Preventing Hearing Loss: A Functional Medicine Approach to Protecting Your Hearing Health

Hearing loss is when one cannot hear as well as others. It is often called an "invisible disability." Over the next 25 years, hearing loss is expected to affect 2.5 billion people. It can make everyday activities, like talking to friends or listening to music, much more difficult. It can also affect quality of life, making one feel isolated or frustrated.

Preventing hearing loss is essential for overall health and well-being. This article provides a complete guide on how to prevent hearing loss. It will cover different ways to protect your ears and maintain good hearing health with a holistic approach.

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Understanding Hearing Loss

Normal hearing is 20 dB or better in both ears. Hearing below this threshold is categorized as hearing loss. 

When the ears are functioning normally, sound passes through the outer ear (auricle), travels through the auditory canal, and vibrates the ear drum (tympanic membrane). These vibrations travel through the small bones of the ear to the cochlea, an organ in the inner ear that transmits stimuli to the 8th cranial nerve and then to the brain. 

Over 430 million people worldwide require treatment for hearing loss, and resource-limited countries are more affected. Hearing loss is categorized into 3 types: Conductive, sensorineural, or mixed.

Types of Hearing Loss

Conductive hearing loss occurs when sound waves are not properly transmitted. It is often caused by physical disruption, such as excess ear wax (cerumen), a foreign body in the ear canal, infection, or an ear that was not properly formed. People with conductive hearing loss hear sounds as diminished. 

Sensorineural hearing loss (SNHL) occurs when the stimulation of the inner ear to the 8th cranial nerve or brain is disrupted. It may happen when the hair cells of the ear are not functioning or the 8th cranial nerve is impaired. Individuals with this type of hearing loss hear sounds as diminished and distorted. 

Mixed hearing loss is a combination of sound not properly traveling through the ear and stimuli not being transmitted to the nervous system. It can occur from physical blocks inside the ear or nerve dysfunction. 

Symptoms of Hearing Loss

Early signs of hearing loss may include: 

• Difficulty hearing with background noise (e.g., in a restaurant) 
• Difficulty hearing consonants
• Muffled sounds
• The need to turn up the volume on the TV or stereo
• Ringing in the ears, also known as tinnitus 
• Advanced symptoms may include social isolation and frustration

Causes and Risk Factors of Hearing Loss

Here are some of the most common causes of hearing loss.

• Aging: Age-related hearing loss, called presbycusis, usually affects both ears. Causes may include the degenerative effects of aging on the hair cells and cochlea. 
• Excess noise: Noise-induced hearing loss is prevalent, affecting 104 million people in America. Exposure can occur in work environments (factories) and daily life, such as concerts or outdoor activities (from vehicles and boats). 
• Genetics: Genetics also plays a role in hearing loss, which affects 1 in 1000 births. Mutations can often cause dysfunction in the cochlea and hair cells. 
• Medical conditions: Medical conditions such as obesity, hypertension, diabetes mellitus, and autoimmune disease (e.g., lupus) can also cause hearing loss to progress faster.
• Medications: Some medications are ototoxic, which means they can damage the ear. These drugs can include NSAIDs and antibiotics, depending on the dose and length of treatment. 

Risk Factors

Certain professions increase the risk of hearing loss. Approximately 104 million Americans are exposed to harmful noises that damage the hair cells of the inner ear, which may cause permanent hearing loss. Factory workers and military personnel are often exposed to unsafe decibel levels, especially when working with machinery and aircraft. 

Certain recreational activities can cause temporary and permanent hearing loss, such as using recreational vehicles, power tools, and shooting sports. Concerts, clubs, and fitness classes are also environments with the potential for very loud music. 

Vascular health influences hearing throughout life, and lifestyle choices like smoking and poor diet can contribute to hearing loss. Smoking and inadequate nutrition can impair blood vessel health and reduce blood flow throughout the body, including the inner ear.

Preventive Strategies for Hearing Loss

Here's what you can do to prevent hearing loss:

1. Protect Your Ears

Protecting your ears over time from loud noises can help prevent age-related hearing loss. Sounds above 70 dB can be damaging over time. Noise exposure is cumulative, and small choices can prevent permanent damage to the structures in the ear. 

Workplace ear protection, such as earplugs and earmuffs, can reduce noise exposure from machinery and other equipment. Volume at 85 dB is the maximum safe level of noise exposure in the workplace. 

Personal music systems at moderate volume, whether over a speaker or headphones, can also aid prevention. Headphone and earbud volumes should be limited to half the maximum volume. 

Earplugs are an excellent option for loud concerts and sporting events. There are several options for earplugs that reduce volume but do not distort the music. Many popular smartwatches provide decibel measurements and can alert users when their environment is too loud. 

