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Rheumatoid Arthritis and Hearing Loss

Medically Reviewed by Shelley A. Borgia, CCCA on April 12, 2022

When you’re living with rheumatoid arthritis, research suggests that you might be more likely to lose some hearing compared to someone who doesn’t have RA.

As if managing RA wasn’t challenging enough, hearing loss could make it harder for you to understand conversations and socialize. It might also make you less likely to stick with your rheumatoid arthritis treatment, which could lead to worse RA symptoms.

Nilanjana Bose, MD, a rheumatologist with Lonestar Rheumatology in Houston, says your chances for hearing loss could go up if you:

  • Have advanced RA
  • Have had the disease a long time
  • Don’t keep up with your treatment to control inflammation

But with your doctor’s help, you can protect your ears and take charge of your RA. And if you lose some hearing, your doctor may be able to treat it.

Here’s what we know about the links between rheumatoid arthritis and hearing loss.

What Types of Hearing Loss Are Linked to RA?

The most common type tied to RA is sensorineural hearing loss, which affects anywhere from 25% to 75% of people with rheumatoid arthritis. People with RA have higher rates of this type than those who don’t have rheumatoid arthritis, researchers say.

Your inner ear has tiny hair cells that help you perceive sound. Sensorineural hearing loss happens when those cells in your inner ear get damaged. It’s the most common type of permanent hearing loss.

You could have symptoms like:

  • Muffled hearing
  • Trouble understanding speech
  • Sudden or steady hearing loss
  • A full or stuffy feeling in your ear
  • Ringing in the ear
  • Dizziness

If you have this type of hearing loss, your doctor might keep you under observation for a while and do more hearing tests. Or they might treat you with:

  • Steroids pills or shots
  • Hearing aids
  • Surgery

A specialist called an ear-nose-throat doctor (also called an ENT or an otolaryngologist) can figure out the right treatment for you.

Two other types of hearing loss are less common in people with RA:

Conductive hearing loss is when sound has trouble getting through the outer or middle ear and reaching the hearing part of your inner ear, the cochlea. The symptoms can be similar to the sensorineural type. They may also include ear draining and pain or tenderness in the ear. Quick treatment can help reverse it. Treatment options include observation and testing, hearing aids, and surgery.

Mixed hearing loss means you have symptoms of both sensorineural and conductive hearing loss in the same ear. You may need treatments for both types.

If you have RA and you’ve lost some hearing, talk to your doctor about it as soon as possible.

How Is Hearing Loss Linked to Diseases Like RA?

Rheumatoid arthritis is an autoimmune disease. That’s a group of conditions in which your body’s defenses (your immune system) go haywire and attack healthy tissues by mistake, leading to inflammation.

Some people with autoimmune diseases like RA also develop a problem that affects the inner ear and causes sensorineural hearing loss. Doctors call this condition autoimmune inner ear disease (AIED). It’s rare, making up about 1 percent of all cases of hearing loss in the U.S.

AIED can happen on its own, but about 20 percent of people with it also have another autoimmune disease like RA.

Some common symptoms of AIED are:

  • Sensorineural hearing loss in both ears that gradually gets worse
  • Hearing loss that isn’t always the same in both ears
  • Dizziness or trouble balancing
  • Ringing in the ears (tinnitus)
  • A feeling of fullness in the ears

If you have AIED and rheumatoid arthritis, you’ll also have your RA symptoms, like swollen and painful joints.

Some treatments for AIED are:

  • Steroids
  • Drugs that work on your immune system
  • Hearings aids or other listening devices

Are Certain Pain Meds Tied to Hearing Loss?

Some common medicines that help ease RA pain may also affect your hearing over time.

One study suggested that men who took aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs), or acetaminophen twice or more a week were more likely to get hearing loss than guys who used these drugs less often. The risk was biggest for men under 60, the researchers said.

Another study suggested that women who took acetaminophen or the NSAID ibuprofen two or more days a week had higher odds of getting hearing loss. The risk was bigger for women under 50, and it tended to go up the more often they took either drug.

Some researchers think that aspirin and acetaminophen may affect hearing by reducing blood flow to a part of your inner ear called the cochlea). One expert says acetaminophen might also cause your cochlea to run low on a protective protein called glutathione.

Talk to your doctor if you take any of these pain relievers for RA regularly and think you’ve lost some hearing or have ringing in your ears. They may lower the dose you take, tell you to use the drug less often, or switch you to a different medicine. This might help reverse your hearing loss if pain meds are the cause.

Some other types of drugs that may affect hearing in people with arthritis are:

Talk with your doctor about the pros and cons of these medications. Don’t stop taking them unless the doctor tells you to.

Show Sources

SOURCES:

Nilanjana Bose, MD, rheumatologist, Lonestar Rheumatology, Houston.

Frontiers in Medicine, Rheumatology: “Effect of Chinese Herbal Medicines on Hearing Loss Risk in Rheumatoid Arthritis Patients: Retrospective Claims Analysis.”

The Open Rheumatology Journal: “Is Hearing Impairment Associated with Rheumatoid Arthritis? A Review.”

Plos One: “Ossicular Bone Damage and Hearing Loss in Rheumatoid Arthritis: A Correlated Functional and High Resolution Morphometric Study in Collagen-Induced Arthritic Mice.”

The Hearing Journal: “Rheumatoid Arthritis and Hearing Impairment.”

American Journal of Epidemiology: “Analgesic Use and the Risk of Hearing Loss in Women.”

The American Journal of Medicine: “Analgesic Use and the Risk of Hearing Loss in Men.”

ENT Health: “Autoimmune Inner Ear Disease,” “Conductive Hearing Loss,” “Sensorineural Hearing Loss (SNHL).”

American Speech-Language-Hearing Association: “Sensorineural Hearing Loss,” “Mixed Hearing Loss.”

Arthritis Foundation: “Arthritis and Hearing Loss.”

Cleveland Clinic: “Hearing Loss.”

Johns Hopkins Medicine: “Types of Hearing Loss.”

CDC: “How Does Loud Noise Cause Hearing Loss?”

NYU Langone: “Types of Hearing Loss in Adults.”

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