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

Thank you for the tip. Too bad that chain services only NY & NJ. Hopefully people from that area will see this post and know who to contact ASAP!

How are you doing?

 

What are the risks associated with Intratympanic Dexamethasone injections?

I might get them tomorrow after a recent acoustic trauma (4 days ago), but I'm very sensitive to medication.

Can it cause permanent balance issues, or worsened tinnitus?

 

Aw man. I’m so sorry to hear about your predicament. I can relate. It took me a full month to get in with any kind of MD who could prescribe. I can offer a personal experience of hope, that it does get better, with ups and downs it DOES get better! Clearly you can find anecdotes here of the contrary but I do believe that most people get better.

No, I didn’t have any side effects at all. It felt a little strange to have a hole in my ear drum but it healed right up.

Permanently perforated ear drum is about it. I guess they could also botch the injection and stab you? That seems extreme. My otologist said of 1,000+ injections he’s performed, he had 2 problems and they were both extreme cases, e.g., the patients having been on oral steroids for a long, long time, and were generally very unhealthy people to begin with. So their healing capacity sounds like it was inhibited at baseline.

I wouldn’t be afraid to do it again.

 

What caused your hearing loss and what frequencies was it at?

 

Just long term noise exposure being the idiot that I am. 8 kHz is where the dip is, but my most recent test showed it back to “normal” range. Ultra high frequency I have pretty great losses shown in one test.

 

Very interesting. Your hearing loss issues closely mirror my own. Moderate loss at 8 kHz and my ultra highs are pretty shot as well.

Had the steroid shots a couple weeks back but it doesn't appear they've done much honestly. Still glad I had them done. Maybe I'll have some delayed improvement like in your case.

 

You’re very recent in onset?

 

Yeah, just over two months since onset. Just going to give it some time and see how things go.

 

I managed to get a prescription for Prednisolone today. I took 30 mg about 8 hours ago and I'm feeling like shit right now. I think my tinnitus is louder (I already had a spike) and there are so many tones... Also have pretty bad anxiety. Is it common to get louder tinnitus at the start of treatment?

I got pills for 5 days only. I got prescribed 25 mg per day but I decided to taper it from 30 mg - 25 mg - 20 mg - 20 mg - 15 mg - 10 mg - 5 mg. Was this a bad idea?

I got it because I was feeling desperate suffering from a spike that's been going for about two weeks. Now I don't know what to do... Stop taking it? Any risks with that?

Any inputs are greatly appreciated.

 

I had a noise exposure 28 days ago which worsened my tinnitus and hyperacusis.

Is it worth getting Prednisone now?

Do doctors in UK prescribe it for this reason?

 

I am over the fence because it's been 3 weeks after I was exposed to some loud noise.

My tinnitus seems more piercing, like it was a 4, and now maybe a 5 or 6. Maybe it's stress, maybe it's temporary. I don't notice changes in my hearing but a new audiogram presented 20 dB loss at 14 kHz and 16 kHz, which is more or less the frequency of my tinnitus.

My ENT refused to prescribe Prednisone saying that, due to my audiogram presenting exactly the same graph as before with the exception of these high frequencies, it could be due to a spike or the new place I had the audiogram at.

Anyway, Prednisone is sold here without prescription so I can still take that route.

The thing is: my CNS is kinda sensitive due to benzo tapering (I am holding now) and 60 mg of Prednisone has a chance to be tough for me. I understood reading previous posts that if you are overstressed while taking it, there is no point and could be more harmful.

In my situation, do you think it's still worth trying? I am concerned about the side effects as I already have a racing mind from the benzos. But the thing with the window of opportunity is making me obsess about taking it or not.

 

I’m on steroids as a result of tinnitus spike caused by a 1.5 hour concert with ear protection. Upon doing some research, I think there is some updated information around the use of oral and/or intratympanic Prednisone for the treatment of noise-induced tinnitus. Particularly because I think the theory behind it is that the noise had an impact on the cochlea and resulting inflammation. I believe the protocol is like 60 mg for 10 days, followed by a taper.

 

How loud is your spike? Is it "only" a spike or do you also notice some hearing loss? How quickly did you start the steroids after the spike started?

 

I can’t say that I notice any hearing loss. I also don’t have any sound sensitivity. I think it’s more reactive which I’m reading online is a form of hyperacusis.

