Major Aggravation of Tinnitus: Prednisolone — Yes or No? Ototoxic or Not?

Discussion in 'Support' started by Bill_, Dec 28, 2018.

    1. Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      As I mentioned in another thread I have a major aggravation of my tinnitus from some stupid ENT who did some LOUD test on my ear.

      Went to see another ENT (at the hospital ER) today and he prescribed me prednisolone (oral, 10 days, starting with 100 mg for 3 days).

      The leaflet doesn't say anything about possible ototoxicity or tinnitus as a side effect, but I have read on this forum that some people had their tinnitus actually aggravated by prednisolone. Actually you won't find any mentions of prednisolone causing tinnitus in any German publications, only in a few English ones, albeit not a lot...

      I took a 4 day-scheme of prednisone in August which I ended without tapering off which caused a spike in my tinnitus (I think that went away eventually).

      But I'm kind of afraid of prednisolone now...

      What should I do?
       
    2. glynis
      Feminine

      glynis Member Benefactor Ambassador Hall of Fame

      Location:
      England, Stoke-on-Trent
      Tinnitus Since:
      2004
      Cause of Tinnitus:
      Meniere's Disease
      100mg is a massive dose of steroid so I would not recommend it.

      love glynis
       
    3. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      I know the international standard would be 60mg but here in germany they even give 250mg IV for 3 days as a guideline treatment, so 100mg isn't that much in comparison.
      I'm just kinda worried because of the possible side effects such as even further aggravation of T (although it's a 0.08% chance according to https://www.ehealthme.com/ds/prednisolone/tinnitus/) and the higher likelyhood of infections, especially ear infections. Also i have read quite a few studies that claimed that steroid intake shows no significant difference to placebo...yet it's prescribed all the time....
       
    4. Red
      Crappy

      Red Member

      Location:
      Northeast USA
      Tinnitus Since:
      06/2017
      Cause of Tinnitus:
      Noise Exposure (Headphones)
      It can be ototoxic, yes. But I've never heard of anyone getting a permanent spike from it, just temporary ones.
       
    5. Bill Bauer
      No Mood

      Bill Bauer Member Hall of Fame

      Tinnitus Since:
      February, 2017
      Cause of Tinnitus:
      Acoustic Trauma
      @Bill_
       
    6. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      100 mg is not a high dose, I've used it numerous times for allergies before.
      30 mg or 60 mg after acoustic trauma or sudden hearing loss is not enough.

      And yes standard treatment protocol in acute cases is starting at 250 mg Prednisolone or 40 mg Dexamethasone.

      @Bill_ Should decide for himself, but if he indeed has a major increase in tinnitus at least 90-100 mg seems to be an adequate dose.

      You should find a HBOT clinic too.
       
      • Like Like x 1
    7. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      Well that sums up pretty well where I am at. On the pro side is: it might help my T. But the con side is: might worsen T (unlikely), May promote infections (This is my biggest concern- ear infection being of particular concern), may cause anxiety (which I am struggling with anyways)...

      All of this wouldn’t matter of course if there was at least some evidence of Prednisolone really helping T but it i actually can’t find any study that states more than „it might help but we don’t know“....
       
      • Agree Agree x 1
    8. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      There‘s an HBOT clinic some 150km away. Will call them tomorrow. Not sure though if I will do it - very few anecdotes of it being actually helpful
       
    9. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      Don't worry about anxiety, just call someone over to monitor you. I have panic attacks and tremor from Prednisolone. It's fine, don't stress about it. It's only scary for first 30 minutes.

      You are unlikely to get any infection if you don't expose yourself to dangerous environments. Especially if your steroid course is under 5 days. Just wear a surgical mask for the next two weeks when going out and use earmuffs instead of earplugs.

      Steroids have a long proven history of treating acute hearing loss. In these cases tinnitus usually goes away when hearing is restored.
       
    10. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      It helped me even after 6 weeks after onset and 4 weeks after noise exposure (brain MRI with earplugs and earmuffs 15 minutes under 99 db).

      If you read HBOT thread I remember one guy did sessions within a week after onset and it his noise induced tinnitus went away completely.
       
    11. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      I have two kids who have runny noses all year long - is that what you would call a „dangerous environment“ ? :)
       
    12. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      If it's from allergies then no. But it's hard to track if it's from allergies or sickness during the winter.
      I advise you to get out more. Cold air kills bacteria and in winter most people get sick, because they just sit at home and transfer viruses and bacteria to each other.
      But I'll wear a surgical mask anyway if I were you. No point in risking it. Don't forget to swap it multiple times a day.
       
    13. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      No it’s most definitely not from allergies but from constant re-infection at the kindergarten I suppose...
       
    14. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      Then use surgical mask at home. Avoid contact with their food plates and cups.
       
    15. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      I also have to mention that I have a mild cold and also some diarrhea - don’t know if that’s a problem too?
       
    16. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      I can't say anything about your cold, you should talk to your doctor about that.
      Regarding intestinal problems if you have history of bleeding or erosions or anything like that you should approach steroids with extreme caution.
       
