April 13 2017

“What’s That?” Ear Health: Dietary and Lifestyle Choices that Preserve It

By Mark Sisson
32 Comments

inline__ear_health_04.13.17Sure, they’re not exactly the sexiest body part, but it’s fair to say that life with substandard ear health would be notably less enjoyable. And as it happens, millions of Americans would be able to speak to that.

Research indicates that an estimated 1 in 5 folks have some form of hearing loss. This rate increases to 1 in 3 for age 65 and over, but some estimates put hearing loss great enough to impair communication even higher for the upper decades at around 40%. Perhaps even more alarming, close to 15% of American kids have some form of hearing loss. In teenagers, prevalence has jumped from 15% in 1994 to almost 20% in 2006. Unfortunately, that hearing difficulty will often go undiagnosed.

Hearing loss is, in fact, the third most common health condition in the country, right on the heels of arthritis and heart disease. And it’s getting worse. Between 2000 and 2015, the number of Americans with hearing loss has doubled, mirroring a worldwide increase of 44% over that same period.

But it’s not all about hearing. What about ear health? Our ears perform plenty more functions than just auditory reception. Let’s not forget that the ears are instrumental in influencing our emotions and state of mind, maintaining our sense of balance, and regulating pressure.

From what meagre stats are available on ear health, we know that close to 16,000 older Americans were killed in falls in 2005. We also know that nearly half of those deaths were balance-related. And that a whopping third of the population report vestibular symptoms (inner ear-related balance issues). Ménière’s disease, a disorder of the inner ear that causes tinnitus, vertigo and hear loss, affects an estimated 615,000 Americans. That’s enough in the way of statistics to indicate that substandard ear health has broad implications for overall health.

Noise Annoys: Let Natural Sound Abound

There’s plenty of mechanisms by which our bodies recognize stress. One such mechanism that often gets overlooked is our ears. At a very basic, primitive level, the sounds registered by our ears dramatically impact our emotions. Birdsong, in particular, and trickling water relax our minds and alleviate stress, while the neighbor’s yapping dog or traffic noise from the street rile us up. This lines up with what we know about the all-important vagus nerve, which plays an influential role in how our bodies control inflammation…and which just so happens to have a few tendrils in your ears.

Along with all the conveniences of the modern world, the Grok-friendly natural sounds of the past have slowly been replaced by anthropogenic noise. Cars, planes, trains, incessant chatter… noise constantly surrounds us, and while it may fade into the background, research shows that it’s slowly but surely contributing to chronic stress.

A 2014 literature review of the effects of noise on health noted that it disturbs sleep (duh), increases the occurrence of hypertension and cardiovascular disease, and impairs cognitive performance.

And by triggering stress and the subsequent release of adrenaline, noise can create a negative feedback loop which worsens the health of your ears. Elevated levels of adrenaline lower blood circulation in the peripheral areas of the body, one of which just so happens to be the ears. With chronic stress, the tiny hairs inside your ear canals become starved of blood and the nutrients it provides. The result is a gradual die-off of these auditory hairs, which of course can lead to permanently impaired hearing. This means that noises that might not directly damage your ears can still harm your hearing.

On the brighter side, nature is the best antidote. Getting away from the urban jungle and immersing ourselves in the sounds of nature has been shown to reduce our perception of pain. A similar therapeutic effect is highlighted by this 2003 study, which modeled the stress-buffering effect that “nearby nature” had on schoolchildren. Unsurprisingly, researchers found that “the impact of life stress was lower among children with high levels of nearby nature than among those with little nearby nature.” The science behind restorative natural sound is largely rooted in evolutionary principle. Our inherent blueprints expect the subtle “aural diet” of our ancestors rather than the bombastic range of noises we feed it today.

Hearing Loss: More to It Than Many Believe

I’ll start with the obvious: if your ears are exposed to loud noises, you may suffer from temporary hearing loss. But newish research published in the Journal of Neuroscience suggests that it may not be over even after the concert’s over. According to the study, “acoustic overexposures causing moderate, but completely reversible, threshold elevation leave cochlear sensory cells intact, but cause acute loss of afferent nerve terminals and delayed degeneration of the cochlear nerve.” This means that going to a one-off music concert, for example, might set in motion a degenerative process which can damage your hearing permanently. Scary stuff.