2. Get Regular Hearing Check-Ups

Early detection of hearing loss is necessary for proper treatment. Newborns should undergo screening for hearing loss in their first month. Well-child visits should include screening questions about hearing loss. Older adults should be asked if they have difficulty hearing, and the Medicare annual wellness visit includes screening questions about hearing. 

Some professional organizations have differing views about the frequency of hearing check-ups. However, the American Geriatrics Society recommends all adults over 65 be screened for hearing loss as there is little risk with routine testing. 

3. Make Healthy Lifestyle Choices

Healthy lifestyle choices promote overall health, including auditory health. An anti-inflammatory diet rich in veggies, fruits, healthy fats, and whole grains can help prevent hearing loss. Reducing saturated fats, sugar, and simple carbohydrates can also promote auditory health and prevent age-related hearing loss. 

Physical activity increases blood flow and has been shown to slow cochlear degeneration. Exercise supports vascular health, and keeping active can reduce age-related hearing loss. The anti-inflammatory effects of exercise delay age-related hearing loss by keeping the capillaries healthy.  

4. Avoid Ototoxic Substances

When prescribed new medications, it is essential to consult a healthcare provider about their potential effect on hearing. Taking over-the-counter medicines at the proper dose and duration can prevent ototoxic effects. 

Avoiding exposure to chemicals and toxins can prevent damage to the ear. These substances include lead, mercury, and arsenic. Some vapors and solvents, such as cyclohexane, hexane (gasoline), and lindane (Kwell), are also risk factors for ototoxicity. Avoiding toxic chemicals and vapors, especially in the workplace, can prevent many health problems. 

Integrative Approaches to Hearing Health

Integrative approaches to hearing health combine nutrition, stress management, natural therapies, and proper ear hygiene to maintain and enhance auditory function. By addressing the body holistically, these strategies can help prevent hearing loss and support overall ear health.

Nutritional Interventions

Dietary factors influence blood flow to the ear, the health of the ear structures, and the odds of developing hearing loss. Appropriate intake of vitamin B12 and vitamin D reduces the likelihood of tinnitus and promotes better hearing. In clinical studies, a higher intake of fruits and vegetables and lower fat positively affected hearing health.

Increasing antioxidant intake promotes vascular health. Intake of omega-3 polyunsaturated fatty acids (PUFAs) positively affects hearing. Zinc and iodine deficiency can increase the risk of hearing loss; supplementing these nutrients may sometimes be necessary. 

Stress Management

Chronic stress is a notable risk factor for many health conditions, including hearing loss. Stress from home, work, and difficult circumstances can increase inflammation throughout the body, which affects the auditory system. Reducing stress through meditation, acupuncture, yoga, and breathing exercises can improve overall health. 

Natural Therapies

Some herbal remedies, including ginkgo biloba, have been shown to improve sensorineural hearing loss. These herbs act on the hair cells of the ear and reduce free radicals and oxidation.  

Ear Hygiene and Care

The ears are "self-cleaning" and do not generally require maintenance. Ear wax (cerumen) keeps the ear canal healthy and protects the inner ear from dirt, excess skin cells, and foreign bodies. It does not require removal unless it is causing hearing loss, and it should only be removed by a medical professional. 

Nothing should be inserted into the ear (e.g., cotton swabs), as this can increase the risk of ear infection and eardrum damage. 

Integrating Hearing Health into Routine Care

Caring for auditory health is essential to holistic care, and hearing protection should be integrated into all preventative care. Maintaining hearing health is as important as any other bodily system for promoting quality of life. 

Healthcare providers should educate patients about preventing hearing loss and emphasize that exposure can cause permanent damage over time. Patients should be encouraged to report any changes to their hearing or new ringing in the ears. 

Auditory health is best promoted through a collaborative approach. Specialty care through otolaryngology (ENT) and audiology can help identify and treat specific causes of hearing loss. If hearing issues arise or more specific testing is necessary, referral to these specialists may be necessary. Changes to hearing should be monitored over time to see if preventative strategies or treatment adjustments are necessary. 

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Key Takeaways

• Hearing loss, often called an "invisible disability," affects the ability to hear everyday sounds. 
• There are three main types of hearing loss: Conductive, sensorineural, and mixed. 
• Over the next 25 years, hearing loss is expected to impact 2.5 billion people. 
• Hearing loss can lead to social isolation and frustration, affecting quality of life. 
• Preventing hearing loss requires a holistic approach, encompassing ear protection, volume control, proper nutrition, exercise, and stress management.
• Ears are self-cleaning, and nothing should be inserted into the ear canal. 
• Providers should educate patients and conduct regular hearing screenings. 
• Future research should focus on new treatments and ways to prevent hearing loss, especially in resource-limited areas.