GLP-1 receptor agonists may cause eustachian tube dysfunction due to tissue shrinkage from rapid weight loss, leading to ear fullness and hearing changes.
FAERS database + case seriesAnalysis linking GLP-1 receptor agonists to eustachian tube dysfunction from tissue volume loss
What the researchers found
GLP-1 receptor agonists were associated with eustachian tube dysfunction, particularly the patulous variant, likely caused by rapid loss of soft tissue bulk around the eustachian tube opening.
Why it matters
As GLP-1 drugs become widely used for weight loss, clinicians need to recognize ear symptoms as a potential side effect. Eustachian tube dysfunction can significantly impact quality of life, and early recognition may lead to better management.
The numbers in context
- 97,237 total GLP-1 adverse events in FAERS
- 958 (0.99%) were ear-related
- Exenatide: highest proportion of ear AEs (1.52%)
- Semaglutide: 1.17% ear AEs
- Liraglutide: 1.16% ear AEs
- Dulaglutide: 417 total ear AEs (highest count)
- Systematic review: 937 articles screened, 10 met criteria
How the study worked
Combined case report, FDA Adverse Event Reporting System (FAERS) database analysis, and PRISMA-guided systematic literature review examining otolaryngologic adverse events of GLP-1 RAs.
Who was studied
2 case patients with patulous ETD on GLP-1 drugs. FDA FAERS database: 97,237 GLP-1 adverse events reviewed. Systematic review of 937 articles.
What this study cannot tell us
Case reports and database analysis cannot establish causation; FAERS data is subject to reporting bias; small number of documented cases; unclear incidence rate in the broader GLP-1 RA population.
How to read the evidence
Case reports and database review — lowest level of clinical evidence but important for identifying novel adverse events. Signals warrant further investigation.
When this study was published
Published in 2025, capturing an emerging adverse effect of the rapidly expanding GLP-1 drug class.
The bigger picture
This is an emerging side effect that parallels other rapid-weight-loss complications. As the GLP-1 drug market expands, understanding the full spectrum of adverse effects beyond GI symptoms becomes critical for comprehensive patient care.
Questions still open
- Is eustachian tube dysfunction reversible if GLP-1 therapy is paused or the rate of weight loss slows?
- Are certain GLP-1 drugs or dosing regimens more likely to cause this side effect?
- Could prophylactic ENT monitoring be warranted for patients on long-term GLP-1 therapy?
Common questions
What is eustachian tube dysfunction?
Why would a weight loss drug affect your ears?
Read the original research
GLP-1 Receptor Agonist Induced Eustachian Tube Dysfunction: Database and Systematic Review of Otolaryngologic Adverse Events.
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 46(1), 19-22
Citation
Pak, Kaitlynne Y; Cutri, Raffaello M; Nadeem, Wasiq; Kothari, Dhruv; Wong, Yu-Tung; Wu, Arthur W; Miller, Mia E. (2025). GLP-1 Receptor Agonist Induced Eustachian Tube Dysfunction: Database and Systematic Review of Otolaryngologic Adverse Events.. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 46(1), 19-22. https://doi.org/10.1097/MAO.0000000000004373