Ozempic, Mounjaro and Tinnitus: What the Hearing Evidence Shows

Tinnitus is not a listed side effect of Ozempic, Wegovy, Mounjaro or Zepbound. No trial has measured it, and none of the nine current US GLP-1 labels mentions tinnitus, vertigo or hearing loss.^[1][2] What exists is weaker. Several hundred reports sit in FDA’s adverse event database. Reporting studies find signals that cannot show cause. Two large health-record studies in people with diabetes found small to modest increases in coded hearing and balance diagnoses. The ear problem with the clearest link is indirect: fast weight loss can leave the Eustachian tube stuck open, which causes ear fullness and a booming own voice. Sudden hearing loss in one ear is an emergency whatever you take.

What the FDA labels say about ears

Nothing. We searched the full prescribing information for Ozempic, Wegovy, Mounjaro, Zepbound, Saxenda, Victoza, Trulicity, Rybelsus and Foundayo. None contains the words tinnitus, vertigo, hearing or deafness, including the Ozempic and Wegovy labels^[1][2] and the Mounjaro and Zepbound labels.^[3][4] A label lists what was seen more often on the drug than on placebo in its trials, plus selected reports after approval. Ear symptoms are in neither part.

Dizziness does appear on all nine, though on some only as a warning sign of low blood sugar. On Wegovy 2.4 mg, 8% of adults in the weight-management trials reported it, against 4% on placebo.^[2] Dizziness and vertigo are not the same thing. Vertigo is a false sense of spinning or movement and often comes from the inner ear; dizziness on these drugs usually tracks falling blood pressure, low blood sugar or a recent dose increase. That is covered in GLP-1 dizziness and blood pressure pills.

Reports to FDA: counts, not rates

Anyone can file a report to FDA’s Adverse Event Reporting System, and a report means only that someone connected a symptom to a drug. There is no denominator, no comparison group and no check that the drug did it. With that limit stated, here is what the database held for the two main drugs when we queried it, counting every report that names the drug.^[5]

Those numbers cannot be turned into a risk. Millions of people take these drugs, tinnitus is common in the general population, and most people with ringing ears would never think to file a report. A count also moves with publicity. What the table does show is that ear complaints are a small fraction of reports, and that tinnitus and reduced hearing are the terms people use most.

What the reporting-signal studies found

Researchers mine the same database with disproportionality analysis, which asks whether a symptom appears more often among one drug’s reports than among others. A positive result is a reporting signal. It is not a rate, and it is not proof the drug caused anything. Four studies have looked at ears.

• Khan 2025. FDA reports through 2023 for five GLP-1 drugs. Liraglutide (Saxenda, Victoza) showed a tinnitus signal; exenatide showed one for hearing disability. The semaglutide signals the authors reported were anosmia, dry mouth, taste change and Bell’s palsy, not tinnitus.^[6]
• Pak 2025. Of 97,237 GLP-1 reports, 958 (0.99%) were ear-related, led by reduced hearing (515), vertigo (203) and deafness (97), with tinnitus at 93.^[7] We cover the paper’s two Eustachian tube cases in the fat pads in your ears.
• Stone 2026. Across 137,451 GLP-1 reports, hearing loss came up as a signal when the drugs were used for diabetes, but not when they were used for weight management.^[8]
• Wang 2026. 1,950 ear and balance reports through early 2026. Reduced hearing made up 46.9%, vertigo 27.7%, tinnitus 12.7% and deafness 7.9%. Dulaglutide reports leaned toward reduced hearing; liraglutide and semaglutide reports leaned toward vertigo and tinnitus. Tirzepatide was not analyzed.^[9]

The Wang team reported a median of 3 days from first dose to symptom, but only 19.3% of reports had usable dates, so the timing tells you little.^[9] The authors’ own conclusion is the right one: the findings generate hypotheses and do not establish incidence, comparative safety or causality.^[9] The pattern of which drug leads which list is the same pattern seen in other signals on the drugs nobody writes about, where older, less publicized drugs sometimes top the counts.

