Steroids: Prednisone / Dexamethasone / Others (Oral and Intratympanic Injections)

[John_415]

@paganismos
Tough luck man, I never had an ear irrigation, could be that its really noisy and indeed that caused it.
Prednisone is a kind of corticosteroids so your allready on a likewise medication then.
I know corticosteroids decrease wound healing (I had a cut on my finger and because of my high dose of corticosteroids it just didn't heal that much). Then again anti-biotics should solve any infection I think.

 

[paganismos]

Thank you for answering, @John_415.
Took my first dose already. The ENT told me that it was probably TMJ, because my left ear hurt real bad yesterday, including parts of the cranium and neck, and also because I've had jaw problems since I was a little kid lol, but I insisted on prednisone because I wouldn't forgive myself if I didn't take the shot. So the dose is like this:
50mg x 7 days
-37mg on day 8
-25mg on day 9
-12.5mg on day 10

Is it too low? Or is it the right dosage?

I have a bit of hope, it's been 80 hours since the onset. I'm quite sad I didn't found out earlier. Thank god I found an appointment yesterday night, or should've waited till tuesday, 8 days after the onset.

 

[John_415]

Thank you for answering, @John_415.
Took my first dose already. The ENT told me that it was probably TMJ, because my left ear hurt real bad yesterday, including parts of the cranium and neck, and also because I've had jaw problems since I was a little kid lol, but I insisted on prednisone because I wouldn't forgive myself if I didn't take the shot. So the dose is like this:
50mg x 7 days
-37mg on day 8
-25mg on day 9
-12.5mg on day 10

Is it too low? Or is it the right dosage?

I have a bit of hope, it's been 80 hours since the onset. I'm quite sad I didn't found out earlier. Thank god I found an appointment yesterday night, or should've waited till tuesday, 8 days after the onset.

Whoops, I called you a man, sorry about that, paganismos sounded not so feminin I thought. My mistake.
I think the dose is right, lots of people here have had to low of a dose (according to my latest ENT doctor who seems very trustworthy) I am no expert, perhaps higher dosages also mean higher risks. I had 30mg for 7 days, 6 weeks after onset) now a different ENT gave met 60mg for 10 days. There is a formula on deciding the ideal Kg to prednison weight ration which he used (probably the same as in Germany).
O yeah, if you look in the booklet it says side effects like: moonface and fat in the tummy area. I didn't take that seriously and still ate lots all-you-can-eat restaurant meals. I now find myself looking at more bellyfat, right at the sides. Im lucky it didn't go right to my face-_-. Im doing a full low sugar, low carb diet (or paleo diet in my case). This should not cause the same issues I think. Nowbody wants to get moonfaced after prednison I think:þ
Your lucky you got there so quickly, I am less lucky I guess. Appointment times with ENT's are very long here.

 

[John_415]

My results with predisnolon so far:

My initial state of T, 6 weeks after onset:
T mostly only in my left ear and only barely audible in my right ear. The sound was an annoying morse code which is harder to mask.

My state of T on week 7 after onset with 30mg of prednisolon for 7 days was as following:
After the 7 day treatment my left ear T changed into a way more steady tone which is a lot easyer to mask or ignore.
Downside was that I got a new barely audable 'hard drive' sound in my right ear (sounds like a mechanical hard drive, inside of a computer, 5 meters away, so barely audable).

My state of T right now in week 8,5 after using 60mg of prednisolon for 2 days (out of 10 days):
The loudness went up in both my left ear and the hard drive sound has gotten louder in my right ear, to a level which is somewhat lower then my left ear. I am wondering if its worth continuing this route or taking my win and leaving prednisolone alone. If the new sound sticks after quiting prednisolone that would not be an improvement.

 

[paganismos]

Whoops, I called you a man, sorry about that, paganismos sounded not so feminin I thought. My mistake.
I think the dose is right, lots of people here have had to low of a dose (according to my latest ENT doctor who seems very trustworthy) I am no expert, perhaps higher dosages also mean higher risks. I had 30mg for 7 days, 6 weeks after onset) now a different ENT gave met 60mg for 10 days. There is a formula on deciding the ideal Kg to prednison weight ration which he used (probably the same as in Germany).
O yeah, if you look in the booklet it says side effects like: moonface and fat in the tummy area. I didn't take that seriously and still ate lots all-you-can-eat restaurant meals. I now find myself looking at more bellyfat, right at the sides. Im lucky it didn't go right to my face-_-. Im doing a full low sugar, low carb diet (or paleo diet in my case). This should not cause the same issues I think. Nowbody wants to get moonfaced after prednison I think:þ
Your lucky you got there so quickly, I am less lucky I guess. Appointment times with ENT's are very long here.

