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Care During Chemotherapy and Beyond

Hearing Problems, Dizziness, and Ototoxicity



Includes:  Dizziness, hearing loss, ototoxicity, tinnitus (ringing in the ears)


DIZZINESS AND VERTIGO

What is dizziness? 
Dizziness is a term used to describe when you feel "woozy" or "faint." Vertigo is a word used to describe the feeling that the room is spinning around you. 

  • When people experience dizziness, it may be a sign that the balance mechanism in your inner ear is not working properly.  
  • Some dizziness and hearing loss are due to chemotherapy. Many medications, treatments, and diseases can cause dizziness. It may also be a result of injury to your ear.
  • Some causes of dizziness may include: 
    • If you are dehydrated and change positions. This is a result of low blood pressure. Your healthcare provider may check your vital signs (including your blood pressure and heart rate) while lying down, sitting up, and standing, to help in determining this.
    • Stress, tiredness, fever, fatigue, anemia, heart problems, or stroke may cause dizziness. 
    • You may feel dizzy if you are depressed, or if you are breathing really hard and fast (hyperventilating). 
    • Inflammation of your inner ear, caused by infection.
    • Infections in your brain and central nervous system.
    • Meniere's disease (an inner ear disease). Meniere's disease is a disorder where patients experience dizziness, tinnitus, and hearing loss, sometimes due to chemotherapy.
    • Certain tumors may cause dizziness, such as brain tumors, and a tumor found in the auditory (hearing) canal of the ear, called a vestibular schwannoma. A schwannoma is a benign tumor. (The word "benign" refers to a medical condition that is not immediately life threatening.  It may progress and symptoms could become worse).  
    • Ototoxicity is something that occurs after you have received medications that have caused you to lose your hearing, or feel dizzy.  Ototoxicity following the use of certain medications may be due to a long-term exposure to damaging drugs. Your risk for developing ototoxicity increases as the drug accumulates in your body. 
    • Ototoxicity may also come from receiving high doses an ototoxic drug at one time, which may damage certain cells in your inner ear. The hearing loss you experience as a result of medications may be irreversible.

What are some dizziness symptoms to look for? 

  • Most people notice dizziness when they change positions, or move their heads.
  • You might feel like the room is spinning around you, or that you are spinning. Some people describe dizziness, as feeling a bit "woozy."  Severe dizziness is the fear that you may fall down when you stand up. 
  • Some people may lose their hearing, or their vision, which may be accompanied by dizziness. 
  • Nausea, ringing in the ears, and vomiting may be associated with dizziness.
  • Severe vomiting over a long period of time may cause you to feel dizzy.  
  • Dizziness may be a symptom or sign of a serious problem. Notify your doctor if you experience any of the symptoms mentioned here. 

How is dizziness diagnosed? 

  • Usually, your healthcare provider will first take a complete health history from you. They will then examine your neurological system through conducting a physical exam in their office. This may include looking in your eyes, watching you stand or walk, and testing your strength. He or she will also look inside your ear, to see if there is an infection. 
  • To distinguish vertigo from dizziness, your healthcare provider may turn your head in different positions, usually from a sitting position, to a lying position, and back again, as they try to elicit the same symptoms that you are describing. 
  • Your healthcare provider may suggest that you have x-rays, an MRI, or a CAT Scan of your head. You may also be referred to a Neurologist, who specializes in dizziness disorders. 
  • Your healthcare provider may order some blood work to be drawn. The blood work will show many things, including if you have anemia, your blood electrolytes (such as sodium, and kidney function) or it may suggest that you are dehydrated, as a cause of your dizziness.

