Hearing loss and rheumatoid arthritis (RA) often occur together. People with RA have an increased risk of hearing loss, especially sensorineural hearing loss.
Sensorineural hearing loss is hearing loss due to damage in the inner ear. This type of hearing loss affects the ability of the brain to interpret sound signals from the ear. Several different factors may contribute to hearing loss in RA.
For instance, damage to the ear from
In this article, we provide more information about RA and hearing loss, including the causes and treatment options. We also discuss other autoimmune diseases that may affect a person’s hearing.
RA may increase the risk of both conductive and sensorineural hearing loss.
Conductive hearing loss happens when there is damage to the outer and middle portions of the ear, making it difficult for the ear to conduct sound.
Sensorineural hearing loss refers to damage that is deeper in the ear, affecting the inner ear and nerves. This type of hearing loss disrupts the brain’s ability to interpret sound.
A person can also experience mixed hearing loss, which means that they have both types of hearing impairment.
Researchers do not yet fully understand how or why RA might cause hearing loss.
However, some potential explanations
Environmental risk factors
Smoking, exposure to loud noises, and alcohol may increase the risk of hearing loss in all people, including those with RA. Smoking is also a risk factor for RA itself.
Various studies have linked over-the-counter drugs, such as ibuprofen, to hearing loss. For example, a
Experts suspect that the reason for this link is that these pain relievers reduce blood flow to the ears. If this is the case, the long-term use of certain pain relievers may damage hearing in some people.
People with RA may also take antibiotics to treat infections, especially when they use immunosuppressants that increase infection risk. Some antibiotics, including streptomycin and neomycin, may also increase hearing loss risk.
RA-related ear damage
As with other autoimmune diseases, RA causes the body to attack healthy tissue. It may damage tissue in the ears or nerves and affect a person’s hearing.
Although hearing loss is treatable, it is not always curable.
When hearing loss or ringing in the ears occurs as a result of medication, stopping the medication
Other treatment options depend on the cause of the hearing loss, as well as its severity. Some options
- Steroids: Corticosteroids may help reverse autoimmune hearing loss.
- Vasodilators: These drugs dilate the blood vessels, improving blood flow to the ear. They may help reverse damage from RA drugs.
- Anti-inflammatory drugs: Drugs to reduce inflammation may prevent further hearing loss, and, in some cases, they may even reverse it.
- Lifestyle changes: Limiting alcohol intake and quitting smoking can also reduce the negative effects of these substances on hearing.
- Hearing aids: Hearing aids do not reverse hearing loss, but they can help a person hear better, reducing the risk of communication issues, depression, and other consequences of hearing loss.
Chronic inflammation is common in autoimmune diseases. Several studies suggest that this inflammation may impair hearing by damaging the ears or the nerves that send signals to and from the brain. Inflammation can also damage the blood vessels, changing the flow of blood to the ears and disrupting hearing structures.
Treating inflammation may reduce the risk of hearing loss. In some cases, anti-inflammatory treatments may even reverse hearing loss.
RA is just one of many autoimmune diseases. Autoimmune diseases cause the body’s immune system to attack healthy cells, which can lead to widespread inflammation, as well as damage throughout the body.
Research on other autoimmune diseases has identified a higher risk of hearing loss among people with autoimmune disorders compared with those without these conditions. For example, 2021 research found that people with systemic lupus erythematosus had significantly higher odds of hearing loss than age-matched controls. Across all the reviewed studies, the average prevalence of hearing loss among people with lupus was 27%.
A rare autoimmune disease called
People with autoimmune diseases are more vulnerable to additional autoimmune issues. Due to this, people with RA should not assume that this condition is the only possible explanation for any hearing loss. A second autoimmune condition, such as autoimmune inner ear disease, may be causing the hearing issues.
Rheumatoid arthritis can cause hearing loss either directly, if inflammation damages the ears and nerves, or indirectly, such as when medication for RA impairs hearing.
Hearing loss is treatable, and it may sometimes even be possible to reverse it. Finding the right treatment requires a trip to the doctor and a comprehensive exam.
An RA specialist can assess whether RA symptoms have spread to the ear. They can help a person weigh the risks and benefits of medication and refer them to a hearing loss expert if necessary.