Finding the Best NSAID

[emz]

Hello,

As many of you are acutely aware, the NSAIDs (non-steroidal anti-inflammatory drugs) that are available OTC tend to cause a temporary spike in tinnitus. This makes dealing with pain and managing fevers very distressing for me when I get sick. Based on my own experience (everyone's different though), I'd rank them like this from highest to lowest impact:

1. Acetaminophen (Tylenol)
2. Naproxen (Aleve)
3. Acetylsalicylic Acid (Aspirin)
4. Ibuprofen (Advil)

My doctor is willing to work with me to find a prescribed anti-inflammatory that has no/less of an impact on my tinnitus. I'm currently trying Indomethacin but I don't think it's any better than the OTC ones listed above. I'm just wondering if anyone has experience with trying different types of NSAIDs or has any theories on what alternative would be worth trying next. Thank you in advance for any guidance!

 

[DirM]

You have to self experiment since everyone is different. For example coffee makes some people spike and others not. Alcohol ditto. A beer makes mine go down quite a bit but many others spike.

Since my tinnitus is related to TMJ I sometimes need something for jaw pain and I found the following results on me:
1. Aleve - no change or even a slight reduction in tinnitus
2. Advil - no change or slight increase
3. Aspirin - definite spike. Tried it again just two weeks ago and regretted it
4. Tylenol - avoid completely due to alcohol consumption (see above)

I only use over the counter and do not need or want anything stronger.

 

[Red]

Acetaminopen is not a NSAID so it should be safe.
Though as always, your mileage may vary.

 

[Pleasure_Paulie]

Acetaminopen is not a NSAID so it should be safe.

I recommend this. Paracetamol seems to be about the safest analgesic for tinnitus. I've taken it many times and never had a problem.

 

[Hazel]

So is tinnitus a temporary or permanent side effect of NSAIDs? I asked my GP and she couldn't tell me.

I'm interested to know because I use naproxen for period pain. I've tried going without, because I was worried about worsening my tinnitus, but the pain is simply unbearable. And believe me, I've tried all the alternatives; naproxen is the only thing that provides good relief (studies have demonstrated this as well).

The thing is, I've not noticed any adverse effects, i.e. no spike when I use it. I'm just worried about any potential cumulative effects. Any insights on this, anyone?

 

[Hanna2019]

I took NSAID and it drove my tinnitus wild to 10. It hasn't improved and it's been 5 days after taking it. I take Turmeric pills and they don't do anything for me.

 

[JohnAdams]

So is tinnitus a temporary or permanent side effect of NSAIDs? I asked my GP and she couldn't tell me.

I'm interested to know because I use naproxen for period pain. I've tried going without, because I was worried about worsening my tinnitus, but the pain is simply unbearable. And believe me, I've tried all the alternatives; naproxen is the only thing that provides good relief (studies have demonstrated this as well).

The thing is, I've not noticed any adverse effects, i.e. no spike when I use it. I'm just worried about any potential cumulative effects. Any insights on this, anyone?

You're probably fine. Everything I've read about NSAIDs causing tinnitus suggests that it is transient. It can however help to make you vulnerable to noise and exacerbate the level of noise damage that is incurred.

 

[linearb]

I recommend this. Paracetamol seems to be about the safest analgesic for tinnitus. I've taken it many times and never had a problem.

I don't disagree but still advise caution because there are reliable studies showing that people who regularly use tylenol, have significantly higher rates of hearing loss, than people who don't.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831770/

Conclusions
Regular use of aspirin, NSAIDs, or acetaminophen increases the risk of hearing loss in men and the impact is larger on younger individuals.

There are other studies that only look at acetaminophen, if you crawl around.

My own takeaway is that the roughly 1-2x a year that I have fever that interferes with sleep I use low doses of APAP, and I think my annual intake is probably like 2000mg and I don't worry about that at all. These days, I don't get headaches as long as I drink enough water, and a combination of yoga and cannabis is sufficient for whatever other aches life throws my way.

I saw another study which concluded people who regularly used APAP have more headaches than people who don't take it at all (RCT, so not a correlation thing). Shocking, right? Not dissimilar to the idea that regular use of opiates leads to increased pain sensitivity in a lot of people, and benzos can lead to more anxiogenic states.

 

[MattS]

So is tinnitus a temporary or permanent side effect of NSAIDs? I asked my GP and she couldn't tell me.

I'm interested to know because I use naproxen for period pain. I've tried going without, because I was worried about worsening my tinnitus, but the pain is simply unbearable. And believe me, I've tried all the alternatives; naproxen is the only thing that provides good relief (studies have demonstrated this as well).

The thing is, I've not noticed any adverse effects, i.e. no spike when I use it. I'm just worried about any potential cumulative effects. Any insights on this, anyone?

