Can osteoporosis cause hearing loss?

Most people are aware of the risks to bone health as we age. But it turns out osteoporosis might have greater implications than just brittle bones. It has recently been linked to hearing health.

A study published online April 16, 2015, in the Journal of Clinical Endocrinology & Metabolism by Dr. Mei- Chen Yeh has shown that those with osteoporosis are 76 percent more likely to develop sudden onset hearing loss. Sudden onset hearing loss is exactly what it sounds like; hearing loss, usually in only one ear, that occurs all at once or in the span of a few days. Almost all sudden onset hearing loss is idiopathic, meaning a cause is never known. But for the small number of cases in which a cause is determined, the link to osteoporosis is a significant finding.

Links have been found in the past to osteoporosis and gradual hearing loss, as in a study done at the University of Illinois in 2013. That study revealed a link between osteoporosis and the demineralization of the three middle ear bones, including the stapes; those who had osteoporosis were more likely to have conductive hearing loss. The researchers in Taiwan were motivated to explore a possible causal relationship between SSHL and osteoporosis after noticing the relatively small sample sizes of previous studies on the subject, as well as noting the common complaints about hearing loss from their osteoporitic patients. As a result, the first Asian population-based study to look at a link between osteoporosis and sudden sensorineural hearing loss was conducted, and the strong correlation between the two was revealed.

Osteoporosis is a common progressive metabolic disorder that affects both men and women. Though all races are affected, it is most common in white and Asian women. Essentially, osteoporosis occurs when bone is being broken down faster than the body can replace it. This leads to bones being structurally weak, and more prone to breaking. Since statistics show that 40 million Americans either have osteoporosis or are at risk of developing osteoporosis, it’s a significant problem.

Using information culled from a national health database, a team lead by Dr. Kai-Jen Tien at the Chi Mei Medical Center in Tainan City, Taiwan compared 10,000 people diagnosed with osteoporosis between 1999 and 2008 to 32,000 people without the condition. 89 percent of the subjects were women. While, in general, those with osteoporosis were 76 percent more likely to develop SSHL, the results for women were even more grave: women with osteoporosis were 87 percent more likely to develop SSHL than the general population.

While the study couldn’t prove cause and effect, it did confirm a relationship exists between the two conditions. The theories about the onset of sudden hearing loss include cardiovascular or cerebrovascular involvement as well as bone demineralization, inflammation and endothelial dysfunction (the lining of the blood vessels).

What this means for those with osteoporosis is that careful attention should be paid to their hearing health in addition to the health of their bones. Patients can and should advocate for themselves if their doctor doesn’t take the correlation into account. “Clinicians should not ignore hearing problems in osteoporotic patients. Likewise, patients with osteoporosis should be aware and inform their clinician if they suffer from suspected hearing impairment,” said Dr. Kai-Jen Tien.

In the United States, one in 5000 people will develop sudden onset hearing loss every year. Fifty percent of those will regain their hearing spontaneously, and 85 percent will recover some or all of their hearing with prompt treatment. “Prompt” is the key word: the window for effective treatment appears to close anywhere from two to four weeks after the hearing loss occurs.

But what about preventive treatment? Is it possible that anti-osteoporotic therapies, meant to reduce the risk of fracture and improve bone quality in patients with osteoporosis, could also reduce the risk of SSHL? Researchers think that is a possibility, although further studies are needed to determine which, if any, treatments are most effective.

What is known is this: it can’t hurt to pay closer attention to bone health and bone density as we age. “More people worldwide are suffering from osteoporosis, and our work shows they are at risk of sensorineural hearing loss as well as bone fracture and other problems,” Dr.Tien said. “Patients who have osteoporosis should be aware they need to seek medical help immediately if they experience hearing loss.”