Hearing wise I feel fine. It’s just that my tinnitus is so much louder. More intrusive. Definitely a little higher pitched so it’s even harder to mask. And my left ear, which is usually pretty quiet and just fluctuates every now and then, is consistently ringing. So it sounds like I have two bandsaws going off in my head. The last two years I’ve had fluctuating tinnitus mostly perceived in my right ear as it was louder. I could have some pretty rough times when it got really loud but generally speaking it never lasted very long. I would go months where it would be so low I wouldn’t even hear it and then I go through a period of time, usually around allergy season, etc. where it was definitely much more noticeable and louder. I also have some issues with my jaw and Eustachian tube dysfunction that’s always contributed to it.

It’s ten days now since the concert. I mean I was wearing hearing protection and I didn’t have any threshold changes after the concert like most people would.

As for how quickly I started the steroids? Within 24 hours. I’m now on day 10. One tinnitus expert, who happens to be an MD and also happens to have tinnitus, who I consulted yesterday, said there is no way in heck I suffered hearing damage because I wasn’t exposed to loud music long enough. 1.5 hours at best with hearing protection. Not like the dB registered at 112 the entire concert. Average 85-88 dB. I don’t take using steroids lightly but I’m doing it just in case I did have hearing loss because obviously tinnitus doesn’t just get louder after noise exposure for no reason.

 

Scheduled for a course of three intratympanic steroid injections in my right ear starting next week. Tinnitus, hyperacusis and 30 dB hearing loss at 6 kHz are the symptoms I'm struggling with.

I'm just over three months since onset. The neurotologist thinks it's not optimal timing-wise, but could still yield results.

Is there any reason why I shouldn't go for it?

 

I had a few noise exposures, some with hearing protection, some not, the week of the 12th this month. It was also a particularly high stress week for me. Seemed like all was good going into that weekend but I began slowly to notice a marked increase in my tinnitus around the beginning of last week. I had hoped it was temporary but it continued to build into what has thus far been a 10/10 experience for me. Unreal. I had no idea how good I had it before, having more or less habituated.

I saw my doctor today. She found my right eardrum completely occluded with wax and removed it. No change. I asked for Prednisone. She prescribed 40 mg/day for four days and if that doesn’t do anything to let her know and she’ll consider a longer period with a taper.

I’m hoping for the best that there is some nerve inflammation the Prednisone might tame and speed a return to baseline. So basically I’m ~2 weeks post noise/stress exposure and ~10 post spike. Thoughts/experiences anyone?

Oh, and I can’t sleep for shit so she prescribed Trazodone... never taken it before, not sure what to expect.

 

I take Trazodone as a sleeping aid. Works rather well for me.

 

Are steroids worth trying for a tinnitus spike, if there is no change neither in your normal nor high frequency audiogram?

 

No. All of the anecdotes I’ve seen regarding the use of steroids for a tinnitus spike is that you’ll get temporary relief while on them, but once the tapering begins, it’ll go back to the way it was (spiked). It’s pointless.

Take them only if you’re noticing any hearing loss or if your doctor prescribed them for something unrelated to tinnitus. Steroids are not to be trifled with IMO.

 

How about mild hearing loss, like 10 dB? Because I am afraid I might have lost some hearing lately, but nothing dramatic.

 

For you guys that believe Prednisone helps lessen the long term/permanent volume of tinnitus if taken soon after audio trauma, how much time to I roughly have to take the stuff?

My ears got (further) damaged 2 months ago from a car horn in an underground parking lot and I'm wondering if it's still worth trying to get Prednisone.

I saw two ENTs at my hospital (they were both in the same room at the end of their shift) and one seemed adamant that Prednisone was only good for sudden hearing loss, but I got the impression the other doctor would have given me some if I'd seen her sooner (this was about 5 weeks after the audio trauma).

What do you guys think?

 

I’ve had tinnitus for 4 years from an acoustical trauma.

I had sudden hearing loss in the higher frequencies of my left ear one week ago. I got an intratympanic injection of Dexamethasone in my left ear 4 days later and started on Prednisone 60 mg x 5 day, 40 mg x 5 days, 20 mg x 5 days, 10 mg x 5 days taper. I go back after 7 days from the intratympanic injection for a follow-up audiogram and possibly another intratympanic injection.

Hope I regain some or most of my sudden hearing loss.

 

After my acoustic trauma, I visited an ER one day later, and then an ENT the next day. Looking back on it, I should have done my research right then and there and demanded Prednisone.

