Hearing Loss and Tinnitus
What are Hearing Loss and Tinnitus?
Hearing loss is one of the most common chronic conditions in older adults, second only to arthritis as the most handicapping condition. Hearing loss and tinnitus (ringing in the ears) can be obstacles to communication and social interactions, contributing to decreased quality of life.
Hearing loss can be conductive, sensorineural, or a combination of both. Conductive hearing loss is generally caused by damage to the outer or middle ear, while sensorineural is caused by damage to the inner ear and often progresses over time.
Natural interventions such as N-acetylcysteine and lipoic acid may help protect the ear and prevent or reverse hearing loss and tinnitus.
What are Causes and Risk Factors for Hearing Loss and Tinnitus?
- Advanced age
- Heart disease
- High blood pressure
- Otosclerosis (abnormal bone growth in the middle ear)
- Exposure to loud noises
- Ototoxic drugs such as some antibiotics, chemotherapy drugs, and high doses of aspirin
What are Conventional Medical Treatments for Hearing Loss and Tinnitus?
- Hearing aids
- Tinnitus retraining therapy or other behavioral therapies
- Masking devices or electrical stimulation for tinnitus
- Stapedectomy (for otosclerosis)
- Cochlear implants
- Implantable bone conduction hearing devices
What are Emerging Therapies for Hearing Loss and Tinnitus?
- Aldosterone replacement therapy
- Neuromodulation, a process to correct the “misfiring” or “continuous” firing of neurons in the brain leading to tinnitus (eg, repetitive transcranial magnetic stimulation, deep brain stimulation, and acoustic stimulation).
- Certain medications (eg, antidepressants and sleep aids) may help with tinnitus; however, more evidence is needed before drug strategies can be used reliably.
What Natural Interventions May Be Beneficial for Hearing Loss and Tinnitus?
- N-acetylcysteine (NAC). NAC, a naturally occurring antioxidant that increases the production of glutathione, protected humans and animals against hearing loss from loud noises.
- Acetyl-L-carnitine. Acetyl-L-carnitine may protect against mitochondrial damage that causes noise-induced and age-related hearing loss. Animal studies have shown that acetyl-L-carnitine can protect the cochlea and prevent drug-induced ototoxicity.
- Lipoic acid. Lipoic acid can protect against age-related hearing loss and cochlear damage. A combination of lipoic acid with vitamin C and rebamipide improved hearing in elderly subjects.
- Vitamins A, C, and E. Animal studies have shown that pretreatment with vitamins A, C, and/or E can protect against noise-induced and other types of hearing loss.
- B vitamins. Elevated homocysteine levels, which are associated with B vitamin insufficiency, are linked with an increased risk of hearing problems. Specifically, low levels of folate and vitamin B12 are linked to hearing loss and tinnitus.
- Magnesium. Magnesium can improve circulation, which is important as loud noises cause damage by decreasing blood flow to specialized ear cells. Magnesium deficiency can increase the risk of noise-induced hearing loss. Supplementation was shown to improve hearing that was damaged by noise.
- Melatonin. Low plasma levels of melatonin are associated with high-frequency hearing loss among elderly subjects. Melatonin has protective effects and was shown to improve tinnitus in clinical studies.
- Coenzyme Q10 (CoQ10). CoQ10 is an antioxidant that supports mitochondrial function. Supplementation reduced hearing loss in people with sudden sensorineural hearing loss and presbycusis (age-related hearing loss) and may alleviate tinnitus as well.
- Taurine. Taurine can reverse certain biochemical processes behind hearing loss and may reduce or eliminate the ringing sound of tinnitus.
- Other natural interventions that may be beneficial for hearing include ginkgo biloba, zinc, and omega-3 fatty acids.