Hearing loss can sometimes be linked to autoimmune diseases rather than just aging or noise exposure. Conditions such as rheumatoid arthritis (RA), lupus, and others are associated with a higher occurrence of hearing problems, including tinnitus.
Experts recommend that people diagnosed with autoimmune disorders undergo regular hearing screenings. Trisha Milnes, chief of Audiology and Speech Pathology at the Charlie Norwood Virginia Medical Center, emphasized this point: "It's very necessary." Her clinic actively contacts patients with certain autoimmune-related illnesses to ask about their hearing health.
Autoimmune diseases occur when the immune system mistakenly attacks healthy tissue in the body. This can lead to inflammation even when there is no actual threat present. Examples include type 1 diabetes, Hashimoto's thyroiditis, Sjögren's syndrome, celiac disease, ankylosing spondylitis, Graves' disease, vitiligo, lupus, and psoriasis.
Not all autoimmune disorders affect hearing, but many do so through inflammation or disrupted blood flow in the ear. The degree of hearing loss varies; it may impact one or both ears and can develop suddenly or gradually across different sound frequencies. Sometimes it is difficult to determine if an autoimmune disorder is responsible for hearing loss because symptoms may come and go without clear cause.
Aaron Abend, executive director of the Autoimmune Registry, Inc., noted: "In many cases, though the hearing loss is permanent, the cause of the damage can [come and go], so there's no way to diagnose the cause of the damage after it has happened."
Some medications used to treat autoimmune conditions are also linked to hearing issues—a phenomenon known as ototoxicity. More than 200 drugs have been connected to hearing loss and tinnitus; these include some monoclonal antibodies used for managing autoimmune diseases.
Treatment options depend on whether the underlying condition or its medication caused the problem. Corticosteroids may be prescribed to reduce inflammation in blood vessels and protect inner ear structures. In certain cases plasma transfers are used to remove harmful antibodies from blood. Other therapies aim at increasing blood flow within the ear or suppressing immune activity overall. When permanent damage occurs, hearing aids might be recommended.
Several specific autoimmune diseases are known for causing hearing problems:
- Autoimmune inner ear disorder (AIED) involves immune cells attacking inner ear structures leading to progressive—and sometimes fluctuating—hearing loss.
- Rheumatoid arthritis increases risk for sensorineural (inner ear) hearing loss by more than four times compared with those without RA.
- Lupus affects multiple organs including ears; about 25 percent of patients experience some form of hearing symptom.
- Hypothyroidism has long been linked with sensorineural hearing loss; treating thyroid dysfunction can improve auditory function.
- Skin conditions like vitiligo and psoriasis also increase risks for certain types of sudden or chronic hearing impairment.
- Meniere's disease presents overlapping symptoms with autoimmunity but its classification remains unclear.
Patients newly diagnosed with an autoimmune disorder should remain alert for changes in their ability to hear. Prompt testing is advised if new symptoms arise so that appropriate interventions can be considered early on.
