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Patients with rheumatoid arthritis may be more likely to experience hearing loss. This article outlines the connection between rheumatoid arthritis and any hearing impairments patients may experience.

While arthritis is characterized by joint inflammation and resulting joint stiffness, swelling, and pain, it often extends beyond the joints and can affect other regions of the body too. These include the eyes, heart, kidney and bones. More recently, studies have shown that patients with arthritis are also potentially at a higher risk for developing hearing loss.

One study that reviewed several clinical reports which looked at the relationship between hearing loss and rheumatoid arthritis showed that patients with rheumatoid arthritis had a higher risk of developing hearing impairments compared to patients without the disease. Furthermore, another report highlighted that over the years, a small amount of studies have described a higher risk for hearing loss in patients with rheumatoid arthritis. This disease is called sensorineural hearing loss (SNHL).

However, these reports are conflicting. Another study from the Mayo Clinic found that there was no correlation with regards to hearing loss when comparing people with rheumatoid arthritis to people without rheumatoid arthritis. Interestingly, patients with rheumatoid arthritis were more likely to feel that their hearing was impaired. However, this was not confirmed when patients underwent hearing tests. Thus, researchers believe that patients may feel that they have hearing loss due to the stress of living with rheumatoid arthritis. Most arthritis specialists (called rheumatologists) are not aware of any potentially increased risk of hearing loss in patients with rheumatoid arthritis, and therefore, is not something that rheumatologists will normally screen for.

So if there is hearing loss, why does it develop?

One of the possible explanations as to why patients with rheumatoid arthritis develop hearing problems is due to the intake of certain medications, rather than because of the disease itself. Some studies have shown a correlation between medication and hearing loss:

  • One study found that women who take ibuprofen six or more days a week have a 24 percent higher risk of developing hearing problems compared to women who do not take ibuprofen often. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is often used to treat inflammatory conditions including rheumatoid arthritis.
  • Another study found that men who used NSAIDs also had a negative impact on their hearing.
Researchers agree that use of NSAIDs is associated with hearing loss. However, researchers don’t believe that other drugs used to treat rheumatoid arthritis, such as biologics, have an effect on hearing.

Another possibility is autoimmune inner ear disease (AIED). Rheumatoid arthritis, and other types of arthritis, are the result of autoimmune disease. Normally, the immune system works to fight against foreign pathogens. However, in the case of autoimmune disease, the immune system goes haywire and starts to attack healthy tissue instead.

AIED develops because the immune system starts to attack the inner ear, a symptom of which is hearing loss. Patients may also experience dizziness and ringing in their ear. The development of AIED has been linked to rheumatoid arthritis, lupus, and psoriatic arthritis. However, it is important to note that AEID is quite rare, and only accounts for about one percent of all cases of hearing loss. Usually, AEID is not associated with rheumatoid arthritis.

So if you have hearing loss, what do you do?

The first step is to let your doctor know that you feel that your hearing is getting worse. You should also inform your doctor about any over-the-counter drugs you are taking (in case they are causing SNHL). Let your koctor know if you hear ringing or roaring sounds, or if you are feeling dizziness (another symptom of SNHL). Your doctor will likely administer a hearing test called an audiogram, and they will be able to use results from the test to let you know if your hearing is getting worse as time goes on.

These are the different treatments that have your doctor can administer if you do suffer from hearing loss:

  • If you have SNHL, then your doctor will adjust your medication
  • If you have AIED, then the doctor will prescribe you medications that have been shown to help
  • If your hearing is already compromised, your doctor will prescribe you a hearing aid

These are things you can do to protect yourself from hearing damage:

  • Avoid listening to loud noise, as that is the primary cause of SNHL
  • Put on ear protection if you are around loud noise
  • Lower the volume on your ear buds if you are listening to music

What else can you do if you can't hear well?

  • Let people know that you are hard of hearing, and most people will be happy to speak more clearly.
  • Speak louder and people will respond by also speaking back more loudly.
  • Physically position yourself to hear people better (turn your ear to them), and move away from noisy areas.
  • Don’t get down on yourself. As people age, they naturally start to lose some of their hearing so you are not too different.

  • Magaro, M., et al. "Sensorineural hearing loss in rheumatoid arthritis." Clinical and experimental rheumatology 8.5 (1990): 487-490.
  • Raut, Vivek V., James Cullen, and Geraldine Cathers. "Hearing loss in rheumatoid arthritis." Journal of Otolaryngology 30.5 (2001).
  • Özcan, Müge, et al. "Hearing loss and middle ear involvement in rheumatoid arthritis." Rheumatology international 22.1 (2002): 16-19.
  • Photo courtesy of SteadyHealth

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