29 June 2026
The Relationship Between Aspirin Use and Hearing Loss: What Does Science Say?
Research Assistant Azize KÖSEOĞLU from the Department of Audiology at the Faculty of Health Sciences examined the relationship between aspirin use and hearing loss in light of the scientific literature.
In addition to its pain-relieving and fever-reducing properties, aspirin, which is widely prescribed worldwide to reduce the risk of heart attacks and strokes due to its blood-thinning effect, has long attracted researchers' interest due to its effects on hearing health. Recent large-scale clinical studies have shown that low-dose aspirin use does not accelerate age-related hearing loss, while a different picture emerges at high doses.
The critical difference between high-dose and low-dose
Research on the subject indicates that the effect of aspirin on hearing is largely dose-dependent. According to a comprehensive systematic review published in 2014, which brought together 37 different studies, the intake of more than 1.95 grams of aspirin daily was associated with hearing threshold shifts ranging from 4 to 112 decibels, and it was determined that this effect was dose-dependent and potentially reversible in the short term.
In contrast, the same review emphasizes that there is no data confirming that the long-term use of low doses such as 81 mg or 325 mg daily has a negative effect on hearing. The researchers state that there is no evidence that these low doses should be discontinued in the case of hearing loss. As an additional finding, it has also been determined that aspirin, when used alone in doses that could be harmful to hearing, plays a protective role when administered together with the antibiotic gentamicin, which is known to have toxic effects.
Low-Dose Aspirin, Findings of the ASPREE Study
One of the studies providing the most up-to-date evidence on the subject is the ASPREE-Hearing substudy, published in the JAMA Network Open journal and conducted by researchers from Monash University and Alfred Hospital in Australia. The randomized controlled trial followed 279 healthy participants aged 70 and over for three years. The study's results suggest that low-dose aspirin use does not affect the progression of age-related hearing loss in healthy older adults. The researchers found that, compared to placebo, the use of aspirin did not affect the age-related decline in hearing and speech perception thresholds over the three-year follow-up period.
Age-related hearing loss is a significant health issue that is estimated to affect more than half of adults over the age of 70 and is associated with social isolation, depression, loss of functional independence, and low quality of life. It is suggested that aspirin may positively affect the microcirculation of the inner ear by reducing platelet aggregation and protect the auditory system at the cellular level due to its anti-inflammatory properties. However, the evidence supporting these possible mechanisms is largely based on experimental and observational studies. The findings obtained in humans are inconsistent, and the protective effect of aspirin on hearing health has not yet been definitively established. This study is the first research to provide a randomized controlled response to the uncertainty in this field.
Conflicting Findings in Long-Term Users
Another study examining the relationship between long-term aspirin use and hearing also points to similar results. In a study comparing 182 patients with heart disease who were on aspirin therapy with a 221-age-matched control group who were not, it was found that the patient's age was a much more significant risk factor than aspirin use. When confounding factors such as hypertension and diabetes were taken into account, no evidence was found that aspirin used in an antiplatelet dose caused audiological problems such as tinnitus and hearing loss.
A more recent study conducted on type 2 diabetes patients using the Taiwan National Health Insurance database has revealed a notable dose-dependent relationship: high cumulative doses of aspirin were found to reduce the risk of sudden sensorineural hearing loss, and particularly in patients in the highest dose cohort, high doses provided a protective effect.
Conclusion: What Should Patients Do?
When the existing scientific evidence is evaluated as a whole, although there is no strong evidence to suggest that patients using low doses (daily 81-325 mg) of aspirin on a doctor's recommendation for the prevention of heart and vascular diseases should be overly concerned about hearing loss, it appears that the use of very high doses (approximately 2 grams or more per day) of aspirin can lead to temporary changes in hearing.
It is recommended that any decision regarding the use of aspirin be made considering individual health conditions and under medical supervision and that individuals with any hearing-related complaints consult a doctor before discontinuing their medication on their own.
The critical difference between high-dose and low-dose
Research on the subject indicates that the effect of aspirin on hearing is largely dose-dependent. According to a comprehensive systematic review published in 2014, which brought together 37 different studies, the intake of more than 1.95 grams of aspirin daily was associated with hearing threshold shifts ranging from 4 to 112 decibels, and it was determined that this effect was dose-dependent and potentially reversible in the short term.
In contrast, the same review emphasizes that there is no data confirming that the long-term use of low doses such as 81 mg or 325 mg daily has a negative effect on hearing. The researchers state that there is no evidence that these low doses should be discontinued in the case of hearing loss. As an additional finding, it has also been determined that aspirin, when used alone in doses that could be harmful to hearing, plays a protective role when administered together with the antibiotic gentamicin, which is known to have toxic effects.
Low-Dose Aspirin, Findings of the ASPREE Study
One of the studies providing the most up-to-date evidence on the subject is the ASPREE-Hearing substudy, published in the JAMA Network Open journal and conducted by researchers from Monash University and Alfred Hospital in Australia. The randomized controlled trial followed 279 healthy participants aged 70 and over for three years. The study's results suggest that low-dose aspirin use does not affect the progression of age-related hearing loss in healthy older adults. The researchers found that, compared to placebo, the use of aspirin did not affect the age-related decline in hearing and speech perception thresholds over the three-year follow-up period.
Age-related hearing loss is a significant health issue that is estimated to affect more than half of adults over the age of 70 and is associated with social isolation, depression, loss of functional independence, and low quality of life. It is suggested that aspirin may positively affect the microcirculation of the inner ear by reducing platelet aggregation and protect the auditory system at the cellular level due to its anti-inflammatory properties. However, the evidence supporting these possible mechanisms is largely based on experimental and observational studies. The findings obtained in humans are inconsistent, and the protective effect of aspirin on hearing health has not yet been definitively established. This study is the first research to provide a randomized controlled response to the uncertainty in this field.
Conflicting Findings in Long-Term Users
Another study examining the relationship between long-term aspirin use and hearing also points to similar results. In a study comparing 182 patients with heart disease who were on aspirin therapy with a 221-age-matched control group who were not, it was found that the patient's age was a much more significant risk factor than aspirin use. When confounding factors such as hypertension and diabetes were taken into account, no evidence was found that aspirin used in an antiplatelet dose caused audiological problems such as tinnitus and hearing loss.
A more recent study conducted on type 2 diabetes patients using the Taiwan National Health Insurance database has revealed a notable dose-dependent relationship: high cumulative doses of aspirin were found to reduce the risk of sudden sensorineural hearing loss, and particularly in patients in the highest dose cohort, high doses provided a protective effect.
Conclusion: What Should Patients Do?
When the existing scientific evidence is evaluated as a whole, although there is no strong evidence to suggest that patients using low doses (daily 81-325 mg) of aspirin on a doctor's recommendation for the prevention of heart and vascular diseases should be overly concerned about hearing loss, it appears that the use of very high doses (approximately 2 grams or more per day) of aspirin can lead to temporary changes in hearing.
It is recommended that any decision regarding the use of aspirin be made considering individual health conditions and under medical supervision and that individuals with any hearing-related complaints consult a doctor before discontinuing their medication on their own.