Regularly taking common over-the-counter painkillers could lead to hearing loss over time, especially in younger men, new research suggests.
Still, experts note that the absolute risk to any single person of suffering hearing loss from these medications is still small.
In the study, published in the American Journal of Medicine, researchers found that men younger than age 50 who regularly took acetaminophen more than twice a week had roughly double the risk of hearing loss compared to men who did not take acetaminophen regularly. Acetaminophen is commonly sold as Tylenol and other brands.
Men younger than age 50 who regularly took ibuprofen (the main ingredient in Advil) or other non-steroidal anti-inflammatory drugs (NSAID) at least twice a week had a nearly two-thirds higher risk of hearing loss than men who took NSAIDs less often.
Men who took acetylsalicylic acid (ASA; sometimes sold as Aspirin) twice a week had a one-third higher risk.
The findings come from a review of the health data of nearly 27,000 men enrolled since 1986 in the Health Professionals' Follow-Up Study.
As part of the study, the men, who were between 40 and 74 years old at the beginning of the study, provided information on their pain reliever use, hearing loss and other factors that might affect their hearing every two years, for 18 years.
During that time 3,488 men were diagnosed with hearing loss. Among men younger than 50, the risk of hearing loss (compared to those who didn't take pain relievers) depended on which painkiller they used. Their risk was:
- 33 per cent higher in those who took ASA twice a week or more
- 61 per cent higher in those who took ibuprofen or NSAIDs twice a week or more
- 99 per cent higher in those who took acetaminophen twice a week or more
For NSAIDs and acetaminophen, the risk of hearing loss increased with longer duration of use.
But interestingly, the increased risks were not seen in older men. Regular ASA use did not raise the risk of hearing loss in men aged 60 and older, and the ties between hearing loss and regular use of NSAIDs and acetaminophen were weaker in the older men.
CTV's medical expert Dr. Marla Shapiro notes that any single individual may not experience these increased risks, even if they regularly take painkillers, and she notes that hearing loss begins for many in middle age.
"What you have to understand is that the baseline of hearing loss is about 1 per cent per year," she explained to Canada AM.
"So even when we're talking about what sound like dramatic increases… you're still looking, in absolute numbers, at a relatively small amount."
She says the concern is that prolonged use of these painkillers raises the hearing loss risk over time, particularly in younger men.
"We've known that pain medications in high doses can be toxic to hearing. For example, high-dose ASA can bring hearing loss and ringing in your ears," Shapiro notes. "Interestingly, low-dose ASA can be useful for hearing protection."
But she adds that the study should be a reminder that just because many pain relievers are available over the counter doesn't mean that they are safe to take over the long term.
She recommends that patients who are experiencing chronic pain should be talking to their doctor about the drugstore medications they are taking and whether there are other alternatives.
The study's lead author Dr. Sharon G. Curhan, of the department of medicine at Brigham and Women's Hospital in Boston, notes that even mild hearing loss can make it hard to understand speech in the presence of background noise.
"Given the high prevalence of regular analgesic use and health and social implications of hearing impairment, this represents an important public health issue," she said in a news release announcing the study's publication.