And as the research into hearing loss begins to accumulate, it’s becoming increasingly apparent that ear health is intrinsically tied into your overall health. For starters, smoking has been directly linked to hearing loss. A 2007 study found that newborns who were exposed to tobacco smoke in the womb had a significantly lower hearing sensitivity than those who weren’t. Obviously, if you’re a Primal lifer you’ve long ago washed your hands of the Marlboros, but second-hand smoke is always a risk to pregnant mothers, no matter how healthy they are. Yet another reason to distance yourself from those noxious clouds…

Another sobering fact—there’s also plenty of evidence showing that diabetes can contribute to hearing loss. Researchers from the University of Maryland School of Medicine examined medical records from 53,461 non-diabetic patients and compared them 12,575 age-matched diabetic patients. They found that sensorineural hearing loss was more common in the diabetic patients, and that this hearing loss impact increased with elevated diabetes severity. Other studies have found much the same correlation, with some indications noting that perception of higher sound frequencies might be the first to go.

The Role of Diet for Hearing

Yes, as with everything else, what you eat (or don’t eat) affects your ear health. Apparently, restricting calories is the new big thing in the ear world. A recent Swedish study proved that rats placed on a 70% dietary restriction showed reduced age-related degenerative shrinking of their inner ear tissues. This resulted in significantly improved hearing function over non-calorie restricted littermates.

For those of us interested in less extreme measures, there are other promising dietary strategies to consider. Multiple studies have shown that a diet rich in the vitamins A, C, E and magnesium can prevent hearing loss by minimizing inflammation and increasing blood flow to the inner ear. Crucially, however, none of these vitamins or magnesium alone were effective in reducing hearing loss or sensory cell death: only when applied synergistically did they provide the protective effect (kind of like the A Team of the hearing world). Specifically, their collective effect helped to protect the ear against the negative feedback degenerative hearing damage I discussed earlier.

And there’s plenty more research where that came from. This study used sound frequency testing and a semi-quantitative questionnaire to establish what impact intakes of certain vitamins and minerals exhibited on hearing health. Vitamins A and E showed the most promise, with vitamin A correlating with a 47% lower risk of hearing loss and vitamin E a 14% lower risk. I like those odds but, again, believe that synergy matters.

The role of magnesium in hearing protection has received particular attention in the literature, and the results continue to be positive. If you’ve got hearing problems and haven’t already invested in the formidable healing powers of quality magnesium supplementation, now might be the time.

So while the rest of the world waits for the development of wondrous oral drugs that capitalize on these findings, here’s an insider’s tip: you can get a head start by simply eating wholesome, nutrient-dense foods. Nothing new there, right? Dark leafy greens for magnesium, avocados for vitamin E, liver for vitamin A, and any number of fruit and vegetables for vitamin C. A comprehensive multi can’t hurt either.

Unpacking the Mystery of Tinnitus

Then there’s tinnitus, the frustrating ringing ear condition that regularly affects an estimated 15% of Americans. As far as causes go, the list is long. In addition to noise exposure, tinnitus can develop as a result of excessive ear wax buildup, medications like aspirin and antibiotics, middle ear infections, and aging. Tinnitus occurs when hair cells in the ear’s cochlea are damaged or destroyed, meaning there are any number of pathways by which someone can develop this condition. I have a friend who’s suffered from tinnitus over the past 5 years due to multiple concussions. Ding your head enough times, and your ears may pay the price. There’s even suggestions that certain folks may be genetically predisposed to developing tinnitus, but that research isn’t conclusive.

And despite our growing knowledge of the causes of tinnitus, it’s on the rise. As the urban population grows, so, too, does the percentage of the population exposed to that anthropocentric din I highlighted earlier. Concerts are just as big and loud if not more so than they were a couple decades ago. We have more and noisier machines in our lives than ever before.

But it’s not all doom and gloom. Those same hearing-protective steps I talked about earlier can also be applied to tinnitus. Concentrating on nutrient-dense foods that provide ample levels of vitamins A, C and E, and perhaps supplementing with magnesium oil, should help to prevent those hairs in your cochlea from sustaining significant damage. Continuing the diet theme, there’s preliminary evidence to suggest that zinc depletion may play a role, and that moderate to high caffeine intake per day has beneficial effect. Probably not a great idea to go crazy on the coffee, however, particularly if you’re sensitive to it.

And, not suprisingly, Inflammation is almost undoubtedly at play here as well, verified by a strong association between hypertension and tinnitus. Reducing inflammatory food intake and minimizing stress should therefore go a long way towards lowering your risk of tinnitus. Similarly, vagal nerve stimulation, which uses small electrical pulses to stimulate an anti-inflammatory feedback in the vagus, shows a lot of promise in treatment for tinnitus.

Thanks for reading, everyone. Have you or those you love experienced any of the above conditions? Are you taking any special steps to preserve your hearing and ear health? Have you heard about other medical treatments or lifestyle interventions? Have a good end to your week.

