Ringing in the Ears (Tinnitus); Which Supplements Help? – Invite Health Podcast, Episode 99

Invite Health Podcast, Episode hosted by Jerry Hickey. Ph

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Tinnitus is the medical term for ringing in the ears. In this situation, a person hears noise when there’s no noise to be heard; it’s otherwise quiet. So it’s phantom noise. That’s why most people first notice it at night; it’s quieter at night and easier to hear that whistling sound inside your head.

What is Tinnitus?

Tinnitus isn’t a condition itself. It’s a symptom of an underlying condition, such as age-related hearing loss, ear injury or a circulatory system disorder. For some, it is very annoying and even disruptive. Tinnitus is very common and affects about 15 to 20 percent of people (More than 3 million cases per year in US) and is especially common in older adults especially older men.

It involves the sensation of hearing sound when no external sound is present. It’s usually described as a

• Ringing sound
• Buzzing
• Hissing

The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In severe cases, the sound can be so loud it can interfere with your ability to concentrate or hear external sound. Tinnitus may be present all the time, or it may come and go.

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What Causes Tinnitus? 

Tinnitus can be caused by ear problems in your outer, middle or inner ear. It can also be caused by problems with the hearing (auditory) nerves. It could be a disconnect between your hearing apparatus in your ear and the auditory processing part of your brain that interprets nerve signals as sound. It can be caused by drugs. It can be caused by injuries or conditions that affect the nerves in your ear or the hearing center in your brain.

In many people, tinnitus is caused by one of these conditions Common causes

• Age-related hearing loss. For many people, hearing worsens with age, usually starting around age 60. Hearing loss can cause tinnitus. The medical term for this type of hearing loss is presbycusis.
• Exposure to loud noise. Loud noises, such as those from chain saws, firearms, or explosions are common sources of noise-related hearing loss.
• Portable music devices, such as MP3 players or iPods, also can cause noise-related hearing loss if played loudly for long periods. Tinnitus caused by short-term exposure, such as attending a loud concert, usually goes away; but long-term exposure to loud sound can cause permanent damage.
• Earwax blockage. Earwax protects your ear canal by trapping dirt and slowing the growth of bacteria. When earwax builds up, it becomes too hard to wash away naturally, causing hearing loss or irritation of the eardrum, which can lead to tinnitus.
• There are other causes that are more serious such as cardiovascular disease, infections, anemia, growths, and an underactive thyroid

Some commonly used drugs can cause tinnitus. Generally, the higher the dose of these medications, the worse tinnitus becomes. Often the unwanted noise disappears when you stop using these drugs. Medications known to cause or worsen tinnitus include:

• Alcohol and smoking
• Antibiotics, including erythromycin,
• Cancer drugs, including methotrexate (Trexall) and cisplatin
• Water pills (diuretics), such as bumetanide (Bumex), ethacrynic acid (Edecrin) or furosemide (Lasix)
• Quinine medications used for malaria or other health conditions
• Certain antidepressants, which may worsen tinnitus
• Aspirin taken in uncommonly high doses (usually 12 or more a day)
• NSAIDS such as ibuporofen and naproxyn
• Reduce your alcohol consumption. Alcohol increases the force of your blood by dilating your blood vessels, causing greater blood flow, especially in the inner ear area.
• Smoking. Smokers have a higher risk of developing tinnitus.

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Risk factors 

Anyone can experience tinnitus, but these factors may increase your risk:

• Loud noise exposure. Prolonged exposure to loud noise can damage the tiny sensory hair cells in your ear that transmit sound to your brain. People who work in noisy environments — such as factory and construction workers, musicians, and soldiers — are particularly at risk.
• As you age, the number of functioning nerve fibers in your ears declines, possibly causing hearing problems
• Men are more likely to experience tinnitus.
• Cardiovascular problems. Conditions that affect your blood flow, such as high blood pressure or narrowed arteries (atherosclerosis), can increase your risk of tinnitus.

