If Prednisone Is Ototoxic, Why Is It Prescribed for Acoustic Trauma?

[Flamingo1]

I'm on a 5 day course of prednisone after noise exposure and aural fullness. Now I find out that prednisone is an ototoxic drug?! Why is it a common treatment for sudden hearing loss and acoustic trauma when it damages the ear? Also, after three days on prednisone, my left ear still feels full.

 

[Gman]

I'm on a 5 day course of prednisone after noise exposure and aural fullness. Now I find out that prednisone is an ototoxic drug?! Why is it a common treatment for sudden hearing loss and acoustic trauma when it damages the ear? Also, after three days on prednisone, my left ear still feels full.

I believe it reduces inflammation that can cause oxidative stress that leads to damage like hair cells dying off.

I think a lot of people jump too quickly to use it, because it is ototoxic and also has a long list of possible nasty side effects. Not saying you should not be taking it because I don't know your situation. Hope it wasn't too bad.

I would be getting on antioxidants unless it's a severe situation (i.e. where there's measurable/perceived hearing loss), in particular ones that boost glutathione. Other things like nicotinamide riboside, r lipoic acid, acetyl-l-carnitine, magnesium, melatonin and others have research to suggest they can reduce hearing loss as a result of loud noise exposure. In fact, some research indicates melatonin is as effective or more effective than prednisone.

 

[Ed209]

I believe it reduces inflammation that can cause oxidative stress that leads to damage like hair cells dying off.

I think a lot of people jump too quickly to use it, because it is ototoxic and also has a long list of possible nasty side effects. Not saying you should not be taking it because I don't know your situation. Hope it wasn't too bad.

I would be getting on antioxidants unless it's a severe situation (i.e. where there's measurable/perceived hearing loss), in particular ones that boost glutathione. Other things like nicotinamide riboside, r lipoic acid, acetyl-l-carnitine, magnesium, melatonin and others have research to suggest they can reduce hearing loss as a result of loud noise exposure. In fact, some research indicates melatonin is as effective or more effective than prednisone.

Was about to post the same thing. Well said.

 

[Bill Bauer]

For what it's worth, I don't recall reading any posts where someone had described taking Prednisone and getting a permanent spike or a new tone. I've been reading the posts on this forum for over 25 months.

 

[Ed209]

For what it's worth, I don't recall reading any posts where someone had described taking Prednisone and getting a permanent spike or a new tone. I've been reading the posts on this forum for over 25 months.

Haven't got time to trawl the forum, but didn't @IvanRus have loads of problems with prednisone? He isn't the only one I've seen.

 

[Bill Bauer]

didn't @IvanRus have loads of problems with prednisone

It was high blood sugar, and not a problem related to tinnitus.
https://www.tinnitustalk.com/thread...ls-after-taking-prednisone-anyone-else.33232/

 

[Ed209]

It was high blood sugar, and not a problem related to tinnitus.
https://www.tinnitustalk.com/thread...ls-after-taking-prednisone-anyone-else.33232/

I'm sure there was more to it than that. Either it was said privately or it's in a random thread somewhere. Or maybe I'm thinking of someone else. In either case, the culture of advising people to take prednisone on a whim needs to be nipped in the bud on here.

 

[Bill Bauer]

In either case, the culture of advising people to take prednisone on a whim needs to be nipped in the bud on here.

People are asking about their options. This is one of the options. I can recall countless posts of people being upset about not knowing about the option of taking Prednisone or getting steroid injections. People should be made aware of the side effects, and then it should be up to them to choose what to do.

 

[Ed209]

People are asking about their options. This is one of the options. I can recall countless posts of people being upset about not knowing about the option of taking Prednisone or getting steroid injections. People should be made aware of the side effects, and then it should be up to them to choose what to do.

I agree with this, but there's a difference between someone having a real acoustic trauma and being exposed to 55 dB for 2 hours. Most stuff in life is higher than this threshold. For example, people go flying all the time with tinnitus, and an average flight is around 79 dB LAeq on some planes (that's about 59 dB or less with plugs). I know the cinema example has been used a lot recently, well what's the difference? Real acoustic traumas involve energy that is orders of magnitude higher than these levels. Like around 10,000 + times more powerful, depending if it's an impulse noise or sustained exposure to something more moderate, this number can go up or down.

To put it another way, if one has a job they will be exposed to more than 55 dBA every single day of their life. You cannot leave your house without this happening.

 

[Fangen]

People are asking about their options. This is one of the options. I can recall countless posts of people being upset about not knowing about the option of taking Prednisone or getting steroid injections. People should be made aware of the side effects, and then it should be up to them to choose what to do.