Your window for recovery is the sooner, the better. After one month (as they say), your ability to recover hearing ends, BUT I saw slight improvements in hearing after taking Prednisone in early September, exactly two months after my trauma. Also take NAC, 1200 mg a day, in conjunction with the Prednisone.

First PubMed study summary I read back in September and immediately got on Prednisone.

Efficacy of Oral Steroids for Acute Acoustic Trauma

I'll go off topic and say I hate when people lock their car doors, and make sure they are locked when they press again on the keyfob, which then the car honks. It's a minefield of noise out there... parking lots especially.

 

I’m 10 months into my onse of reactive tinnitus + hyperacusis (both were starting to improve).

7 days ago, thanks to my husband, a big metal chair fell over right beside my most sensitive ear (left one) and made a VERY LOUD BLAM! I swear it was easily more than 100 dB. I felt some pain in this ear at the very instant. I took 1800 mg of NAC and some Magnesium bisglycinate right away.

The same night I had a new sound added to my 2 tone high pitched tinnitus: cicadas.

The next day another sound: some crazy beeps that come and go. The baseline in my left ear is now also much louder. Now my left ear (which was my most sensitive ear) is hurting inside, and everything sounds loud, even TV at its lowest volume or my own voice. And I think I’m back to the square one, because It’s again reacting to every single sound (steps, voices, running water...)

I feel my situation is so much worse.

Do you think Prednisone will help me? I don’t know if I should go to the doctor and ask for it.

 

I am confused about something: intratympanic steroid injections have the same side effects as the oral steroids? I have been very anxious lately due to benzo tapering and some stuff so I don't want to overload my system with stress... and stress itself could cause tinnitus, right?

Are intratympanic Dexamethasone injections safe? I will maybe talk about it with a doctor because I got a new tone 5 days ago during a stressful/burnout episode.

 

The difference with intratympanic steroids is that they only affect the ears, compared to pills that go through the body.

 

Can I ask how did you notice the hearing loss in the higher frequencies? How did it happen years after the onset of your tinnitus? Were the oral Prednisone and injections effective?

 

I woke up with muffled hearing in my left ear. My hearing seemed like I was wearing an earplug in my left ear vs. no earplug in my right ear. It was very noticeable. I went to the ENT within 4 days and took a hearing test which showed a small drop at 2000 Hz and large drops (30-40 dB) at 6000 Hz and 8000 Hz in the left ear. Right ear was normal. The ENT thinks it was caused by a virus. My kids were sick the week before my hearing loss and I had mild symptoms a few days before as well. The Prednisone and intratympanic Dexamethasone injections were very effective and my hearing recovered back to almost baseline. I ended up getting 3 intratympanic injections total. One per week for three weeks. The key to recovery success is starting treatment ASAP. The ENT was very happy with my recovery as was I.

I have been a patient at this ENT for about 5 years and when I mentioned sudden hearing loss when I called to schedule an appointment, they got me in the next day!

 

Hi @F-u-T, did the intratympanic Dexamethasone shots have any effect on your tinnitus?

 

I wanted to bump this thread. I have found many studies that show promise in intratympanic steroid treatment for tinnitus. Question is, would this work several years after onset? Anyone had any luck with the shots?

Intratympanic dexamethasone as an adjuvant to oral imipramine hydrochloride (Tofranil, a TCA) 25 mg twice daily in management of idiopathic unilateral subjective tinnitus | The Egyptian Journal of Otolaryngology | Full Text (springeropen.com)

The Efficacy of Intratympanic Steroid Injection in Tinnitus Cases Unresponsive to Medical Treatment - PMC (nih.gov)

Intratympanic injection of dexamethasone for treatment of tinnitus in patients with sudden sensorineural hearing loss - PMC (nih.gov)

:: Clinical and Experimental Otorhinolaryngology (e-ceo.org)

Tinnitus: Evaluation of Intratympanic Injection of Combined Lidocaine and Corticosteroids - Abstract - ORL 2016, Vol. 78, No. 3 - Karger Publishers

KoreaMed Synapse

Effectiveness of Intratympanic Dexamethasone with Lidocaine for Alleviation of Tinnitus | Pakistan Armed Forces Medical Journal (pafmj.org)

Efficacy and safety of post-auricular injection of methylprednisolone sodium succinate and lidocaine in the treatment of acute tinnitus, and its effect on sleep quality | Tropical Journal of Pharmaceutical Research (ajol.info)