Prednisone and Dexamethasone Injection Makes Tinnitus Worse?

I have pppd that was manageable. I developed auto immune hepatitis and was put on 40mg of prednisone, then 30mg. The pppd is much worse and my balance is terrible. Could this be a side effect of prednisone and could the symptoms get better as my dose is lowered? Anyone have similar side effects?

Hello, I also had an inner ear injection of dexamethasone, 9/30/2025, by my ENT. My hearing hasn't improved and the tinnitus in my right ear is much worse. Did your severe tinnitus get better over time after your ear injection or has it been permanent?

@danadcm69 it is still louder than my baseline but not as bad as it was when all this started. I have seen 5 ents, rheumatology, and neurology and they all think I had a reaction to the steroids, oral and injected, but they haven’t seen this type of reaction before. I think the dexamethasone made my left ear extra sensitive. I’ve been using ChatGPT to research this, and it is likely because the injected steroids diffuse through the round window of your middle ear into the inner ear and affect the nerve and the cochlea which can cause sensitivity and an increase in central gain in the auditory system so the brain turns up the volume of tinnitus as a result. Hopefully it is temporary, and I think it usually is from the injections. Mine is just compounded by my reaction to the oral meds too. I’ve been dealing for 5 months but I’ve also had swelling in my head and ears and eustachian tube dysfunction which has just exacerbated everything. I also have hyperacusis in the ear that got the injection. I’ve come to realize recovery could take many more months. And I’m doing my best to stay hopeful. Do you have sensitivity to sound after the injection?

@kap333 When the TV volume is up too loud, it is almost painful. I turn the volume up to try to mask the tinnitus, but I have to lower it again if it's too much. I'm glad to hear that you are staying hopeful. It sounds like you have been through a really rough time! I'm happy to know that your baseline has improved. I'm very concerned that my much worse tinnitus could be permanent. I'm functioning worse than ever with this affliction. I have to always have some form of sound on all the time. I have 2 white noise machines and a fan going all night. Do you know of any apps for phones that are good for masking? Sleep has been disruptive for about a year already, but now it's worse. I've had tinnitus for several years now, but it has been getting much more severe for about 6-8 months. My hearing loss is not that bad, but the tinnitus has been very difficult for me to cope with in recent months. My ENT told me before I got the injection that the tinnitus wouldn't get any worse if I got it. I went ahead and got it but now I'm very sorry I did. I'm supposed to call his office and report how I'm doing, after 2 weeks, which will be Oct. 14. What kind of treatments have you had that helped with the severity of your tinnitus? My tinnitus is worse now in my left ear too, and I didn't have an injection in that ear, but it's not nearly as bad as the right ear. I can hear the tinnitus over every other sound in my right ear! I would appreciate any and all help with this condition!

@danadcm69 I have background noise on a lot too. A fan or tv or something. I have had the same experience with the noise too where it feels too loud or too quiet. It gets very frustrating. Also hard to sit in a restaurant. I always bring ear plugs. The app I use at night is ReSound. You can layer sounds to best mask the sound of your tinnitus. And it has a timer function which is nice. I’m also tracking the latest tinnitus research. The two I’m most interested in are the Susan Shore device and spi-1005. I haven’t had any treatments for the tinnitus. I’m just giving it time. Is your ENT an otologist? Be sure you are seeing an otologist or a neurotologist specifically, not just a general ENT, if possible. They can also order an MRI or a CT to check for anatomical abnormalities that might be impacting your tinnitus. And also talk to them about anything like TMJ dysfunction that could also be contributing.

@kap333 My doctor's appointment card shows he is "Board certified in otolaryngology/head and neck surgery". Does that mean he is an otologist? I have had recent (last month) CT and MRI in the ER due to stroke symptoms. I was ok as far as stroke per the hospital, and my ENT has reviewed also and said it was all good. I don't think I have TMJ, that's jaw pain, correct? Thank you for your input, it helps!

@danadcm69 nope not necessarily. You need an ENT that specializes in ear concerns. It’s a subspecialty of otolaryngology. That person might be an otologist but you can’t tell by the title you gave. Not all private practice ENTs will have an otologist specialist on staff but they might. I would ask specifically. Otherwise, I would try to find one in your area. Best bet is to look for an academic medicine institution in your area, like a university for example. I’m in Denver so I transferred my care to UCHealth which is affiliated with University of Colorado med school. These centers are teaching and research hospitals so they have a lot more highly specialized providers and are more up to date on the latest research and treatments. Mayo is a good example. It is also important to get multiple opinions, so if your general ENT doesn’t have answers, ask a more specialized physician.

@kap333 I'm very thankful for your insight about looking for a specialized doctor. My ENT is not an otologist or neurotologist. However, I found a doctor in my city who is both. He is from a different network of doctors than my Primary Care doctor. I asked my Primary doctor to send a referral to the specialist doctor, and he did. I was told I probably would have to wait about 2 weeks to hear from his office, but they made an appointment for me within a few days. The appointment, however, is set up for a month from today. I'm very grateful for the appt., but I'm having a harder time managing the tinnitus. It continues to get worse, especially in my right ear, but even the left ear has gotten worse. The left ear didn't get an injection, only the right. The tinnitus gets worse in both ears, I believe due to stress, fatigue, impaired thinking, sleep issues, even possibly from the flu shot I got yesterday. The masking isn't helping as much. The left ear is manageable, but the right ear seems out of control to me. Any suggestions for the next month of coping would be appreciated. Being busy helps but everything has become much harder to do. I've been unable to do as much as I need to get done. Thanks for your help, I'm really struggling!

@kap333 P.S. Could I have some kind of permanent damage?

I’m not sure if you could have permanent damage it all depends on what the cause is. But it’s worth looking into since it is getting worse. I would call the ENTs office to explain that it is getting significantly worse to see if they can get you in sooner based on the urgency of your situation. If not, I would see if they can put you on a cancellation list. But I would definitely try to push to be seen sooner if at all possible.