Things you can do to minimize or prevent dizziness:

  • It is important to notify your healthcare provider if you notice any dizziness, or any change in the pattern of dizziness you are experiencing.  Also, notify your healthcare provider if you have any loss of vision, hearing, or if your symptoms become more severe, and do not improve. 
  • Drink 2-3 liters of fluid per day to prevent dehydration. This may include fruit juices, water, non-caffeinated sodas and coffee, and non-alcoholic beverages. Alcohol and caffeine may cause dehydration, so these should be avoided. Always carry a "sipper" cup with you, filled with your favorite drinks.
  • Change positions slowly. Allow your body a chance to adapt to the position change. For some people, lying down until the dizzy episode passes may be the best solution.
    * With moderate dizziness, walk slowly and often. Walk with assistance if the dizziness is severe. 
  • If you have vertigo, your doctor or a trained therapist may teach you exercises, called "vestibular exercises," to try to get rid of your dizziness. These exercises involve you sitting down, and changing into different positions. This may cause you to be dizzier at first, while you are performing these movements, but should help to correct the vertigo. You may expect improvement in 2-6 months.
  • If you have Meniere's disease, your doctor or healthcare provider may tell you to limit the amount of salt you eat in a day, and prescribe anti-nausea or anti-vertigo medications, along with a medication to help your body rid itself of salt and fluids (a diuretic). The goal is to decrease the pressure of your inner ear, in an effort to control the vertigo.   
  • Depending on the cause of dizziness, it may last a few days to a few months. It is important to follow all the instructions your healthcare provides. 
  • If your dizziness is a result of medications you have taken in the past, it is important to avoid these in the future, if possible. Be sure that you tell each of your health care providers about all of the medicines you are taking, including over-the-counter medications, vitamins, and herbal remedies. It is important to avoid the use of drugs that may cause further damage the cells in your ear. 
  • Make sure to keep all appointments. 
  • Do not share your medications with anyone.

Drugs that may be prescribed by your doctor: There are many drugs that can be used to treat dizziness. These may include: 

  • Meclizine (Antivert®), dimenhydrinate (Dramamine®), or the scopolamine patch (Transderm-Scop®). These medications may help to decrease the feelings of unsteadiness or imbalance that you may be feeling.
  • Prochlorperazine (Compazine®), and promethazine (Phenergan®), may work by preventing a feeling of dizziness, or by preventing nausea and vomiting that may cause dizziness.
  • These are just some of the most commonly used drugs. Your healthcare provider may prescribe others.   

If you believe you are suffering from dizziness or hearing loss due to chemotherapy, the following guidelines suggest when to call your doctor or health care provider:

  • If you develop any sudden severe ear pain.
  • If you have a temperature greater than 100.5 F (38 C). 
  • If you experience vomiting more than 4-5 times in a 24 hour period.
  • If you have a sudden loss of vision, or if you lose your hearing.   
  • If you fall down, or lose consciousness as a result of your dizziness. 
  • Severe, uncontrolled nausea and vomiting, unrelieved by anti-nausea medications.  
  • If your symptoms worsen within 3 days of treatment.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.


HEARING LOSS

What is hearing loss, and what is the relationship of hearing loss to chemotherapy?

  • Hearing loss occurs as a result of many different things. Hearing loss may be associated with age, or as a result of certain chemotherapy treatments or medications. By the age of 75, many have some sort of hearing loss. 
  • Many diseases can cause hearing loss. This includes Meniere's disease, an inner ear disease.
  • There are many different types of hearing loss. They may include: 
    • Presbycusis - This is a word that means "hearing loss." This is the normal loss of hearing and sound detection that comes with age. If you have presbycusis, it becomes harder to hear people if there is background noise. High-pitched sounds also become "muffled." 
    • Sensory hearing loss - occurs when there is a more central problem. Certain diseases, infections, or damage to the cells that help you to hear sounds may cause this. 
    • Conduction hearing loss - occurs as a result of a blockage in your ear. This may be from earwax, infection, a foreign body, or tumor. This can be resolved by treating the cause of the hearing loss.

Some common medications that cause hearing loss may include:

  • Cisplatin chemotherapy
  • Diuretics or "water pills" such as furosemide (Lasix®), in high doses.
  • Antibiotics, such as gentamycin, tobramycin or streptomycin. 
  • Ototoxicity is something that occurs after you have received medications that have caused you to lose your hearing, or feel dizzy.  Ototoxicity following the use of certain medications may be due to a long-term exposure to these drugs. Your risk for developing ototoxicity increases as the drug accumulates in your body. 
  • Ototoxicity may also come from receiving high doses of an ototoxic drug at one time, which may damage certain cells in your inner ear. The hearing loss you experience as a result of medications may be irreversible.

What are some symptoms to look for? 

