Americans love NSAID pain relievers. Millions take ibuprofen (Advil, Motrin IB), or naproxen (Aleve) every day. Millions more swallow NSAID pain relievers their physicians prescribe. These drugs include celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), meloxicam (Mobic), naproxen (Naprosyn), piroxicam (Feldene) and sulindac (Clinoril). Most people know that such drugs can be hard on the digestive tract. But did you know that these drugs can also be hard on your hearing?
Hearing Loss and NSAID Pain Relievers:
Regular use of NSAID pain relievers like ibuprofen or naproxen may increase a woman’s risk of hearing loss. That is the finding from analyzing more than six years of data from the Nurses Health Study (American Journal of Epidemiology, online Dec. 14, 2016).
In this research, almost 56,000 women answered questions about their use of over-the-counter pain relievers. Those who used a nonsteroidal anti-inflammatory drug (such as ibuprofen) or acetaminophen at least twice a week had a 9 to 10 percent increased chance of developing hearing loss.
This is not the first time we have heard about NSAID pain relievers and hearing. In the 1990s experts were warning (Otolaryngologic Clinics of North America, October, 1993):
“Salicylates and most NSAIDS in high doses cause mild to moderate temporary hearing loss, either flat or greater in the high frequencies. Hearing loss is accompanied by tinnitus [ringing in the ears] and suprathreshold changes.”
In March of 1996, authors writing in the journal Drug Safety noted that “Over 130 drugs and chemicals have been reported to be potentially ototoxic [damaging to hearing].” One prominent class of drugs on their list includes NSAID pain relievers, ie, anti-inflammatory drugs.
Stories from Readers:
It is hard for people to understand how incredibly disruptive tinnitus can be. It not only affects hearing; it can ruin the quality of a person’s life. Here are just a few reports from visitors to this website.
J.C. is caught between two terrible choices:
“I have suffered from migraines since I was a teen. If I catch a headache soon enough, three Advil will stop it. It’s better than taking Imitrex and feeling out of it all day.
“I now have severe tinnitus and hearing loss in my left ear. I’ve been to every doctor, had an MRI, and found nothing. I would like to stop taking Advil so I don’t get tinnitus in my right ear but I have no idea what pain reliever is safe for me to take.”
Frances in California shared this:
“My mother had tinnitus for 30 years before she died in April. No doctor could ever help her suffering with the constant ringing in her ears. No one could ever give her a reason for her having the problem, either. She told me that I’d probably, eventually, have it, too. (A doctor told her that it was genetic).
“She took an overabundance of pain meds throughout her life thinking there would be no side effects.”
“I have the same problem with ringing in the my ears if I take Tylenol.”
What About Acetaminophen?
Most people assume that the ingredient in Tylenol, acetaminophen, is super safe. An overview of epidemiological studies suggests that there may very well be a link between acetaminophen and hearing loss (Otolaryngology, Head and Neck Surgery, March, 2015).
“This systematic review evaluated the impact of NSAIDs and acetaminophen on sensorineural hearing loss. Overall, the data were frequently limited by the method of hearing evaluation or sample sizes. These data also varied, demonstrating a measurable effect on self-reported symptoms from NSAIDs as a class, ibuprofen, and acetaminophen but without audiometric data to confirm this suggested audiometric effect…
“When multiple NSAIDs were evaluated together, self-reported hearing results suggested an approximately 20% risk increase, but audiometric data have yet to corroborate these findings; the extent of the potentially associated hearing loss also remains uncharacterized. Similarly, self-reported hearing results regarding ibuprofen suggest a 13% to 24% associated increase in risk of hearing loss in large prospective studies, but studies with formal audiometric measurements have yet to confirm this finding.”
The study just published in the American Journal of Epidemiology pretty much confirmed those findings.
What Can People in Pain Do?
Millions of people are in pain. NSAIDs not only appear to affect some people’s hearing, they have other side effects as well. Adverse reactions from NSAID pain relievers include high blood pressure, edema, heart attacks, strokes, atrial fibrillation, congestive heart failure, indigestion, ulcers, perforation of the stomach or intestines, kidney damage, liver damage and blood disorders (anemia).
Short-term use of NSAIDs in low doses are unlikely to cause many of these complications. And a 10 percent increase in hearing problems is quite modest. But considering how many people use an NSAID on a regular basis, it could still end up with a lot of people straining to hear.
A nurse is caught between a rock and a hard place:
“I have taken Advil for years for inflammation or pain. I have stopped because I began to have ringing in the ears, ear pain, dizziness and loss of hearing. This all disappeared when I stopped the Advil.
“I just assume that I can’t take NSAIDS anymore. What do you recommend I take for problems with heel spurs, disc problems and torn cartilage in the knee? I am an RN and do a lot of walking and lifting at work.”
Some people may benefit from topical NSAIDs like Voltaren Gel or Pennsaid. They are less likely to get into the blood stream in levels that can cause hearing loss and tinnitus.
There are a great many nondrug options for dealing with inflammation and arthritis pain. Some people find that home remedies like gin-soaked raisins are helpful. Others like Certo and grape juice, Knox Gelatine, or vinegar and juice. Herbs and spices such as turmeric, Boswellia, ginger and Ashwagandha may also be helpful.
You can learn more about home remedies and the medicinal value of kitchen spices in our books:
Share your own experience with NSAIDs and hearing in the comment section below.