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Diagnosis of Ototoxicity Diagnosis is based on a combination of: Medical History : Exposure to known ototoxic substances14

Prx1 is primarily located in the cytosol, nucleus, and peroxisomes, but it can also be detected in serum [50]

Black Box Warnings (abbreviated version): Because of the possibility of serious toxic (and potentially fatal) reactions, methotrexate should be used only in life threatening neoplastic diseases or severe recalcitrant psoriasis or rheumatoid arthritis which is not responsive to other forms of therapy

For ulnar (pinky side) issues including TFCC: Inject in the depression between the ulnar styloid and the fifth metacarpal base

PMID 3025077

So once you identify it, then you can start to kind of get your hands dirty and reprogram