New Concept about Hearing Loss in the Elderly

by Dr. James Howenstine, MD

Hearing loss afflicts one third of Americans over age 65. The most common cause for this deafness is injury to the hair cells in the inner ear (presbycusis) which transmit sound to the brain. The major cause for this condition is exposure to excessive noise. Arteriosclerosis, hypertension, and diabetes decrease blood flow to these hair cells contributing to further damage.

In a 1998 study of women over 60 with presbycusis there was a 38% incidence of lower levels of B12 and a 31% incidence of lower folic acid values than women with normal hearing. Supplying B12 and folic acid could be helpful. Deficiency of vitamin D can cause hearing loss that sometimes reverses with supplementation of this vitamin 3000 to 4000 I.U. daily.

The product Vinca Hear contains Gingko Biloba, Vinpocetine, and nutrients which may help hearing loss by improving blood flow. You can call 800 543-3873 or visit a health food store to obtain this.

Sudden hearing loss has been regarded as an autoimmune problem that may respond to high doses of cortisone (prednisone). Hearing aids have been the standard solution for lost hearing in the elderly but they are not an ideal solution.

Careful study of Tom, a patient of Dr. Jonathan Wright,[1] has brought forth new ideas about the cause of hearing loss in the elderly. Tom experienced loss of nearly all the hearing in his right ear over a period of three weeks. Tom had symptoms of dizziness (vertigo), weakness and dizziness with sudden standing related to low blood pressure and also complained of excessive fatigue after physical exertion. A year and a half later he suddenly lost low frequency hearing in his remaining good left ear. He was placed on high dosage of prednisone because of the suspicion this hearing loss might be an autoimmune problem. This was followed by return of hearing in the left ear.

Some research had suggested that the adrenal hormone aldosterone might be a factor in hearing loss. Aldosterone is a potent hormone produced in the cortex of the adrenal gland that has a role in regulating sodium and potassium balance in the body. Aldosterone decreases the excretion of sodium by the kidney and increases the excretion of potassium and acid by the kidney. When aldosterone is produced in large amounts by a generally benign tumor of the adrenal cortex (aldosteronoma) patients develop hypertension and low serum potassium values.

The glucocorticoid type adrenal hormone (cortisone, prednisone) have primary effects on the immune system and carbohydrate metabolism. When these drugs are used in high dosage or for long periods of time the blood sugar may rise along with difficulty recovering from infections.

The drug Aldactone (spironolactone) blocks the effect of aldosterone in the body. Researchers at the University of Oregon decided to use Aldactone to learn whether it was suppression of the immune system by prednisone or an activation of aldosterone that produced hearing recovery in what had been assumed to be an autoimmune loss of hearing. The use of Aldactone prevented any recovery of hearing so it became clear that aldosterone was responsible for hearing recovery not high doses of prednisone. When prednisone is used in high doses there are some slight aldosterone like effects from the drug which may have been responsible for the benefits in persons suffering sudden hearing loss. Prednisone in low doses over a long period of time can result in hypertension so sodium retention it's aldosterone activity can be seen.

Tom had low levels of aldosterone on two 24 hour urine studies obtained previously (4.7 mcg and 3.6 mcg. normal level is above 6 mcg.). Tom was started on bio-identical aldosterone 125 mcg. twice daily. One year later he related that on three occasions when he stopped taking aldosterone the hearing in his left ear had suddenly diminished with prompt return when he resumed aldosterone.

A research study in November 2005 had revealed that there appeared to be a direct correlation between low blood levels of aldosterone and hearing loss. Forty seven healthy men and women between age 58 and 84 were given extensive hearing tests and had blood aldosterone measured. These studies showed that the more aldosterone in the blood the better the hearing.[2] Persons with severe hearing loss averaged aldosterone blood levels half as high as those with normal hearing.

The inner ear is sensitive to changes in potassium levels which tend to decrease with aging. Falling potassium values play a role in the hearing loss[3] in the elderly. Blood levels of aldosterone generally decline with aging as well.

Aldosterone is a normal hormone found in all humans. This is safe to take and requires only an occasional check of electrolytes (sodium, potassium, chloride, bicarbonate).

My impression is that taking a safe preparation to restore and maintain hearing (aldosterone) will be preferred by most individuals to wearing a hearing aid.

Footnotes:
1. Wright, Jonathan "Nutrition & Healing Take charge of your hearing loss before it is too late". Vol 13, Issue 4 May 2006 pg 1
2. ibid pg 4
3. ibid pg 4