PPI's and TINITTUS :(

Hi guys,

I have had GERD for 8 months now. Three months ago, I began taking Prevacid. It took about a month to really kick in but I am now symptom-free 90% of the time, which I consider a success. Three and a half weeks ago, I noticed a mild to moderate ringing in my ears (tinnitus) when I awoke one morning (the house was quiet for once :) I had a stomach virus several days earlier where I actually passed out and noticed a ringing in my ears when I regained consciousness but that faded after a few minutes. I have been searching for reasons why I may be having this since I take no other meds besides Prevacid (and vitamins of course although those have not changed in years). I read on the internet that less than 1% of people have tinnitus as a side effect.

My symptom control is so good with the medicine that I shudder to think of getting off of it to shed the tinnitus. My questions are whether or not this a side effect that will go away in time? Will it progressively worsen? Is it dangerous that I'm having this? Will I lose my hearing as a result? I am feeling like it's unfortunately something I will have to live with but it sucks that I have to start a new problem to fix another. Anyone have any words of experience or advice on this???

Thanks in advance,

Liz

I've just recently acquired my GERD (and started daily usage of PPI's) and have also noticed an uptick in my tinnitus. I'm on 40mg of Prilosec a day, for reference.

I've had tinnitus for about 2 years now and when I first got it, I was quite bothered by it - almost as much as this GERD is bothering me now! Mine started after a night in a loud bar and it was a low ringing that just never went away. Initially it made me crazy and I could barely sleep or function at all knowing that I'd be hearing ringing for the rest of my life (the sound of silence is no more, etc).

However, within 6 months after the initial diagnosis, I got used to it and it faded into the background as one of life's little annoyances. I rarely hear it nowadays and have only started noticing it more since I started my Prilosec treatment. I've also been wondering if it's related to the PPI or GERD somehow, and it certainly seems possible.

The one thing you could easily do is go to an Audiologist and have them test your ears. Mine is directly related to some high frequency hearing loss and they identified this connection immediately. Some people get it and some people don't, but most of the time it can be attributed to hearing loss. In some ways I'm glad I got it because it provided me with an early warning signal that I need to protect my ears. I now generally always carry ear plugs with me to protect myself in loud situations and prevent any further hearing damage. Having a little siren in my head has probably protected my hearing long term over my peers who get no such warning.

So back to your question about whether Prevacid and other PPI's have any ototoxic effects and are actually damaging your hearing (resulting in tinnitus) or if you've always had some very quiet tinnitus and they are just temporarily turning up the volume while they are in your system. I'm hoping that it's just a temporary uptick and that it will go away if / when you go off of PPI's.

Did you take any antibiotics or other medication for your stomach virus? Did the sickness move into your head at all? Both of those things can definitely cause hearing damage and tinnitus as well.

Hello lanab and speedygerd,

Thank you for your nice responses. I have just made an appt with an ENT just to rule out anything serious. Unfortunately, I am sentenced to life with PPI's unless I want to feel the constant burn like I did for those awful 5 months.

Speedygerd,
In answer to your question about my stomach bug, I did NOT take any other meds. I just drank Smar***er and ate saltines :) I did have a fever of 102 degrees which is not too terribly high as I know high fevers can cause hearing loss.

It's comforting to hear that you guys both said that the ringing is something I will get used to. I forget all about it when there's background noise like when I'm at work or listening to headphones while I work out. I feel like I've kind of been "listening" for it lately though, which I know probably amplifies it a bit.

Thanks again,

Liz

I'm a firm beleiver that ppi's have many side effects,even though doctors will disagree,i've been on prevacid over 4 yrs and have had many side effects some minor,some not so minor.

Yes ive had tinnitus for 20 years or so

and much of what has been said upthread is spot on especially about how eventually you will very very likely get used to it even if it is driving you so crazy that you think its the end of the world

i initially got tinnitus by taking a drug that was ototoxic...that is poisonous to the cochlea andd then subjecting myself to loud noise

after about 1 year later i got better mostly because i achieved what is called "habituation"...for example work in a big office with florescent lights that give off a 60 cycle hummm for long enough and eventually your brain tunes the noise out

or those who live in a part of town where the 3 am freight train goes by every night eventually dont wake up to hear it

in the last two years ive been on so many different drugs that its difficult to know why my tinnitus has gotten so much worse, but i believe that PPIs have played a part.

but before anybody goes off their meds keep in mind that i had damaged hearing before PPIs so it may be that the stress that these drugs put on a healthy persons ears might have a much smaller effect than on an older person who has already sustained damage such as myself

aminoglycoside antibiotics, loop diuretics and nsaids and cis-platin (platinum based chemo) are also notorious for ototoxicity as is quinine...in the case of aspirin the ringing almost always goes away after one stops taking aspirin...in the case of the aminoglycoside antibiotics especially gentamicin...the damage is usually permanent after several doses

