Loud Noise Exposure Caused My Tinnitus — Prednisone Made It Worse

[DSL]

Hi everyone,

I wanted to share my story as I am in complete panic and exhausted, even if my tinnitus is 3 weeks old.

I went to a gig 3 weeks ago, as I usually have done every weekend for 4/5 years but I usually wear earplugs, as I know that tinnitus was a real problem. But that day, the song felt not so strong and I decided to stay for 1 hour and 30 minutes (usually the gigs last 5-6 hours). When I went home, I immediately felt that I had tinnitus and I hoped that it will disappear the next day.

I took an appointment with an ENT 13 days after, as it was bearable during the day; I could only hear the tinnitus when going to bed. But I wanted to be safe and my doctor gave me 50 mg Prednisone per day for 1 week. After 3 days of treatment, my tinnitus went through the roof, it's at a 8/10 now, I can hear it all the time (with white noise/cooking/running/in the train) and my head hurts a lot. It is giving me suicidal thoughts, as I was not prepared for the Prednisone to worsen my tinnitus.

Will it go back to normal? Could someone help me and give me support or any recommendations?

Thanks everyone.

 

[TheHonoredOne]

Prednisone always helps my tinnitus get quieter after a spike or loud noise so I'm surprised it made yours worse. But I wouldn't worry if I were you because I have heard that if Prednisone causes a spike it's usually temporary and goes away shortly after stopping it.

Good luck. I hope your tinnitus gets quieter.

 

[MindOverMatter]

@DSL, given you are in panic mode after this trauma, you will feel miserable and freak out. That will in turn make your brain perceive the tinnitus even worse and more intrusive.

Remember that Prednisolone is a strong anti-inflammatory steroid. Did you taper properly? It can temporary worsen tinnitus for some, but usually it will ease off and go back to baseline.

Given your timeline, you will most likely feel better soon. But you need to get in control of yourself again, and not let the anxiety and fear occupy your mind.

 

[DSL]

I wasn't told to taper my Prednisone treatment, maybe because it's only 1 week of treatment. Do you think I should continue a little bit more and taper it myself? (I still have 13 pills of 50mg.)

Thank you both for your kind words!

 

[MindOverMatter]

@DSL, I don't know what is the standard where your are from among doctors, but here, with such a dosage, it is always followed by tapering over a week or so.

This is to avoid having the sometimes nasty side effects that may appear with Prednisolone. Temporarily increased tinnitus could be one of them.

I'd say call your doctor tomorrow and ask.

 

[TheHonoredOne]

Yeah there is no need to taper for courses <=7 days long. I would first ask your doctor if it's okay to stop. If he says it's okay, then I would probably stop after day 4 or 5 if you think it is not benefiting you much anymore and just save the rest in case of acoustic trauma in the future so you can use it fast. But ask your doctor first to be safe.

 

[GeorgeLG]

Tapering Prednisone is to avoid an adrenal crisis for longer courses. Anything less than 3 weeks or so may or may not be tapered. That's a decision for your doctor to make based on your specific situation, I don't think that there is only one philosophy on this. I would make any modifications in coordination with your doctor.

That said I, I am not a doctor but believe that Prednisone is normally prescribed (in relation to ears) for sudden idiopathic hearing loss to attempt to recovery hearing function.

Prednisone like hundreds of other drugs can make tinnitus worse (often temporary) and this varies tremendously by individual so they should be used after carefully considering the risks and presumed benefit. No chemical that spends part of its time in your body as a toxic substance disrupting your natural balance is a 100% free lunch.

George

 

[Matchbox]

I wasn't told to taper my Prednisone treatment, maybe because it's only 1 week of treatment. Do you think I should continue a little bit more and taper it myself? (I still have 13 pills of 50mg.)

Thank you both for your kind words!

The safest thing to do is taper. And there's no such thing as too slow. Go slowly down. Daily.

Listen to the guy above me and you could end up waking up with lost hearing bilaterally and new droning noises.

