The importance of treating hearing loss is to understand how entire body and all its symptoms are linked together. If we are not able to exercise regularly this can affect so many aspects of our physical and mental health. Much is the same for hearing loss. Understanding the connections and educating ourself on the ailments can help us to prevent a hearing loss and so much more. Both hypothyroidism and hyperthyroidism can cause hearing loss, and different thyroid conditions can affect not only hearing loss but also tinnitus, and balance disorders.

The two most common problems in thyroid dysfunction are hormone overproduction (hyperthyroidism) and hormone underproduction (hypothyroidism).

Hyperthyroidism is rare, affecting about 1% of the population. It results in the quickening of metabolic processes. Symptoms include nervousness, irritability, weight loss, shaky hands, panic disorder, racing heart and tinnitus. The most common cause of hyperthyroidism is Graves’ disease, an autoimmune response that over-stimulates the thyroid. The tinnitus caused by hyperthyroidism is usually associated with heart rate.

Hypothyroidism, also called under active thyroid disease, is a common disorder. With hypothyroidism, our thyroid gland does not make enough thyroid hormone. The thyroid gland is located in the front lower part of the neck. Hormones released by the gland travel through our bloodstream and affect nearly every part of our body, from our heart and brain, to our muscles and skin.

Also Read: Hypothyroidism- commonest problem faced by women! 

The thyroid controls how our body’s cells use energy from food, a process called metabolism. Among other things, our metabolism affects our body’s temperature, our heartbeat, and how well we burn calories. If a person doesn’t have enough thyroid hormone, his/her body processes slow down. That means his body makes less energy, and our metabolism becomes sluggish.

Fibromyalgia and Chronic Fatigue Syndrome (CFS) are conditions frequently associated with hypothyroidism. Studies suggest that up to 15% of people diagnosed with thyroid problems will end up with fibromyalgia.

Relation between hearing Loss and hypothyroidism

Hypothyroidism is the result of the thyroid not producing enough of the hormone thyroxine. This can cause depression, fatigue, forgetfulness, and weight gain. Thyroxine is also needed for normal development of the auditory system. In fact, about half of the people with low thyroid function have hearing losses.

The Journal of Clinical Endocrinology & Metabolism published a study linking hearing loss and hypothyroidism. The research study looked at how untreated hypothyroidism is known to impair hearing. The study found :
Patients were 3 times more likely to self-declare hearing loss than that for the reference population.

17% of affected patients required hearing support in early adulthood. Hearing loss was associated with the type of congenital hypothyroidism with disease severity. Hearing loss was mostly bilateral (90%), mild to moderate (96%), of the sensorineural type (76%), and compromised higher frequencies.

Treatment

Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levo-T, Synthroid, others). This oral medication restores adequate hormone levels, reversing the signs and symptoms of hypothyroidism. We will likely start to feel better soon after you start treatment. The medication gradually lowers cholesterol levels elevated by the disease and may reverse any weight gain. Treatment with levothyroxine will likely be life long, but because the dosage you need may change, our doctor is likely to check our TSH level every year.

Hearing test

Hearing loss is typically not one of the first symptoms for either hypothyroidism or hyperthyroidism. It is therefore possible to diagnose and treat thyroid issues before they impact your hearing. Common symptoms for hypothyroidism can include depression, fatigue, forgetfulness, and weight gain. Symptoms of hyperthyroidism include irritability, nervousness, muscle weakness, unexplained weight loss, sleep disturbances, vision problems, and eye irritation.

Our hearing and health are connected in more ways that we realize. Identifying changes to our hearing may help to identify other issues that we are unaware of. This is why we at Hearing Consultants cannot stress enough, the importance of annual hearing check-ups to ensure that our valuable hearing doesn’t slip away. The sooner you catch a hearing loss the sooner we can help you get back on track and maintain the hearing we still have.

Conclusion: Studies have revealed that abnormal changes in serum thyroid hormone levels, such as hyperthyroidism and hypothyroidism, can cause both sensorineural and conductive hearing loss. Both hypothyroidism and hyperthyroidism can cause hearing loss, and different thyroid conditions can affect not only hearing loss, but also tinnitus, and balance too. Hearing loss in hypothyroidism was found remediable and even reversible after proper replacement therapy. In a study by Di Lorenzo et al. a significant improvement in the hearing condition was reported in hypothyroid patients, after 6–12 months of L- thyroxine replacement therapy.