Remember that it is not used in every country. My country rarely if at all, prescribe prednisone for traumas. The drug does not cure anything, it can potentially help but it makes it sound like some kind of miracle drug that works on everyone, which it doesn't even if you get it in time.

 

[Bill Bauer]

I agree with this, but there's a difference between someone having a real acoustic trauma and being exposed to 55 dB for 2 hours. Most stuff in life is higher than this threshold. For example, people go flying all the time with tinnitus, and an average flight is around 79 dB LAeq on some planes (that's about 59 dB or less with plugs). I know the cinema example has been used a lot recently, well what's the difference? Real acoustic traumas involve energy that is orders of magnitude higher than these levels. Like around 10,000 + times more power, depending if it's an impulse noise or sustained exposure to something more moderate, this number can go up or down.

To put it another way, if one has a job they will be exposed to more than 55 dBA every single day of their life. You cannot leave your house without this happening.

I agree with what you are saying. The fact that one develops certain symptoms is important, but of course if the noise was moderate, the chance that one has had the type of damage for which Prednisone might help is low. But there exists some kind of a volume (which depends on a person) above which taking Prednisone is a reasonable option to be considered.

Having a dental procedure done is an example of a borderline case for which it is not clear what one should do.

 

[gorzakus]

Haven't got time to trawl the forum, but didn't @IvanRus have loads of problems with prednisone? He isn't the only one I've seen.

I took a course in the beginning and will never take this stuff again in my life.
It doubled my resting heart rate and I had suddenly immense pain in all my joints during the course to the point I couldn't even walk, this all subsided after ending the course. I also didn't read one success story from members who took prednisone after their trauma. It surprises me why it is advised by many members on this board.

 

[Jack Straw]

Is there any evidence that prednisone helps tinnitus? I heard that that may help with hearing loss.

 

[Jack Straw]

Remember that it is not used in every country. My country rarely if at all, prescribe prednisone for traumas. The drug does not cure anything, it can potentially help but it makes it sound like some kind of miracle drug that works on everyone, which it doesn't even if you get it in time.

Haven't seen you in a while @Fangen . I hope you're doing well!

 

[Ed209]

I'm on a 5 day course of prednisone after noise exposure and aural fullness. Now I find out that prednisone is an ototoxic drug?! Why is it a common treatment for sudden hearing loss and acoustic trauma when it damages the ear? Also, after three days on prednisone, my left ear still feels full.

Have your ears been assessed? Have you been checked for compacted wax? This is a likely scenario after using earplugs, especially if water gets trapped in your ear canal as well. Was a tympanometry test done because that could show signs of there being something behind your eardrum, like fluid? An endoscopy could also reveal if there is any inflammation and/or mucus in your sinuses, and this could also look at the end of the Eustachian tube of the affected ear. You may have ETD/glue ear. I get it all the time and go slightly deaf until it drains, and the one time it took a couple of months.

Sorry for all the questions, but can you pop your ear? Can you voluntarily open your Eustachian tube? If not try yawning and/or swallowing and listen if either side crackles.

 

[GregCA]

For what it's worth, I don't recall reading any posts where someone had described taking Prednisone and getting a permanent spike or a new tone. I've been reading the posts on this forum for over 25 months.

My onset of T happened right after a course of Prednisone. I was taking it for SSNHL (which was a misdiagnosis), and of course it didn't help. I don't know if/how Prednisone contributed to my T, since my stapes & cochlea seemed to already be undergoing nasty changes when this started, so it could be correlation rather than causation.

There is one theory that explains why the cochlear hair cells get destroyed when a person suffers from otosclerosis (which generally affects the middle ear only): it turns out the bone remodeling process (which isn't supposed to happen to healthy individuals in that area) releases enzymes into the cochlea that are toxic to the hair cells.

Maybe the combination of things such as: otosclerosis, Prednisone and low vitamin D created the perfect storm to weaken and kill hair cells... nobody can tell for sure, but what all doctors agree on is that they've never seen an air-bone gap of 50 dB appear in just a few weeks because of otosclerosis (it generally takes years if not decades).

 

[Ed209]

My onset of T happened right after a course of Prednisone. I was taking it for SSNHL (which was a misdiagnosis), and of course it didn't help. I don't know if/how Prednisone contributed to my T, since my stapes & cochlea seemed to already be undergoing nasty changes when this started, so it could be correlation rather than causation.

There is one theory that explains why the cochlear hair cells get destroyed when a person suffers from otosclerosis (which generally affects the middle ear only): it turns out the bone remodeling process (which isn't supposed to happen to healthy individuals in that area) releases enzymes into the cochlea that are toxic to the hair cells.

Maybe the combination of things such as: otosclerosis, Prednisone and low vitamin D created the perfect storm to weaken and kill hair cells... nobody can tell for sure, but what all doctors agree on is that they've never seen an air-bone gap of 50 dB appear in just a few weeks because of otosclerosis (it generally takes years if not decades).

