DEAR DR. ROACH: About a month ago, I woke up without hearing in my left ear. I initially suspected a wax blockage or a blocked eustachian tube but eventually realized that it was more serious. I saw an ENT doctor who gave me a steroid shot and put me on prednisone. An MRI doesn’t show a stroke or tumor.

About 5% to 10% of my hearing seems to have returned after two weeks of treatment. I had never heard of this problem before but have since learned of others who’ve had it. Usually they’ve had permanent hearing loss. What causes this? Is there anything else I can do? — T.D.S.

ANSWER: This is called sudden sensorineural hearing loss. It is uncommon, with less than 1 person per 1,000 being affected each year. Although sometimes a cause can be identified, often no cause can be found. Viruses and blood clots have been suspected as underlying causes in some people.

Sudden hearing loss on one side or both should prompt immediate evaluation. Oral prednisone is recommended as an initial treatment, ideally within a few days of the symptom onset. People who cannot take oral steroids receive an injection directly into the ear, and those with profound hearing loss like yours often get both.

Unfortunately, the greater the initial hearing loss, the worse the prognosis. However, the fact that you have recovered some within a month is good news, and you may continue to improve in the next few months. But after six months, additional recovery is unlikely.

Hyperbaric oxygen is a promising treatment for this condition, although availability and cost can be a problem. A future column will address this further.

DEAR DR ROACH: I read your recent column on A1C levels. You said that 7% to 7.5% was ideal for most people. For older people, you said 8% can be good. My longstanding understanding of A1C levels is that less than 5.7% is good, 5.7% to 6.4% indicates prediabetes, and greater than 6.4% indicates diabetes. I am totally confused; could you please unconfuse me?

I am 94, and my most recent A1C was 5.9%. I take metformin and a host of other drugs daily. — M.S., PhD

ANSWER: I am sorry to have confused you. It’s best not to have prediabetes or diabetes at all, so having a normal A1C level (below 5.7%) is optimal. But if you have diabetes, then the A1C goal depends on the person. For a young person with Type 1 diabetes, an A1C in the normal range is ideal but often hard to achieve due to the risk of too-low blood sugar. The risk of developing organ damage, especially to the eyes, kidneys and nerves, is lowest when the A1C is normal.

In older people, most of whom have Type 2 diabetes, a goal of 7% is reasonable for most. A large study (ACCORD) showed us that in people with known blockages in the arteries of the heart (or those who are at a very high risk for blockages), an A1C goal of 7% led to better outcomes than an A1C goal of 6%.

In older people who have multiple medical problems, an A1C goal that isn’t so stringent (compared to a strict goal) may improve their quality of life without significantly increasing the risk of complications that take years to develop.

With my patients who are in their 90s, once their A1C levels are below 7% (and certainly below 6%), I consider stopping their diabetes medications one by one while watching their sugar levels and A1C numbers. But some elect to continue the medications.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved