Hearing Loss: Causes & Treatments
Hearing is something most of us don’t pay much attention to until there’s a problem. But the older you get, the worse your hearing is likely to become – though hearing problems can affect you at any age. Indeed, it’s estimated there are more than 45,000 deaf children in the UK, as well as many more who are affected by temporary hearing loss.
According to the national charity Action on Hearing Loss, more than 70 percent of 70-year-olds and 40 percent of the over-50s have some kind and degree or hearing loss, which works out at around 11 million people in the UK altogether (or one in six of the population). And by 2035, it’s estimated there’ll be 15.6 million people with hearing loss in this country, which is one in five.
Hearing loss can start suddenly, though it usually develops gradually – so gradually, in some cases, that you may not notice you have a problem for some time. Most people with hearing loss are affected in both ears (unilateral hearing loss), though each ear is often affected to a different extent. Some people, however, will be affected by loss of hearing in just one ear, which is sometimes referred to as single-sided deafness.
It’s not always easy to tell if your hearing is getting worse. Ask yourself if any of the following apply to you:
Do you find yourself asking other people to repeat what they’ve said?
Do other people sound as if they’re mumbling rather than speaking clearly?
Do you have to concentrate so hard when listening to others talking that it makes you tired?
Do other people often tell you to turn down your TV or music because it’s too loud?
Do you find it difficult to understand conversations in places where there’s lots of background noise, whereas others don’t seem to have a problem?
Do you struggle to keep up with conversations when you’re in a group of people?
Do you find it difficult to hear what people are saying on the phone?
How hearing works
The ear is made up of three parts:
This consists of the pinna (the part of the ear you can see), the ear canal and eardrum.
This is an air-filled chamber that houses three tiny bones – or ossicles – called the malleus, incus and stapes (or hammer, anvil and stirrup), as well as the other side of the ear drum. The Eustachian tube connects the middle ear to the back of the nose.
This consists of the cochlea – a chamber shaped like a snail shell – and the vestibular system, both of which are connected to the auditory nerve.
When sound waves enter the ear canal, they make the ear drum vibrate. These vibrations are transmitted to the cochlea via the middle-ear bones. Sensory cells – called hair cells – in the cochlea then transform the vibrations into electrical signals. The signals travel to the brain via the auditory nerve, and certain areas of the brain receive the signals and translate them into what we recognise as sound.
Damage to any part of the ear can mean sound signals won’t reach your brain, which causes hearing problems. The level of hearing loss you may be affected by depends on the extent of the damage. Four levels of hearing loss are recognised by health professionals, each of which is measured in units of sound levels called decibels (dB).
If you have mild deafness, the quietest sound you can hear is between 21 and 40dB.
In moderate deafness, this increases to between 41 and 70db, which means you may have difficulty hearing people talking if you don’t use a hearing aid.
Severely deaf people can only hear sounds from 71 to 90dB and above – they usually need a hearing aid and may also use lip reading or sign language.
The highest level of hearing loss is profound deafness, which is when the quietest sound you can hear is more than 90dB (more than 900,000 people in the UK are severely or profoundly deaf, says Action on Hearing Loss).
If you’re not sure you have a problem with your hearing, try taking the Action on Hearing Loss online test.
What causes hearing loss?
If you were born with hearing, there are lots of reasons why you may develop problems with it. There are two main types of hearing loss: sensorineural and conductive.
Sensorineural hearing loss happens when the hair cells in the cochlea or the auditory nerve become damaged. There are several things that can cause this, including the following:
According to the NHS, getting older is the biggest single cause of hearing loss, and by the age of 80 most people have significant hearing problems. The medical term for age-related hearing loss is presbyacusis, and in most people hearing can start to deteriorate from the age of 40. This is caused by wear and tear of the hair cells in the inner ear. And because this deterioration tends to happen very gradually, many people live with it for years before they do anything about it.
Repeated exposure to loud noise can damage the ears over time. This damage can happen to people who work with noisy equipment or in a noisy environment (in nightclubs, concert halls or factories, for example), and also those who listen to loud music through headphones or who like to stand next to the speakers in nightclubs. Sudden loud noises – such as that caused by an explosion or fireworks – may cause acoustic trauma, which can lead to hearing loss too. Any of these types of noise exposure can damage the hair cells in the cochlea.
Certain medical conditions can cause sensorineural hearing loss, including Ménière’s disease (which often causes vertigo and another hearing problem called tinnitus), meningitis, encephalitis, multiple sclerosis, stroke, autoimmune conditions, head injury and acoustic neuroma (a benign growth on or near the auditory nerve). Some viral infections such as mumps, measles and rubella can damage your hearing to, as they can affect the inner ear or auditory nerve.