(i got a flu shot this year and learneed there was a small dose of gentamicin included in the shot next day my tinnitus was very much louder...proof, i dont have it just suspicions

there is a great debate going on in the field of tinnitus study as to whether or not one can get tinnitus without hearing loss. i side with the doctors and researchers who say tinnitus is virtually always the result of damage to the hair cells (cillia?) that vibrate within the organ of corti (part of the cochlea) when moved by sound

there has been a big push in the last several years to say that tinnitus is caused "centrally" by the brain rather than the inner ear damage but really its both

virtually all people who have tinnitus have measurable hearing loss and thus hearing hair cell damage in specific locations in the snail shell shape cochlea and often the pitch of the "noise" whether its humming, ringing or in my case all of the above plus a dog whistle high pitched sound, usually corresponds to the frequencies of hearing that one has lost

think of tinnitus as being like phantom limb syndrome

but evidently more than just hearing loss has to take place for tinnitus to occur. two "executive funtion" parts of the brain that filter out "meaningless" sound have to break down also...a breakdown in the "filter" capacity of the nuclear accumbens and a hyper plasticity of the hippocampus allegedly also has to take place. and these event may in part be due to traumatic stress either environmental-emotional or physiological or both.

bottom line...try to avoid loud noises and or protect your hearing with ear plugs etc when you have to run that noisy blender or vacuum cleaner

and

try to avoid taking ototoxic drugs when you have a choice...but this isnt easy because the PDR lists more than 200 common meds many OTC that can cause ototoxicity in "SOME" people

good luck...i suffer

and im sorry you suffer too but i believe we will get better

listening to quiet broad spectrum music when ever you can and or white noise especially sound tracks of wind and rain are very helpful

avoid foods that aggravate tinnitus...coffee, preservatives esp sulfites, nitrates, sugar, salt some cheeses and for some alcohol, and many others...a list can easily be found on the net

hang in there
mock turtle

speedy
yes
good point...excellent point
if a person can respond to the tinnitus right away with what you said
and
the us navy and others have found that taking n-acetylcysteine right after injury may preserve hearing hair cells

Hey Liz,

Try not to let it get you down too much. Even a very small amount of hearing loss can cause tinnitus, and some people are just a lot more susceptible to getting it than others (no one knows why). Also, everyone naturally loses their high frequency hearing as they age, so it's nothing to get too alarmed about.

The only thing I can think of that *might* me a culprit in your case is headphone usage (I noticed you mentioned using them above). I used to listen to Bose headphones all the time at work, and in the end, I think that's what caused my issues over the long run (hearing loss is cumulative). Many audiologists refuse to use iPods whatsoever for just this very reason, as they see the results of widespread usage day in and day out.

And, on your second point, I COMPLETELY UNDERSTAND. It really sucks to feel like you've done everything right, everything you could to stay healthy, and STILL things like GERD or tinnitus come up. It simply isn't fair. In fact, just hearing you say that makes me feel better as I feel the exact same way most of the time.

I'm 33, have worked out my whole life, eaten right, and tried to manage any and all health problems almost to the point of obsession. And yet, here I sit in my chair, feeling like I can barely bend over to pick up a dropped pencil without stomach acid flowing up into my esophagus and burning my insides out. And now, I'm looking forward to a lifetime of PPI usage, or surgery that could change my internal anatomy forever and still not completely solve the problem!

Not only that, but I look around at all my peers who continue to abuse themselves and their bodies without apparent consequences. People who drink every weekend, eat fried food nonstop, never exercise, or do anything right for that matter and they still seem healthier than me now, living with this disease. It's very disappointing.

I think the hardest part for me is that there were no warning signs, and no way for me to be "healthier" or fix any issues that started creeping in. My GERD just suddenly appeared one night. I'd never had heartburn in my life and then one night, BAM!, instant, incredibly intense heartburn that never goes away. And here I sit a month later trying to figure out what I did so wrong to deserve this.

The punch you don't see coming is truly the one that hurts the most.

Take care of yourself.

Lucas

Liz:
I had an acoustic neuroma brain tumor which destroyed my balance nerve and the hearing nerve on my left side. In order to remove the tumor, they had to remove the ear canal portion where it was located making me totally deaf on that one side.

The reason I bring this up is that even though I can't hear on that side I have developed tinnitus in that side! Weird, right? So I can only conclude that it must have something to do with the brain's interpretation of sound.

I do know it gets worse in noisy environments. But like Mock Turtle said, after a while it does seem to subside. Because I have had fundoplication surgery recently, I am no longer on PPI's, but I still have the tinnitus. So, perhaps that's one correlation you don't have to worry about!

Nyteller