New noises you got on it should disappear a couple weeks after you're off.

 

[MindOverMatter]

I would agree that the safest way is always to taper Prednisone.

 

[Forever hopeful]

Hi everyone,

I wanted to share my story as I am in complete panic and exhausted, even if my tinnitus is 3 weeks old.

I went to a gig 3 weeks ago, as I usually have done every weekend for 4/5 years but I usually wear earplugs, as I know that tinnitus was a real problem. But that day, the song felt not so strong and I decided to stay for 1 hour and 30 minutes (usually the gigs last 5-6 hours). When I went home, I immediately felt that I had tinnitus and I hoped that it will disappear the next day.

I took an appointment with an ENT 13 days after, as it was bearable during the day; I could only hear the tinnitus when going to bed. But I wanted to be safe and my doctor gave me 50 mg Prednisone per day for 1 week. After 3 days of treatment, my tinnitus went through the roof, it's at a 8/10 now, I can hear it all the time (with white noise/cooking/running/in the train) and my head hurts a lot. It is giving me suicidal thoughts, as I was not prepared for the Prednisone to worsen my tinnitus.

Will it go back to normal? Could someone help me and give me support or any recommendations?

Thanks everyone.

Sorry to hear about your experience. It's not the Prednisone. Prednisone will decrease any inflammation that might be contributing to hearing loss. Works on the auditory nerve. I think you're spiking for another reason. I would finish the Prednisone in case you do have inflammation to prevent hearing loss.

 

[Forever hopeful]

Tapering Prednisone is to avoid an adrenal crisis for longer courses. Anything less than 3 weeks or so may or may not be tapered. That's a decision for your doctor to make based on your specific situation, I don't think that there is only one philosophy on this. I would make any modifications in coordination with your doctor.

That said I, I am not a doctor but believe that Prednisone is normally prescribed (in relation to ears) for sudden idiopathic hearing loss to attempt to recovery hearing function.

Prednisone like hundreds of other drugs can make tinnitus worse (often temporary) and this varies tremendously by individual so they should be used after carefully considering the risks and presumed benefit. No chemical that spends part of its time in your body as a toxic substance disrupting your natural balance is a 100% free lunch.

George

I've never read or heard of Prednisone making tinnitus worse. I suppose anyone who experiences it while taking medication would make that assumption or reported as a potential side effect.

 

[Brian P]

Prednisone causes temporary flares for me. In a few days gone. Don't worry.

 

[Matchbox]

It's also important to note Prednisone affects mineral balance within the inner ear and could actually create hydrops temporarily.

It also affects a tissues ability to heal, often arresting that process.

Yes it does knock out inflammation and immune response, and yes it promotes survival of most cells (not immune B cells where I believe there it induces cell death), but it's a jack of all trades and extremely potent drug. Taking it lightly is not advised.

Dexamethasone is even stronger, but lacks this mineral balance receptor transmission... So imo would be safer to use for noise trauma or sudden hearing loss (which in fact it is used in IT injections). I'm not sure why Prednisone is prescribed so much. It's probably simpler to dose for potency, safer to taper, safer metabolically for long periods as it mimics cortisol better (which is helpful to reproduce the mineral effects of cortisol in those with real adrenal deficiency) , and is probably cheaper.
In those without damaged ears this probably isn't even a second thought (MS, Lupus, etc.)

Just important to keep in mind. Immediately after a fresh severe noise trauma resulting in bent or torn hair cells, hair cells surrounding the damage will also die, but in order to scar to seal the membrane after initial cell death, preventing leakage of endo/perilymph. If they can't do that you are setting yourself up for more cumulative damage as that tear worsens or never heals.

Not to say it doesn't have it's place in rescuing cells that are on the life/death verge. Just that immediate use (pre-48/72 hours) is probably a bad idea for very intense sound trauma vs. sudden hearing loss. Cells keep dying after that, but the majority of mechanical damage occurs immediately and needs to heal quickly (and does), metabolic damage occurs afterwards days to weeks in (and for nerves, swelling, unsynapsing and death occurs over months to even years). This is in mice and cats. But it's probably accurate for humans.