The health-record studies: real comparisons, coded diagnoses

Two studies compared people who started a GLP-1 with similar people who did not, using the TriNetX network of US health records. These are stronger than report counts because they have a comparison group. They are weaker than trials because nobody was randomized and the outcomes are diagnosis codes, not hearing tests.

Read Huang first. A hazard ratio of 1.17 means hearing impairment diagnoses were about 17% more common in the GLP-1 group over follow-up. The authors list the limits themselves: the records hold codes but no clinical notes, people paying cash for a GLP-1 would have been counted as non-users, and the link “might be an observed finding rather than a causal relationship.”^[10] People starting a newer diabetes drug may also simply see doctors more, and more visits means more diagnoses recorded.

Toraih reported hazard ratios of roughly 4 to 5 for vestibular disorders on semaglutide, which sounds alarming. The absolute numbers are small: 0.41% of semaglutide users had a new vestibular diagnosis by three years, against 0.16% of controls. For tirzepatide the gap was 0.19% against 0.15%.^[11] Matching was on demographics and other conditions, which cannot remove every difference between someone prescribed a GLP-1 and someone not.

Two gaps matter. Neither study used tinnitus as an outcome. And no published study has looked specifically at sudden sensorineural hearing loss, the urgent kind, in people on these drugs.

The randomized-trial evidence

The best available test of whether the drugs themselves raise hearing loss comes from pooling randomized trials. A 2025 network meta-analysis combined 29 trials of GLP-1 drugs and SGLT2 inhibitors with 145,895 participants and compared hearing-loss events recorded in them. Only two drugs stood out: lixisenatide and a high 6 mg weekly dose of efpeglenatide, both built on exendin-4. No other GLP-1 drug, semaglutide and liraglutide among them, showed a significant increase.^[12]

Neither lixisenatide nor efpeglenatide is Ozempic, Wegovy, Mounjaro or Zepbound. The analysis counted hearing loss as recorded in the trials, which is a coarse measure, so it can miss small effects. It is still the only evidence in this whole topic where the drug was assigned at random.

Could GLP-1 drugs protect hearing instead?

Some research points the other way. Type 2 diabetes is itself linked to worse hearing. In a 2026 study from Palermo, 240 people with type 2 diabetes had worse hearing thresholds than 105 people without it, and those taking a GLP-1 drug, metformin or pioglitazone had better thresholds than those who were not.^[13] That was a retrospective snapshot at one clinic, and people on different drugs differ in many ways, so it shows an association only.

The rest is laboratory work. The GLP-1 receptor is present on the nerve cells of the inner ear in mice, and exendin-4 protected those cells from an antibiotic known to damage hearing in a dish.^[14] In chinchillas exposed to repeated blasts, liraglutide given beforehand reduced the temporary hearing threshold shift.^[15] None of this has been tested in people, and it is not a reason to take a GLP-1 for your ears.

Ear pressure and a booming voice: the patulous Eustachian tube

The ear complaint with the strongest evidence behind it is not caused by the drug directly. The Eustachian tube runs from the middle ear to the back of the nose and normally stays closed, opening briefly when you swallow or yawn. Soft tissue, including fat, helps hold it shut. When that tissue shrinks, the tube can stay open. Doctors call this a patulous Eustachian tube. The signature symptom is autophony: your own voice, breathing or chewing sounds loud and echoing in your ear. Many people also describe fullness or pressure.