I took a reasonably high dose of Advil for a broken toe about a month ago, before I realized that it was ototoxic. After two days of high dose, my tinnitus went pretty wild (volume was up only a bit, but pitch went way up). While it eventually came back down, it stayed up for about a week; and even now, when I do spike, I now reach that higher pitch. Meaning, I guess, that it's now in my 'repetoire', so to speak.

So: mostly transient.

 

[raymundo2245]

Running water sound helped me a lot and helped through my habituation the first time. Time is the key, it reduces the high pitch sound dramatically, I experienced that!

Teas to relax your anxiety, a lot of antioxidants and flavonoids (I take turmeric). I also believe inflammation causes the hyperacusis and higher tinnitus volume, so I think it helps to take anti-inflammatories and lots of natural supplements other than meds.

Just a personal opinion.

 

[pleasejuststop]

I have a very bad foot injury ongoing for 6 months and I recently worsened it and need to bring down the swelling and inflammation.

I already took Tylenol several times this week and month. I can't go out and get topical NSAIDs right now due to a very bad storm.

Can I take Tylenol again multiple times this week and next month until it is recovering? I don't want worsened tinnitus or hearing loss and I don't want this injury to become permanently worse either. I'm extremely stressed.

 

[Brooklyn NY]

Sorry about your foot problem, from someone who also has foot problems. Instead of pills, I use weekly acupuncture treatments. These treatments are very good at reducing inflammation. You might consider this. Good luck.

 

[ronman]

I started using 81 mg daily baby Aspirin (as commonly recommended for heart health and anti-cancer effects) and didn't notice anything for 60 days, then (coincidence?) a stuffy feeling in the right ear and a new roaring tinnitus sound, much lower than my customary 10 kHz. It has lasted two days so far.

I'd like to know whether

• low doses of Aspirin can still be implicated in tinnitus spikes or
• have other lingering effects even if any tinnitus spike is temporary, similar to those described below for high doses of Advil, or the study quoted above for higher probability of hearing loss with Tylenol

I'm a piano tuner so my ears are my work.

 

[brynon]

I also have taken daily baby Aspirin for a while (nearly 3 months) and last week tinnitus started for the first time - two low frequency tones that switch back and forth in left ear.

Thought the Aspirin might be involved but some research I read said the dose would be too low to have any effect - need gram quantities to be ototoxic. But just to try I stopped taking it today and if that's it, the tinnitus should stop in 1-3 days. I need the Aspirin because I recently had triple bypass surgery. But I'm willing to risk for a few days because the tinnitus is driving me crazy.

 

[CC_16]

Ibuprofen.

 

[DebInAustralia]

Hello,

As many of you are acutely aware, the NSAIDs (non-steroidal anti-inflammatory drugs) that are available OTC tend to cause a temporary spike in tinnitus. This makes dealing with pain and managing fevers very distressing for me when I get sick. Based on my own experience (everyone's different though), I'd rank them like this from highest to lowest impact:

1. Acetaminophen (Tylenol)
2. Naproxen (Aleve)
3. Acetylsalicylic Acid (Aspirin)
4. Ibuprofen (Advil)

My doctor is willing to work with me to find a prescribed anti-inflammatory that has no/less of an impact on my tinnitus. I'm currently trying Indomethacin but I don't think it's any better than the OTC ones listed above. I'm just wondering if anyone has experience with trying different types of NSAIDs or has any theories on what alternative would be worth trying next. Thank you in advance for any guidance!

Curcumin.

NSAIDs increase TNF alpha = drive up neuroinflammation.

 

[pleasejuststop]

My doctor just prescribed me Tramadol with Acetaminophen. Tylenol is ototoxic. I'm in a lot of pain. But I don't want permanently worse tinnitus. I had to take Toradol for 2 months ago and it gave me a huge spike.

Is Tramadol with Acetaminophen safe to take?

 

[pleasejuststop]

My doctor just prescribed me Tramadol with Acetaminophen. Tylenol is ototoxic. I'm in a lot of pain. But I don't want permanently worse tinnitus. I had to take Toradol for 2 months ago and it gave me a huge spike.

Is Tramadol with Acetaminophen safe to take?

I tried it last night. The Acetaminophen in it made my tinnitus louder. Very stressed.

 

[pleasejuststop]

My tinnitus is so loud from Tramadol that contained Acetaminophen. It's been this way for a week, since I've taken it.

I don't understand how one dose could do this, but I was forced to take Toradol (very ototoxic) for a severe injury 3x a day for 5 consecutive days 2-3 months ago, which made my tinnitus so loud. It came down a little but I'm afraid it made permanent spikes from NSAIDs more likely.

Every sound is tinny and painful, and I hear a new tone. Can someone please help? I'm near vomiting. I almost passed out from anxiety in public. I can barely hear my thoughts.