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

[Ant_BXL]

Are there differences between Prednisone and Methylprednisolone in terms of effectiveness for treating tinnitus?

Also, is there a difference in terms of getting it via intravenous injection vs. orally?

Thanks!

 

[kingsfan]

Are there differences between Prednisone and Methylprednisolone in terms of effectiveness for treating tinnitus?

Also, is there a difference in terms of getting it via intravenous injection vs. orally?

Thanks!

Drugs.com: Methylprednisolone vs Prednisone - How do they compare?

 

[NikoD]

These two steroids can be a saviour for people with sudden hearing loss.

However, I believe taking them just because you have tinnitus is a bad idea. These drugs can also increase the risk of osteoporosis which is associated with hearing loss.

 

[SuzMcG]

Steroids have ruined my life. I had some SSHL misdiagnosed as glue ear last August and was given nasal spray which turned the hearing loss into full-blown ETD, tinnitus and hyperacusis. I wish to God I'd never gone for any 'treatment'.

A week-long course of oral 20 mg Prednisone in May this year made everything even worse. I now can hardly leave the house.

 

[Nick47]

Meta analysis: No difference between intratympanic and oral steroids at all. Combining them also makes no difference.

→ Intratympanic vs Systemic Corticosteroids in First-line Treatment of Idiopathic Sudden Sensorineural Hearing Loss

 

[mrpetrov]

Meta analysis: No difference between intratympanic and oral steroids at all. Combining them also makes no difference.

→ Intratympanic vs Systemic Corticosteroids in First-line Treatment of Idiopathic Sudden Sensorineural Hearing Loss

For me, choosing intratympanic over oral Prednisone wasn't because I thought there'd be a better outcome, it was because the significant potential side effects of oral Prednisone were eliminated by having Dexamethasone administered by intratympanic injection (whose potential side effects are vastly less severe than oral Prednisone).

 

[Pharz]

Meta analysis: No difference between intratympanic and oral steroids at all. Combining them also makes no difference.

Yeah I have done both, makes no difference.

 

[gameover]

I'll keep you posted if I see any further improvements or when I eventually finish the the medication to see if it goes back to its original form or if it hopefully just stays like it is now.

Wish we got an update

 

[St0PR1NGiNG!]

I've been experiencing ringing in my left ear for the past two weeks. There doesn't seem to be anything visibly wrong inside my ear. During the final part of the audiogram, my left ear's hearing was worse than my right, but the doctor suggested that it might be because I couldn't hear the test tone due to the ringing.

The ENT specialist wants me to take Prednisone for 9 days. The treatment plan involves starting with 60 mg for 3 days, then reducing to 40 mg, and then 20 mg. I'm not sure what I will end up doing. I asked if I could wait a week since I am going away, but he didn't recommend it. I'm hesitant to start this new medication while I am away, and I'm feeling quite anxious after reading about the potential side effects.

The doctor mentioned that if the prednisone doesn't work, we will probably need to do an MRI to ensure that there's nothing else going on in my head.

 

[kingsfan]

I've been experiencing ringing in my left ear for the past two weeks. There doesn't seem to be anything visibly wrong inside my ear. During the final part of the audiogram, my left ear's hearing was worse than my right, but the doctor suggested that it might be because I couldn't hear the test tone due to the ringing.

The ENT specialist wants me to take Prednisone for 9 days. The treatment plan involves starting with 60 mg for 3 days, then reducing to 40 mg, and then 20 mg. I'm not sure what I will end up doing. I asked if I could wait a week since I am going away, but he didn't recommend it. I'm hesitant to start this new medication while I am away, and I'm feeling quite anxious after reading about the potential side effects.

The doctor mentioned that if the prednisone doesn't work, we will probably need to do an MRI to ensure that there's nothing else going on in my head.

If you're going to take the Prednisone, you don't want to wait. It's normally taken within 48-72 hours of any sudden hearing loss. At 60 mg, you'll have side effects: anxiety, jitteriness, and probably increased appetite. Taking it in the morning helps against sleeplessness.

 

[Nick47]

I've been experiencing ringing in my left ear for the past two weeks

Prednisone is useless to take now, pal. It's normally useless unless given within 72 hours, and then it's still often useless. It's only for sudden hearing loss of over 30 dB on at least three frequencies.

Is there money in it for the ENT, either privately or through insurance?

 

[justguts]

Wish we got an update

It went back to baseline. I still go back and take Prednisolone every few months because I can't deal with my tinnitus most of the time. Sorry for not updating, but I've been super demotivated, and I only feel normal when I'm on the drug since it makes my tinnitus barely noticeable unless I'm going to sleep.

 

[Calapsodis]

Prednisone is NOT ototoxic. Most things do not damage the ear. A few do.

