What vitamins can help with hearing health?

Vitamins for Hearing Health

There is insufficient high-quality evidence to recommend routine vitamin supplementation for preventing or treating general hearing loss in adults, though specific genetic conditions may benefit from targeted vitamin therapy.

Evidence-Based Recommendations

General Population

• No routine vitamin supplementation is recommended for preventing age-related or noise-induced hearing loss based on current guideline-level evidence 1
• The American College of Medical Genetics states that individuals should acquire daily vitamin and mineral requirements from natural food sources rather than supplements, and warns about potential toxicity of megadoses 1
• Vitamin supplementation in pharmacological doses should be viewed as therapeutic intervention requiring placebo-controlled trials to demonstrate safety and efficacy 1

Specific Genetic Conditions Requiring Vitamin Therapy

Vitamin A for Usher Syndrome:

• Vitamin A therapy may be beneficial for persons with Usher syndrome in slowing retinal degeneration, which can help preserve overall sensory function including hearing 1
• This represents a specific genetic indication rather than general hearing protection 1

Biotin for Biotinidase Deficiency:

• Biotin treatment in children with biotinidase deficiency (identified through newborn screening) can prevent hearing loss 1
• This is a specific metabolic disorder requiring early intervention 1

Research Evidence (Lower Quality)

Folate (Men ≥60 years):

• One prospective study in 26,273 men found that higher folate intake was associated with reduced risk of hearing loss specifically in men aged ≥60 years (relative risk 0.79,95% CI 0.65-0.96) 2
• However, this was not incorporated into clinical guidelines and represents isolated research findings 2

Vitamins C, E, Beta-Carotene, and B12:

• A large prospective study found no significant association between intake of vitamins C, E, beta-carotene, or B12 and risk of hearing loss in adult males 2
• Cross-sectional data suggested dietary vitamin E and vitamin A intake were associated with lower prevalence of hearing loss, but these nutrients did not reduce 5-year incidence of new hearing loss 3

Antioxidant Combinations:

• Research combining beta-carotene, vitamins C and E with magnesium showed reduced temporary threshold shift in guinea pig models, but this has not translated to clinical guideline recommendations 4
• The Institute of Medicine concluded that megadoses of dietary antioxidants have not been demonstrated to protect against various diseases and may lead to health problems including diarrhea, bleeding, and toxic reactions 1

Vitamins NOT Recommended for Ototoxicity Prevention

Vitamin E for Cisplatin-Induced Hearing Loss:

• Clinical practice guidelines specifically note that vitamin E alone was evaluated in only one methodologically flawed study (108 adults randomized, only 23 analyzed) and no recommendation was generated 1
• Similarly, combinations of vitamin C, vitamin E, and selenium were evaluated in single studies insufficient for guideline recommendations 1

Clinical Approach

For patients asking about vitamins for hearing:

1. Assess for specific genetic conditions (Usher syndrome, biotinidase deficiency) that have established vitamin therapy benefits 1
2. Recommend obtaining vitamins through balanced diet rather than supplements 1
3. If considering supplementation in men ≥60 years, folate intake within recommended dietary allowances (400 µg/day dietary folate equivalents) may be reasonable, though this is not guideline-supported 1, 2
4. Avoid megadose vitamin supplementation due to potential toxicity without proven benefit 1

For patients with vitamin D deficiency and hearing concerns:

• Vitamin D deficiency should be corrected for general health reasons, particularly in conditions like congenital ichthyoses where hearing loss may co-occur 1
• However, vitamin D supplementation is not specifically indicated for hearing loss prevention 1

Important Caveats

• The relationship between diet and hearing is complex, with healthy dietary patterns (vegetables, fruits, omega-3, limiting cholesterol and sugar) showing more promise than isolated vitamin supplementation 5, 6
• Nutritional deficiencies can affect hearing, but this does not mean supplementation beyond correcting deficiency provides additional benefit 6
• Most positive associations between vitamins and hearing come from cross-sectional studies showing prevalence relationships, not prospective studies demonstrating prevention of incident hearing loss 3