If you already have several decades of life tucked under your belt, you’ll know that with older age come both perks and drawbacks. Perks generally include more wisdom, real-world experience, a greater sense of self-acceptance… while drawbacks include rickety knees, thinning hair, and an increased risk of a multitude of health conditions, including osteoporosis and hearing loss. Cue smooth segue into this common bone disease and how it can affect your hearing.

What is Osteoporosis?

Osteoporosis is a bone disease affecting an estimated 10 million American adults over the age of 50. In addition to this number, an additional 43 million have low bone density, which is a risk for developing osteoporosis. Though women are far more susceptible to osteoporosis, men are not immune either.

Healthy bone is constantly turning over. This means that old bone tissue is broken down while new bone tissue is being formed. During osteoporosis, there is an imbalance between the rate of creation of new bone and the loss of old bone. This results in a loss of bone density and a weakening of the bone structure so that it becomes more susceptible to breaks and fractures. An underlying process of osteoporosis is called demineralization – when important strengthening minerals such as calcium and phosphorous are lost from the bones faster than they can be replaced. These problems tend to be most pronounced in the hip, spine, and wrist but can happen in any bone throughout the body.

Since cases of osteoporosis often go undetected until you have a coughing fit and crack a vertebra, osteoporosis is often called a “silent disease”. However, you can be alerted to get regular screening check-ups with your family physician by being aware of your risk factors. Factors that have the potential to increase your risk of osteoporosis include:

  • Female gender
  • Older age
  • Low body mass index or small-boned body types
  • Caucasian and Asian ethnicity
  • Family history of osteoporosis
  • Hormonal changes such as menopause
  • Low dietary calcium and vitamin D
  • Certain medical conditions, such as rheumatoid arthritis and some forms of cancer
  • Long-term use of certain medications, such as steroids
  • Low levels of physical activity
  • Chronic heavy alcohol intake
  • Smoking

What Does a Bone Disease Have to Do with Hearing Loss?

Well, wouldn’t you know it, your ears have bones! The cochlea of the inner ear and the internal auditory nerves are surrounded by a bony structure, known as the temporal bone. Since osteoporosis is a systemic disease, meaning it affects multiple areas of the body, it’s conceivable that it can also cause weakening and dysfunction of the bones involved in hearing.

Although more research is needed to fully understand how osteoporosis works as a risk factor for hearing loss, one hypothesis is that the demineralization of bone as it breaks down upsets the composition of the endolymph fluid of the ear. This fluid is important for the proper function of the cochlea; a disruption to the mineral content of endolymph could interfere with the transmission of signals through this space.

Despite doctors not yet understanding how osteoporosis relates to hearing loss, the evidence for the relationship between the two is, well, evident. Studies have shown that women with low bone mineral density or diagnosed osteoporosis are at a whopping 40% higher risk of developing hearing loss. In addition to this, a rare type of hearing impairment known as sudden sensorineural hearing loss is also more common in people with low bone density or osteoporosis.

Prevention is Better than Cure

As with most things in healthcare, if you can prevent it from happening in the first place, that’s much more preferable than trying to manage or treat it later. Though you can’t do much about getting older, there are steps you can take to keep your bones happy and healthy and minimize the contribution of bone problems to your hearing problems.

  • Keep to a diet rich in nutrients that support bone health. These include calcium, such as from dairy products, fish, and grains; vitamin D from fortified cereals, milk products, fatty fish; and proteins. If you’re finding it difficult to incorporate sufficient amounts of calcium and vitamin D, your doctor may be able to suggest a suitable supplement.
  • Get in enough physical exercise. Weight-bearing exercises help to build bone strength. You can consider doing weights, hiking, jogging, or even sports like tennis.
  • Quit smoking. Though easier said than done, it’s not just your bones that will thank you once you manage to kick the habit.
  • Limit alcohol intake. Alcohol might be good for some things (such as making easy conversation) but is not good for other things, especially as your body becomes a bit fickler with age and interacts with alcohol differently.

Ultimately, the moral of the story is to be vigilant about both your bone health and your hearing. If you have osteoporosis, it’s worth getting regular hearing checks so that you can manage it sooner rather than later. Treatment may include being fitted with hearing aids or more aggressively tackling other risk factors for hearing loss such as blood pressure, your diet, or certain medications that may be damaging your hearing. And if you don’t have osteoporosis (yet), and don’t want it, consider working with your family physician about the steps you can take to prevent it.