If you're like most people, you probably assume that hearing loss is an inevitable part of growing older and that you can't do anything about it other than get a hearing aid. But that's not always true.

Most of the nearly 40 million Americans who don't hear as well as they used to have sensorineural hearing loss (SNHL)-damage to delicate, hairlike nerve endings (hair cells) in the inner ear. These tiny hair cells translate sound vibrations into electrical impulses that are sent to the brain.

While SNHL often does result from aging or loud noise (repeated exposure or a single exposure to a very loud noise, such as an explosions), it also can be due to unexpected causes such as certain health problems or even prescription or over-the-counter (OTC) drugs.

Latest development: Recent scientific research is revealing that there may be more opportunities to prevent or slow SNHL than once thought. Surprising causes of SNHL and what you can do to prevent it...

Viagra and other drugs

There are hundreds of "ototoxic" drugs that can damage hearing. For example, in a study published in 2011 in Laryngoscope, researchers in the UK identified 47 cases in which men who took sildenafil (Viagra) or other drugs for erectile dysfunction experienced SNHL-and 67% of them developed it within 24 hours of starting the medication. Other ototoxic drugs include...

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Motrin) and naproxen (Aleve).

• Loop diuretics, such as furosemide (LasiX), used for high blood pressure, congestive heart failure and kidney disease.

• Antidepressants, such as fluoxetine (Prozac), clomipramine (Anafranil) and amitriptyline.

• Antianxiety medications, such as alprazolam (Xanax).

• Certain antibiotics, including erythromycin, gentamicin, neomycin and tetracycline.

• Chemotherapy drugs, such as cisplatin and carboplatin.

• Quinine-based antimalarial drugs, such as Qualaquin.

Important: The hearing loss caused by these drugs may be temporary or permanent depending on factors such as dosage and the length of time the medication was taken.

Self-defense: If your doctor prescribes a new medication, ask whether it could cause hearing loss. You also can research drug side effects online at the Physicians' Desk Reference website, www.pdrhealth.com.

If the medication can affect hearing, ask your doctor if there are alternatives that are suitable for your particular condition. If not, an audiologist should conduct hearing tests before you begin taking the medication to obtain a baseline. These tests should be repeated several times during the course of treatment with the drug.

For the greatest protection: Normally, an audiologist checks hearing in the 250-Hertz (Hz) to 8,000-Hz range, but to monitor drug related hearing loss, it is best to examine the high-frequency range (between 9,000 Hz and 20,000 Hz), where damage is likely to occur first.

If your hearing is affected, the prescribing physician should reconsider how best to treat the condition for which you were prescribed medication.

If you're already taking a drug that you suspect may be causing hearing loss, see an ear, nose and throat (END specialist for advice. Also notify an ENT specialist if you develop a sense of fullness in one or both ears (which could signal hearing loss) or tinnitus (ringing, buzzing or other unwanted sounds with or without hearing loss).

Blood Sugar Problems

Most physicians realize that diabetes slowly destroys blood vessels throughout the body, increasing risk for heart disease, stroke, Alzheimer's disease, chronic kidney disease, blindness and even amputation of circulation starved limbs. Now, hearing loss has been identified as an underrecognized complication of diabetes.

Recent research: In a study of 46 people with type 2 diabetes and 47 with rheumatoid arthritis, those with diabetes had three times more cases of hearing loss than the study participants with arthritis.

Possible mechanism: Diabetes reduces circulation and causes nerve degeneration-two factors that can affect the viability of hair cells involved in hearing.

Another danger: Studies have linked obesity and high triglyceride levels-both of which often accompany diabetes-to SNHL.

To preserve your bearing: Take steps to prevent high blood sugar. Weight loss, regular exercise and a diet that limits processed foods and emphasizes unprocessed foods (such as vegetables, fruits, whole grains, legumes, fish, lean meat and poultry) are the best approaches to take.

Riding in a convertible and loud noises

Most people know that loud noises such as jackhammers and explosions can damage hearing. But other causes now are being discovered. For example, researchers at the St Louis University School of Medicine tested noise levels while riding in a convertible at 55 miles per hour or faster with the top down and windows open. Levels were found to be above 85 decibels (dB)-the point at which hearing damage begins.

Self-defense: Avoid regularly exposing your ears to any sounds above 85 dB. To protect yourself...

Use earplugs when you operate noisy equipment of any kind, such as a lawn mower, power saw, chain saw, snowmobile-or even your vacuum cleaner.

Also helpful: If you are in an environment where you can't hear another person talking to you who is three feet away or closer, wear earplugs-or leave.

Lower the volume of your iPod or other music player if you notice any signs of hearing damage, such as your ears feeling muffled or full, or ringing in your ears.

Antioxidant = Better Hearing

In many cases, you may be able to prevent hearing loss that could require a hearing aid by consuming an abundance of certain antioxidants."' For example...

Coenzyme Q1O (CoQ1O). In people with SNHL, those who took the powerful antioxidant CoQ1O daily experienced improved hearing, according to recent research by Italian scientists.

Fish oil. Several studies link diets high in omega-3 fatty acids from fish to preventing or delaying age-related SNHL.

Important: I recommend using molecularly distilled fish oil (check the label)-it is less likely to contain toxins such as mercury than other fish oil products.

Also helpful: Diets rich in vitamin C, vitamin E, the B-vitamin riboflavin, magnesium and the antioxidant lycopene were linked to better hearing, according to a recent study from researchers at Vanderbilt University in Nashville. Other nutrients that may help prevent hearing loss include resveratrol, lecithin alpha lipoic acid, acetyl-L-carnitine and N-acetylcysteine.

*Consult your doctor before starting this or any other supplement regimen.

Talk to an integrative physician for advice on the specific nutrients and dosages that would be best for you. To find an integrative physician, consult the Academy of Integrative Health and Medicine, www.aibm.org.

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