Hearing Loss With Rheumatoid Arthritis: Is There a Link?
There’s some concern over hearing loss with RA, but are you really at an increased risk? Find out what’s known to date and how to protect your hearing.
Rheumatoid arthritis often affects more than your joints, with heart disease, osteoporosis, kidney issues, and even gum disease among the conditions it can lead to, according to the Arthritis Foundation. But there’s also concern that hearing loss should be on that list.
The Arthritis Foundation reports that over the years, a few studies have found a higher risk for hearing loss in people with rheumatoid arthritis (RA). It’s called sensorineural hearing loss (SNHL).
However, a Mayo Clinic study published in the journal Laryngoscope in 2006 did not find increased hearing loss when comparing 29 people with RA to 30 age-matched people who didn’t have RA. The people with RA were more likely to feel that their hearing was decreased, but these complaints were not confirmed by hearing tests. The researchers theorized that the increased sense of hearing loss may have been caused by the stress of living with RA.
“Most rheumatologists are not aware of any increased risk of hearing loss in RA,” says Stacy Ardoin, MD, an associate professor of rheumatology at Ohio State University’s Wexner Medical Center in Columbus. “It is not something that we would routinely screen for. There have been some conflicting studies, but they have involved small numbers of patients.”
“At this point,” she says, “I would say the jury is still out on RA as a cause of hearing loss.”
Medication and Hearing Loss With RA One explanation for hearing loss with RA could rest with some medications used to treat RA rather than with the disease itself. Researchers found, for instance, that women who took ibuprofen six or more days a week had a 24 percent increased risk for hearing loss, compared with women who did not take ibuprofen frequently. The finding, published in the American Journal of Epidemiology in 2012, is considered significant because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) frequently used to treat RA. Also, a study done two years earlier on men and published in the The American Journal of Medicine found that their hearing, too, was impacted by NSAID use.
“NSAIDs in high doses have been linked to hearing loss,” Dr. Ardoin notes. “We are not aware of any clear links between other RA medications, like biologics, and hearing loss.” However, she says that “there are so many variables that it is hard to tease out any link — it could be medications or it could just be older age.”
Autoimmune Inner Ear Disease (AIED) When you have an autoimmune disease like RA, your body’s defense system — the immune system — mistakes parts of your body for foreign invaders, like germs, and attacks them. According to the American Hearing Foundation, AIED develops when the immune system attacks the inner ear. A symptom of AIED is worsening hearing loss. You may also have dizziness and ringing in your ears, the foundation reports.
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AIED has been linked to RA as well as to other autoimmune diseases like lupus and psoriatic arthritis, according to the foundation. However, it notes that AIED is a rare cause of hearing loss, accounting for only about 1 percent of all cases of hearing loss.
“Most rheumatologists are familiar with AIED, but we don’t usually associate it with RA,” Ardoin says.
Hearing Loss Management With RA If you have RA, getting a hearing test called an audiogram at the first sign of hearing loss is important, notes the Arthritis Foundation. Your doctor can then use that test to tell whether your hearing is getting worse over time.
If you have SNHL, your doctor may adjust your medications. If you have AIED, there are medications that may help. In some cases, the best treatment may be a hearing aid.
To protect hearing when you have RA, the Hearing Loss Association of America suggests that you consider these steps:
Let your doctor know about any over-the-counter drugs you take, as some can cause SNHL.
Let your doctor know about any ringing or roaring sound in your ears or any dizziness. These can be symptoms of inner ear disease that goes along with SNHL.
Avoid any long exposure to loud noise. Noise exposure is the most common cause of SNHL.
Wear ear protection if you’re working around loud noise or using noisy equipment, like a lawn mower.
Keep the volume down when listening to music through earbuds.
The jury may still be out on how much RA raises your risk for hearing loss, but you still want to protect your hearing.
For more information regarding Hearing Loss and Rheumatoid Arthritis, please visit EverydayHealth.com.