Can Aspirin Cause Hearing Loss?
Anthony L. Komaroff, M.D., Editor in Chief, Harvard Health Letter
Harvard Medical School Healthbeat
Q. I am 85 and have taken an 81-mg aspirin each day for decades for heart attack prevention. Recently, I noticed these words on the label: “Stop using if you get ringing in your ears or loss of hearing.” Should I be worried?
A. In a word, no.
In the body, aspirin gets converted into a chemical called salicylic acid, so the side effect that the label is referring to is sometimes called salicylism, or more simply, aspirin poisoning. Very high levels of aspirin in the blood can have toxic effects. Tinnitus — a ringing or whistling noise in the ear — and hearing loss are among them. But there’s no risk of that happening at an 81-mg dose.
People have been taking aspirin for more than a century, and I think it’s still the most widely used medicine. Like you, many people take small doses daily for cardiovascular health. But large doses used to be prescribed much more often, partly because we didn’t have nearly as many other medications to choose from. Doctors have also learned that many drugs, including aspirin, work just as well at lower doses as at higher ones, and — no surprise — lower doses are often associated with fewer side effects.
Aspirin for rheumatoid arthritis, an inflammatory condition that damages joints, is an example of what I am talking about. Today, if someone with rheumatoid arthritis is treated with medication, there are several choices among the disease-modifying antirheumatic drugs, or DMARDs. But when I was in medical school, aspirin doses of 1,500 milligrams (mg) a day or more were often prescribed for rheumatoid arthritis. Taking that much aspirin on a daily basis can have toxic effects, including tinnitus, and I saw cases of salicylism early in my medical career.
Your 81-mg dose is about one-twentieth of 1,500 mg. You really don’t have to worry about salicylism. The evidence for cardiovascular protection from small, regular doses of aspirin is solid. So congratulations on reaching 85, and I think there’s a good chance that your aspirin habit might have helped you get there.
Anthony L. Komaroff, M.D., Editor in Chief, Harvard Health Letter
Harvard Medical School Healthbeat
Q. I am 85 and have taken an 81-mg aspirin each day for decades for heart attack prevention. Recently, I noticed these words on the label: “Stop using if you get ringing in your ears or loss of hearing.” Should I be worried?
A. In a word, no.
In the body, aspirin gets converted into a chemical called salicylic acid, so the side effect that the label is referring to is sometimes called salicylism, or more simply, aspirin poisoning. Very high levels of aspirin in the blood can have toxic effects. Tinnitus — a ringing or whistling noise in the ear — and hearing loss are among them. But there’s no risk of that happening at an 81-mg dose.
People have been taking aspirin for more than a century, and I think it’s still the most widely used medicine. Like you, many people take small doses daily for cardiovascular health. But large doses used to be prescribed much more often, partly because we didn’t have nearly as many other medications to choose from. Doctors have also learned that many drugs, including aspirin, work just as well at lower doses as at higher ones, and — no surprise — lower doses are often associated with fewer side effects.
Aspirin for rheumatoid arthritis, an inflammatory condition that damages joints, is an example of what I am talking about. Today, if someone with rheumatoid arthritis is treated with medication, there are several choices among the disease-modifying antirheumatic drugs, or DMARDs. But when I was in medical school, aspirin doses of 1,500 milligrams (mg) a day or more were often prescribed for rheumatoid arthritis. Taking that much aspirin on a daily basis can have toxic effects, including tinnitus, and I saw cases of salicylism early in my medical career.
Your 81-mg dose is about one-twentieth of 1,500 mg. You really don’t have to worry about salicylism. The evidence for cardiovascular protection from small, regular doses of aspirin is solid. So congratulations on reaching 85, and I think there’s a good chance that your aspirin habit might have helped you get there.
And I'm not talking about people like my grandfather who already have heart disease. 