  • Most people notice that sounds are muffled or not as loud.
  • Most types of hearing loss are progressive, and painless. It may be noticed on one side of your head, or both. 
  • There are some hereditary or family related causes of hearing loss. Know if hearing loss runs in your family. 
  • Some people may experience dizziness with a trouble hearing.  
  • Nausea, vomiting, dizziness and tinnitus (ringing in the ears), may be associated with hearing loss in some diseases. 
  • Hearing loss may be a symptom or sign of a serious problem. Notify your doctor if you experience any of the symptoms mentioned here. 

How is hearing loss diagnosed? 

  • Your healthcare provider will usually, at first, take a complete health history from you. They will conduct a physical exam in their office. They will also look inside your inner ear, to see if there is an infection. 
  • With certain types of hearing loss, your healthcare provider may suggest that you see an audiologist, a professional who diagnoses, treats, and manages individuals with hearing loss or balance problems.
  • A hearing test may be performed, to see if you have problems hearing at different levels or pitches (frequencies) of sound. Some people cannot hear high or low-pitched sounds, but may hear normal tones without any problem.

Things you can do to minimize hearing loss due to chemotherapy:

  • It is important to notify your healthcare provider if you notice any change in the hearing loss you are experiencing.  Also, notify your healthcare provider if you have any loss of vision, dizziness, or if your symptoms become more severe, and do not improve.  
  • If your hearing loss is caused by a build-up of wax, there are many over the counter eardrops available for you to use. Discuss this with your healthcare provider. 
  • Tell people that you have trouble hearing sounds. Discuss ways for them to speak, so you can hear them more clearly. Some suggestions include: 
    • Tell them to speak slowly, and clearly, and not to shout. Shouting creates high-pitched sounds that could make it harder for you to hear what they are saying. 
    • Encourage the use of gestures, if you find it helpful. 
    • Many people have trouble hearing consonants. Tell them to enunciate, or pronounce their words more slowly and clearly. 
    • With severe hearing loss, lip reading and sign language may be helpful.
  • Depending on the cause of your hearing loss, hearing aids may be useful to better your hearing. Hearing aids use an amplifier to pick up sound, and help to make sounds clearer. There are many forms of hearing aids available today. Seek assistance from a hearing aid specialist, who will help you to select the best kind of hearing aid, to suit your needs.
  • Even with hearing aids, it may still be difficult for you to understand what people are saying to you. If you do not understand someone who is speaking to you, ask him or her to clarify what is being said. Tell them what parts of the sentence you were able to understand. 
  • If you have Meneire's disease, your doctor or healthcare provider may tell you to limit the amount of salt you eat in a day, and prescribe anti-nausea or anti-vertigo medications, along with a medication to help your body rid itself of salt and fluids. The goal is to decrease the pressure of your inner ear, and to control the dizziness you may be experiencing, in addition to the hearing loss   
  • It is important to follow all the instructions your healthcare provides. 
  • Make sure to keep all appointments. 
  • Do not share your medications with anyone.

Drugs that may be prescribed by your doctor:

  • There are few drugs that specifically treat hearing loss, if it is a result of aging, or due to damaged hearing cells in your ear. However, if there is a conductive hearing loss, antibiotics may be prescribed to treat an infection that may be blocking the transmission of sound to your ear.
  • If your hearing loss is a result of drugs or medicines that you have received in the past, it is important to avoid these in the future, if possible. Be sure that you tell each of your health care providers about all of the medicines you are taking, including over-the-counter medications, vitamins, and herbal remedies. It is important to avoid the use of drugs that may cause further damage the cells in your ear.

If you believe you are suffering from hearing loss due to chemotherapy, the following guidelines discuss when to call your doctor or health care provider:

  • If you develop any sudden severe ear pain.
  • If you have a temperature greater than 100.5 F (38 C).
  • If you experience vomiting more than 4-5 times in a 24 hour period.
  • If you have a sudden loss of vision, or if you lose your hearing. 
  • If you fall down, or lose consciousness as a result of dizziness or hearing loss.
  • Severe, uncontrolled nausea and vomiting, unrelieved by anti-nausea medications. 
  • If your symptoms worsen within 3 days of treatment.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.


OTOTOXICITY

What is ototoxicity and how is it related to chemotherapy?