I'm paleo too A bit of weight gain is not a big deal... And it's coming from someone on recovery for bulimia! I'd rather have fully cheeks which probably will go down because is not a long time, than annoyance thanks to T.

Has anyone recovered completely after Prednisone? Or it just lowers the symptoms?

 

[John_415]

Does anyone with experience with multiple sessions of Prednisone know if it works the same way every time you take a course of it? Like does it either improve or do nothing, or does it improve the one course and then get worse the next course? I wonder if prednisone keeps working bound to the person or if its just random coin flips every time.

@paganismos
Paleo is great, I know some people who did it for about a year and they look 5 years younger after that. Plus you can eat a lot of the healthy stuff without gaining weight. I believe its all the sugars and white flour that cause the negative/ inflamation effects.

 

[paganismos]

Hey everyone. Just came back from the ENT. Told her I was on prednisone 50mg. She prescribed me dexamethasone injection in my bum and diclofenac. Today is 8th day after the onset. Should i go for it?

 

[just1morething]

Hey everyone. Just came back from the ENT. Told her I was on prednisone 50mg. She prescribed me dexamethasone injection in my bum and diclofenac. Today is 8th day after the onset. Should i go for it?

Does that mean through the eardrum injection of dexamethasone? IT injections are usually done for sudden hearing loss.

 

[paganismos]

Help me please, I'm really debating. It's dexamethasone 4mg intramuscular injection

 

[just1morething]

Okay it must be a way of getting dexamethasone into the bloodstream. If your ENT recommends doing so, it probably is okay I would guess. Most Dr.'s have a "do no harm" policy. I have only heard of IT dexamethasone injections. Someone else on the forum might have had this done? I would think prednisone orally or an injection of dexamethasone into the muscle would do about the same thing, but I'm just guessing. You could ask if there could be any side effects or complications.

Personally if the risk-benefit ratio is reasonable, why not? Your window of opportunity could be closing on it helping.

 

[paganismos]

Okay it must be a way of getting dexamethasone into the bloodstream. If your ENT recommends doing so, it probably is okay I would guess. Most Dr.'s have a "do no harm" policy. I have only heard of IT dexamethasone injections. Someone else on the forum might have had this done? I would think prednisone orally or an injection of dexamethasone into the muscle would do about the same thing, but I'm just guessing. You could ask if there could be any side effects or complications.

Personally if the risk-benefit ratio is reasonable, why not? Your window of opportunity could be closing on it helping.

Yes, I had an anxiety attack that made my jaw tense and didn't go for it. Spoke to another ENT who told me it wasn't necessary and that it didn't reccommend me doing it because it was "deposit" (not sure of what he means by that, but the injection wasn't giving me good vibes and my treatment with prednisone has been more than OK for me. Thanks for helping me.

 

[just1morething]

@paganismos, I guess I would go with what you feel the most comfortable with. It appears that the dexamethasone injection would give you the highest dose of steroid. You could always ask a 3rd ENT and also your primary care Dr. what they think? I had a (3) IT injections of dexamethasone years ago, but it was way past any ear trauma I had. That would be by far the most direct steroid placement without affecting the rest of your body.

https://www.sciencedirect.com/science/article/pii/S101631901300013X

https://link.springer.com/article/10.1007/s12070-017-1213-3

This place did my ear perfusion but it appears they no longer do them:

https://www.pehni.com/patient_ed/tinnitus.htm

I also had ear perfusion here:

http://www.sheaclinic.com/services/17/Tinnitus

 

[paganismos]

@paganismos, I guess I would go with what you feel the most comfortable with. It appears that the dexamethasone injection would give you the highest dose of steroid. You could always ask a 3rd ENT and also your primary care Dr. what they think? I had a (3) IT injections of dexamethasone years ago, but it was way past any ear trauma I had. That would be by far the most direct steroid placement without affecting the rest of your body.

https://www.sciencedirect.com/science/article/pii/S101631901300013X

https://link.springer.com/article/10.1007/s12070-017-1213-3

This place did my ear perfusion but it appears they no longer do them:

https://www.pehni.com/patient_ed/tinnitus.htm

I also had ear perfusion here:

http://www.sheaclinic.com/services/17/Tinnitus

The thing is it wouldn't be intratympanic, but intramuscular. So I'm not sure. Took the diclofenac and I'm having a spike, so I'll stop it for now. Still not sure what to do. Sh*t.

 

[John_415]

Any one here had a stinging sensation in the stomach area because of Prednisolone?
Im at day 7 out of 10 on 60mg, taking 3o mornings and evenings. This evening after I took 30mg at dinner and I am getting the feeling im getting pricked by a pin about every 10 minutes now. I hope this is nothing bad.
The only change I made tonight compared to any other time is that I didn't drink it with milk (which ran out today).
I am guessing milk is as stomach protecting as I read it is, so thats an important note here.