    17. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      Ok so i went to bed yesterday without taking the prednisolone because I couldn’t make up my mind. Was able to fall asleep fairly easily but woke up just 5 hours later and could not really get back to sleep.
      T seems to have dialed down VERY slightly but can’t say for sure.
      I‘m still worried about infections while taking prednisolone because I had this diarrhea yesterday (although it seems to be gone now) and in general because i don’t want to conceive something that might require to take antibiotics at some point

      /edit i‘m Still within the 48h windows - 44h now
       
    18. Gman

      Gman Member Benefactor

      Tinnitus Since:
      07/2016
      Cause of Tinnitus:
      Ototoxic earwax drops
      For a very risky medication that’s on the ototoxic list, it sure gets recommended a lot on this site.

      I’ve read that melatonin is more effective.

      Anyway, I hope your spike subsides soon. Sounds like a big dose. Would have thought tapering would be a must for that amount.
       
    19. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      Yeah it’s with a taper. It’s something like 100-100-100-70-60-50-40-20-5-2.5
       
    20. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      It gets recommended a lot because it's first in line treatment for acute hearing loss. It get prescribed by most ENTs in cases like this, because it has a proven track record of being effective in restoring hearing.
      Melatonin is just a sleeping aid it has nothing to do with tinnutis. It doesn't reduce the inflammation in cochlea. It might be good in preventing hearing loss, but after damage is done it's not effective.
       
    21. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      The dosage seems to be pretty good. In some cases it might make sense to take higher dose for 5-7 days and then taper.
       
      • Like Like x 1
    22. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      If you decide to take them and feel that your cold or other symptoms increase you can just stop taking Prednisolone without taper if you took 1 or 2 100 mg doses.
      I also recommend taking it in the morning and always at different time so your adrenal glands don't get used to steroids at the same time.
       
      • Informative Informative x 1
    23. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      I just got up and noticed my nose being completely clogged which only adds to my fear of inducing infections of my respiratory/ auditory system by taking prednisolone.
      This is so hard to decide
       
    24. Gman

      Gman Member Benefactor

      Tinnitus Since:
      07/2016
      Cause of Tinnitus:
      Ototoxic earwax drops
      Please. I know pred is prescribed for hearing loss. It’s apparently also a form of TT candy. Not saying @Bill_ shouldn’t be taking it if it’s really called for. It has proven to have a tonne of bad side effects too.

      I also know what melatonin is typically used for, but I have read it was shown in at least one study to be more effective than pred for hearing loss. Just saying. :cool:

      Karlidag T, Yalcin S, Ozturk A, et al. The role of free oxygen radicals in noise induced hearing loss: effects of melatonin and methylprednisolone. Auris Nasus Larynx. 2002 Apr;29(2):147-52.

      Bas E, Martinez-Soriano F, Lainez JM, Marco J. An experimental comparative study of dexamethasone, melatonin and tacrolimus in noise-induced hearing loss. Acta Otolaryngol. 2009 Apr;129(4):385-9.
       
    25. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      I understand. Can you call a doctor to consult with him about your situation?
      After my spike I had to stop steroids, because I got side effects and continued them couple of days later. I definitely regret this decision.
       
    26. Arseny
      Wishful

      Arseny Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Possibly from problems with blood flow
      Thanks man, I'll will read it today.
      Tacrolimus? It's ototoxic. I had topical tacrolimus cream that I applied a couple of times to my ears. I always wonder if this was a culprit of my original tinnitus along with Cipro.
       
    27. Eric N

      Eric N Member Benefactor

      Location:
      Montreal QC Canada
      Tinnitus Since:
      10/2012, 03/2016, 05/2017, 05/2018
      Cause of Tinnitus:
      noise + 3 major increases via (shouting / MRI/ flu+Tylenol)
      I am not sure it would be a good idea to take prednisone unless you have a clinically significant hearing loss and even then it is not proven to work at all for this type of hearing loss, and if it does work it seems like the window of opportunely is only 1 hour and it wont actually make the tinnitus better even it helps hearing according to https://www.ncbi.nlm.nih.gov/pubmed/11318462

      The degree of hearing improvement after medication did not seem to correlate with the relief of tinnitus.
       
    28. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      I wrote a friend of mine who’s ENT just a moment ago. He said the cold wouldn’t be an issue and that I can take the prednisolone regardless.

      What exactly do you regret? Stopping the steroids or taking them?
       
      • Good Question Good Question x 1
    29. glynis
      Feminine

      glynis Member Benefactor Ambassador Hall of Fame

      Location:
      England, Stoke-on-Trent
      Tinnitus Since:
      2004
      Cause of Tinnitus:
      Meniere's Disease

      It must be different in other countries as in the uk Prednisalone is only used for Allergies and breathing problems and not given out for tinnitus by doctors.
      I have used Prednisalone many times for sever asthma.

      love glynis
       
    30. AUTHOR
      AUTHOR
      Bill_
      Insomnious

      Bill_ Member

      Location:
      Germany
      Tinnitus Since:
      04/1998
      Cause of Tinnitus:
      1. loud Concert | 2. loud club | 3. tympanometry
      That’s my main concern! Although there’s quite a few stories on this board on how people who took prednisone/prednisolone actually experienced an improvement for their T there‘s no hard evidence that this wouldn’t have occurred also without steroids.

      My main fear is that i‘ll contract some infection that might ultimately do more harm to my T - be it because it might be something ear-related it be it something that might require treatment with antibiotics

      This sucks so bad
       

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