The hypothesis behind tinnitus and the route most companies (Otonomy, Auris Medical) are going, is that nerves are actually the ones less resilient to damage and synapse trauma than hair cells when it comes to noise and excitotoxicity.

True noise trauma you "may" actually be better off with boat loads of antioxidants like vitamin C, E, Mg, (and maybe a calcium channel blocker like Gabapentin to impede nerve swelling) as well as using a low dose of Lasix (immediately) after trauma (probably for 2 days?) to prevent any hydrops from occurring and the desynapsing that follows suit. This is... albeit in mice models with blast damage to their ears. Mice were shown to develop temporary hydrops and this caused the onslaught of desynapsing, as well as excitotoxicity causing nerve swelling. Injections of hypertonic saline in the middle ear near the windows, as well as Lasix both prevented these blast induced hydrops immediately post trauma, it was also shown this co-related with a remarkably high re-synapsing rate of neurons next to the inner hair cells vs control treatment).

I can find sources if requested, but this was months of reading about a year ago when I got a lot worse.

 

[TheHonoredOne]

@Matchbox, wow I never even knew this. Almost a week ago I had an event that spiked my tinnitus and I took Prednisone within two hours. I should have waited longer perhaps? What is hydrops?

Thanks.

 

[Wrfortiscue]

It's also important to note Prednisone affects mineral balance within the inner ear and could actually create hydrops temporarily.

It also affects a tissues ability to heal, often arresting that process.

Yes it does knock out inflammation and immune response, and yes it promotes survival of most cells (not immune B cells where I believe there it induces cell death), but it's a jack of all trades and extremely potent drug. Taking it lightly is not advised.

Dexamethasone is even stronger, but lacks this mineral balance receptor transmission... So imo would be safer to use for noise trauma or sudden hearing loss (which in fact it is used in IT injections). I'm not sure why Prednisone is prescribed so much. It's probably simpler to dose for potency, safer to taper, safer metabolically for long periods as it mimics cortisol better (which is helpful to reproduce the mineral effects of cortisol in those with real adrenal deficiency) , and is probably cheaper.
In those without damaged ears this probably isn't even a second thought (MS, Lupus, etc.)

Just important to keep in mind. Immediately after a fresh severe noise trauma resulting in bent or torn hair cells, hair cells surrounding the damage will also die, but in order to scar to seal the membrane after initial cell death, preventing leakage of endo/perilymph. If they can't do that you are setting yourself up for more cumulative damage as that tear worsens or never heals.

Not to say it doesn't have it's place in rescuing cells that are on the life/death verge. Just that immediate use (pre-48/72 hours) is probably a bad idea for very intense sound trauma vs. sudden hearing loss. Cells keep dying after that, but the majority of mechanical damage occurs immediately and needs to heal quickly (and does), metabolic damage occurs afterwards days to weeks in (and for nerves, swelling, unsynapsing and death occurs over months to even years). This is in mice and cats. But it's probably accurate for humans.

The hypothesis behind tinnitus and the route most companies (Otonomy, Auris Medical) are going, is that nerves are actually the ones less resilient to damage and synapse trauma than hair cells when it comes to noise and excitotoxicity.

True noise trauma you "may" actually be better off with boat loads of antioxidants like vitamin C, E, Mg, (and maybe a calcium channel blocker like Gabapentin to impede nerve swelling) as well as using a low dose of Lasix (immediately) after trauma (probably for 2 days?) to prevent any hydrops from occurring and the desynapsing that follows suit. This is... albeit in mice models with blast damage to their ears. Mice were shown to develop temporary hydrops and this caused the onslaught of desynapsing, as well as excitotoxicity causing nerve swelling. Injections of hypertonic saline in the middle ear near the windows, as well as Lasix both prevented these blast induced hydrops immediately post trauma, it was also shown this co-related with a remarkably high re-synapsing rate of neurons next to the inner hair cells vs control treatment).