According to the NHS, those who have diabetes, cardiovascular disease and chronic kidney disease also have an increased risk of developing hearing loss. Taking certain medicines and treatments can damage your hearing too, including some chemotherapy medicines, certain antibiotics and radiotherapy treatments for nasal and sinus cancer.
Conductive hearing loss
The other main type of hearing loss is usually caused by a blockage in the ear. This is called conductive hearing loss, and it can be the result of having a build-up of ear wax or ear fluid (a condition known as glue ear), or an ear infection. Various other things can also cause conductive hearing loss, including otosclerosis (a condition that affects the bones of the middle ear), a perforated eardrum, an injury that damages the bones in the middle ear, a problem with the Eustachian tubes, or having an object stuck in your ear. The good news is that – unlike sensorineural hearing loss – conductive hearing loss isn’t usually a long-term condition, and can usually be treated successfully.
Treatments for hearing loss
According to Action On Hearing Loss it takes 10 years on average for people to do something about their hearing loss. In many cases this is because the change in hearing is so gradual, people simply put up with before they accept that they need help.
If you suspect you have a hearing problem – whether the problem has started gradually or suddenly – ask your GP for an ear examination. This can help determine whether anything unusual is happening inside your ear, such as an infection, a perforated ear drum, fluid behind the ear drum (glue ear) or a build-up of earwax that’s causing a blockage. If you experience earache and ear pain, this could also be a sign of infection.
Your GP may then refer you to a specialist such as an audiologist or an ear, nose and throat (ENT) specialist. The specialist will do further tests to find out what may be causing the problem as well as suggest a suitable treatment.
The type of treatment you’ll be offered will depend on what’s causing the problem. If your hearing has been affected because of excess ear wax, you may need drops or the wax may be removed with a syringe or suction device. If you have an ear infection, all you may need is a course of antibiotics. Or if you have another problem causing conductive hearing loss, you may need surgery to correct it (to repair a perforated ear drum or to drain a build-up of fluid, for example).
Sensorineural hearing loss – where your hearing has been affected by damage to your inner ear or the nerves that send sound signals to your brain – cannot be cured. However there is a range of treatments that can boost your ability to hear, including the following:
One in 10 adults in the UK would have better hearing if they wore hearing aids, but according to Action On Hearing Loss, only one in 30 people actually uses them.
There are several types of hearing aids available, and they all amplify sound in similar ways. A hearing aid contains a tiny microphone that picks up sound, which is transformed into an electronic signal and passed on to a receiver. The receiver then coverts the signal back into louder sounds, which helps you hear more clearly.
You can get behind-the-ear hearing aids free on the NHS, but you’ll usually have to pay privately for other types – such as in-the-ear, in-the-canal, bond conduction and body-worn hearing aids.
There are also lots of specialist devices you can use around the home to make hearing easier or to make you more aware of sounds. For instance special telephones can let you hear someone on the phone better, or you can buy equipment that amplifies the sound from your television or radio. Doorbells with flashing lights and vibrating alarm clocks can also be helpful. Many of these products are available from the Action On Hearing Loss website.
If you have severe to profound hearing loss in both ears and hearing aids aren’t helping you, your specialist may recommend a cochlear implant (children can usually get two implants but adults are generally only allowed one on the NHS). Cochlear implants are devices that are surgically fitted under the skin behind the ear. They work by stimulating the auditory nerve, and are thought to be used by around 11,000 people in the UK. Auditory brainstem implants – where electrodes are implanted into the brain – may also be recommended to those with severe to profound hearing loss who have a problem with the auditory nerve.
Not a treatment as such, but lip reading can also be helpful if you were affected by hearing loss after you learned to talk, whatever degree of hearing loss you have. To find a lip reading class, call the free Action On Hearing Loss information line on 0808 808 0123 (textphone 0808 808 9000). On the other hand those who were born with hearing impairment are more likely to use sign language than lip reading.
How to prevent hearing loss
Unless you were born with hearing impairment or you have a medical condition that affects your hearing, there’s lots you can do to protect yourself against the damage that can cause hearing loss caused by long-term noise exposure.
