some point. She might be able to contribute to counteracting the toxins through a regime of self care including cleanses, sweats (especially exercise induced sweats) meditations, etc.

Other co-morbidities often seen with ototoxicity include poor kidney function, neuropathy, reduced cognition, thyroid imbalance, and diabetes.

My patients exhibit ototoxicity in dozens of ways. A few can claim toxic exposure as the trump flush in their hearing loss card hand. Most have been dealt a mixed suit. A few of the hearing-loss risk factors that could amplify a toxic exposure include genetic predispositions, pre-natal toxins or illness, early childhood high fever, chronic infections, excessive exposure to cold and/or wind, immunodeficiencies, head trauma, sinusitis, stroke, thyroid, diabetes, and noise exposure (sudden or long term).

Nearly all of us will have age-related hearing loss at some point and most of us will eventually benefit from some level of hearing correction. At what age we need that correction and what level that correction requires will depend on many factors.

It’s important to understand that, regardless of the cause, the biggest risk factor is unwillingness to learn the truth about the situation. Those who suspect a hearing loss and don’t do anything about it may be sentencing themselves to unrecoverable speech discrimination losses, vastly increased health risks and potentially devastating costs in all areas of life.

Thus, our motto:

“Hear Well, Live Well”.