Does Prednisone Help Tinnitus? What the Evidence Actually Says

Don’t Take Prednisone for Tinnitus (Unless Your Doctor Can Answer This One Question)

I’m going to say this directly: Do not take prednisone for tinnitus. I’m going to say that again—do not take prednisone for tinnitus unless your doctor can answer one very specific question. And I’m going to tell you exactly what that question is.

I can’t tell you how many Prednisone Warriors have contacted me saying, “My doctor prescribed prednisone and I took it for the tinnitus. Now I’m dealing with all these horrible side effects. And it didn’t even help.”

That didn’t have to happen.

Today I’m going to share what I told her so you can understand how to make this decision for your own health.

I’m going to show you what the best medical evidence actually says, why your doctor may not realize they’re giving you false hope, and the one narrow situation where prednisone for tinnitus might—might—be justified.

Watch now!

The Prednisone Warrior Story That Changes Everything

Eight months ago, she got a viral infection that caused massive congestion and swelling in her ears and sinus passages. One ear got so congested that she started losing her hearing. At this point, that hearing loss is permanent according to her audiologist.

But the part that bothers her most is the ringing, pounding, weird sounds she hears when it’s quiet. That’s tinnitus (or tinnitus—say it however you want).

That weird thrumming sound. When I personally had it, I could hear my heartbeat in my ear when lying down trying to go to sleep: thud, thud, thud, thud, thud. It was so loud when it was quiet. I never noticed it during the day or when there was noise around me—and that’s actually a clue for what helps, which I’ll get to later.

She told me that just like me, she only had symptoms when lying down or when it was quiet. It wasn’t affecting her overall quality of life. She said it was something she could live with.

But here’s what made her reach out to me. She said: “I’m the type of person who will react poorly to medications. If there’s a side effect, I’m going to get it.”

And her number one concern? Bone loss.

She has a history of osteoporosis and has been doing everything she could. She’s changed her diet, does all the best exercises, and has tried bone medications—but they haven’t worked for her. She’s had bad reactions to them. She cannot afford any more bone loss.

Her doctor recommended a short course of prednisone for the tinnitus. And when she expressed her concern about her bones, her doctor reassured her:

“Short-term prednisone won’t affect your bones.”

Was that actually true?

I begged to differ. And I’m going to show you why.

What the Evidence Actually Says About Prednisone for Tinnitus

Let’s talk about what the evidence actually says. What do clinical trials—where they’ve given some people prednisone, some people something else, and some people a placebo, and actually measured what works—tell us?

Guess how much evidence there is that prednisone works for tinnitus.

None.

UpToDate—a medical reference guideline that is highly respected by doctors and built into most hospital computer systems—has this to say. This is a direct quote from their tinnitus treatment article:

“Medications are NOT a mainstay of tinnitus treatment.”

Multiple guidelines advise against pharmacotherapy for tinnitus.

What DOES Have Evidence?

So what do they recommend instead? Non-drug treatment options.

The One Very Narrow Exception

But there is a key caveat—a very narrow window of opportunity. And it’s controversial. The doctors who wrote the guidelines don’t all agree.

Some think that between 7 and 14 days after sudden hearing loss and tinnitus onset, there might be benefit to taking prednisone or another steroid for tinnitus.

But it has to be very high-dose prednisone. And what comes with very high-dose prednisone? Very awful side effects.

Beyond two weeks? There’s zero evidence.

Remember, my client was 8 months post-infection. She was nowhere near that two-week window.

She asked her doctor, “Is there anything we could try?”

And the doctor said, “We could try it.”

When a Doctor Says “We Could Try It”

When a doctor says “we could try it,” that should put some red flags in your brain. How much confidence does your doctor have that this is really going to help you?

If you’re wondering whether you should take prednisone, or if you have to take prednisone and want to know how to stay as safe as possible and keep your bones safe, I have something for you.

Download: The Free Prednisone Checklist →

It covers the things you need to be looking out for to keep your body as safe as possible. You can go through it and check off: “Yep, watching that. Checking this.” All of the things within your control to actually keep your body safe while on prednisone.

The Bone Loss Bombshell: Short-Term Steroids Are NOT Safe

Now back to the bone loss question she was asking.

“Short-term steroids are safe for bones, right?”

Wrong.

I want to give her doctor the benefit of the doubt. He probably got similar training as I did when I was personally prescribed high-dose prednisone.

I didn’t think I needed to take precautions for my bones because I thought it was just going to be short-term. And since then, I’ve discovered—and more research has come out showing—that short-term steroids are not without risks.

The Study That Changed My Understanding

Researchers did a study of millions of people in a health insurance plan. They looked at those who had steroid treatment for less than 30 days to see whether they had higher risks for certain diagnoses after those 30 days.

That’s short-term. Less than 30 days.

And in that study, they showed higher risks not only for sepsis (a full-body infection that can kill you) and certain types of heart disease, but also broken bones.

Where do broken bones come from? Bone loss and osteoporosis.

With less than 30 days of treatment. And most of those people were getting much smaller doses than are required to attempt to help with tinnitus and hearing loss issues.

Think about that. If a low dose can lead to bone loss, fractures, and being stuck in the hospital—or maybe even a nursing home because now you can’t use your hip—is it worth it to take this medication?

