Risks of Getting Hearing Aids Without a Prescription

Everyone is thrilled with the new U.S. Federal Drug Administration (FDA) guidelines this year, which establish a new category of hearing aids that can be purchased by anyone over the counter (OTC). And there are valid reasons for the excitement.

Key takeaways:
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    OTC hearing aids may only be a good hearing loss solution for some people.
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    Judging your hearing loss may be challenging on your own. You may still need to see an audiologist to be sure you have it right.
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    You may still find it necessary to seek help from an audiologist to get your OTC hearing aid programmed and fitting correctly.
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    Check with your primary care provider first before using an OTC hearing aid, during your yearly wellness exam or regular appointment.
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    Many people may need to see an ENT specialist for further medical evaluation, particularly if the person has other symptoms such as vertigo or headaches, or if their hearing loss is one-sided.

The primary reason is cost. The idea is that, not only should the OTC hearing aids cost less, but purchasing them eliminates that pesky middleman: the hearing aid specialist or audiologist. But should it?

Also, by purchasing an OTC hearing aid, you might think there is no reason to see your doctor first about your hearing or see an ear-nose-and-throat (ENT) specialist. But is that the best idea?

Hearing loss is more common than diabetes mellitus and many other medical conditions. It is often misjudged and misunderstood.

We depend so much on our hearing. There are risks to going it alone, without professional help. Why take the chance?

What is the risk if I will save money?

The reality is that many of us do not know how much hearing loss we have. Our hearing loss may develop slowly over years. It is a tough call to judge, just like it is difficult to know whether we have cataracts, which affect our vision.

And then there is the factor of denial. Nobody wants to admit we cannot hear, particularly in important situations at work or in crowded environments such as a restaurant where we may be trying to impress someone.

The latest innovation is the online hearing test. Almost all hearing aid manufacturers make online hearing tests readily available.

Online hearing tests are a good starting point but are by no means the final answer. It should be noted that OTC hearing aids are designed to be used by adults over 18 years of age and those who have a mild or moderate hearing loss only. Fitting into this particular level of hearing loss may be a tough call for some folks.

The hearing test and all the associated tests that an audiologist does in evaluating your hearing are detailed and complex. For instance, the audiologist determines what type of hearing loss you have, whether you are compensating for the inferior hearing ear, whether you are cheating on the hearing test consciously or unconsciously, whether you understand what you hear, and much more.

A comprehensive hearing test and evaluation provides invaluable information that cannot be replicated by a simple hearing test that you find online or even at a retail store. Your hearing testing results are an individual blueprint for you and you alone. Audiologists and ENT doctors can learn more about your ear health by reviewing these tests than you can imagine.

This is not a warning or a statement to avoid assessing your hearing yourself and using an online hearing test. Nor is it meant to discourage people from exploring the purchase of OTC hearing aids.

It is merely an outline of some of the risks entailed, including avoiding misjudgment of your hearing loss and choosing an incorrect hearing loss solution. In the end, you may find yourself wasting time and money on OTC hearing aids that may not be the right fit.

Audiologists and hearing aid specialists are sensitive to these new issues. Most are happy to help, even if you don’t purchase the hearing aids they prescribe or have available. Getting the OTC hearing aid programmed and fitting properly may pose some challenges without professional help.

What else should I be aware of when purchasing OTC hearing aids?

In medical school and residency, most doctors learn the basics about the head and neck. On their paperwork, they refer to HEENT when doing a physical examination. H is the head, E is the ear, E is the eye, N is the nose, and T is the throat. You will see a doctor write HEENT “unremarkable or noncontributory" on the patient’s history.

Similarly, patients often self-diagnose what is wrong with their ears. Or they take out their smartphone and look for answers by asking “Dr. Google.”

The point is that although our hearing and balance systems are complex and have a wonderful design, many factors can affect our hearing.

Even family doctors or pediatricians may not be able to determine what is wrong or whether there is something that can be fixed to improve our hearing. It cannot be overstated, however, how important it is for your primary care doctor to take a look at your ears to make sure everything looks “unremarkable or noncontributory,” as they write in their notes.

Primary care physicians can play a crucial role in removing obstructions caused by earwax, solving ear canal infections and middle ear infections, and treating upper respiratory issues, all of which may affect hearing. It may be that you don’t need an OTC hearing aid after all; you just need to see your primary care provider.

In many cases, your hearing loss may be even more complicated than your primary care provider can determine. Solving the puzzle requires a referral to an ENT specialist and/or an audiologist.

In some cases, the reasons for your hearing loss may be unbeknown to you or your doctor. The hearing loss may be unilateral (one-sided) and you need to undergo specialized testing to rule out a more serious problem. This is rare, but using an OTC hearing aid instead of finding the cause of the loss may be a poor decision that delays your treatment.

Other more common reasons include the fact that hearing loss is related to either an eardrum that has a hole in it, a cholesteatoma (a benign skin tumor) that is damaging your ear, a problem with the tiny bones behind your ear such as the stapes (anvil), or other problems.

These are medical conditions that an ENT doctor can repair. Using an OTC hearing aid is not going to harm you, but it sure is not going to make the problem go away and it may make the OTC hearing unusable.

With over-the-counter hearing aids now available in the U.S., people are purchasing these to deal with hearing loss. However, it’s not a good idea to skip getting your hearing checked by a professional, to find out the cause of the loss.

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