Anemia & Hearing Loss

Iron deficiency anemia may be a contributor to loss of hearing according to new research published in the journal of Jama Otolaryngology-Head and Neck Surgery.  Individuals who have iron deficiency anemia were found to have more than twice the rate of hearing loss than those who did not have the condition.

What is iron deficiency anemia?

Iron deficiency anemia is a condition in which blood lacks adequate healthy red blood cells.  Red blood cells carry oxygen to the body’s tissue.  When there is not enough iron the body cannot produce enough of a substance called hemoglobin in red blood cells enabling them to carry oxygen.  Without sufficient hemoglobin, iron deficiency can leave a person feeling frequently tired and short of breath.

Two types of hearing loss and iron deficiency anemia

What the researchers found was two types of hearing loss, sensorineural and combined sensorineural and conductive hearing loss, that were particularly strong for having an association between iron deficiency anemia and loss of hearing.

The type of hearing loss called sensorineural, according to the American Speech-Language-Hearing Association (ASHA), is when there is damage to the inner ear (cochlea) or to the nerve pathways from the inner ear to the brain.  This type of hearing loss usually cannot be medically or surgically corrected and is the most common type of permanent hearing loss.

Conductive hearing loss according to the Hearing Loss Association of America is due to problems with the ear canal, ear drum, or middle ear and its little bones (the malleus, incus, and stapes).  Causes range from fluid in the middle ear from colds, ear infection or otitis media, benign tumors or impacted earwax.

Results from the study

Between 2011 and 2015, the study looked at the diagnoses of hearing loss in over 300,000 adults between the ages of 21 and 90 in the U.S.  Results from the study revealed that in the general population, 1.6 percent of adults had hearing loss but 3.4 percent of individuals with iron deficiency anemia had hearing loss.   Researchers found that the overall risk for sensorineural hearing loss was 82 percent higher in a person with iron deficiency anemia than someone who did not have the blood condition.  Individuals with combined sensorineural and conductive hearing loss had a 2.4 times greater risk of having anemia. 

Even though the results from this study only show a possible connection between iron deficiency anemia and hearing loss, it does not prove that one is the cause of the other.  It also does not prove that a person who has iron deficiency anemia and loss of hearing, will be able to regain their hearing if their iron deficiency anemia is treated. 

Why would hearing be affected by iron deficiency anemia?

There can be several reasons why iron deficiency anemia may affect a person’s hearing:

·         The inner ear is very sensitive to changes in blood supply.  When a person has iron deficiency anemia, there is a lack of oxygen in the blood which could be affecting the workings of the inner ear.

·         In sensorineural hearing loss, the part of the inner ear that is affected is supplied by only one artery.  If there is a low amount of oxygen present in the blood supply to that artery, it could damage that part of the inner ear. 

·         Too little iron may disrupt how the cells are working and possibly even kill them.  If this happens to hair cells in the inner ear, they are not able to be restored to have satisfactory auditory functioning.

·         In order to have normal auditory functioning, adequate iron is required. 

Treating iron deficiency anemia

Iron deficiency anemia is easily treated but treatment needs to begin as soon as possible once it is discovered:

·         Iron supplements

These are usually over-the-counter and may need to be taken for several months.  Infants and small children will be given a liquid form.  Absorption of iron pills is increased if taken on an empty stomach unless it causes an upset stomach which then it can be taken with a meal.  Avoid taking an antacid with an iron supplement as it will interfere with the absorption.  Iron pills should be taken with a good source of vitamin C as vitamin C helps improve the absorption of iron. Drinking a small glass of orange juice when you take the iron pill is advised.

·         Eat more iron rich foods

The best source of iron is heme iron which is found in animal foods.  Our body absorbs iron better (20-30%) from animal sources as opposed to plant sources or iron. 

Animal sources of iron that are better absorbed include:

·         red meat especially beef and liver

·         chicken and turkey

·         fish and shellfish

·         pork

Plant sources of iron contain nonheme iron which is not as well absorbed (1-10%).  Plant sources include:

·         Iron-fortified breakfast cereals and bread

·         Peas, lentils, beans such as red, kidney, pinto and soybeans

·         Dried fruit such as prunes, raisins, and apricots

·         Spinach and other dark green leafy vegetables

·         Tofu

·         Prune juice

·         Include a vitamin C rich food at each meal

Vitamin C not only helps absorb iron from an iron supplement but also food sources of iron.  Vitamin C rich foods include citrus fruits such as oranges, grapefruit, tangerines, also kiwi fruit, strawberries, tomatoes, broccoli, cabbage, potatoes, peppers, spinach and other leafy green vegetables. 

·         Phytates and tannins

Compounds called phytates and tannins can interfere with the absorption of iron.  Phytates are found in whole grains, bran and soy products and will bind with iron carrying it on out the body.  Tannins are found in black tea and some grains and also reduce absorption of iron.  It is advised to not drink tea with a meal.