  • Ototoxicity occurs most often, after you have received medications that have caused you to lose your hearing, or feel dizzy. 
  • Ototoxic medications are drugs that can cause damage to the inner ear, and result in temporary or permanent loss of hearing. It may also cause your loss of hearing to become worse.
  • Some common medications that cause ototoxicity, if given in high doses may include:
    • Cisplatin, and other types of chemotherapy
    • High doses of salicylates, such as aspirin
    • Non-steroidal anti inflammatory medications (NSAIDs), such as naproxen sodium
    • Diuretics or "water pills," such as furosemide (Lasix®)
    • Antibiotics, such as Erythromycin, Gentamycin, Tobramycin or Streptomycin.
  • Ototoxicity following medications may be due to a long-term exposure to these drugs. Your risk for developing ototoxicity increases as the drug accumulates in your body.
  • It may also come from giving high doses of the drug at a time, which may damage certain cells in your inner ear. The hearing loss you may experience as a result of medications may be irreversible.
  • When people experience dizziness as a result of ototoxicity from medications, it may be a sign that the balance mechanism in your inner ear is not working properly, or has been damaged. 
  • The first sign of ototoxicity may be dizziness.  Some other causes of dizziness may include:
    • You may feel dizzy when you are dehydrated, and you change positions. This is a result of low blood pressure. Your healthcare provider may check your vital signs while lying down, sitting up, and standing, if you are dizzy, and seek medical care.
    • Stress, tiredness, fever, fatigue, anemia, heart problems, or stroke may cause dizziness. 
    •  You may feel dizzy if you are depressed, or if you are breathing really hard and fast (hyperventilating). 
    • Inflammation of your inner ear, caused by infection.
    • Infections in your brain and central nervous system.
    • Meniere's disease, an inner ear disease. Meniere's disease is a disorder where patients experience dizziness, tinnitus, and hearing loss.
    • Certain tumors may cause dizziness, such as brain tumors, and a tumor found in the auditory (hearing) canal of the ear, called a vestibular schwannoma. A schwannoma is a benign tumor. (The word "benign" refers to a medical condition that is not immediately life threatening, and is not likely to become worse).

What are some symptoms to look for when diagnosing ototoxicity?

  • Ototoxicity may be accompanied by a tinnitus. Tinnitus is a word used to describe any ringing, or abnormal sound in your ear or head. Some people may hear roaring, hissing, or humming sounds. This may interfere with your ability to rest, or concentrate. You may be unable to sleep at night. As your ototoxicity becomes worse, the sounds become louder.
  • You may feel a pressure or fullness in your head or ears, like you have a cold.
  • You may notice a loss of hearing, or your existing hearing loss may become worse.
  • You might feel like the room is spinning around you, or that you are spinning. Some people describe dizziness, as feeling a bit "woozy."  Severe dizziness is the fear that you may fall down when you stand up.
  • Nausea and vomiting may be associated with ototoxicity.
  • Even if you have been diagnosed with ototoxicity, dizziness may be a symptom or sign of a serious problem. Notify your doctor if you experience any of the symptoms mentioned here. 

How is ototoxicity diagnosed?

  • Your healthcare will usually, at first, take a complete health history from you. They will then examine your neurologic system by conducting a physical exam in their office. This may include looking in your eyes, watching you stand or walk, and testing your strength. They will also look inside your inner ear, to see if there is an infection.
  • If you are dizzy, it is important to distinguish vertigo from dizziness. Your healthcare provider may turn your head in different positions, usually from a sitting position, to a lying position, and back again, as they try to elicit the same symptoms that you are describing.
  • Your healthcare provider may suggest that you have x-rays, an MRI, or a CAT Scan of your head.
  • You may also be referred to a specialist, such as an audiologist, otolaryngologist, or a Neurologist; depending on the type of symptoms you are experiencing. 
    • An otloaryngologist or neurologist will usually perform the complete physical examination, and order all the tests. Your healthcare provider may also do this.
    • A Neurologist specializes in dizziness disorders, and tinnitus.
    • You may also be referred to an audiologist, a professional who diagnoses, treats, and manages individuals with hearing loss or balance problems.
  • Your healthcare provider may order some blood work to be drawn. The blood work will show many things, including if you have anemia, low electrolytes, or it may suggest that you are dehydrated, as a cause of your dizziness.