I can find sources if requested, but this was months of reading about a year ago when I got a lot worse.

Bro why aren't you the one in a lab coat coming up with a cure for us? Need folks like you leading this shit lol.

 

[Exit]

I wasn't told to taper my Prednisone treatment, maybe because it's only 1 week of treatment. Do you think I should continue a little bit more and taper it myself? (I still have 13 pills of 50mg.)

Thank you both for your kind words!

If you're done with the week, of course you can taper a little bit yourself.

Example: Go 50% down in 2 days, then more slow.

My experience is that as soon as you go down to medium dose instead of high (40-60mg), your tinnitus will go down to normal.

Prednisone stresses your body, hence high dose = increased tinnitus.

 

[Matchbox]

@Matchbox, wow I never even knew this. Almost a week ago I had an event that spiked my tinnitus and I took Prednisone within two hours. I should have waited longer perhaps? What is hydrops?

Thanks.

It honestly probably had little impact.

My large rant was mostly based on mice with blast damage.

But a small dose of Lasix would probably be ok to try to see if it helps.

Hydrops is akin to Meniere's disease in which endolymph swells with fluid. In noise trauma it is temporary, in that disease not so much.
It's thought the hydrops cause synapse or nerve damage, and not so much hair damage as otoacoustic emissions can exist in Meniere's patients.

Just taper your dosing for everything is a good rule of thumb.

 

[Wrfortiscue]

It honestly probably had little impact.

My large rant was mostly based on mice with blast damage.

But a small dose of Lasix would probably be ok to try to see if it helps.

Hydrops is akin to Meniere's disease in which endolymph swells with fluid. In noise trauma it is temporary, in that disease not so much.
It's thought the hydrops cause synapse or nerve damage, and not so much hair damage as otoacoustic emissions can exist in Meniere's patients.

Just taper your dosing for everything is a good rule of thumb.

How does someone manage Meniere's?

 

[Matchbox]

How does someone manage Meniere's?

I wouldn't know. I might very well have just hydrops. It can be just ringing and weird hearing loss or much much worse.

I hear pure chaos but no ENT knows what is up and refuse injections of any kind.

 

[Wrfortiscue]

I wouldn't know. I might very well have just hydrops. It can be just ringing and weird hearing loss or much much worse.

I hear pure chaos but no ENT knows what is up and refuse injections of any kind.

Treatments coming our way in 2022, no? Some hope.

 

[Wrfortiscue]

Yes @Exit, I'm optimistic lol… People here hanging to that hope as well.

 

[PeteJ]

How do so many here get Prednisone like it's candy? The physicians there must be really open and flexible to whatever you request.

 

[tpj]

If you're done with the week, of course you can taper a little bit yourself.

Example: Go 50% down in 2 days, then more slow.

My experience is that as soon as you go down to medium dose instead of high (40-60mg), your tinnitus will go down to normal.

Prednisone stresses your body, hence high dose = increased tinnitus.

How does Prednisone stress your body?

 

[Exit]

How does Prednisone stress your body?

It raises your cortisol level and the rest is a snowball effect.

Basically the drug works by putting you and your immune system in a hyper alert state.

 

[GeorgeLG]

Depends on the person, dosage and duration but as stated it raises cortisol, the stress hormone, sometimes called the wear and tear hormone. It can be a critical drug in managing certain conditions but at a cost. IOW, it needs to be worth it. We should strive during most of our lives to manage stress and keep cortisol in the normal range,not be amped up. It can affect:

Mood
Blood sugar
Eyes
Blood pressure
Bone density
Immune system
Inflamation
Sleep
...

George

 

[Lane]

Depends on the person, dosage and duration but as stated it raises cortisol, the stress hormone, sometimes called the wear and tear hormone.