Hi Greg, did you hear about the new conductive hearing loss procedure in South Africa? I thought you may find it interesting if you haven't seen it already.

https://buff.ly/2W2zdo6

 

[GregCA]

Hi Greg, did you hear about the new conductive hearing loss procedure in South Africa? I thought you may find it interesting if you haven't seen it already.

https://buff.ly/2W2zdo6

Yeah I read about it, but not from the article you linked. That article doesn't seem to have been proof-read very well: the title is "African professor makes history, performs world's 1st 3D inner-ear surgery" and the first sentence (bullet item) says "Professor Mashudu Tshifularo and his team at the University of Pretoria performed the world's first middle-ear surgery using 3D technology".

Clearly it's the middle ear that is being worked on (not the inner ear) as they figured out a way to 3d print a middle ear ossicle. My stapes is now a titanium prosthesis, but perhaps it will be a 3d printed bone in the future.

It's not clear how useful it can be for otosclerosis as the fusion/remodeling often happens at the interface between the stapes and the cochlea, so replacing the stapes bone may still keep some hyperactive area by the cochlea, but it sure is a great step forward for many other ossicle pathologies.

Science brings progress. It's good news!

At any rate, kudos to the team(s) involved!

 

[JohnFox]

I just completed a 3 week oral prednisone regime and experienced absolutely zero noticeable side effects. I am on the injections now. BTW, my T was not noise induced. It was a sudden event while sleeping.

 

[Amv]

Hello all, does prednisone increase tinnitus temporarily for some of you? Thanks and regards!

 

[annV]

Hello all, does prednisone increase tinnitus temporarily for some of you? Thanks and regards!

Yes temporarily, once you're off the prednisone it returns to baseline.

 

[Juan]

Remember that it is not used in every country. My country rarely if at all, prescribe prednisone for traumas. The drug does not cure anything, it can potentially help but it makes it sound like some kind of miracle drug that works on everyone, which it doesn't even if you get it in time.

So what is the standard treatment in Sweden for hearing loss resulting from noise trauma?

 

[Bill Bauer]

t @IvanRus have loads of problems with prednisone?

I don't believe he got a spike in his tinnitus:

Because of taking prednisone for my tinnitus, I then got more serious problems, I was examined for 2 months because I felt terrible. It turned out that I had developed adrenal insufficiency from taking prednisone. And 3 months later, it persists. What's the reason for this, nobody knows.

 

[all to gain]

Is prednisone the same as prednisolone?

I recently got some prednisolone and dexamethasone over the counter where I am. Cheap as chips.

I don't intend using either unless I get sudden hearing loss, but this thread has put me off even using them for that to a certain degree.

 

[Freyja95]

So what is the standard treatment in Sweden for hearing loss resulting from noise trauma?

Late reply, I can say that not really anything is done here for that. I hadn't even heard of "Prednisone" before entering this forum. Steroids are given here for SSNHL because there's good research to support it, but I'm guessing the research for acoustic trauma treated with Prednisone isn't considered to be enough. Just guessing, it wasn't talked about at all during my education (audiologist). I know in the military here they advise "sound rest in the home" after noise exposure.

These patients would usually meet a doctor here before an audiologist, and I'm guessing they would just get a hearing test and be advised to stay away from additional loud sounds. It's certainly frustrating to not have more to help with it.

 

[Juan]

Late reply, I can say that not really anything is done here for that. I hadn't even heard of "Prednisone" before entering this forum. Steroids are given here for SSNHL because there's good research to support it, but I'm guessing the research for acoustic trauma treated with Prednisone isn't considered to be enough. Just guessing, it wasn't talked about at all during my education (audiologist). I know in the military here they advise "sound rest in the home" after noise exposure.

These patients would usually meet a doctor here before an audiologist, and I'm guessing they would just get a hearing test and be advised to stay away from additional loud sounds. It's certainly frustrating to not have more to help with it.

I think after a noise trauma there may be hidden hearing loss, some damage to OHC or synapses. After sounds that triggered reactions (pressure, fullness, headaches, tension, etc) I have tried 30 mg a day of Deflazacort for 10 days, or low doses of Prednisone, starting at 30 or 40 mg and tapering... the Deflazacort did something and relieved my symptoms a bit. The Prednisone sort of masked the symptoms but in the end did not do much.

I have also tried a big dose of Prednisone, without prior noise exposure, prescribed by a doctor on suspicion of autoimmune issues (?) playing up. The Prednisone did nothing.

My personal feeling is that right after a noise trauma there must be a way to reverse it, but researchers have not still found the right way to approach this or to create an effective medication for it.