Things you can do to minimize ototoxicity:

  • It is important to notify your healthcare provider if you notice any dizziness, or any change in the pattern of dizziness, or the ringing in your ears that you are experiencing.  Also, notify your healthcare provider if you have any loss of vision, hearing, or if your symptoms become more severe, and do not improve.
  • Drink 2-3 liters of fluid per day to prevent dehydration. This may include fruit juices, water, non-caffeinated sodas and coffee, and non-alcoholic beverages. Alcohol and caffeine may cause dehydration, which can lead to dizziness, so these should be avoided. Always carry a "sipper" cup with you, filled with your favorite drinks.
  • Change positions slowly. Allow your body a chance to adapt to the position change. For some individuals, lying down until the dizzy episode passes may be the best.
  • With moderate dizziness, walk slowly and often. Walk with assistance if the dizziness is severe.
  • If you have vertigo, your doctor or a trained therapist may teach you exercises, called "vestibular exercises" to try to get rid of your dizziness. These exercises involve you sitting down, and changing into different positions. This may cause you to be dizzier at first, while you are performing these movements, but should help to correct the vertigo. You may see some improvement in 2-6 months.
  • You may have tinnitus (ringing, humming or any abnormal sound in your ear or head) as a result of your ototoxicity. Stress, anxiety and tiredness may cause your tinnitus to become worse. If stress and anxiety causes your tinnitus to become worse, relaxations techniques may help. You may also be prescribed an anti-anxiety drug.
  • Using a quiet radio, television, or any low levels of sound when you are trying to rest may help you to ignore the tinnitus, and make it easier to sleep or relax.
  • If you have Meneire's disease, your doctor or healthcare provider may tell you to limit the amount of salt you eat in a day, and prescribe anti-nausea or anti-vertigo medications, along with a medication to help your body rid itself of salt and fluids. The goal is to decrease the pressure of your inner ear, and to control the vertigo.  
  • Depending on the cause of dizziness, it may last a few days to a few months. It is important to follow all the instructions your healthcare provides.
  • If your hearing loss is a result of drugs or medicines that you have received in the past, it is important to avoid these in the future, if possible. Be sure that you tell all of your health care providers about all of the medicines you are taking, including over-the-counter medications, vitamins, and herbal remedies. It is important to avoid the use of drugs that may cause further damage the cells in your ear.
  • Always ask your healthcare provider if they know of your hearing loss, especially if it is sensory.
  • Make sure to keep all appointments.
  • Do not share your medications with anyone.

Drugs that may be prescribed by your doctor to control the symptoms of ototoxicity:

  • There are no drugs to specifically treat ototoxicity. The treatment is aimed at controlling the symptoms.
  • Dizziness is a major symptom, and there are many drugs that can be used to treat dizziness. These may include:
  • Meclizine (Antivert®, dimenhydrinate (Dramamine®), or the scopolamine patch (Transderm-Scop®). These medications may help to decrease the feelings of unsteadiness or imbalance that you may be feeling.
  • Prochlorperazine (Compazine®), and promethazine (Phenergan®), may work by preventing the feelings of dizziness, or by preventing nausea and vomiting that may cause dizziness.
  • These are just some of the most commonly used drugs. Your healthcare provider may prescribe others.   

When to call your doctor or health care provider:

  • If you develop any sudden severe ear pain
  • If you have a temperature greater than 100.5 F (38 C).
  • If you have nausea that interferes with your ability to eat, or experience vomiting more than 4-5 times in a 24 hour period.
  • If you have a sudden loss of vision, or if you lose your hearing.  
  • If you fall down, or lose consciousness as a result of your dizziness.
  • Severe, uncontrolled nausea and vomiting, unrelieved by anti-nausea medications. 
  • If your symptoms worsen within 3 days of treatment.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.


TINNITUS

What is tinnitus?

