This amazing guest post was written by Dr. Sarah Brewer, a licensed Medical Doctor, a Registered Nutritionist, a Registered Nutritional Therapist! Check out her website here!
There is a growing recognition that people with arthritis may have an increased risk of developing hearing problems. Although the link is far from proven, there are several reasons why these conditions could be connected.
What is Arthritis?
Arthritis is an umbrella term that literally means inflammation of the joints. Over 100 different types exist, of which the most common is osteoarthritis (OA). One in two people over the age of 60 show X-ray evidence of this process in which the cartilage protecting the bone ends weakens and flakes away.
This triggers an inflammatory process in which the underlying bone swells and the joint space narrows. Eventually, the bone ends may rub together, causing increasing pain, stiffness, and deformity.
The second most common form of arthritis is rheumatoid arthritis (RA). This is an autoimmune condition in which the immune system mistakenly attacks the synovial membrane lining certain joints. Inflammation gradually spreads to involve other tissues and can lead to eye problems, weight loss, fever, and exhaustion.
But why would having arthritis increase the chance of deafness?
Hearing loss is the most common problem to affect the special senses, with as many as 37.5 million American adults reporting they have hearing problems.
As 53 million Americans also have arthritis, it’s not surprising that significant numbers of people will have both conditions – any associations could be down to chance alone, especially as both arthritis and hearing loss become more common with increasing age. The following factors suggest the link could be a real one, however.
Is Medication to Blame?
Painkillers play a key role in the treatment of all forms of arthritis and have been implicated in hearing loss. A review of 23 studies, involving over 92,500 people found that taking either non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or acetaminophen (paracetamol), was associated with a 21% increase in self-reported hearing loss.
These findings have not been confirmed by audiometry testing and could be due to the underlying painful or inflammatory condition present, or to chance, rather than to the painkillers themselves.
Hydroxychloroquine, an anti-malaria drug that is still occasionally used to treat RA when other more modern drugs are not suitable, has also been associated with hearing loss after prolonged treatment, although this was reversible when treatment stopped.
Researchers looking for an explanation for the possible link suggest that NSAIDs may harm the tiny hair cells or blood vessels within the inner ear. Laboratory studies also suggest that paracetamol can damage hearing cells in the same way that it damages liver cells.
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Are Auto-Immune Reactions Involved?
Rheumatoid arthritis is an auto-immune condition in which immune cells attack the synovial lining of certain joints. Although the joints of the hands, wrist, knees and feet are most often affected, joints elsewhere in the body can also form a target.
The middle ear contains three small bones which amplify and transmit the vibration of sound waves to the inner ear. These bones are hinged together with synovial joints and, although small, they are vulnerable to autoimmune attack.
This would set up inflammation and stiffness that would limit their ability to conduct vibrations, leading to a progressive hearing loss.
Immune processes associated with rheumatoid arthritis can also target moisture-producing glands such those that produce tears and saliva. This can lead to the dry eyes and mouth of an uncomfortable condition known as sicca or Sjogren’s syndrome.
As the inner ear is filled with fluid, which is vital for sound perception, this can be affected, too. Severe hearing loss can be an early sign of having this condition.
Researchers have even identified an anti-inner ear antibody that specifically attacks tissues of the inner ear. In one study, this anti-inner ear antibody was present in 9 out of 71 people with autoimmune diseases who were tested, including some with RA.
It was only present in 10% of patients experiencing sudden deafness, however, and can also occur in people without hearing loss, so the jury is still out on whether or not it accounts for any link between arthritis and hearing problems.
It Could Come Down To Your Genes
Researchers have identified a gene, known as KIAA1199, that is involved the breakdown of fibers in synovial joints. This gene also has an unknown effect within the ear, and at least three different mutations within the gene are associated with hereditary forms of deafness in some families.
This gene is also involved in the breakdown of cartilage fibers and the gene is more active in synovial cells taken from people with both osteoarthritis and rheumatoid arthritis. This may help to explain any link between arthritis and loss of hearing, although the exact connection is poorly understood.
If you notice difficulty in hearing, do see your doctor who can investigate possible causes – including a build-up of ear wax. Never attempt to clean your ear by inserting an object such as a cotton-bud.
This will push the wax plug further down, may damage the ear drum and can even dislocate the tiny bones in the middle ear to cause permanent deafness.
Fruits & Vegetables
If you have arthritis, nutritional approaches can help reduce pain and stiffness. Fruit and vegetables are rich in anti-inflammatory substances which are beneficial for both the joints and your hearing.
Oily fish provide beneficial anti-inflammatory omega-3s, and research suggests that fish oil supplements can double the rate of remission in people with rheumatoid arthritis. They may also help to protect the delicate cells of the inner ear. Supplements are widely available.
Turmeric (curcumin) supplements are as effective as ibuprofen for reducing knee pain in osteoarthritis.
I am also a great fan of rub-in pain-relieving creams and gels which sink into the skin to relieve discomfort in the underlying joints without the side effects associated with taking painkillers long-term.
Dr. Sarah Brewer is a medical nutritionist, nutritional therapist and the author of over 60 popular health books. Follow her Nutritional Medicine blog at www.DrSarahBrewer.com, her blood pressure advice at www.MyLowerBloodPressure.com and her health product reviews at www.ExpertHealthReviews.com. For nutrition and recipe tweets follow @DrSarahB and for general health and fitness tweets follow @DrSarahBHealthy.
- Kyle et al. 2015 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465569
- Seckin et al 2000 https://www.ncbi.nlm.nih.gov/pubmed/10984140
- Eckhard et al 2012 https://www.ncbi.nlm.nih.gov/pubmed/22732097
- Tucci et al 2005 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639870/
- Zou et al 2000 https://www.ncbi.nlm.nih.gov/pubmed/12768666
- Abe et al 2003 https://www.ncbi.nlm.nih.gov/pubmed/14577002
- Yoshida et al 2013 https://www.ncbi.nlm.nih.gov/pubmed/23509262
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