Steroids: Prednisone / Dexamethasone / Others (Oral and Injections)

So is there any point for me to try to hunt down a GP that will give me a "real" dose of prednisone next week? Then it would be about 2-3+ weeks after the acoustic trauma that caused my tinnitus. I am so confused with the success rate of prednisone for tinnitus from acoustic trauma... My doctor basically said "I'll give you this cortisone pills for 5 days (15 mg each day) but there is no real evidence that it will work, but we can try". Then I asked "but that is a really small dose from what I've read online for treating acoustic trauma" and he said "well the side effects will not be worth it". Why try something that is very unlikely to work? It makes me mad the Swedish health system is a f*#! joke!

Reading this whole thread still makes me confused if prednisone has any good benefits for treating acoustic trauma after 48 hours+. Shouldn't there be any studies done to see correlation from the prednisone in this case? Acoustic traumas causing tinnitus must happen every day...

 

Nobody?

 

I can only speak from my experience that a prednisone course 2 weeks after my acoustic trauma did absolutely nothing for me.

Most of the literature I have read suggests that the window for steroids is about 24-48 hours.

 

Your GP should reconsider his job... 15 mg is a far to low dose... especially when is is + 2 weeks ago...

 

Yes I know. He was incompetente in this area (as many doctors seems to be in Sweden unfortunately).
But is there any point trying to get another appointment with another doctor to get a "real" dose of prednisone? From what I understand it is not likely to help acoustic trauma after like 48 hours anyway? And I read hours on this and other websites and hasn't heard anyone who said it cured their noise induced tinnitus anyway.

 

Thanks for the reply. That's what I've read too. I wish I'd knew to get it as soon as the noise trauma happened. But I didn't know and also hoped it would disappear in the first 48 hours. I can't go back in time so it's stupid to think about I guess.

 

It honestly might be worth a shot. I’m on a 21 day taper (starting at 60mg for 7 days) but the first ENT I went to refused to prescribe me anything despite how concerning my hearing distortion was. Luckily I had booked 2 backup appointments in the event that he would refuse and the second one really listened to me, and wanted to do everything she could think of to help me in the acute phase.

This was 2 weeks after onset so the jury’s still out of I’ll see improvement in the distortion, but the prednisone does seem to have quieted some of my high frequency hissing and crickets somewhat.

 

But reading this thread almost everyone has gone back to the original tinnitus sound after the pred it seems?

 

“I can't go back in time so it's stupid to think about I guess.”

This is the best, most basic premise people with tinnitus need to learn. Sh!t happens... and move on and get on with life. It’s not easy, and downright difficult at times.

What is a 21 day taper? I see 60mg x 7 and then what are you doing?

You are in the US and found a doctor to give you that much prednisone... wow! I literally had to doctor shop and see several minute clinic doctors to get multiple dose packs to add up the quantity which “could” “may” probably not” help...

These docs have no idea what the dosing needs to be to even have a 1% chance to help.

 

Possibly. I only have one other experience with pred for a previous worsening and that dosage was a lot like yours (20 mg 5 day taper) and it did nothing. It could be my hissing goes back to baseline too after the taper. But it doesn’t hurt to try. You might get lucky.

 

Well, to be honest she was much more apt to prescribe that much do to my sudden onset of severe hearing distortion, not tinnitus. I think if had come in for tinnitus that dosage might have been off the table.

But I also explained the hearing loss notches that I found at specific frequencies; and unlike many ENTs she seemed really sympathetic. Maybe I just got lucky to have found her.

Sorry, I don’t have the taper schedule on hand but its something like 60mg for 10 days, then down to 40 for 3, then 20 for 3, then 10 for 2, etc...

For the record, I haven’t experienced any side effects at all (outside of some insomnia and a little bit of anxiety at night) and I’m on day 8 right now. But to be fair, other people can have some really ugly side effects. I think that’s why doctors can be hesitant to do the “big boy” dose when it’s “just tinnitus”.

 

I’ve seen a 7 day course, but not 10... wow, I’m on 60mg on day 7 now and plan to go 50, 30, 10, 10...

I get some eye blurring and that’s about it.

Thanks and good luck.

 

I wouldn’t kick yourself, the evidence for them working even if administered within 24-48 hours is pretty sketchy.

 

Thanks. This is what I think also. Otherwise I think I would have more or less demanded a "real" dose when I visited the GP last week. I am not convinced, I think if prednisone worked for "curing" acoustic trauma it would be standard to give to 60mg starting dose all over the world (it is not a rare medicine), but this isn't the case. I think many doctors give it because it's the only thing that COULD work, in theory. And then the doctor have "done something", instead of just saying "sorry, there's nothing I can do". But the evidence of them working seems lacking from what I've read (hours and hours of searching online). I rather go all in on vitamins and stuff that gives no side effects and perhaps at least can give me some good placebo effects if nothing else.

 

I tried to take one pill of 20 mg prednisolone and I feel it's spiked my tinnitus within 10 minutes. Is this even possible?

 

I would say unlikely... 20mg is a relatively low dose, and 10 minutes is a pretty quick reaction. If you were allergic you would have other symptoms than just your tinnitus.

But I’m not a doctor....

 

What are you taking it for?

 

Two acoustic traumas.
So I was tinnitus free for 15 years after a 3-4 years habituation from a 30 minute rock band set, first time not wearing earplugs.

2 months ago I had a “routine” MRI... not realizing how loud... no earplugs... welcome back to the tinnitus nightmare I thought I had conquered. I got prednisone 3 days after the exposure.

A month later trying sound therapy, I screwed up an iOS app and got a blast of full volume, that was a week ago. So my 2nd course of prednisone now in 2 months time.
I will start tapering today...

It’s been a sucky 2 months...

 

I'm not a doctor. But I do like to read lots of literature and try to stay informed about this kind of stuff.

My understanding is that there is very little evidence of Prednisone or other steroids being helpful for hearing loss from acoustic trauma.
Prednisone is usually prescribed for patients who experience sudden hearing loss (not noise induced). The reason is that in cases of hearing loss not related to acoustic trauma, it is much more likely that the issue causing the hearing loss is related to some type of dysfunction in the inner ear. Often times there can be swelling and inflammation as a result and since it is in an enclosed space this can often result in damage. Steroids reduce inflammation and swelling, and if this is what is causing the hearing loss/inner ear damage they (steroids) can help prevent long term hearing damage from occurring.

But from the research that I have done, that is the extent of what steroids do in treating hearing loss/tinnitus. They don't do anything specific to the ear structures, and they are not regenerative in any way.

Again - I'm not a doctor. (I've just spent too many hours questioning real ones about my hearing loss : (

 

So did you have tinnitus for 3-4 years and then disapeared?

 

Wow, I've never heard of anyone having their tinnitus disappearing after years when the reason for the tinnitus is acoustic trauma. How is this even possible?