Seventy percent of people gain weight on prednisone. That’s just one of 150 possible side effects. And my client’s number one concern was bone loss and osteoporosis.

It’s such a widespread problem that there’s an entire guideline created for this condition: glucocorticoid-induced osteoporosis.

The Math Doesn’t Add Up

For this patient specifically:

“I’m the type of person who gets side effects.”
“I already have osteoporosis.”
“I’m doing everything I can, and I can’t afford any more bone loss.”
And this much chance that prednisone is going to help her tinnitus? Almost zero.

It makes no sense for her to take prednisone in her situation.

The math doesn’t add up: almost 0% chance of help with a 99% chance it’s going to hurt her.

Yeah, no. Don’t do it.

It’s not worth it for this condition—and many others.

Making a Deal with the Devil

Many people who end up on prednisone call it “Satan’s Tic Tacs.”

And if you’re going to be making a deal with the devil, it better be worth it.

Remember in The Little Mermaid when Ariel made a deal with the sea witch Ursula? She gave up her beautiful voice so she could walk. That was worth it to her. She lost one thing and got another.

When it comes to prednisone and tinnitus, you’re going to lose your voice and you’re still not going to be able to walk.

Not worth it, right? Why give up your voice for nothing?

(That was an analogy. You’re not actually going to lose your voice with prednisone. But you get the point.)

What She Should Actually Do Instead

So what did I recommend she do instead?

I said: Unless your doctor has evidence-based proof that this is going to help, don’t do it.

But there are some things that actually can help.

What the Evidence DOES Support

According to UpToDate, there has been reported success with:

Tinnitus Retraining Therapy (TRT)
Cognitive Behavioral Therapy (CBT)
Biofeedback
Stress reduction programs

And guess how many side effects those come with?

Very little—except maybe the expense and time spent doing them.

What’s the worst that can happen when you’re learning how to train your brain better? Very minimal side effects compared to prednisone.

The Three Questions You MUST Ask Your Doctor

If you have a prescription for prednisone and your doctor says, “Hey, it might help”—whether for tinnitus or any other condition—these are the questions you need to ask:

Question 1: Is there clinical trial evidence that prednisone specifically helps tinnitus at this stage?

In my client’s case, she was 8 months post-infection. Is there evidence for that timeline? The answer is no.

Question 2: Given my osteoporosis history, what bone protection plan comes with this prescription?

This wasn’t even on her doctor’s radar. They didn’t think it was a risk she was going to deal with. But the research says otherwise.

Question 3: What are the non-drug treatment options that are appropriate for my diagnosis?

Your doctor may not be wrong to offer prednisone. “We could try it.” But you deserve a real answer to these questions.

When Might Prednisone Actually Be Worth It?

If the tinnitus is ruining your life—like truly ruining the quality of your life, you cannot function otherwise—and you’re within those first two weeks after sudden hearing loss, maybe it’s worth considering.

But how much evidence is there even then? Very little.

So you and your doctor have to have a lot of confidence that taking this risk is going to be worth it for you.

Because when people come to me and tell me, “I’m having this side effect and this side effect and that one and that one”—up to 150 possible side effects—they’re suffering dramatically.

And they say: “I wish I’d never taken prednisone. Ever.”

They say it should be banned in most circumstances.

Another doctor at the University of North Carolina Chapel Hill said: “Prednisone is the most hated drug in the world, and it’s for good reason.”

When Prednisone IS Worth It

For people like me who got prednisone for a condition where it actually helps—it literally saved my life. I wouldn’t be here without it.

But for a condition like tinnitus? The benefits have to outweigh the risks.

And for most people, they simply don’t.

Be sure to have a frank, candid conversation with your doctor about what you can actually do.

If You’re Already Taking Prednisone

Now that you know the truth about prednisone and tinnitus, there’s one more thing that keeps coming up in conversations with patients: What they wish they’d known.

We already know they wish they’d known not to take it. But if you’re already taking prednisone, what are the other things you should be avoiding while on it?

I answer that in my very popular video and article: “7+ Things to Avoid While Taking Prednisone.”

Watch: 7+ Things to Avoid While Taking Prednisone →

These are common mistakes that can sabotage your prednisone experience and make side effects worse. If you’re on prednisone right now—for any reason—you need to know what these are.

Final Thoughts

The bottom line is this: Don’t take prednisone for tinnitus unless:

You’re within 2 weeks of sudden hearing loss
Your doctor can cite specific evidence for your situation
You’ve had an honest conversation about bone protection
You understand why the evidence-based alternatives aren’t appropriate in your case

If you can’t check all those boxes, the answer should be no.

You’re not being difficult by asking these questions. You’re being informed. And that’s exactly what you should be.

Download: Free Prednisone Checklist →

Keep fighting, Prednisone Warriors. I’m here with you.

References:

Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA, Hollingsworth DB, Kelley DM, Kmucha ST, Moonis G, Poling GL, Roberts JK, Stachler RJ, Zeitler DM, Corrigan MD, Nnacheta LC, Satterfield L. Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngol Head Neck Surg. 2019 Aug;161(1_suppl):S1-S45. doi: 10.1177/0194599819859885. PMID: 31369359.

Wei BPC, Stathopoulos D, O’Leary S. Steroids for idiopathic sudden sensorineural hearing loss. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003998. DOI: 10.1002/14651858.CD003998.pub3.