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32 thoughts on ““What’s That?” Ear Health: Dietary and Lifestyle Choices that Preserve It”

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  1. I bought safety earmuffs to wear when I use my Magic Bullet.

  2. I developed tinnitus suddenly at age 51 (I’m 53 now), after a minor neck strain, but the predisposing factor was probably exposure to low-to-moderate industrial noise over a long period of time, having a cumulative effect. I was doing everything right diet-wise, but was well below normal exercise levels due to an injury (more on that later.) BTW, I keep my diet ketogenic most of the time — only way to keep my weight down — and mostly but not all Paleo; since I’m not dairy-sensitive, I do use some cheese.

    My chiro. did myofascial release massage on my neck, which turned off the tinnitus for a day, but then it came back. Two more rounds of chiro. and that trick stopped working. Then in panic I tried every herb, supplement, vitamin, mineral, etc, that anyone has ever recommended for tinnitus anywhere — at one point I was taking over 40 pills a day — all to no avail. I even got a prescription for hydergine for a while, as that is rumored to help tinnitus, but that’ didn’t fix it either. .

    One thing that helped temporarily, was hyperbaric oxygen, especially if I took a flushing dose of niacin right before going into the chamber to open up all the small blood vessels. This toned down the tinnitus temporarily but significantly, and also temporarily improved my hearing — when i’d get home from hyperbaric sessions, my wife and children’s voices sounded louder and “crisper” as I was hearing the high notes more. I also, at times, took the hydergine along with the niacin right before the hyperbaric chamber but as far as I know there was no synergy there.

    So the key seems to be, getting more oxygen to those ear cells. I tried clearing out my small blood vessels nutritionally via various methods — Pauling therapy (Vit C plus Lysine, 6 g each per day) to remove protein plaques, Niacin + Lecitihin to clear fat deposits, and enhanced levels of K2 (over the background of an already A/D rich diet) to remove minerals, all in the hopes of opening up circulation. I definitely FEEL better head to toe on the Pauling therapy (which I’m still doing), but the tinnitus is still there.

    I mentioned an injury above. I was a runner from age 15, but the unfortunate sequelae of a youthful weightlifting accident ended my running career at 50; the old mensicus injury finally just broke down. It was about 9 months after being forced to quit running, that the tinnitus came upon me. Did running prevent the tinnitus all those years, by regenerating me neurologically, in a way that my brisk-walking program doesn’t? Or is it because running oxygenates me better than walking? I don’t know. I’m desperately trying to rehab my injury — gelatin, broth, walking, autologous stem cells, etc — and have actually added about 1 mm of cartilage in the last year… i’m hopeful that another couple of years of this may regenerate me enough that I can run again, and then we’ll see.

    I’m also currently looking into infrared laser therapy and/or pulsed electromagnetic field therapy for tinnitus, and by strange coincidence I find that these therapies are also recommended for cartilage regrowth as well! I’ve also looked into intermittent fasting, since that, too, has a neuro-regenerative effect.

    Anyway, that’s my saga, If I ever find an answer, I’ll come back and post it.

    1. anonymous, thanks for sharing your story. Just curious…have you ever tried acupuncture? Good luck to you!

      1. No. A doctor friend of mine, told me that she’s seen x-rays people who get acupuncture, with dozens or even hundreds of small metal needle-tips broken off inside them. The needles are so thin that they are fragile enough to lose pieces in the body.

        I’m mainly focused on enhanced oxygenation and neuroregeneration at this point.

        1. I feel I have gotten great benefit from acupuncture. The needles are disposed of after use. They are very flexible and are only inserted a short way. I can’t imagine them breaking.

        2. I was curious, so I did a Google search, and there is an article, with x-ray pictures of a woman with hundreds of gold needle fragments in her knees, but that it is believed that they were left intentionally. They I found an article that stated “Some forms of acupuncture involve the deliberate placement of “permanent” silver or gold needles into the patient. This are typically 1 cm in length and at one time may have been needles broken off deliberately but more recently involve the injection of short needles using a spring-loaded syringe.” So, your doctor friend may have seen cases where the needles were intentionally left, not cases where the needles accidentally broke off.

    2. If it is oxygen, have you tried breathing exercices? There are some exercices on a site called “normal breathing”.

    3. Look up yogalign as this is about correcting posture, oxygen can then travel to the ears through improved blood flow. Michaelle Edwards is a genius.

  3. Medical Medium, Anthony William says:

    “Tinnitus, or ringing in the ear, is usually caused by EBV (Epstein-Barr Virus) getting into the inner ear’s nerve channel, called the labyrinth. The ringing is the result of the virus inflaming and vibrating the labyrinth and the vestibulocochlear nerve.”