  • Tinnitus is a word used to describe any ringing, or abnormal sound in your ear or head. Some people may hear roaring, hissing, or humming sounds. This may interfere with your ability to rest, or concentrate. You may be unable to sleep at night.
  • Tinnitus may be divided into 2 categories: Objective tinnitus and Subjective tinnitus.
    • Objective tinnitus is when another person, such as a healthcare provider, may hear a similar noise as you are hearing. This may be caused by heart valve problems, blood vessel abnormalities, or problems with the tubes in your ear (Eustachian tube). This form of tinnitus is more rare.
    • Subjective tinnitus, which is far more common, is a result of damaged cells in your inner ear. This is when the person can tell other people what they hear - but the other persons cannot hear it themselves.
  • Although the cause of tinnitus may be unknown, certain things can make your symptoms worse. These may include:
    • Anxiety
    • Injury to your ears, head or neck
    • Certain kinds of tumors
    • Infections in your ear or sinuses
    • Wax or any foreign objects in your ear canal
    • Certain diseases, such as Meniere's disease, heart disease (especially blocked arteries), and thyroid disease. Meniere's disease is a disorder where patients experience dizziness, tinnitus, and hearing loss. 
    •  Heavy smoking, problems with your jaw
  • Certain medications that cause tinnitus, may include:
    • Diuretics or water pills, such as Diamox®
    • Heart and blood pressure medications, such as metoprolol (Lopressor®)
    • Antibiotics, such as gentamycin
    • Anti-nausea medications, such as promethazine (phenergan®).
    • Anti-malaria drugs, such as quinine
    • High doses of salicylates (aspirin), if taken for long periods of time.
  • Ototoxicity is a word to describe damage to the ear due to many causes. It may be due to a long-term exposure to certain drugs, as the drug accumulates in your body. It may also come from giving high doses of the drug at a time, which causes damage certain cells in your inner ear. The hearing loss you could experience as a result of medications may be irreversible.
  • If you have experienced ringing in your ears, or tinnitus, it may be on one side or both.

What are some symptoms to look for?

  • Many people have a tinnitus that comes and goes. Some have a ringing or abnormal noise in the ears at all times. It may or may not be associated with hearing loss or dizziness.
  • Along with tinnitus, you might feel like the room is spinning around you, or that you are spinning. Some people describe a feeling of dizziness with a ringing in the ears, and feeling a bit "woozy."  Severe dizziness, and the fear that you may fall down when you stand up, should be reported to your healthcare provider.
  • Nausea and vomiting may also be associated with tinnitus.
  • Severe vomiting over a long period of time may cause you to feel dizzy, or cause you to have abnormal sounds in your ear.
  • Notify your doctor if you experience any of the symptoms mentioned here. 

How is tinnitus diagnosed?

  • Your healthcare will usually, at first, take a complete health history from you. They will then examine your neurological system through conducting a physical exam in their office. This may include looking in your eyes, watching you stand or walk, and testing your strength. They will also look inside your inner ear, to see if there is an infection.
  • If you have dizziness with your tinnitus, they will also perform a few different tests. Your healthcare provider may turn your head in different positions, usually from a sitting position, to a lying position, and back again, as they try to elicit the same symptoms that you are describing.
  • Your healthcare provider may suggest a few special tests to diagnose your condition. These may include:
    • A hearing test, to see if you have problems hearing different levels or pitches (frequencies) of sound. Some people cannot hear high or low-pitched sounds.
    • X-rays of your head
    • Angiography to look at the vessels in your neck
    • MRI, or a CAT Scan of your head.
  • An otloaryngologist or neurologist will usually perform the complete physical examination, and order all the tests. Your healthcare provider may also do this.
  • You may also be referred to a Neurologist, who specializes in dizziness disorders, and tinnitus.
  • You may also be referred to an audiologist, a professional who diagnoses, treats, and manages individuals with hearing loss or balance problems.
  • Your healthcare provider may order some blood work to be drawn.
  • If they are able to find the cause of your tinnitus, it is likely that there are some forms of treatment available, especially if it is due to an infection, or a blocked tube.