Treatment

Noise suppression

In some cases white noise may help suppress the sound so that it’s less bothersome. Your doctor may suggest using an electronic device to suppress the noise. Devices include:

• White noise machines. These devices, which produce simulated environmental sounds such as falling rain or ocean waves, are often an effective treatment. You may want to try a white noise machine with pillow speakers to help you sleep. Fans, humidifiers, dehumidifiers and air conditioners in the bedroom also may help cover the internal noise at night.
• Hearing aids. These can be especially helpful if you have hearing problems.
• Masking devices. Worn in the ear and similar to hearing aids, these devices produce a continuous, low-level white noise that suppresses symptoms.
• Tinnitus retraining. A wearable device delivers individually programmed tonal music to mask the specific frequencies of the tinnitus you experience. Over time, this technique may accustom you to the tinnitus, thereby helping you not to focus on it. Counseling is often a component of retraining.
• Earwax removal if needed.
• Cognitive behavioral therapy may be helpful for tinnitus. Several studies have confirmed an association between psychological factors, such as anxiety and depression, and severe tinnitus.

The treatment approach includes applied relaxation, imagery and distraction techniques, advice regarding environmental sounds, management of sleep, cognitive restructuring of thoughts and beliefs associated with tinnitus, and relapse prevention.

Alternative medicine

ALCAR with ALA can be beneficial, especially if combined with Cocoa. Tinnitus is the perception of sound when no actual external noise is present, often referred to as “ringing in the ears”, that affects almost 50 million Americans. ALCAR with ALA are two nutrients that support energy production in the brain, supporting healthy brain metabolism which is needed for repair. The effects of Cocoa are well documented, displaying antioxidant and circulatory support for the brain. Together they help support the brain-hearing health of people with Tinnitus.†

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Scientists believe tinnitus may be linked to a deficiency in zinc and vitamin B12. Recent studies show that a sufficient level of Vitamin B12 is needed by the body to reduce homocysteine levels, protect the heart and arteries, support the weight of brain matter, promote mental energy and mood, protect memory function, and support hearing health. Vitamin B12 is also required for energy, stamina, and blood cell formation and division. Those going through periods of stress may have increased demand for B12, as it is involved in the production of stress hormones – this means that our bodies need more of it during times of high stress. Stomach acid is required for B12 absorption. Vitamin B12 supports nerve and cardiovascular health.†

Clinical studies on melatonin and tinnitus clearly show that the hormone can help ensure a good night’s sleep and help with tinnitus symptoms. One study on the use of melatonin to aid sleep and tinnitus came from the Ear Research Foundation in Sarasota, FL. Researchers conducted a double-blind, placebo-controlled crossover trial on 30 patients with subjective tinnitus. They evaluated them using the Tinnitus Handicap Inventory (THI) questionnaire. They found, “Among subjects reporting difficulty sleeping attributable to their tinnitus, 46.7% reported an overall improvement after melatonin…” They concluded, “Melatonin has been shown to be useful in the treatment of subjective tinnitus. Patients with high THI scores and/or difficulty sleeping are most likely to benefit from treatment with melatonin. In light of its minimal side effects, melatonin should be a part of the physician’s armamentarium in the treatment of tinnitus.” Study co-author Kathleen Yaremchuck, MD explained, “It involves cognitive, emotional, and psycho-physiological processes, which can result in an increase in a patient’s distress. Sleep complaints, including insomnia, in these patients may result in a decrease in their tolerance to tinnitus.”†

According to a 2003 clinical trial by the Department of Ear, Nose, Throat, Head and Neck Surgery from Ankara Numune Research and Education Hopistal in Turkey, investigated the role of zinc for tinntius. This was a randomized, placebo-controlled study. Forty-six percent of patients were given zinc. Although the decrease was not statistically significant, the “severity of subjective decreased by 82% in the patients receiving zinc.”†

• Ginkgo biloba may be tried for up to four months to see if there is any improvement, if no benefit then it is reasonable to stop its use.†
• Since the serotonergic system is involved, 5-HTP may be tried for a couple of weeks to see if it provides tinnitus relief.†

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