Hearing loss is one of the most common chronic conditions in older adults, second only to arthritis as the most handicapping condition.

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What are Causes and Risk Factors for Hearing Loss and Tinnitus?

  • Advanced age
  • Heart disease
  • High blood pressure
  • Diabetes
  • Smoking
  • Otosclerosis (abnormal bone growth in the middle ear)
  • Exposure to loud noises
  • Ototoxic drugs such as some antibiotics, chemotherapy drugs, and high doses of aspirin

What are Conventional Medical Treatments for Hearing Loss and Tinnitus?

  • Hearing aids
  • Tinnitus retraining therapy or other behavioral therapies
  • Masking devices or electrical stimulation for tinnitus
  • Stapedectomy (for otosclerosis)
  • Cochlear implants
  • Implantable bone conduction hearing devices

What are Emerging Therapies for Hearing Loss and Tinnitus?

  • Aldosterone replacement therapy
  • Neuromodulation, a process to correct the “misfiring” or “continuous” firing of neurons in the brain leading to tinnitus (eg, repetitive transcranial magnetic stimulation, deep brain stimulation, and acoustic stimulation).
  • Certain medications (eg, antidepressants and sleep aids) may help with tinnitus; however, more evidence is needed before drug strategies can be used reliably.

What Natural Interventions May Be Beneficial for Hearing Loss and Tinnitus?

  • N-acetylcysteine (NAC). NAC, a naturally occurring antioxidant that increases the production of glutathione, protected humans and animals against hearing loss from loud noises.
  • Acetyl-L-carnitine. Acetyl-L-carnitine may protect against mitochondrial damage that causes noise-induced and age-related hearing loss. Animal studies have shown that acetyl-L-carnitine can protect the cochlea and prevent drug-induced ototoxicity.
  • Lipoic acid. Lipoic acid can protect against age-related hearing loss and cochlear damage. A combination of lipoic acid with vitamin C and rebamipide improved hearing in elderly subjects.
  • Vitamins A, C, and E. Animal studies have shown that pretreatment with vitamins A, C, and/or E can protect against noise-induced and other types of hearing loss.
  • B vitamins. Elevated homocysteine levels, which are associated with B vitamin insufficiency, are linked with an increased risk of hearing problems. Specifically, low levels of folate and vitamin B12 are linked to hearing loss and tinnitus.
  • Magnesium. Magnesium can improve circulation, which is important as loud noises cause damage by decreasing blood flow to specialized ear cells. Magnesium deficiency can increase the risk of noise-induced hearing loss. Supplementation was shown to improve hearing that was damaged by noise.
  • Melatonin. Low plasma levels of melatonin are associated with high-frequency hearing loss among elderly subjects. Melatonin has protective effects and was shown to improve tinnitus in clinical studies.
  • Coenzyme Q10 (CoQ10). CoQ10 is an antioxidant that supports mitochondrial function. Supplementation reduced hearing loss in people with sudden sensorineural hearing loss and presbycusis (age-related hearing loss) and may alleviate tinnitus as well.
  • Taurine. Taurine can reverse certain biochemical processes behind hearing loss and may reduce or eliminate the ringing sound of tinnitus.
  • Other natural interventions that may be beneficial for hearing include ginkgo bilobazinc, and omega-3 fatty acids.
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