 

[Jan64]

Any one here had a stinging sensation in the stomach area because of Prednisolone?
Im at day 7 out of 10 on 60mg, taking 3o mornings and evenings. This evening after I took 30mg at dinner and I am getting the feeling im getting pricked by a pin about every 10 minutes now. I hope this is nothing bad.
The only change I made tonight compared to any other time is that I didn't drink it with milk (which ran out today).
I am guessing milk is as stomach protecting as I read it is, so thats an important note here.

My German ENT said: take it all in the morning. You will also sleep better! When I took it, it also made me a bit sick, you can ask your GP for a stomach protector (NL: "maagbeschermer' but be aware that medicine is not causing tinnitus..., just check the internet). Or get 'Strepsils' from the drugstore.
What also helps is to get the prednisolon in 5 mg pieces and take in with some time (10 min) between it. You can discuss this with your farmacy. Every time I got a prednisolon prescription I request the prednisolon in 5 mg pieces...
Power to you!

 

[annV]

I had a (3) IT injections of dexamethasone years ago, but it was way past any ear trauma I had.

How did the dexamethasone IT injections help you? Any effect at all?

 

[John_415]

Results on my second course of Prednisolone:
My T went up from day 1 of taking 60mg. It went up a lot, it went down on day 6 to baseline. The effects of taking prednisolone are fairly bad, like little pains in the stomach, intestins, feeling my heart beating faster and all. I sometimes am thinking what the hell I wrote myself up for, taking this stuff. Anyway the effects should only be short term as I read.
So now my T went back to baseline... or perhaps a bit below that, but its hard to tell with it varying from day to day. Im sure it didn't get any louder then before. Im also very glad to have my T on this level and not on the much louder level I had when on prednisolone. I would almost say I appreciate my T more for being on this lower level and not being as loud as it was on prednisolone. It really almost stepped into the daylight following me around but now its back to only being heard by me in a very quiet room. So im happy about that.

Doing HBOT now, while still inside my 3 month window. After this its just onward to accepting this stuff, which will be a lot more easy since I (waded) trough waiting times to get pred and HBOT, and can feel I did all I can to delete it. If I can't delete it, il accept it somehow. Il post HBOT results in the HBOT thread: https://www.tinnitustalk.com/threads/hyperbaric-oxygen-therapy.211/

@Jan64
Good idea taking it in smaller dosage pils, I split the pils I had in pieces and took them spread over the day. I didn't think about thatXD. I sticked with milk for the stomach issues, I didn't like getting even more kinds of medication.

 

[John_415]

My conclusion on 2 sessions of prednisolone:
Before the sessions my T was basically only in my left ear at 5000Hz.

After session 1 (5 weeks after onset) the volume dropped a lot in my left ear.
Very light T started appearing in my right ear as well at 10000Hz.

After session 2 (8 weeks after onset) the volume of my left ear decreased a little bit.
Light T in my right ear increased a little bit as well.

So The volume decreased in my left ear (mainly after taking pred asap), the second course did not do much.
My advice on prednisone would be to take it really early and then afterwards leave it alone.
I would also recommend having some at home stashed somewhere (expiration date would be 3 years), or having an ENT you can call immediately to get a new recepy of prednison so you can take it right after onset. Next to that its still a heavy medicine, at least I am glad I did try this stuff and perhaps it will increase spontanious recovery speed later on.

 

[Natalie Roberts]

I had an MRI Thursday evening and since then have noticed my tinnitus spiking. Is it too late to take steroids for the noise exposure?? Not sure it's from the MRI or not but I am looking for any relief.

Thanks

 

[RallySportRyan]

Hello everyone!

I've had an unfortunate incident a month ago where I went to new indoor shooting range. I always wear ear protection in the form of foam ear plugs that have a 32db nrr. This particular range allows patrons with rifles. About midway into my 1 hr shooting session I think one or two people showed up with a shotgun and high powered .308 rifle. Once they began firing I should have just got out of there or at least been told by a range officer to double up with ear muffs because it literally felt like it shook the whole range every shot. I finished the entire 1 hr session and I fired 100 rds of 9mm and 100 rds of 40 cal ammo.

I never did notice any ringing or cotton ball effect on my hearing after leaving the range that night and went to sleep. The next day I decided to mow and weed eat the yard which took about 2 hrs to do with foam ear plugs but no muffs. That day I didnt notice anything different with my hearing either. Then by Friday morning and definitely by Friday night the ringing in my ears was unbearable and I only got 4 hrs of sleep for the next 2 or 3 days.

On the 5th day I finally went to immediate care about my problem and told them about taking prednisone for my acoustic trama. He agreed to start me on a 12 day regimen of 10 mg pills 4 times a day and then taper off. He also gave me a steroid shot that night in the thigh to get it going. I noticed on the 3rd or 4th day my tinnitus went silent but I was having some hypercusis.

