Loud and then not clear
Hearing loss is a common problem, particularly among older adults. But loud noise isn’t the only culprit for why your hearing may be fading.
These 13 causes of hearing loss may be contributing to the problem, and unfortunately not all of them can be mitigated.
1. Loud noises and noise pollution
It should come as no surprise that noise is a significant contributor to hearing loss, especially in our increasingly urbanized world.
“If you’re in a Western developed country, there’s noise everywhere. You walk out on the street … in your home, it’s ubiquitous,” says Richard Salvi, co-founder and director of the University at Buffalo’s Center for Hearing and Deafness in Buffalo, New York.
Indeed, noise pollution is a major issue when it comes to not only hearing loss, but also overall health, says Dr. Jennifer Derebery, an otologist with Providence St. Joseph Health and The House Institute Ear Clinic in Los Angeles, California. “There is evidence that even short-term exposure to noise pollution can result in negative effects on health, including a temporary rise in blood pressure most likely related to the release of stress hormones and the effect on the nervous system. During nighttime, it can result in insomnia, impaired sleep and daytime fatigue.”
Over time, this exposure can have lasting impacts, she says, resulting in increased risk of the development of cardiovascular disease. “It can also lead to irritability, frustration and anger.”
During the span of your life, it’s clear that all that exposure to loud sounds can lead to hearing loss. But the din of city life or exposure to everyday commotion aren’t the only causes of hearing loss. As it turns out, soundless risks — some common, others less so — can also quiet a person’s world.
2. Early exposures
In the U.S. today, babies are routinely screened for hearing loss. The vast majority don’t have any issues, but various factors can increase the risk for a baby to develop hearing problems.
These factors include:
— Developmental problems. Babies who are born premature, have a low birth weight or are born with certain genetic mutations may be born deaf or hearing-impaired or develop hearing problems later in life.
— Infections passed on from the mother to child like mumps or measles. “Babies exposed to the herpes simplex virus through birth can have hearing loss,” says Tricia Ashby-Scabis, an audiologist and director of audiology practices at the American Speech-Language-Hearing Association.
— Lack of prenatal care. Maternal diabetes — including gestational diabetes — can increase the risk of hearing loss for the baby as well. “Having good prenatal care and good maternal health programs can prevent hearing loss,” Ashby-Scabis says.
3. Your genes
For at least half of the children with hearing loss, genes are the culprit, according to the Centers for Disease Control and Prevention. The agency reports that about 20% of babies with genetic hearing loss have a syndrome, such as Down syndrome or Usher syndrome — which is characterized by hearing loss that worsens over time.
In the majority of people, though, genetics affect the onset of hearing loss over time — “kind of analogous to eyesight,” explains Dr. David Haynes, vice chair of the department of otolaryngology at Vanderbilt University Medical Center in Nashville. Some people will wear glasses and some don’t, “and it’s nothing environmental that’s causing that.”
4. Your age
The relentless march of time has a big impact too. “As we age, our hearing worsens, but not at the same level for every person,” Ashby-Scabis says. “The older you get, the more likely you’re going to have hearing loss. Like every other organ system, your ear deteriorates.”
Though scientists don’t yet know how or if there’s a way to prevent age-related hearing loss, or presbycusis, reducing exposure to other risk factors can help. This means wearing ear plugs or noise-canceling ear muffs while using a lawnmower or leaf blower or discharging a firearm.
5. Ear infections
Young children in particular are often prone to ear infections, which frequently accompany the cold, flu or other respiratory infections. Fluid builds up in the middle ear, the cavity behind the eardrum, and it can be painful for kids. For many, monitoring, TLC and — where appropriate — antibiotics are all that’s needed, and no lasting hearing loss occurs. But sometimes doctors recommend surgically placing ear tubes to drain fluid that persists.
If chronic ear infections are left untreated, that can lead to hearing loss, the American Academy of Otolaryngology-Head and Neck Surgery notes. If your child has frequent ear infections, talk to their pediatrician about how best to address the problem and preserve hearing.
A family history of otosclerosis, which involves abnormal bone growth in the middle ear, increases your risk of developing this condition. The condition disrupts the ability for sound to travel into the inner ear, causing hearing loss.
While a hearing aid may amplify sound for those with mild otosclerosis, experts say the best option is typically surgical. “We can take that fixed bone — it’s an isolated bone called the stapes bone — we can remove it with a laser and replace it with a custom-made prosthesis that’s made just for that, and it restores the hearing,” Haynes says. “It’s a very effective surgical option.”
7. Meniere’s disease
This condition typically affects one’s ear, and it can cause symptoms ranging from pressure or pain in the ear to ringing and dizziness. “Meniere’s disease is an underlying inner ear disorder that causes fluctuating and eventually progressive hearing loss with vertigo,” Haynes notes.
Experts say it’s important to see a doctor about symptoms to rule out other causes and ensure a proper diagnosis. Though there’s no cure for the disease, a timely diagnosis and treatment, such as medication to reduce vertigo and a hearing aid, can help address symptoms and severity.
8. Diabetes and weight gain
While the precise reasons for the link aren’t clear, research finds hearing loss is twice as common in people with diabetes as in the general population. That’s especially problematic, experts say, given the rising rates of this chronic condition in the U.S.
“And diabetes is one of the things that will probably accelerate age-related hearing loss,” Salvi points out. “So healthy lifestyle is, I think, really important.” That includes being physically active and eating a well-rounded diet, with lots of veggies — to keep weight under control and lower the risk of developing diabetes.
Alongside diabetes, weight gain may also contribute to hearing loss, Derebery says. “Elevated weight and obesity are associated with worse hearing.”
