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Commentary on the affects of the various types of
hyperlipidemia on one's hearing.DigiCare Hearing
Research & Rehabilitation
Cholesterol & Hearing Health: A Commentary
By Max Stanley Chartrand, M.A.
Director of Research
The effects of cholesterol-based conditions called
hyperlipidemia or hyperlipoproteinemia on human
cochleae, particularly at the stria vascularis, have
presented a number of “mystery cases” of fluctuating
cochlear threshold readings. Some of the most dramatic
cases observed in our practice are those hearing aid
patients who come in with high lipid tests and are later
placed on statin drugs. In many of those cases, high
frequency thresholds have been found to rise by as much
as 10-20dB @4KHz, enough that reprogramming of their
hearing aids was required.
Some of the ways in which these forms of high blood
lipids can affect one’s hearing health is in:
·Fluctuating hearing thresholds (at the cochlea) over a
period of weeks or months
·Changes in loudness growth perception (recruitment,
hyper-recruitment)
·Tinnitus (ringing in the ears, usually at or near the
frequency band of greatest hearing loss)
·Episodic or mild vertigo (rototary)
·Cochlear stroke at the stria vascularis
·Complications of arteriosclerosis at the middle or
inner ear
Type I Hyperlipidemia (Chylomicrons):
This form is considered rare in the population, and is
most often related to systemic lupus erythematosus (SLE).
Lupus, an autoimmune disorder, is one of the most
difficult human conditions to diagnose. Because the
affected areas of the body vary significantly from
person to person, and because the symptoms are a result
of a syndrome of pathologies, early diagnosis is rare.
Tell-tale symptoms may also include: fatty nodules on
the skin, inflamed pancreas and chronic abdominal pain,
as well as developing heart disease.
Treatment, as a rule, merely controls symptoms, and
customarily consists of corticosteroid drugs to control
inflammation and fever, pleurisy, and neurological
problems. Involvement of the kidneys can make lupus life
threatening. It is critical that hearing health
professionals be aware of the specifics in both
diagnosis and treatment the patient may be under before
beginning the test battery for hearing acuity, and
especially note same when hearing aids are being fitted
and programmed. This form of hyperlipidemia is usually
controlled by diet alone.
Type II Hyperlipidemia (Low-density lipoproteins):
Type II appears to be the most common form for patients
within +/-30 lbs. their ideal body weight, and whose
diets are already low in saturated fats. Indeed, it is
ironic that a person within that range of normal weight
and who already practices good eating habits would
display such high levels of low and very low density LDL
blood lipids. But in each of those cases there are
attendant conditions or treatments, such as
hypothyroidism, corticosteroid therapy, Cushing’s
syndrome, or nephrotic syndrome (related to diabetes II,
edema, and/or pleural effusions). Certain liver
conditions, including toxicity from Aspertame, etc. are
suspected causes of some “mystery cases”. Even though
these conditions may be controlled by medication, the
lipid problem tends to persist.
Statin drugs simply mask the cause effect link between
the conditions, which means the underlying cause may
continue to persist. Semi-dehydration, especially in
older patients, can cause hypernatremia (high sodium
levels), which in turn can lead to Type II
Hyperlipidemia. Therefore, any treatment program should
include ascertaining that the patient is drinking enough
water daily that is appropriate to body weight and
physical activity level. Left untreated, Type II nearly
always leads to risk for coronary heart disease. One of
the telltale signs of this form is fatty nodules on the
eyelids and on feet and hand tendons, and/or a white
line around the rim of the cornea of the eye.
Type III Hyperlipidemia (Intermediate density
lipoproteins)
Like Type II, Type III is often related to
hypothyroidism and/or systemic lupus erythematosus (SLE),
but involves intermediate density lipids at small to
medium elevations in the blood. Visual symptoms include
fatty deposits over the palm and/or joints. Low-fat diet
(high in fresh fruits and vegetables) plus supplemental
forms of chromium niacin (picolinate or nicotinate) are
usual courses of control. This form is likely to have
very little effect upon the inner ear status, but
combined with low blood pressure, varicose (large)
veins, and/or overuse of diuretics can cause deleterious
effects on one’s hearing health.
Types IV & V (Very low density lipoproteins and
Chylomicrons)
These two types are closely related and share in
symptoms and treatment, as the population most afflicted
with these are usually obese. Secondary and often
causal, however, are a vast array of related conditions:
·Diabetes Mellitus II
·Obesity
·Alcoholism
·Renal failure
·Neuropathies of all kinds
·Nephrotic syndrome
·Cardiovascular disease
·Osteoarthritis/Osteoporosis
·Medication (corticosteroids, estrogen, etc.)
In cases of diabetes mellitus, renal failure and
nephritic syndrome patients should be advised to avoid
aminoglycoside antibiotics, such as gentamycin and
streptomycin, because their half-life far exceeds the
kidney’s ability to process and eliminate them. Other
cautions would include avoidance of monosodium glutamate
(MSG) or any of its chemical equivalents (which unleash
a flood of free glutamic acid into the system) in their
diet, and also Aspertame (Nutrasweet), an artificial
sweetener.
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