Pain Relievers May Cause Hearing Loss
13 August 2014 by Larissa Long in Newsletter 2014 Newsletter 2014 August General Health Newsletter - No Comments
By Larissa Long
While over-the-counter pain relievers are usually considered very safe and effective by the majority of people, they do have a dark side—especially if used in excess.
One of the biggest drawbacks of taking too much acetaminophen—better known as Tylenol—is liver failure, while overuse of the popular nonsteroidal anti-inflammatory drug (NSAID) ibuprofen—also called Advil or Motrin—can cause gastritis, gastrointestinal bleeding, increased risk of cardiovascular events, kidney damage and a variety of other side effects.
Unfortunately, that’s not all.
Recent research has discovered that excessive use of certain over-the-counter analgesics could dramatically raise the risk of hearing loss in both men and women! This is pretty astounding when you consider that roughly 48 million adults in the U.S. report some degree of hearing loss, and by the age of 65, one-third of the population is affected. But what, exactly, is the tie to painkillers?
A team of Harvard researchers first discovered this link several years ago and published their results in 2010.1 In this study, they examined the association between regular use of aspirin, NSAIDs and acetaminophen in 51,529 men aged 40-74 years. The participants completed questionnaires, which asked about their use of painkillers, at baseline (in 1986) and every two years thereafter for 18 years. (Regular use was defined as two or more times per week.)
In 2004, these men completed a final, detailed questionnaire that included an inquiry about whether or not they had been professionally diagnosed with hearing loss. Of the 31,496 men who returned this questionnaire to researchers, 8,291 (26.3 percent) had been diagnosed with hearing loss. After excluding the men who were diagnosed prior to the start of the study, who received chemotherapy (which can be ototoxic) and who reached age 75 during follow-up (since advanced age is a strong risk factor for hearing problems), the number of men included in final analysis totaled 26,917—with 3,488 in that group suffering from hearing loss.
The researchers found that regular use of all three of the pain relievers was independently associated with a higher risk of hearing loss. With NSAIDs and acetaminophen in particular, the risk increased with longer duration of use. This problem seemed to affect men younger than age 50 more drastically than older men.
In a study published a few years later, this same team of researchers linked certain analgesics with hearing loss in women.2 Using a similar design as their previous study, the researchers followed women who were part of the Nurses Health Study II.
At baseline (in 1995), these women were 31-48 years of age. Just like their male counterparts, the women completed questionnaires at baseline, then every other year for 14 years.
Of the 77,956 women who turned in the detailed, long-form questionnaires at the end of the study period, 23.8 percent reported having a hearing problem. Using exclusion criteria similar to that used in the male study, 62,261 women remained for final analysis—10,012 of whom had some form of hearing loss.
Compared to the women who used ibuprofen less than one time per week, those who used this NSAID two or three days per week raised their risk for hearing loss by 13 percent. The women who took ibuprofen four or five days per week had a 21 percent higher risk, while those who used the medication six or seven days per week had a 24 percent increased risk.
Acetaminophen fared no better. Compared to those who used this pain reliever less than once per week, women who took it two or three days per week had an 11 percent higher risk for hearing loss, and four to five days per week equated to a 21 percent heightened risk.
Unlike in men, aspirin appeared to have little to no effect on hearing in women. However, just like with the men, age played a role. Women younger than age 50 had the greatest risk—especially if they used ibuprofen six or seven days per week.
According to the lead author of these studies, “Possible mechanisms might be that NSAIDs may reduce blood flow to the cochlea—the hearing organ—and impair its function. Acetaminophen may deplete factors that protect the cochlea from damage.”3
What Should You Do?
As this study highlights, just because a drug is sold over the counter does not mean it’s completely safe and free of harmful, long-term side effects.
If you take painkillers like acetaminophen and ibuprofen as intended—on an occasional, as-needed basis for acute pain—then there is no reason to stop using these medications. They do help most people and are usually well tolerated when used as directed. However, if you find that you use these meds more than once a week for chronic, lingering pain or inflammation, you may want to consider other options that don’t have nearly the risk profile.
Some of the most effective naturally sourced pain relievers you can find include capsaicin (which is an ingredient in some over-the-counter topical creams), bromelain, turmeric/curcumin, white willow bark and methylsulfonylmethane (MSM). You can find all of these at your local health food store, vitamin retailer or online.
In addition, be sure you are getting enough vitamin D every day, either through adequate sun exposure or supplementation. (Blood levels above 30 ng/mL are ideal.) Research links low levels of D to more severe pain sensitivity in those who suffer from chronic pain conditions.4
References:
- Curhan SG, et al. Am J Med. 2010 Mar;123(3):231-7.
- Curhan SG, et al. Am J Epidemiol. 2012 Sep 15;176(6):544-54.
- Harvard Gazette. http://news.harvard.edu/gazette/story/2012/09/pain-relievers-increase-hearing-loss-risk.
- von Känel R, et al. Pain Med. 2014 Apr 14. [Epub ahead of print.]
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