    “Vertigo and Meniere’s disease are often attributed by doctors to calcium crystals, or stones, becoming disrupted in the inner ear. However, most chronic cases are actually caused by EBV’s neurotoxins inflaming the vagus nerve.”

    See William’s books, blog, and SoundCloud for more.

    1. Hi Adam — You are correct that Meniere’s syndrome can cause tinnitus — but tinnitus has many possible causes. My father in law also has it, due to weapons discharges in the military; clearly no virus was involved there. One of my coworkers has a father with tinnitus, who was told that it was due to his alcoholism.

      I had no other Meniere’s symptoms but I was prepared to try anything. Since the causative agent of Meniere’s, EBV, is a lipid coated virus, I took BHT for a while, to try to destroy the viral cell walls (this is potentially dangerous BTW, so do your homework and talk to a doctor before considering BHT). I also took the lemon bioflavonoid product which is sold OTC in drug stores, which does seem to help some cases of Meniere’s-based tinnitus. Neither of these helped MY tinnitus.

    2. Look into posture as this will be linked to blood flow and therefore oxygen getting into the ears. Best method I know for correcting posture is Yogalign.

  4. Thanks for this post; I have been hoping for a post related to hearing and ear health for some time. I suffer from a range of auditory issues and have very bad tinnitus in both ears, from different causes. By far the worst problem is related to fluid and eustachean tube dysfunction and has caused all sorts of suffering — ear infections, ruptured ear drums, hearing loss, airplane suffering, surgeries, tubes, etc., throughout my life. I still have problems. It has taken me years to figure out that I can help these problems with my own behavior. First, I believe the dietary connection mentioned here is correct and just as you can improve other inflammation-related issues such as allergy symptoms and arthritis, you can also improve auditory and ear function through an anti-inflammatory diet. Most importantly I have finally figured out that there is a strong mechanical connection here. That is to say, once I finally figured out how to “pop” my ears (can be very difficult and take a long time and require different strategies when you have the problems I have) and keep my jaw and neck happy, I was able to avoid the surgeries and medications and tubes. If my jaw and neck are tense or sore from…. too many pull-ups, too much bike-riding, too much chewing jerky, (too much sitting is by far the worst offender here) etc., my tinnitus is worse and my hearing is worse, and they don’t improve until I massage and stretch the muscles from the upper pec all the way up to right behind the ears and also the upper back, and also pop my ears. And when my neck and jaw are happy and my ears are clear I notice that the tinnitus is … maybe not better, but ?? less severe? Less distressing? And I also notice that my hearing is significantly better. A litmus test for me is sitting in a quiet room playing my acoustic guitar with fingertips. If my ears are clear and my neck and jaw are happy, it can sound like I just put on new strings. Conversely, if my jaw and neck are unhappy and my ears are not clear, I can’t hear a normal conversation in a crowded restaurant.

    As far as “popping” the ears, just holding my nose and closing my eyes and blowing seldom if ever works, definitely not on the first try, but some version of this always works eventually. It can take days. And one “pop” usually doesn’t do it. Now I know the amount and quality of the “pop” that will clear me and have found that it is most easily achieved during exercise. So if I stop during my bike ride to work and blow my nose, it almost always clears my ears.

    I have plenty more to say about all this, but I’ll cut it off here…. thanks again for the great post.

    1. yeah I do some weird thing applying pressure on the little flap over the earhole–when I used to teach I would joke that I was taking a few seconds to get down to the same altitude as my students–and it gives ten seconds better hearing and relief from tinnitus. Mostly I’ve just gotten good at tuning it out, and it’s all in the left ear.

  5. Mark, thank you so much for posting this!!! I sent you a note a while back begging for a post on tinnitus, so I’d like to think this one was for me. (:

  6. “There’s even suggestions that certain folks may be genetically predisposed to developing tinnitus, but that research isn’t conclusive.” Well, my father had tinnitus. I have had it all my life. It was very quiet when I was a child, but in my 40s tinnitus and hyperacusis became severe enough to force me to leave my profession as a piano tuner/technician. My sister was diagnosed with Meniere’s several years ago. Both my kids have mild tinnitus.
    I eat primal. Mostly I am very careful about hearing protection. I use earplugs when I use any sort of power tools, and also when I go to a movie.

  7. I started using medical cannabis ointment for arthritis. My eyesight, hearing and other senses improved dramatically. (Also the arthritis.) Before, I could only faintly hear my turn signal clicking. After starting the cannabis, I could hear it clearly. Then recently I was unable to use the cannabis for a month. All my senses declined. I started saying “Huh? Huh?” again. As soon as I got back on cannabis, the hearing, vision and sensitivity came back. N=1 and not much research but I’m convinced.