Hi @GeorgeLG -- Below is a copy a post I made three years ago on this forum.

Re: Prednisone: -- It's a drug that's about 4 times more potent than the cortisol that's naturally made in our bodies. Our bodies produce about 40 mg/day, so if you take say 60 mg of Prednisone, that's equivalent to 240 mg of cortisol. In other words, WAY more than your body would produce in a single day.

One alternative is to take some bio-identical cortisol, also known as hydrocortisone. I've taken low doses of it for years (approx. 20 mg/day), and so have a lot of experience with it, including taking more when my body needs or even requires it. Like Prednisone, it too can reduce inflammation, which is what you're after at this point.

I have a prescription for my own bio-identical cortisol, but I've seen it sold on online pharmacies without a prescription. So perhaps you can get access to it that way. You can take more than 40 mg/day for a while, but longer term use eventually leads to your adrenal glands stopping production (they sense the body doesn't need even more than you're supplementing with).

I actually think hydrocortisone may be a better option than Prednisone, as a person can experience some pretty severe side effects from Prednisone, including anxiety, sleeplessness, etc. I believe that even with relatively low doses of hydrocortisone for a few days would likely have a significant impact on inflammation in your inner ears. -- Remember, even if your tinnitus goes away soon, your ears will likely be vulnerable to acoustic shocks for the rest of your life--ESPECIALLY the next two years. -- Take care!
​

Here's a LINK to another post I made on the topic...

 

[teacher34]

Prednisone should always be tapered, and it has consistently helped both my and my son's ear problems. It reduces inflammation and damage.

 

[Freerunner]

@DSL, any update? Did the spike subside? Were there any side effects?

 

[DebInAustralia]

Hi @GeorgeLG -- Below is a copy a post I made three years ago on this forum.

Re: Prednisone: -- It's a drug that's about 4 times more potent than the cortisol that's naturally made in our bodies. Our bodies produce about 40 mg/day, so if you take say 60 mg of Prednisone, that's equivalent to 240 mg of cortisol. In other words, WAY more than your body would produce in a single day.

One alternative is to take some bio-identical cortisol, also known as hydrocortisone. I've taken low doses of it for years (approx. 20 mg/day), and so have a lot of experience with it, including taking more when my body needs or even requires it. Like Prednisone, it too can reduce inflammation, which is what you're after at this point.

I have a prescription for my own bio-identical cortisol, but I've seen it sold on online pharmacies without a prescription. So perhaps you can get access to it that way. You can take more than 40 mg/day for a while, but longer term use eventually leads to your adrenal glands stopping production (they sense the body doesn't need even more than you're supplementing with).

I actually think hydrocortisone may be a better option than Prednisone, as a person can experience some pretty severe side effects from Prednisone, including anxiety, sleeplessness, etc. I believe that even with relatively low doses of hydrocortisone for a few days would likely have a significant impact on inflammation in your inner ears. -- Remember, even if your tinnitus goes away soon, your ears will likely be vulnerable to acoustic shocks for the rest of your life--ESPECIALLY the next two years. -- Take care!
​

Here's a LINK to another post I made on the topic...

Another relapse.

Went to Bioresonance practioner yesterday who said I have low cortisol.

Spoke to my naturopath today who has suggested Adaptan to improve adrenals. Could this approach help tinnitus?

 

[DSL]

I wanted to give you all a feedback on my case, as I'm the original poster of the discussion. After my 50 mg/day for 10 days treatment, my tinnitus is worse than before and it doesn't seem to decrease after 4 month.

I'm really pissed off because my tinnitus wasn't really a trouble before my visit to the ORL, I just went there by precaution. According to my doctor, the Prednisone is not the cause of the tinnitus worsening. So what made it worse?

I'm taking Ginkgo biloba pills everyday, but no effect whatsoever.

I just hope it will fade with time or it will become bearable, as it really affects my psychological health.

Take care y'all! Any more advice is welcome