The Harvard Nurses’ Health Study, which involved more than 68,000 women, found that study participants who had a higher body-mass index or larger waist circumference were also at increased risk for hearing problems compared with normal-weight study participants. “Add hearing loss to the known health risks of weight gain, as an additional reason to address it,” Derebery says.
9. Autoimmune disorders
Usually your immune system protects you from threats like disease. But autoimmune disorders turn that typical reality on its head — and they can affect the ear.
“Just like an autoimmune disorder can attack any other part of your system, an autoimmune disorder, such as lupus, can attack the ear, which can cause some fluctuation in hearing and can cause permanent hearing loss,” Ashby-Scabis says.
Medication, such as steroids, may help, but it’s not always possible to stop hearing loss from occurring. The main line of defense is treating the autoimmune disorder itself.
10. Medications that are toxic to the ear
“Certain medications, especially some chemotherapy meds, can lead to hearing loss,” says Dr. Eugene Chio, an otolaryngologist with the Ohio State University Wexner Medical Center in Columbus. Cisplatin and carboplatin are two specific chemo drugs that are ototoxic, or harmful to the ears.
In addition to chemotherapy drugs, certain aminoglycoside antibiotics, like gentamicin (typically only given in the U.S. when less toxic options aren’t sufficient) can also cause hearing loss. These drugs are usually reserved for addressing a pressing or life-saving need.
But it isn’t only prescription medications that can create an issue. “If you take aspirin in too high of a dose, you can develop hearing loss,” Ashby-Scabis says. “You can also develop really severe tinnitus — ringing in the ears.”
Experts say it’s key to discuss these side effects with your doctor, or check with a pharmacist regarding over-the-counter meds in advance and to ensure hearing is monitored as needed.
11. Other chemicals
Derebery says that in addition to medications, exposure to other chemical compounds can contribute to hearing loss.
“An example would be BTEX (benzene, toluene, ethylbenzene and xylene), a cocktail of highly soluble and volatile organic compounds naturally occurring in crude oil and petroleum products. Ototoxic levels of BTEX can be present in both indoor and outdoor environments,” Derebery says.
She notes that exposure from cars, gas stations and refineries “can occur on a regular, or even daily, basis,” and that these common sources “constitute up to 60% of the volatile organic compounds in the urban atmosphere that are not methane.”
BTEX can also be found in indoor environments, as it can be a constituent component of various products including paints and lacquers, thinners, rubber products, adhesives, inks, cosmetics and pharmaceutical products. “The degree of hearing loss associated with exposure varies with the organic solvent type and exposure level,” Derebery says.
12. Unknown cause
Sometimes hearing loss occurs without warning or apparent cause. “It’s called idiopathic sudden sensorineural hearing loss,” Haynes says. And it may be erroneously assumed that a person has an issue like an ear infection. “We tend to see people diagnosed with having fluid in their ear when they don’t really have fluid, and they’re treated for a middle ear infection,” Haynes says.
That’s why it’s critical, experts say, that patients with sudden hearing loss don’t delay in seeing a specialist who regularly treats hearing loss, such as an otologist. You need a proper diagnosis and treatment to slow or reverse hearing loss. When administered promptly, “either steroids given by mouth or steroids injected into the ear (have the) ability to reverse that loss,” Haynes says.
13. A combination of factors
Over your lifetime, various factors, from genetics to noise to aging, have a cumulative effect on hearing. As such, experts advise taking a broad view of the risks, thinking preventively — where it’s possible to reduce those risks — and not waiting to get hearing checked and address hearing loss if or when it occurs.
And while more data is still needed to understand the role a healthy lifestyle may play in potentially reducing hearing loss — with factors like smoking linked to a higher rate of hearing loss — clinicians say there’s certainly no harm in hedging your bets by eating well, exercising and kicking bad habits that might make you older sooner.
Preventing hearing loss
“I usually tell patients that hearing loss is a factor of your age, genetics and prior noise exposure history. Of those three, you only have control over your noise exposure,” Chio notes. To mitigate that as a factor, he recommends “wearing hearing protection with any noisy event, including concerts, yard work, working with power tools, around loud engines, etc.”
He adds that for many people, hearing loss will become a fact of life eventually. “Hearing loss is something that most of us will encounter in life, especially as we age.”
Derebery adds that “the incidence of hearing loss is increasing, and much of it is associated now with everyday living, rather than occupational.” To help mitigate that, she recommends “using an app on your cell phone to monitor your daily exposure to ambient noise and familiarize yourself with the guidelines established by OSHA of ‘how much is too much’ loud noise and consider ways to lessen it.” OSHA is the Occupational Safety and Health Administration, a regulatory authority that oversees workplace safety in the U.S.
She says it’s also a good idea to “give your ears a metabolic break from even lower-level constant background noise, just as you would give your eyes a break from continued exposure to a computer monitor.”
Talk with your doctor if your hearing is fading.
If you’re starting to have difficulty hearing or understanding others, its best to check in with your doctor, Chio says. And, “see your physician immediately if you have a sudden drop in hearing in one ear or new onset ringing in one ear. This may be a sign of a viral ear infection and treatment for this is very time sensitive.”
Derebery agrees: “If you suspect hearing loss, or that someone you know has hearing loss, encourage them to be seen by an otolaryngologist,” also called an ear, nose and throat physician, for diagnosis and treatment options.
13 causes of hearing loss:
1. Loud noises and noise pollution.
2. Early exposures.
3. Your genes.
4. Your age.
5. Ear infections.
7. Meniere’s disease.
8. Diabetes and weight gain.
9. Autoimmune disorders.
10. Medications that are toxic to the ear.
11. Other chemicals.
12. Unknown cause.
13. A combination of factors.
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Update 08/17/21: This story was previously published at an earlier date and has been updated with new information.