Prof. (Dr) Vivek Kumar Jha

Principal

Department of Audiology and Speech Language Pathology

Sumandeep Vidyapeeth (Deemed to be University)

Vadodara, Gujarat

Mob.No : 95602 76840

Email ID: jhavivek98@yahoo.com

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All living beings including humans live in their environment by constantly interacting with it. Numerous changes of various types happen in their environment constantly and the living beings need to change themselves in order to survive and thrive. It is quite systematic that they are continuously receiving information about these changes taking place in their physical environment. It is possible due to the presence of sensory systems in the living beings.

The changes in photic and radiant energy, vibratory energy, chemical and mechanical energy impact the sensory system of living beings though selectively depending upon the intensity of these changes as well the inherent capacity of sensory systems.  When the intensity of these changes is sufficient enough, i.e., above a threshold value, we call it, stimulus, the sensory system shall receive it and the information regarding the changes in physical energy is transmitted to the organism. It happens after a series of transformations taking place within the organisms so that sensory receptors are activated.

It is very interesting to note that as we ascend on the evolutionary ladder, this sensory system becomes more complex, efficient and varied as it responds to variety of physical changes taking place in the environment. Such system not only communicates information efficiently but primes the organism to respond effectively to the changes in the environment. This stimulus – response mechanism is key to the interdependent relationship between the environment and organism. When an appropriate response is made to the stimuli, it is considered to be the adjustment, i.e., contributing to the survival of the organisms.

Hearing impairment

Hearing impairment is one of the most common chronic health conditions in the world. The recent study has proved that  Hearing loss reduces the quality and quantity of couple communication. Considering the centrality of communication between spouses, a person’s hearing loss may negatively affect the relationship. Communication problems manifest  themselves through constant repetitions and misunderstandings. The broad aim of this study is to explore the role of hearing impairment in marital adjustment in elderly couples.

A total of 120 couples between the age ranges of 60 to 80 years came to Audiology clinic for routine check-up at SGT Hospital, Gurugram. The total population was divided into three different groups i.e., Group A (Experimental group I), Group-B (Experimental group II) and Group C (control group). Group A was further subdivided into A-I and A-II whereas Group B was subdivided into B-I and B-II.  Univariate analysis, ANOVA followed by post-hoc Duncan’s were used to estimate the effects of the hearing impairment of the self/partner on marital adjustment and mental health of subjects and their partners with and without hearing aids. All the 3 groups, i.e.; groups with normal hearing, hearing impairment and hearing impairments with hearing aids were selected for the study.

First of all, descriptive statistics was used followed by ANOVA and post-hoc analysis. The result shows that the main effect of group, i.e., (individual with hearing impairment with hearing aids, hearing impairment, normal hearing, was found to be significant (p<0.001) on mental health score. The result shows that the main effect of group, i.e., (individual with hearing impairment with hearing aids, hearing impairment, normal hearing, was found to be significant (p<0.001) on marital adjustment score.

Marital adjustment of individuals with hearing impairment was significantly poor adjustment than normal hearing, hearing impairment with hearing aid was also close to normal hearing. Whereas, the marital adjustment of hearing impairment was found to be worst than hearing impairment with hearing aids. Marital adjustment of partners with hearing impairment was significantly poor adjustment than normal hearing, hearing impairment with hearing aid was also close to better adjustment as well as in normal hearing. Whereas, the marital adjustment of hearing impairment was found to be worse than hearing impairment with hearing aids.

On the basis of the findings of the present study, the following conclusion can be drawn:

1. The individuals with Hearing aid were having better marital adjustment as compared to individuals with hearing impairment. It shows that prescription of hearing aid is helpful for patients with hearing impairment to improve their marital adjustment.

2. Similarly, partners of individuals with Hearing aid were having better marital adjustment as compared to individuals with hearing impairment. It depicts that prescription of hearing aid is not only helpful for patients with hearing impairment but also for their partners to improve their marital adjustment.

