Is it possible that the many ibuprofens I have taken over a year (maximum doses) led to me becoming quite deaf?
Ann Burgess, East Sussex.
Dr Martin Scurr replies: I’m afraid to say you may well be right. In fact, a link between regular consumption of ibuprofen – a type of drug known as a non-steroidal anti-inflammatory (NSAID) – and hearing loss was first identified in a major US study, the Nurses’ Health Study, back in 2012.
The research, which is actually a series of ongoing projects investigating how lifestyle factors influence women’s health, revealed that taking ibuprofen more than twice weekly was linked to a 10 per cent higher risk of some degree of sensorineural deafness.
This is a type of hearing loss caused by damage to the hearing mechanism in the inner ear, affecting the delicate hair cells in the cochlea, the spiral-shaped structure in the inner ear that is crucial for hearing.
Infection, trauma and chronic exposure to loud noise can all damage the hair cells. With ibuprofen, the mechanism isn’t clear, but one theory is that the drug impairs blood flow to the cochlea – the inner ear needs a steady blood supply to function correctly and chemicals called prostaglandins are key to maintaining the correct blood flow. And NSAIDs block prostaglandins.
Once hair cells are damaged, that’s it – they can’t be repaired.
Ibuprofen is now classified as having ototoxic (ear-damaging) effects. Other NSAIDs – indomethacin, naproxen, piroxicam and celecoxib, commonly used to treat pain caused by osteoarthritis, rheumatoid arthritis and sports injuries – are also associated with irreversible hearing damage.
Ibuprofen is a type of drug known as a non-steroidal anti-inflammatory (NSAID). Taking it more than twice weekly was linked to a 10 per cent higher risk of some degree of sensorineural deafness in a major study in 2012
However, aspirin, another type of NSAID, did not have this effect, in women at least.
This indicates that whatever condition you need regular pain relief for, you should not continuously use an NSAID long term. It’s better to try to adhere to short courses, maybe a week or two maximum, not months.
I am an 82-year-old fairly fit man with no health problems other than suffering from discitis for the past six months. I’ve been having infusions of antibiotics for about seven weeks. This has now stopped and the lower back pain continues. Will I see an end to this debilitating and depressing condition?
Frank Allen, Lyme Regis.
Dr Martin Scurr replies: Discitis is a rare but serious condition, where the disc between two bones in the spine becomes chronically inflamed – typically in the lower spine as a result of infection caused by bacteria that’s spread via the bloodstream.
The discs have little in the way of blood vessels in them, which limits the immune response, so bacteria can thrive. This leads to intense inflammation: potentially the infection can spread into the bone of the vertebrae either side, and form an abscess, affecting the nerves running in the spinal canal.
Discitis is typically caused by staphylococci bacteria, found naturally on the skin. Discitis is more common in those with weakened immune systems, including older people.
One of my patients suffered this condition some years ago, caused by salmonella, which we had to assume gained access to his body from food. Like yourself, the patient was a man in his eighties.
The treatment involves a long course of high-dose antibiotics which must be given intravenously to ensure high levels in the blood. Usually this would continue for 12 weeks. Strict rest is important. In rare cases, surgery may be required to drain the abscess between the vertebrae.
The persisting pain is not uncommon but your spinal specialist team can always refer you to pain control specialists. Your symptoms should settle entirely in the following months.
IN MY VIEW: Insurers shouldn’t give health advice
Many people are having to raid their savings, their pension funds and even family coffers to purchase treatment in the private sector.
Seduced by the smart marketing, they often don’t realise until too late that insurers impose strict rules governing any claims.
What also deeply worries me is that general practice is not covered. Instead, these insurers see themselves as guiding their customers through the so-called ‘healthcare journey’.
But patients need to be wary: the only professionals who are trained and entitled to guide patients through the ‘healthcare journey’ are GPs. Insurance firms have only one motive, the drive to increase profits, which means ensuring their customers receive the cheapest option.
This isn’t necessarily the best or the most appropriate. Not least, the insurer does not know the patient and their history, let alone their psychology, so how can they choose the best treatment options?
So regard the advice given by an insurer with great caution, including the recommended specialist. If in doubt, your GP is the best guide – both in terms of specialist and treatment.
- Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email drmartin@dailymail.co.uk – include your contact details. Replies should be taken in a general context and always consult your own GP with any health worries.
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