Things you can do:

  • It is important to notify your healthcare provider if you notice any change in the pattern of tinnitus you are experiencing.  Also, notify your healthcare provider if you have any loss of vision, hearing, or if your symptoms become more severe, and do not improve.
  • If you have hearing loss with your tinnitus, you may require hearing aids.
  • Avoid loud noises.
  • It is important to drink 2-3 liters of fluid per day to prevent dehydration. This may worsen your symptoms. Things to drink may include fruit juices, water, non-caffeinated sodas and coffee, and non-alcoholic beverages. Alcohol and caffeine may cause dehydration, so these should be avoided. Always carry a "sipper" cup with you, filled with your favorite drinks.
  • Stress, anxiety and tiredness may cause your tinnitus to become worse. If stress and anxiety causes your tinnitus to become worse, relaxations techniques may help. You may also be prescribed an anti-anxiety drug.
  • Using a quiet radio, television, or any low levels of sound when you are trying to rest may help you to ignore the tinnitus, and make it easier to sleep or relax.
  • If your tinnitus is related to jaw abnormalities, you may be referred to a specialist for possible surgery to correct the problem.
  • If your tinnitus is a result of drugs or medicines that you have received in the past, it is important to avoid these in the future, if possible. Be sure that you tell all of your health care providers about all of the medicines you are taking, including over-the-counter medications, vitamins, and herbal remedies. It is important to avoid the use of drugs that may cause further damage the cells in your ear.
  • Change positions slowly if your tinnitus is accompanied by dizziness. Allow your body a chance to adapt to the position change. For some individuals, lying down until the dizzy episode passes may be the best.
  • With moderate dizziness, walk slowly and often. Walk with assistance if the dizziness is severe. 
  • If you have vertigo, your doctor may teach you exercises, called "vestibular exercises" to try to get rid of your dizziness. These exercises involve you sitting down, and changing into different positions. This may cause you to be dizzier at first, while you are performing these exercises, but should help to correct the vertigo. For these exercises, a trained therapist will teach you. You should expect improvement in 2-6 months.
  • If you have Meneire's disease, your doctor or healthcare provider may tell you to limit the amount of salt you eat in a day, and prescribe anti-nausea or anti-vertigo medications, along with a medication to help your body rid itself of salt and fluids. The goal is to decrease the pressure of your inner ear, and to control the dizziness, and tinnitus.  
  • Depending on the cause of tinnitus, it may last a few days to a few months. It also may never fully resolve. It is important to follow all the instructions your healthcare provides.
  • Make sure to keep all appointments.
  • Do not share your medications with anyone.

Drugs that may be prescribed by your doctor:

  • There are many drugs that can be used to treat dizziness and tinnitus. These may include:
  • Antidepressants, such as nortriptyline at bedtime, are often effective in decreasing your symptoms..
  • Meclizine (Antivert®), dimenhydrinate (Dramamine®), or the scopolamine patch (Transderm-Scop®) may also be prescribed. These medications may help to decrease the feelings of unsteadiness or imbalance that you may be feeling.
  • Prochlorperazine (Compazine®), and promethazine (Phenergan®), may work by preventing the feelings of dizziness, or by preventing nausea and vomiting that may cause dizziness.
  • These are just some of the most commonly used drugs. Your healthcare provider may prescribe others.   

When to call your doctor or health care provider:

  • If you develop any sudden severe ear pain.
  • If you have a temperature greater than 100.5 F (38 C).
  • If you have nausea that interferes with your ability to eat, or experience vomiting more than 4-5 times in a 24 hour period.
  • If you have a sudden loss of vision, or if you lose your hearing.   
  • If you fall down, or lose consciousness as a result of your dizziness or tinnitus.
  • Severe, uncontrolled nausea and vomiting, unrelieved by anti-nausea medications. 
  • If your symptoms worsen within 3 days of treatment.
  • As always, notify your doctor or healthcare provider if you are concerned about any of the symptoms you are experiencing.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.


Additional resources for hearing problems:

Better Hearing Institute
515 King Street, Suite 420
Alexandria, VA 22314
800-EAR-WELL(327-9355)
http://www.betterhearing.org

The National Association of the Deaf
814 Thayer Ave.
Silver Spring, MD 20910-4500
Voice: 301-587-1788
TTY: 301-587-1789
http://www.nad.org

Self Help for Hard of Hearing People
7910 Woodmont Ave., Suite 1200
Bethesda, MD 20814
Voice: 301-657-2248
TTY: 301-657-2249
http://www.shhh.org

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.