Dr. Vivek Kumar Jha

Professor(Speech Pathology & Audiology)

Department of Audiology & Speech Language Pathology

Faculty of Behavioural Sciences

SGT University, Gurugram, Haryana

Email: jhavivek98@yahoo.com

Mob: 95602 76840

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Deafness defined as, Partial or total inability to hear. The two principal types of deafness are conduction deafness and nerve deafness. In conduction deafness, there is interruption of the sound vibrations in their passage from the outer world to the nerve cells in the inner ear. The obstacle may be earwax that blocks the external auditory channel, or stapes fixation, which prevents the stapes (one of the minute bones in the middle ear) from transmitting sound vibrations to the inner ear.

In nerve deafness, some defect in the sensory cells of the inner ear (e.g., their injury by excessive noise) or in the vestibulocochlear nerve prevents transmission of sound impulses from the inner ear to the auditory centre in the brain. Deafness at birth is nearly always of the nerve type and cannot be improved by medical means. Hearing loss can be inherited. Around 75-80% of all cases are inherited by recessive genes, 20-25% are inherited by dominant genes, 1-2% are inherited by X-linked patterns, and fewer than 1% are inherited by mitochondrial inheritance.

When looking at the genetics of deafness, there are 2 different forms, syndromic and non syndromic. Syndromic deafness occurs when there are other medical problems aside from deafness in an individual. This accounts for around 30% of deaf individuals who are deaf from a genetic standpoint . Nonsyndromic deafness occurs when there are no other problems associated with an individual other than deafness. From a genetic standpoint, this accounts for the other 70% of cases, which attributes to the vast majority of hereditary hearing loss.

Syndromic cases occur with diseases such as Usher syndrome, Stickler, Waardenburg syndrome, Alport, and Neurofibromatosis type 2. These are diseases that have deafness as one of the symptoms or a common feature associated with it. The genetics that correspond with these various diseases are very complicated and are difficult to explain scientifically because the cause is unknown. In non syndromic cases where deafness is the only ‘symptom’ seen in the individual it is easier to pinpoint the physical genes.

Deafness is defined as a degree of impairment such that a person is unable to understand speech even in the presence of amplification (Elzouki, Abdelaziz Y.).In profound deafness, even the loudest sounds produced by an audiometer (an instrument used to measure hearing by producing pure tone sounds through a range of frequencies) may not be detected. In total deafness, no sounds at all, regardless of amplification or method of production, are heard.

Hearing loss exists when there is diminished sensitivity to the sounds normally heard. The terms hearing impairment or hard of hearing are usually reserved for people who have relative insensitivity to sound in the speech frequencies. The severity of a hearing loss is categorized according to the increase in volume above the usual level necessary before the listener can detect it.

The diagnosis of hearing loss is often a shock and brings with it a need to know why and how such a thing could have happened. Often it is difficult to determine the cause of a child’s hearing loss. There may be several factors that contribute to the hearing loss. Questions that may arise in parents mind can be: Why did this happen? Will my child be abnormal? What caused it? What will my child be like when he or she grows up? Why do I feel responsible? How will my deaf child and I communicate with each other? How well will my child be able to speak? What impact will hearing loss have on my family relationship?

What do I do when other people treat my child differently? How can I get other family members involved? How can I help hearing siblings adjust to a deaf or hard of hearing brother or sister? Parents with a child who has a hearing loss have many anxieties, concerns, and questions that are normal for concerned parents of any child. Some parents are able to adjust quickly to the demands presented by having a child who cannot hear. Other parents many never completely accept the fact that they have a deaf or hard of hearing child, but they learn to cope with child’s hearing loss in various ways.

A range of emotions and reactions – grief, guilt, anger, are common. Many parents find that these emotions return at each new stage of their child’s development, so that adjusting to deafness is a continuing process. Other parents may accept deafness at one point  in life, only to find another area where acceptance has not yet been achieved. According to the World Health Organization (WHO) 2004, mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stress of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.