  8. For 25+ years, I lived with inner ear congestion and actually thought it to be normal. Traveling on an airplane with a sinus infection (had them frequently) was brutal and would take a full week for the pressure to get back down to normal (bad) levels. After one unusually bad experience, I sought help from and ENT. I have severe hearing loss in both ears and wear hearing aids full time. The medications from the ENT did little to alleviate the pressure. After reading articles on inflammation here at MDA, and watching the TEDX talk from Dr. Terry Whals on her autoimmune experiment with nutrients, I gave up gluten to see if it might make a difference. I will never forget that moment at 2am, after 10 days or so of being gluten free, when my ear drum popped. It woke me up. I was generally feeling less pressure in my ear, but when my ear drum popped that night, I realized that it had been over 20 years since that had happened. I started back eating wheat to see if maybe it was a delayed reaction from the meds (ENT Doc assured me that was the case), but it only took a few days of eating bread and pasta before the pressure returned. And a few days after abstaining from gluten, it went away again. Thank you Mark for giving this some attention. My hearing test have been about the same for the last 5-6 years, so I’m hoping that I’ve halted the hearing loss progression. I am planning to further supplement with the vitamins as you recommend . . . anything that might preserve and protect my hearing is worth it. And for what it’s worth, I’ve not had a sinus infection since I gave up wheat. I usually had one 5-6 times a year. Please keep posting updates on this as you come across any studies. Thanks!

    1. I used to say to people that it felt like an elephant stood on my head while I slept due to the sinus pressure every night. I would remove all mucus causing foods like milk products and orange juice, however, when I heard that wheat produces mucus as well I quit that. Turns out that was the problem. I can have milk products with no problems.

      1. As an added bonus, my issues with soft cheeses went away as well. It was not until a couple of years ago that I ate fresh mozzarella by accident. I braced my self for the onslaught . . . and nothing happened. Not sure how long it took for my intestinal track to get back to the point where it could handle the cheese.

  9. There has gotten to be quite a lot of information regarding the fact that NSAID use can cause hearing loss, particularly ibuprofen. I would not be surprised if various other pharmaceuticals, both prescription and OTC, can damage the hearing.

  10. Such an important (and often neglected) place of discussion when it comes to the effect of surrounds, habits and diet on health and well-being. Thank you!

    I especially appreciate your attention to noise pollution…and the impact of foods and pharmaceutical drugs. In working with patients, I find primal eating, herbal medicine and acupuncture a powerful combination when treating tinnitus.

    Personally, I crave quiet in a deep body-mind way…and am disturbed by the widespread aversion to silence among many people these days. Seems part of the wider pattern of creating distraction after distraction, rather than pausing to truly check in, listen, and sit with anything that’s uncomfortable.

  11. I have fairly significant “industrial deafness”…. the inability to distinguish speech from background noise.

    It may be a neural thing rather than an actual auditory damage issue…. the hearing software receiving the input but being unable to filter the information adequately.

    And yes, tinnitus as well.

  12. “With chronic stress, the tiny hairs inside your ear canals become starved of blood and the nutrients it provides. The result is a gradual die-off of these auditory hairs, which of course can lead to permanently impaired hearing.”

    which is why we should all do headstands every day. Which I do.

    1. Jed, thank you for saying this. I needed to hear that. Pun intended, I suppose.

  13. The dawn chorus is not a “coincidence ” with the EMF dawn chorus

  14. Sure, they’re not exactly the sexiest body part, but it’s fair to say that life with substandard ear health would be notably less enjoyable.
    I unno man, Tauriel is pretty hot.

  15. I’ve had inner ear disease for 10 years and am still learning about it. Thanks, Mark, for pointing out that “the ears are instrumental in influencing our emotions and state of mind.” The balance disorder, hearing loss, tinnitus and hyperacusis are bad enough on their own, but the accompanying anxiety? Yikes! I ride my bike nevertheless, as it’s good for both my physical and mental health.

  16. Hi Mark, thank-you for this post. With regards to tinnitus, I read somewhere in the last 6 months or so, possibly on Dr Jason Fung’s website, that recent research points to a link between diabetes, high blood glucose/insulin, and tinnitus. Have you seen any of this research?

    I’ve had tinnitus all my life (I’m 55yo) and I can say from my own experience, since I started leaning into Paleo 4 years ago, that my tinnitus lessens when I eat really clean but as soon as I fall off the wagon into a packet of lollies or chocolate biscuits (cookies to you) it ramps back up again for about 24 hours.