6 lesser-known and better-known causes of hearing loss

About 48 million Americans, or approximately 20 percent of the population, have some degree of hearing loss. According to the Centers for Disease Control and Prevention, hearing loss is now the third-most common chronic health condition in the United States.

Many cases of hearing loss are preventable. And many more are treatable. We often have an easier time treating hearing loss if you have hearing exams on a regular basis. Talk to your doctor if you think you have hearing loss or if you’re at risk for it.

"Talk to your doctor if you think you have #hearingloss or if you’re at risk for it." via @MedStarWHC

Hearing loss can be a symptom of many other conditions. Some, like diabetes, we know a lot about. And some we’re just recently beginning to understand.

Lesser-known causes of hearing loss

Iron-deficiency anemia

Hearing loss has been in the news recently because of the results of a recent study linking it to iron-deficiency anemia. This study found that iron-deficiency anemia was associated with an 82 percent higher chance of sensorineural hearing loss. In cases of sensorineural hearing loss, there is damage to the inner ear or the nerves leading from the inner ear to the brain. The study didn’t determine that iron-deficiency anemia definitely causes hearing loss, but it suggested that the lack of iron may reduce blood flow to the inner ear.

Several groups of people are at particular risk for iron-deficiency anemia, including:

  • Babies and young children, especially premature babies or those with a low birth weight
  • People who get kidney dialysis treatment
  • People who have internal bleeding because of colorectal cancer, bleeding ulcers or other medical conditions
  • People whose diets don’t contain enough iron
  • Women of childbearing age who have regular menstrual cycles


Another cause of hearing loss that most people don’t know about is otosclerosis. Otosclerosis is a condition in which one of the ossicles, or the tiny bones in the middle ear, gets stuck and isn’t able to vibrate normally. This normally happens to the ossicle called the stapes. When these bones can’t vibrate, sound can’t travel through the ear to the auditory nerve, which carries signals to the brain that allow us to hear. This is a type of conductive hearing loss.

Otosclerosis tends to occur in people with a family history of the condition. Researchers think otosclerosis also could be associated with previous cases of measles, stress fractures to the bony area around the inner ear and immune disorders. Some researchers also believe a lack of fluoride in drinking water can contribute to the development of otosclerosis.

Better-known causes of hearing loss

Unfortunately, numerous factors can cause or contribute to hearing loss. Some of the better-known ones include:

  • Ototoxins
  • Ear infections and cholesteatomas
  • Microvascular disease
  • Age


One fairly common cause of hearing loss is exposure to chemicals or medications that can damage the ear. We call these ototoxic substances or ototoxins. Many medications and chemicals can cause either temporary or permanent ear damage, including:

  • Aspirin
  • Certain antibiotics, including gentamicin and vancomycin
  • Cisplatin and carboplatin, used in chemotherapy for cancer treatment
  • Loop diuretics, used to treat some kidney and heart conditions
  • Quinine, used to treat malaria

"One fairly common cause of hearing loss is exposure to chemicals or medications that can damage the ear." via @MedStarWHC

Ear infections and cholesteatomas

Untreated ear conditions like ear infections can also lead to hearing loss without proper treatment. Ear infections are a common childhood illness, but some adults continue to get them as they age. This can be linked to a condition called Eustachian tube dysfunction, which happens when the tube that links the nose to the middle ear doesn’t open or close properly. Adults with Eustachian tube dysfunction are at higher risk for ear infections.

Chronic ear infections can lead to the development of a cholesteatoma. A cholesteatoma is a cyst of skin in the middle ear space, or mastoid. Someone with a cholesteatoma might have painless ear drainage that they just might get used to over time. But without treatment, the cholesteatoma can break down the bones in the middle and inner ear. Not only can this cause hearing loss, but a cholesteatoma also can cause:

  • Brain infection, or encephalitis
  • Dizziness or a lack of balance
  • Facial paralysis, resembling Bell’s palsy
  • Meningitis

Diabetes, high blood pressure and high cholesterol

Hearing loss is linked to several fairly common conditions, including diabetes; high blood pressure, also known as hypertension; and high cholesterol, also known as hyperlipidemia. All of these conditions can cause microvascular disease, which is a problem with the tiny blood vessels that supply blood to the inner ear. Microvascular disease of the ear’s blood vessels can narrow these inner-ear blood vessels, which can either cause hearing loss or cause it to get worse.


Of course, perhaps the best-known cause of hearing loss has to do with the aging process. Our risk for hearing loss goes up as we get older. This is called age-related hearing loss, also known as presbycusis. Almost 25 percent of Americans between 65 and 74 have some degree of hearing loss. And nearly half of Americans 75 and older have hearing loss.

"Nearly half of Americans 75 and older have #hearingloss." via @MedStarWHC

Lower your risk of hearing loss

Of all the causes of hearing loss, exposure to loud noises is one of the most common. We can minimize this risk by protecting ourselves from loud noises when possible. Keep the volume down on your devices when listening to them with earbuds and headphones. And wear earplugs or other ear protection when you know you’ll be exposed to loud noises, like at a concert or while using noisy equipment.

Microvascular disease from diabetes, high blood pressure or high cholesterol also is something we can work to reduce or eliminate. Talk to your doctor about keeping your blood sugar, blood pressure and cholesterol under control through lifestyle changes, medications and other treatments to reduce your risk of microvascular disease.

Unfortunately, the most common cause of hearing loss is the aging process, and there isn’t much we can do to stop that. But we may be able to stop the aging process’s effects on hearing sometime in the future. During my PhD studies at the University of Minnesota, I created an antioxidant medication that was able to prevent the onset of age-related hearing loss and keep it from getting worse. The goal of my research is for people to one day have a supplement they can take to reduce their risk for age-related hearing loss.

Hearing loss can result from a number of factors. When we identify which of these factors apply to you, we’re one step closer to finding treatment options to either cure or manage your condition.

Listen up: Get your hearing tested!

According to data from the U.S. Department of Health and Human Services, nearly 25 percent of people between the ages of 65 and 74 have a hearing problem. And for people 75 and older, that number rises to nearly 50 percent.

People often think of hearing loss as a fact of life—something that comes along with getting older. But hearing loss can affect anyone. More than 10 percent of U.S. adults between 20 and 64 have hearing loss caused by exposure to loud noise. In total, about 48 million Americans, or 20 percent of the country, have some amount of hearing loss.

Unfortunately, most people don’t get their hearing checked until they notice hearing loss or people around them complain. And that’s a problem, because it can make hearing loss more difficult to treat in the long run. Every adult should have regular hearing tests to monitor for hearing loss.

Are you overdue for a hearing exam? Make an appointment today!

How often should you have a hearing test?

All adults should have their hearing tested at least once every five years, according to the Office of Disease Prevention and Health Promotion (ODPHP).

But 2012 ODPHP data show that only about 21 percent of adults between 20 and 69 had a hearing test in the previous five years. And just over 40 percent of adults 70 and older, who are much more likely to have a hearing problem, had a hearing test within the recommended time.

As part of its Healthy People 2020 initiative, the ODPHP hopes to improve these numbers by the year 2020. The goal is a 10 percent improvement for all adults. But even that increase would mean most adults still wouldn’t receive regular screening. We clearly have a lot of work to do to get the word out about the importance of regular hearing tests.

Why do you need regular hearing tests?

Just like we do for blood pressure, it’s helpful for your doctor to have a regular reading of your hearing function. Regular hearing tests help us establish your baseline, or normal, hearing level. That way, if you notice a change in your ability to hear, or if we start to see a change from one test to the next, we can identify how abnormal your hearing function is and when the change likely happened.

If you wait until there’s an issue to have a hearing test, it’s harder to determine the problem. The doctor will have just the current exam to work from. One test won’t help us determine just how much your hearing has changed and when. A problem you may think appeared out of nowhere might have been developing for many years before you noticed.

Different types of hearing loss have very different management and treatment strategies. In some cases, we can correct hearing problems with surgery. In others, we can’t correct the disorder itself, but we can improve hearing ability with the use of hearing aids. The more time we lose trying to find the cause of hearing loss, the more hearing you could lose.

Health effects of hearing loss

Hearing loss is a major problem that is related to multiple health and emotional disorders. As a 2011 study noted, older adults with hearing loss are more likely to have difficulty with the normal activities of daily life than older adults without hearing loss. Hearing loss is associated with several problems in adults of all ages, including:

  • Dementia
  • Depression
  • Emotional difficulties
  • Feeling isolated from friends and family members
  • Lower workforce participation

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In addition, many people are unaware of the link between hearing loss and diabetes. Over time, people with diabetes can develop a condition called diabetic neuropathy. This is a type of nerve damage that can cause pain, loss of function or other problems in different areas of the body.

In some cases, hearing loss can be an early warning of diabetic neuropathy. That can be a warning sign for people to get their blood sugars under control. Hearing loss might even be a sign to diagnose diabetes in patients if they’re not already being treated for the disease.

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Talk to your doctor about hearing tests

Most primary care doctors don’t regularly test their patients’ hearing. Your primary care provider can refer you to an audiologist—a doctor who evaluates patients’ hearing and treats hearing disorders.

Hearing tests are covered by most insurance plans with a doctor’s referral. The test takes about 30 minutes to an hour. Our Hearing and Speech team uses sounds with different tones, frequencies and intensities to measure your hearing threshold – the minimum level of sound a person can hear. During the test, the audiologist also will present a series of words to see what percentage you hear correctly and can repeat. The audiologist will plot your results on an audiogram, which is a visual readout of your hearing thresholds, and go over them with you after the test.

Hearing loss can sneak up on us if we’re not careful. But it doesn’t have to. Regular hearing tests can give your doctor a head start toward keeping your hearing strong and healthy as you age.