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

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 begin treatment expecting only the most well-known effects such as weight loss, appetite reduction, 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 "lightheadedness," instability when walking, or even exaggerated perception of their own voice inside the ear.

And the most curious thing: many of these symptoms began after starting tirzepatide or after a dose increase.

What do the most recent studies show?

In recent months, researchers began investigating a possible relationship between GLP-1 agonists in the Mounjaro® class and hearing and vestibular alterations.

Recent pharmacovigilance analyses identified increased reports involving:

  • tinnitus;

  • dizziness;

  • vertigo;

  • hearing alterations;

  • sensation of clogged 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

  • Reduction in hearing

  • Sensation of echo of one's own voice

  • Clicking in the ear

  • Hypersensitivity to sounds

  • Vertigo

  • Dizziness

  • Imbalance

  • Sensation of floating or instability

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

Other hypotheses include:

  • alterations in the circulation of the inner ear;

  • rapid metabolic changes;

  • impact on vestibular structures;

  • inflammatory and vascular alterations.

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

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

  • Hearing alterations

  • Vestibular disorders

  • Taste alterations

  • Changes in smell

  • Persistent hoarseness

  • Sensation of irritated throat

  • Intense fatigue

  • Brain fog

  • Sensation of excessive cold

  • Sleep alterations

  • Accelerated loss of muscle mass

  • Menstrual alterations in some patients

  • Episodes of unusual sweating

These effects are still being studied, but they reinforce the importance of regular medical monitoring during treatment.

When to seek medical evaluation?

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

  • sudden hearing loss;

  • unilateral tinnitus;

  • intense vertigo;

  • significant difficulty with balance;

  • persistent sensation of clogged ear;

  • progressive worsening of hearing.

In these situations, evaluation with an otolaryngologist and performance of specific tests may be necessary.

The most important: do not normalize persistent symptoms

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

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

This content is exclusively for informative and educational purposes. The information presented does not replace medical consultation, individualized clinical evaluation, diagnosis, or professional treatment. Each patient should be evaluated in a personalized manner by a doctor, especially in the face of persistent symptoms, hearing alterations, or reactions after medication use. Never discontinue or start medications without medical guidance.

Dr. Rebeca Soares Andrade

CRM-GO 39335