"Doctor, I started hearing a constant whistling sound in my ear and thought it was stress. Then came mild dizziness, a sensation of blocked ear and moments when it seemed my hearing decreased."

This has been an increasingly frequent report since the growth in the use of Mounjaro® (tirzepatide), a medication used in the treatment of type 2 diabetes and obesity.

Many people start treatment expecting only the more well-known effects such as weight loss, reduced appetite or gastrointestinal discomfort. However, some patients began to notice different and unexpected symptoms related to hearing and balance.

In some cases, tinnitus appears in a subtle way, especially at night. In others, the person reports a sensation of pressure in the ear, difficulty understanding conversations, vertigo, sensation of "light-headedness", instability when walking or even exaggerated perception of one's own voice within the ear.

And most curiously: many of these symptoms began after starting tirzepatide or after an increase in dose.

What do the most recent studies show?

In recent months, researchers have begun to investigate a possible relationship between GLP-1 agonists in the Mounjaro® class and hearing and vestibular changes.

Recent pharmacovigilance analyses have identified increased reports involving:

  • tinnitus;

  • dizziness;

  • vertigo;

  • hearing changes;

  • sensation of blocked ear;

  • peripheral vestibular disorders.

Researchers are still studying whether there is a direct relationship between the medication and these symptoms, but the most current data indicate that the topic deserves clinical attention.

What symptoms can appear?

The most commonly described reports to date include:

  • Continuous or intermittent tinnitus

  • Sensation of pressure in the ear

  • Reduced hearing

  • Sensation of echo of one's own voice

  • Clicking in the ear

  • Hypersensitivity to sounds

  • Vertigo

  • Dizziness

  • Imbalance

  • Sensation of floating or instability

  • Hearing discomfort without signs of infection

Some patients report progressive worsening; others describe transient symptoms that improve after medication adjustment.

What could explain this?

There is still no definitive answer, but studies raise some important hypotheses.

One of them involves the rapid weight loss caused by tirzepatide. This accelerated reduction can alter structures around the Eustachian tube, causing symptoms such as ear pressure, autophony (hearing one's own voice very loudly) and sensation of resonance.

Other hypotheses include:

  • changes in inner ear circulation;

  • rapid metabolic changes;

  • impact on vestibular structures;

  • inflammatory and vascular changes.

Beyond nausea and vomiting: lesser-known adverse effects of tirzepatide

When talking about Mounjaro®, most people are only aware of gastrointestinal effects. But recent studies have drawn attention to less discussed reactions, including:

  • Hearing changes

  • Vestibular disorders

  • Taste alterations

  • Changes in smell

  • Persistent hoarseness

  • Sensation of sore throat

  • Intense fatigue

  • Brain fog

  • Sensation of excessive cold

  • Sleep alterations

  • Accelerated loss of muscle mass

  • Menstrual changes in some patients

  • Episodes of unusual sweating

These effects are still being studied, but reinforce the importance of regular medical follow-up during treatment.

When to seek medical evaluation?

Some signs should not be ignored, especially when they appear suddenly:

  • sudden hearing loss;

  • unilateral tinnitus;

  • intense vertigo;

  • significant difficulty with balance;

  • persistent sensation of blocked ear;

  • progressive worsening of hearing.

In these situations, evaluation by an otolaryngologist and specific tests may be necessary.

Most importantly: do not normalise persistent symptoms

Many people end up associating tinnitus, dizziness or hearing changes only with stress, anxiety or fatigue. However, new symptoms after starting a medication deserve proper investigation.

Although studies are still ongoing, the most recent evidence suggests that hearing and vestibular changes related to tirzepatide may be more common than initially thought.

This content is intended exclusively for informative and educational purposes. The information presented does not replace medical consultation, individualised clinical evaluation, diagnosis or professional treatment. Each patient should be individually evaluated by a doctor, especially in the presence of persistent symptoms, hearing changes or reactions after use of medications. Never stop or start medications without medical guidance.

Dr. Rebeca Soares Andrade

CRM-GO 39335