Thank you for all your support. I really appreciate the messages of support.
I’d like to update you that after 10 days of high dose oral steroids (Methylpredisolone) my hearing in my right ear returned. As you must have gathered from my last post, losing more hearing was SERIOUSLY STRESSFUL and really hit my world. Thankfully I was tooled up with the knowledge to fight my way through the system and get what I needed. I want to make sure that you are to!
If you find you are in a situation where you have sudden hearing loss please check my post here for instructions (which I have updated given my new learning’s of how difficult the NHS system can be to navigate!).
The main points are to:
- Get yourself onto high dose oral steroids immediately.
- After 7-10 days consider intratypanic steroid injections if there is no improvement
- Argue for additional steroids for a further 1-3 weeks (or longer if you feel strong enough and are not showing any other health symptoms from the drugs).
So since October was the month of steroids steroids steroids…
Do steroids work for sudden hearing loss?
The scientific literature is a bit mixed. But given that some research shows positive impacts to hearing, they are generally given as the standard treatment for sudden hearing loss around the world. Nothing else seems to be working as well. The issue is that in the UK, the waiting system means that many people get them too late. This is why I’m constantly going on and on about making sure people do everything they can to get steroids as soon as they notice a hearing drop. I didn’t get them on time and I’ll never know if they may have saved me from this level of deafness I now have to live with every day.
Whilst the scientific literature confirms that steroids can often help, there is still no consensus at to why, how, or which are the most effective. No single treatment has unequivocally been shown to work. It really is a bit of a ‘hit and hope’ process so you need to make sure you do your best to give it the best shot.
I’m not one for taking chemicals, in fact I often think they do more harm than good. But in this case, if steroids can have any positive effect on your hearing, I think it’s worth trying them.
This is a good overview research article: Corticosteroid therapy for hearing and balance disorders. Trune & Canlon 2012.
How do steroids work for hearing loss?
If you read all my posts you’ll know by now that my opinion, based on Anthony Williams information, is that many cases of sudden sensorineural hearing loss, tinnitus and dizziness are caused by the Epstein Barr Virus (EBV) in the labyrinth of the inner ear (for more information read here). Steroids work by reducing inflammation so the theory would fit that they help hearing by reducing inflammation in the inner ear caused by the active virus, to a significant enough degree to reverse tissue/nerve or organ damage.
I would add that while steroids may save the day when a sudden hearing loss event is taking place, they don’t tackle the real cause. You need to also be thinking about how you can get to the bottom of the issue. If it’s viral, are you implementing a longer-term antiviral protocol? I’m a qualified kinesiologist now and I help people to work out what the cause is of their health issues and what they need to heal. For further information please see my website here.
Which steroids for hearing loss?
It is common practice in the UK to prescribe 60mg Predisolone per day for sudden hearing loss. On this last occasion of hearing loss I demanded Methyl predisolone, simply because my hard of hearing friends in the USA claimed that there are better results with it. I could find barely any research to back this up, but was relieved to find that for the first time they did actually help me. In the past I had intratympanic (injections in the ear) methylpredisolone which helped me (see below).
How long should steroids be taken?
It is common practice in the UK for doctors to give just one weeks worth of steroids. In order to get more you will need to argue your case. I suggest printing out these research articles and highlighting the recommended course of steroid treatment. Many suggest 2-4 weeks. You have a right to make your own choices as a patient.
- Immunosuppressive therapy for autoimmune inner ear disease, Bruniel et al. (2009)
- Oral steroid regimens for idiopathic sudden sensorineural hearing loss, Slattery et al. (2005). (2 week course)
- Massachusetts Eye and Ear also recommend a 19 day course of steroids here.
Some research suggests that outcomes are most positive when oral steroids are combined with intratympanic steroids (injected through the ear drum) over the course of a month. It’s not conclusive as other studies suggest that oral steroids and intratympanic steroids produce the same outcomes. If you are not having any improvement from oral steroids its worth trying the injections.
Generally much of the research I have seen shows a greater effect from intratympanic methylpredisolone compared to intratympanic dexamethasone.
- A prospective, multi-centered study of the treatment of idiopathic sudden sensorineural hearing loss with combination therapy versus high-dose prednisone alone: a 139 patient follow-up. Battaglia et al (2014)
- Intratympanic Methylprednisolone as Rescue Therapy in Sudden Sensorineural Hearing Loss (2010) Raymundo et al.
- Intratympanic Methylprednisolone for Sudden Sensorineural Hearing Loss: Comprehensive Re Examination of the Model (2005) Pinones.
- Intratympanic dexamethasone injection vs methylprednisolone for the treatment of refractory sudden sensorineural hearing loss (2016) Berjis et al.
Be wary of taking long-term steroids as they can cause serious, systemic (whole body) health issues. They are associated with numerous side effects and some of them quite serious. For example, weight gain, cataracts, glaucoma, increased susceptibility to infection, bruising, thinning bones and skin.
Short term side effects include high blood pressure, fluid retention, sleeplessness, mood swings, depression, psychological disturbance and fluid retention.
If they are taken for 10-14 days then your physician should taper you off them gradually, reducing the dose every day until you stop taking them.
Sometimes, people find that they become steroid dependent. This means that their hearing improves on the steroids but whenever they lower their dosage below a certain level, their hearing starts to deteriorate again. In patients like this, the doctor will attempt to reduce the steroids to as low a dose as possible whilst maintaining hearing improvement and avoiding other health issues.
I’ve outlined my summary instructions for how to get hold of steroids when you lose hearing, here.
Once you have obtained your steroids, and if they have helped you, discuss with your doctor how you will get them in future should you have another hearing loss. You don’t want to be sent all over the place creating stress and delaying you getting them. He/she can give you a prescription to keep as an emergency and hopefully give you a direct number to call so that you don’t have to go through A&E or your GP again and can get direct advice from him/her when you need it.
I will keep updating this page as I come across new information. Please feel free to send any links over to me which have been helpful for you. Its not always easy to convince the medical practitioners so you need to be well informed and armed with the best information.