Well after tapering off by the 12th day my tinnitus came back about the same as before. So I scheduled an appt with an ent since my T spiked back up. It turns out my left ear is fine and robust at all frequencies. My right ear is reduced at 6 to 9db around 5 to 6 kHz and 19-20db around 8-9 kHz :-(. Thats the right side the rifle/shotgun people were on but several stalls down from me. I am hearing ringing in both ears though.

The ENT talked about the intratympanic injection in my ear but he wanted to put me back on prednisone first for 14 days and to take all 4 10mg pills each day for a week and then taper off. This time around though the prednisone is not working as well as the first course I took 3 weeks ago. What are my other options left to get this tinnitus under control? I've been taking NAC this whole time since the first round of prednisone and I am now taking Inner ear health pills (aka lipo-flavonoid). So far my T is slightly reduced but I can still hear it above certain sounds like for example air rushing out of the floor vents at night doesn't mask it :-( What should be my next course of action? This is depressing and maddening knowing what I had before all this occurred.

Thank you all!

 

[annV]

The ENT talked about the intratympanic injection in my ear but he wanted to put me back on prednisone first for 14 days and to take all 4 10mg pills each day for a week and then taper off. This time around though the prednisone is not working as well as the first course I took 3 weeks ago. What are my other options left to get this tinnitus under control? I've been taking NAC this whole time since the first round of prednisone and I am now taking Inner ear health pills (aka lipo-flavonoid). So far my T is slightly reduced but I can still hear it above certain sounds like for example air rushing out of the floor vents at night doesn't mask it :-( What should be my next course of action? This is depressing and maddening knowing what I had before all this occurred.

I think you are doing all the correct emergency procedures, prednisone, NAC... There is unfortunately not much else you can be trying.

 

[IvanRus]

Do any of you take short oral corticosteroid courses (prednisolone and others) as for prophylaxis, after unpleasant high-profile events provoking bursts of tinnitus?

My grandmother swore loudly, being in the same room with me about 2 weeks ago. Since then, tinnitus is louder, and my home audiogram showed different meanings than usual. I took 3 days for 15 mg of prednisolone immediately after the event, but apparently this is not enough. I thought about another short course, for example starting at 30 mg.

What do you say ?!

 

[Bill Bauer]

Do any of you take short oral corticosteroid courses (prednisolone and others) as for prophylaxis

I do.

I took 3 days for 15 mg of prednisolone immediately after the event, but apparently this is not enough. I thought about another short course, for example starting at 30 mg.

The standard dose is 1 mg per 1 kg of body weight, with a maximum of 60 mg. The standard duration is 14 days + tapering, but I think taking it at the standard dose for 2-3 days ought to help too (with minimum risk of complications/side effects).

 

[IvanRus]

@Aaron123 , @Markku , @Steve ,

I have several questions of principle regarding Corticosteroids, and prednisolone in particular.

1) Who can briefly explain the pathogenetic validity of the use of prednisolone in acute sensoneural hearing loss / tinnitus?

By what kind of pharmacological properties does it help?

After all, logically, he on the contrary increases the production of the hormone cortisol - a stress hormone, a destructive hormone. Discharges sodium from the body and delays the water ?!

2) Is it possible to simultaneously take an antidepressant from the SSRI group and prednisolone in a medium dose a short course? Does anyone have a similar experience?

Thank you!

 

[fran dana]

Can prednisone cause glaucoma?

 

[Liam_Cairns]

Can prednisone cause glaucoma?

I'm not a doctor, But doing a search online it says that it can, which makes sense as it does raise your blood pressure. A side effect which I definitely noticed.

 

[Tamara]

Yes, because corticosteroids may increase intraocular pressure. The dose and time of treatment have to be controlled and accompanied by a doctor who understands about corticosteroids. There are many other consequences of using this type of medication.

 

[fran dana]

Liam_Cairns , Tamara

thanks to both!
It's ALL a decision. be deaf or go blind hehe

 

[Noise_sucks]

What is the recommend dosage for Prednisolone?
I had a recent (mild) acoustic trauma and want to give the steroids a try.

 

[1MW]

1mg / kg is usual the doctors recommend.
But this summer I had a mild sudden hearing loss and I did pulse IV methylprednisolone 500mg / day for 3 days and after that tapering.
About 8 hours after the first pulse the hearing returned to normal confirmed with audiogram.

Doctors said to me to do 80mg / day but made my decision to take a huge dose of 500mg and the result showed that I was correct.

In sudden sensorineural hearing loss / Tinnitus/ Hyperacusis corticosteroids have very good results if taken immediately and at huge doses.