Is this still true? If you search "Is Prednisone ototoxic?" on Google, there are (at least from what I saw) five websites that come up on the first page saying glucocorticoids like Prednisone and Dexamethasone are ototoxic. All of them say that the potential for it to occur depends on how much you're taking and for how long.

 

[Nick47]

on Google, there are (at least from what I saw) five websites that come up on the first page saying glucocorticoids like Prednisone and Dexamethasone are ototoxic.

Don't use Google, then. All sorts of rubbish is on there. Use literature libraries like PubMed or Google Scholar.

 

[gameover]

This paper explains the inflammatory mechanism after acoustic trauma and why steroids, while not perfect, can be beneficial.

→ Inflammation associated with noise-induced hearing loss

When I experienced my noise trauma, I did not know what to do. I had some ear fullness, but tinnitus only showed up about four days later. Only then did I find Tinnitus Talk. Finding information on what to do after noise trauma is difficult. The tinnitus was initially mild, and while I was terrified, I believed it would pass in time. No, it did not; it got much worse. My ears were self-destroying themselves, and within two months, my tinnitus had become severe.

I found information about steroids early on here, but the reports were conflicting; the majority of posts are about oral steroids, which come with serious side effects.

If I knew what I know now, I would have run to get intratympanic steroid injections. Perhaps I could have saved my life from the destruction a severe, sometimes catastrophic, reactive tinnitus has caused.

 

[FlatDarkEarth]

This paper explains the inflammatory mechanism after acoustic trauma and why steroids, while not perfect, can be beneficial.

→ Inflammation associated with noise-induced hearing loss

Can I ask what your noise trauma was from?

I recently just got over a flare-up from a dental procedure, and I got exposed to semi-loud sound last week. I'm having worse issues now, and I'm not sure if it's just a flare-up or if I could have done some more damage.

It really didn't seem loud enough/long enough to give me damage from my estimation, but now I am getting worried and wondering what I can do. I just got through a Prednisone pack I had lying around at home.

 

[Bob3382]

I was recommended Prednisone, so I decided to do some research. When some people experience an inner ear infection accompanied by sudden hearing loss, treatment with Prednisone within the first three to four weeks can reduce the inflammation, and the tinnitus disappears. It was a long shot, but I decided to try it. Unfortunately, it did not work for me.

 

[ringinginmyears]

I have low-frequency hearing loss in my right ear, along with severe, fluctuating tinnitus. Whenever I take Prednisone, much of the blocked sensation in my ear goes away, and the tinnitus initially turns into a low, bass-like hum before disappearing altogether.

However, whenever I stop taking the medication, my hearing deteriorates again, the blocked feeling returns and the tinnitus comes back. I've had MRIs, which were all clear, but I'm still unsure what the underlying issue is.

What could be wrong with me?

 

[Nick47]

What could be wrong with me?

Maybe Meniere's or Cochlear Hydrops.

 

[kingsfan]

I have low-frequency hearing loss in my right ear, along with severe, fluctuating tinnitus. Whenever I take Prednisone, much of the blocked sensation in my ear goes away, and the tinnitus initially turns into a low, bass-like hum before disappearing altogether.

However, whenever I stop taking the medication, my hearing deteriorates again, the blocked feeling returns and the tinnitus comes back. I've had MRIs, which were all clear, but I'm still unsure what the underlying issue is.

What could be wrong with me?

I have similar results with Prednisone, though I don't have any of the low-frequency stuff going on—my tinnitus gets noticeably calmer, and my ears feel free from constant but fluctuating pressure.

I also have terrible allergies that I can no longer take medication for since they spike my tinnitus and asthma, which I do manage to take Singulair for. Still, I haven't had an inhaler since switching to Medicaid, which they won't pay for, and no other inhalers actually help.

 

[ringinginmyears]

Maybe Meniere's or Cochlear Hydrops.

Unfortunately, I experienced a severe spike in my tinnitus again last night. It was so intense that I almost felt like putting a knife in my ear to dig it out. I contacted my ENT, and now I'm on my fourth course of steroids this year. Once again, the tinnitus has significantly decreased within 24 hours.

I'm still waiting for a proper diagnosis, and I'm not comfortable continuously relying on these medications, but they're the only thing keeping me sane at the moment.

 

[LemonCube]

Does anyone have any recent experience with oral dexamethasone? I was put on a low dose of 4mg which is around 30mg of prednisone for 5 days following acoustic trauma.

I'm considering getting intratympanic steroid injections if the opportunity arises but the closest ENT appointment is 3 weeks away. I've also seen some say it resulted in tinnitus that became worse which leaves me terrified.

 

[Nick47]

I've also seen some say it resulted in tinnitus that became worse which leaves me terrified.

Generally, it is considered safe for short-term use. The usual dose is 60 mg, typically taken for one to two weeks. Timing is important—three weeks may be too late for it to be effective. Always follow your doctor's advice rather than relying on information from internet forums.