The weight-loss link was established long before GLP-1 drugs, in people who had bariatric surgery or severe malnutrition:

• Bariatric surgery, Chile, 2010. Of 141 patients examined, 21% had a patulous tube, and almost all of them (96.6%) had autophony. Those with it had lost weight faster: 5.3 kg a month on average against 3.0 kg.^[16]
• Sleeve gastrectomy, 2026. In 60 patients followed for a year, 55% developed symptoms, and in 43.3% they lasted. Speed of weight loss predicted who stayed symptomatic better than total weight lost.^[17]
• A counterpoint, 2026. A Mexican study using formal diagnostic criteria found no definite cases in 52 patients three months after surgery, despite 19.3% weight loss, and suggested earlier high rates reflect loose definitions.^[18]
• Anorexia nervosa, 2022. In hospitalized patients with autophony who were examined, every symptomatic ear showed an open tube on testing, and 9 of 11 ears had settled within 12 days of refeeding.^[19]

Now the GLP-1 cases. A German clinic described seven adults on semaglutide or tirzepatide who developed the condition after 4 to 10 months of treatment, having lost 8.2% to 18.7% of their weight. All seven had autophony, six had ear fullness and five could hear their own breathing. One improved with conservative care; six had a filler implant placed in the tube.^[20] A 2026 report describes a 79-year-old man with ear fullness and popping after losing about 200 pounds on semaglutide, managed with hydration, saline nasal spray and no decongestants.^[21] Pak and colleagues added two more cases with endoscopy showing thinned tissue around the tube.^[7]

That is ten published GLP-1 cases, and no count of how often it happens. A 2026 review of the bariatric literature concluded that surgery cannot yet be shown to be an independent cause.^[22] The mechanism is plausible and the anatomy has been seen directly, but how common it is on these drugs is unknown. One finding is reassuring: in a series of 124 patients with the condition, those whose symptoms followed rapid weight loss were more likely to improve than those whose did not.^[23]

Ringing in time with your heartbeat is a different symptom

Most tinnitus is a steady ring, hiss or buzz. Tinnitus that pulses with your heartbeat is called pulsatile tinnitus and has different causes. One of them is idiopathic intracranial hypertension, raised pressure around the brain that mostly affects women with obesity; headache, blurred vision and pulsatile tinnitus are its main features.^[24] GLP-1 drugs are being studied as a treatment for that condition, not a cause of it, as set out in GLP-1 headache and intracranial pressure. A pulsing sound in the ear together with new headaches or vision changes needs a prompt medical review.

When an ear symptom is an emergency

Sudden sensorineural hearing loss is a problem in the inner ear that comes on all at once or over a few days, often noticed on waking, and usually in one ear. It is often accompanied by tinnitus or vertigo.^[25][26] The National Institute on Deafness and Other Communication Disorders says to treat it as a medical emergency and see a doctor immediately. About half of people recover some or all of their hearing on their own, but waiting can make treatment less effective.^[26]

The otolaryngology guideline on sudden hearing loss asks clinicians to tell inner-ear loss apart from a blocked or fluid-filled ear at the first visit, to get a hearing test as soon as possible and within 14 days, and to check for neurologic signs. Steroid treatment is an option within two weeks of onset.^[25] Those time windows are why the first days count.

• Same day: sudden hearing loss or a sudden muffled ear, especially in one ear, with or without ringing or spinning. Do not assume it is wax or a cold.
• Same day: hearing loss together with weakness, numbness, facial droop or slurred speech. The guideline flags neurologic findings for a reason.
• Soon: a pulsing sound in the ear with headaches or blurred vision.
• Routine appointment: a steady ring that came on gradually, or ear fullness with a loud own voice and no hearing loss.

If your ears changed after starting a GLP-1

• Write down the timing. When the symptom started, which ear, and whether it followed a dose increase or a stretch of fast weight loss.
• Separate the symptom. Ringing, muffled hearing, spinning and a loud own voice point to different problems. Name the one you have.
• Tell the prescriber, and stop nothing on your own. No label lists these symptoms, so the decision about the drug is a clinical one.
• See an ear specialist for anything persistent. A hearing test settles whether there is real hearing loss, which no questionnaire can.
• Report it. A report to FDA MedWatch is how a signal becomes visible. The counts above exist because people filed them.

For how long the common side effects usually last, see how long GLP-1 side effects last. For the eye questions that sit beside this one, see GLP-1 eye risks.