According to the NHS, continued exposure to noise at or above 85dB – which is about the level of a lawn mower or loud traffic – can over time cause a problem with hearing. Here are some suggestions to help prevent noise-induced hearing loss:
Keep it down at home
When you’re watching the TV or listening to music or the radio, make sure the sound isn’t turned up too high. You should be able to comfortably hear someone talk from about 2m away – if you can’t, your TV/radio/music is too loud (it’s also too loud if your ears ring when you switch the sound off). Always make sure noise levels stay at an acceptable level if you have young children, as their ears can be more easily damaged than those of adults.
Use noise cancelling headphones
If you find you tend to turn up the volume of your music in your headphones because there’s a lot of noise around you, it’s a good idea to use noise-cancelling headphones instead of an ordinary pair. These block a lot of outside noise, so you can keep the level of your music lower.
Protect your hearing at work
People who work in a noisy environment are especially susceptible to noise-induced hearing loss. If you work in the music or entertainment industry, if you work in construction, manufacturing or are a member of the armed forces, your employer should make sure you use hearing protection, such as ear muffs or ear plugs.
Watch your ears when you’re out
Even if you don’t work at a nightclub, going to clubs or concerts with loud music can have a damaging effect on your ears. Other events – such as motor racing – can have high noise levels too. Make sure you use ear protection equipment, such as ear plugs, to avoid any problems. And if you’re in a nightclub, try to avoid standing too close to the speakers and use chill-out rooms every now and then to give your ears a break.
Meanwhile, it’s also a good idea to avoid putting any foreign objects into your ears, including cotton buds to clean them. Using cotton buds can damage your eardrum or ear canal, and make any wax in your ears impacted – all of which can cause temporary or permanent hearing loss.
Taking certain nutritional or herbal supplements may be useful to improve the symptoms of several types of hearing loss:
Some experts believe age-related hearing loss may be linked to nutritional deficiencies, including a deficiency of vitamin B12 and one study suggests elderly women with hearing problems may have lower B12 levels than those whose hearing is normal (i). There is also some evidence that B12 deficiency may play a part in noise-related hearing loss too, with the authors of one study concluding there may be a relationship between vitamin B12 deficiency and dysfunction of the auditory pathway (ii).
Low levels of folic acid have also been linked with age-related hearing loss (i). One study conducted in the Netherlands suggests folic acid supplements may help slow down the progress of age-related hearing loss in men and women aged between 50 and 70 years old. The participants in the study also had high levels of the amino acid homocysteine, which may also be caused by low levels of folic acid (iii). After three years of taking a daily folic acid supplement, the volunteers had reduced low-frequency hearing loss when compared to those who were taking a placebo.
Separate vitamin B12 and folic acid supplements are available. However, many natural health practitioners recommend taking a single vitamin B complex supplement, which contains the correct levels of all the B vitamins (including folic acid).
A tree native to parts of Asia – including Japan, Korea and China – ginkgo biloba is now grown in many other parts of the word, and is recommended for several health disorders. Some natural health experts consider ginkgo supplements to aid reduction of inflammation in the ear. Ongoing research is considering the active compounds in ginkgo biloba in relation to the symptoms of age-related hearing loss (iv), while other studies have looked at this herb as a treatment for sudden hearing loss (v). Some believe that circulation may be responsible in some cases of sudden hearing loss, and ginkgo has been shown to help with the circulatory system.
Experiencing hearing loss can be difficult, but these steps should help to support you through it. If you’d like more information on a range of common health conditions, feel free to visit our health library.
Houston. DK, et al. Age-related hearing loss, vitamin B12, and folate in elderly women. Am J Clin Nutr 1999 Mar;69(3):564-71.
Shemesh. Z. Vitamin B12 deficiency in patients with chronic-tinnitus and noise-induced hearing loss. Am J Otolaryngol. 1993 Mar-Apr;14(2):94-9.
Durga. J, Verheof. P, Anteunis. LJ, Schouten. E, Kok FJ. Effects of folic acid supplementation on hearing in older adults: a randomized, controlled trial. Ann Intern Med 2007 Jan 2;146(1):1-9.
Kumar. A, Raizada. RM, Chaturvedi. VN. Role of ginkgo biloba extract in acquired sensorineural hearing loss. Indian J Otolaryngol Head Neck Surg. 2000 Jul;52(3): 212–219.
Burschka. MA, Hassan. HA, Reineke. T, et al. Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients. Eur Arch Otorhinolaryngol. 2001;258:213–219.
Reisser. CH, Weidauer. H. Ginkgo biloba extract EGb 761W or pentoxifylline for the treatment of sudden deafness: a randomized, reference-controlled, double-blind study. Acta Otolaryngol. 2001;121:579–584.
Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.