Marien etal (2012) studied the factors related to mental health; these factors are; Physical/ Social and Environmental/ Psychological/ Family History. Anitha etal (2016)  studied on 300 hearing impaired adolescents of both the gender, between the age range of 11 to 19 years to investigate anxiety, loneliness, adjustment, shame and depression with respect to marital status of parents.ADS (Anger disorder scale) was used to obtain the scores of anxiety, loneliness, adjustment, shame and depression. The results showed that anxiety in deaf has a significant relationship with marital status of parents.

Impact of Deafness on Mental Health and mental illness:

Hearing loss is directly related to mental retardation. Lots of studies are there,  to verify the relationship between mental health and hearing loss. Packer (2015) studied hearing aids  help out and reduce the strain of trying to understand the mumbles. New research shows that untreated hearing loss has a profound effect on mental state, affecting everything from temperament to perceived life satisfaction to cognition. Social isolation, depression and cognitive decline are all possible if hearing loss goes untreated. Ayonayon etal (2017) reported anxiety in older adults having hearing loss.

Depression, is a state of mood or emotional that is marked by feelings of low self-worth or guilt and a reduced ability to enjoy life. Written by: The Editors of Encyclopedias Britannica,(2018). Jillman Friedman (2008) studied the  predictors of depressive symptoms in Persons with Deafness and Hearing Loss. Cognitive decline simply means that your brain doesn’t work as well as it used to. This isn’t the same as cognitive impairment, which can be the result of damage, disease or an increased level of cognitive decline from another source. Cognitive decline is a response to the aging of neurons and the decreased speed at which the brain functions.

Simonsick etal (2013) stated that cognitive decline is a significant problem that has been linked to untreated hearing loss in recent studies as well. Social isolation is defined as having little or no contact with other people. It usually lasts for extended periods of time. James (2014) studied among seniors, loneliness and social isolation are common problems which are unfortunately only exacerbated by hearing loss.

Major problem associated with the family:

Communication is Vital. It is not uncommon for parents to believe that serious hearing loss will destroy all chances of a normal, healthy family. This need not be the case. Your family unit can be happy and vigorous as any other. Thus early communication between parent and child is imperative. Parents should explore communication modes used by deaf and hard of hearing people and start communication with their child as soon as possible.

The ability to communicate clearly with their child is the most important task parents will face and will have the greatest impact on developing an integrated family unit. Parent of deaf children frequently must deal with the negative reactions of others. Relatives as well as strangers often react as if the child were incapable of doing anything independently. It is normal for parents to feel angry and hurt when this happens.

You can develop strategies for coping with other people’s responses:

• You can confront people’s ignorance by discussing deafness and ways to communicate with your child.
• You can explain that pity is needless and only hurts the child.
• You can provide a positive, loving model for how to behave toward your child.
• In situations where you are frustrated, tired, or out in public, you can choose not to explain at all.
• Other parents who have coped with similar experiences have valuable insights to share about coping with these difficult situations.

Each family member will react differently to the diagnosis of hearing loss. Some members will learn to cope with the loss more easily than others. Problems existing in the family before the diagnosis may be magnified due to the additional stress associated with a child who has a disability in the family.

Additional responsibility always falls on parents Shoulder usually on the mother. In this process sometimes the female have to scarify her carrier for the well being of  her child and family.Hearing brothers and sisters need as much information’s as adult family members do. They feel the stress in the family and may be expected to participate in activities that they might not understand or they would rather avoid. Whether younger or older, hearing siblings often feel jealous and resentful of the attention the deaf sibling receives. They may also feel embarrassed when they are playing with friends.

Parents need to strive to treat hearing and deaf siblings as normally as possible and not force the hearing children to participate in every activity related to the non-hearing child. By treating each child in your family as unique and special parent-time to each, you avoid singling out the deaf child as more important. This enhances positive self-concept in all siblings, reduces feelings of resentment, and encourages total family involvement. You can also encourage all siblings to help each other in certain situations. In this way the deaf child becomes both a receiver of help and a giver of help.

Vivek Kumar Jha
Associate Professor (Speech and Hearing)
Department of Audiology and Speech, Language Pathology
Faculty of Behavioural sciences
SGT University, Gurugram, Haryana
jhavivek98@yahoo.com
Mob:09560276840

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