Around 15 years ago, Patricia L. Morris was diagnosed with hearing loss while working in Papua New Guinea. She was age 55 at the time, and the issue was deeply problematic. As she told HearingTracker, “with air conditioning and different people’s accents, I couldn't hear [well] enough.”

This was not the only new health challenge that Morris faced at the time. A writer now based in Vancouver, she also developed osteopenia (bone loss), a harbinger of osteoporosis, a more serious condition in which bone loss intensifies, making fractures a real danger. While her doctors never made the connection between the two, Morris—like many her age—now wonders if her hearing loss and osteoporosis are related in a way. Morris wears hearing aids and also receives daily teriparatide injections to promote bone growth and manage her osteoporosis.

Given that both hearing loss and bone loss are both associated with age, HearingTracker decided to take a closer look at this possible connection. Here’s what you should know about osteoporosis, its relationship with hearing loss, and some measures that you can take to protect your hearing health.

What is osteoporosis?

First, let’s go into a bit more detail about osteoporosis. According to the National Osteoporosis Foundation, osteoporosis is “a bone disease that occurs when the body loses too much bone, makes too little bone, or both.” The age of onset of osteoporosis is typically around 50—similar to that for age-related hearing loss.

Normal bone versus osteoporosis
Normal bone versus bone with osteoporosis (right). If you are over 50, or suspect that you may have osteoporosis, you can talk with your doctor about whether you should have a bone density test, which is like having an x-ray, and can diagnosis the issue.

Breaking a bone may be the first sign of osteoporosis; otherwise, a person may not be aware of bone loss. These breaks usually occur in the hip and the spine, which can greatly affect mobility. Some health conditions may increase the likelihood of osteoporosis as well, both due to the illness itself and the medications (say, steroids) used to treat them. These include:

  • Rheumatoid arthritis
  • Multiple sclerosis
  • Lupus
  • Ankylosing spondylitis
  • Chronic kidney disease

Are osteoporosis and hearing loss connected?

While more research is needed, people with osteoporosis appear to have an increased risk of developing hearing loss. For example, a June 2015 study published in the Journal of Clinical Endocrinology & Metabolism found that osteoporotic patients in Taiwan were 1.76 times more likely to experience sudden sensorineural hearing loss.

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The researchers believe this significant correlation could be explained as follows: “Because osteoporosis is possibly a systemic metabolic disease with demineralization of skeletal system, it is reasonable to hypothesize that [this] may not spare the temporal bone, which contains the cochlea capsule and the conductive system.” In other words, the bones in the hearing system are as vulnerable as other bones in the body.

Female Temporal Bone Skull Anatomy
The temporal bone is highlighted in yellow on this female model.

Another possibility is that the systemic inflammation that is part of osteoporosis is a cause. The researchers noted that “there is also a close association between systemic inflammation and SSNHL.” Female patients who had osteoporosis were more likely to have sudden sensorineural hearing loss than male patients, though it is not yet clear why this is the case.

Can medication for osteoporosis cause hearing loss?

While osteoporosis can’t be cured, it can be treated with medications to improve bone density. Bisphosphonate are one class of drugs commonly used to treat bone loss. There has been some question as to whether these meds may contribute to hearing loss, but existing research suggests that this is unlikely.

A May 2021 study published in the Journal of American Geriatric Society looked at the relationship between osteoporosis, the use of bisphosphonates, and the risk of moderate or worse hearing loss in American women. The research found that osteoporosis was associated with higher risk of moderate or worse hearing loss, similar to the study in Taiwan. They also found that bisphosphonates used to manage osteoporosis did not seem to play a role in the development of hearing loss.

How you can avoid osteoporosis – and perhaps hearing loss

If you want to reduce the possibility of osteoporosis-related hearing loss, try to prevent osteoporosis from developing in the first place. Get enough vitamins to ensure bone health. Calcium and vitamin D supplements are commonly recommended.

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“For treatment and prevention, I suggest taking supplements designed to support aging and are completely made from natural ingredients,”  Janet Coleman, a nutritionist and co-founder of the Consumer Mag, tells HearingTracker. She also recommends making sure you are getting enough protein in your diet to optimize bone strength.

In addition to diet, Kendall F. Moseley, M.D., endocrinologist and osteoporosis specialist at the Johns Hopkins Metabolic Bone Center, advised that exercise is crucial for bone health. “Weight-bearing exercises focus on carrying the weight of your body against gravity,” she wrote. “Walking is a great weight-bearing activity, as are running, dancing, aerobics, hiking and tennis.”

Lastly, have an ongoing dialogue with your healthcare team about what you can do to protect both your bone strength and your hearing health, and reach out for help if you experience signs of either diminishing.