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HEALTH

How to Treat Tinnitus

By Dr. Mercola

Tinnitus, a chronic ringing in your ears,1 affects an estimated 1 in 10 adults.2 The sounds are caused when cells are damaged inside the cochlea, your inner ear, and the malfunctioning cells end up sending signals to your brain even in the absence of audible sound. Your brain translates these signals into what has been described as ringing, buzzing, hissing, clicking, chirping, screeching, static, roaring, pulsing, whooshing and/or whistling sounds.

The pitch can be either high or low, and may intermittently change. The volume may also be higher or lower, depending on your surroundings and other factors. Oftentimes, it’s most noticeable at night, which is why tinnitus is often associated with sleep disturbances and depression. Tinnitus treatment recommendations, however, specifically instruct doctors to not use medical therapy such as antidepressants or anticonvulsants in the management of tinnitus.3

Many tinnitus sufferers say it affects their quality of life. Tinnitus may also be a sign of some other, more serious underlying condition such as ear injury or circulatory system disorder.4 Worse still, it may be a sign of permanent nerve damage that could predict future hearing impairment.

Tinnitus Among Youth Is Becoming More Prevalent

While most common among those over 50, tinnitus in younger people is on the rise, likely due to increased exposure to loud music in headphones and other environmental noise, which are among the most common causes. In one study,5 29 percent of students between the ages of 11 and 17 years had already developed chronic tinnitus, as evidenced by a psychoacoustic examination conducted in a sound booth.

Youth with and without tinnitus had a similar ability to hear, but those with tinnitus had significantly reduced tolerance for loud noise and tended to be more protective of their hearing. Reduced sound level tolerance is a sign of damage to the auditory nerves because, when nerves used to process sound are damaged, it prompts brain cells to increase their sensitivity to noise, essentially making sounds seem louder than they are.

What Causes Tinnitus?

Inner ear damage leading to tinnitus can be caused by a number of things, including:

Exposure to loud sounds, be it in the form of music, machinery or explosions, for example Medication side effects (including some antibiotics, diuretics, antiseizure drugs and pain medication)
Age-related hearing loss Poor posture; “text neck
Head or neck injuries, as well as temporomandibular joint (TMJ) problems Certain diseases, including neurological disorders, blood vessel disorders and auditory tumors
Otosclerosis (stiffening of the bones in your middle ear) Damage from severe ear infection
Genetic inner ear disorders Electromagnetic field (EMF) exposure

Tinnitus Shares Pathophysiology With Electromagnetic Hypersensitivity

Likely the most overlooked cause of tinnitus is EMF exposure. As you probably know, things that use electricity will generate EMFs. This includes power lines, household appliances, computers, radios, televisions, wireless phones and cellphones, routers, Wi-Fi and so on.

Your body also uses electrical signals to transmit information. In your brain, neurons communicate with each other via minute electrical charges, and external EMFs can interfere with these signals. It’s possible hypersensitive individuals who claim they can hear electricity are reacting to this interference.

Another explanation was offered in a 2009 study.6 The researchers found a significant association between tinnitus and EMF hypersensitivity, hinting at a shared pathophysiology. Eighty-nine EMF hypersensitive patients were compared to 107 controls, matched for age, gender, living surroundings and workplace environment.

Nearly 51 percent of EMF hypersensitive patients had tinnitus, compared to just 17.5 percent of controls. While prevalence was significantly higher among those sensitive to EMFs, tinnitus duration and severity did not differ between the two groups. According to the authors:

“Our data indicate that tinnitus is associated with subjective electromagnetic hypersensitivity. An individual vulnerability probably due to an overactivated cortical distress network seems to be responsible for both electromagnetic hypersensitivity and tinnitus. Hence, therapeutic efforts should focus on treatment strategies (e.g., cognitive behavioral therapy) aiming at normalizing this dysfunctional distress network.”

Cognitive Therapy Can Help Tinnitus Sufferers

Recent research7 suggests their recommendation was on target, showing cognitive therapies such as mindfulness training can significantly reduce the impact of tinnitus. A conventional treatment for chronic tinnitus is relaxation therapy, but mindfulness was shown to be a far more effective option. Not only did it result in greater relaxation — and tinnitus itself can cause severe distress for some — but it also significantly reduced severity, and the improvement was longer lasting.

What exactly is the difference between these two stress-reduction approaches? While relaxation therapy is focused on teaching you to relax and ease stress, mindfulness requires you to stay in the present moment, paying careful attention to everything you’re experiencing without trying to suppress or ignore anything. In other words, mindfulness teaches you to accept the sounds you hear rather than trying to fight them. The Guardian writes:8

“Mindfulness does not aim to change the tinnitus’s nature or sound, but the therapy can lead to it becoming less intrusive, to a point where it is no longer a problem for people. ‘MBCT turns traditional tinnitus treatment on its head,’ [Dr. Liz] Marks said.

‘So rather than trying to avoid or mask the noise, it teaches people to stop the battle with tinnitus.’ David Stockdale, chief executive of the BTA [British Tinnitus Association], said: ‘The results of this research are extremely encouraging, particularly for people with chronic tinnitus who find that current treatments are not working for them. We really hope that more people will be able to benefit from this approach moving forward.’”

Other Helpful Treatment Options

The Levo System is a new device cleared by the U.S. Food and Drug Administration as a treatment option for tinnitus.9 While it cannot cure it, by mimicking the sound of your tinnitus, it allows your brain to become more accustomed to the sound, thereby making it more tolerable. This is known as tinnitus retraining therapy, and there are other devices that function in a similar manner. With the Levo, you’re supposed to listen to the sound overnight, during sleep, when your brain is most plastic, for 90 days straight.

Other sound machines such as white-noise or pink-noise generators may also be helpful by allowing you to “tune out” the internal sound. When picking a device, be sure to choose one that has a sound similar to your tinnitus.

Red/brown noise is any sound that mimics Brownian motion, or a random placement of particles in liquid and the subsequent collisions between fast moving atoms and molecules. This type of sound is best suited for tinnitus that responds well to low sounds, like thunder. Even a small tabletop water fountain can help mask the noise.

You may also need to address potential underlying causes such as poor posture, or dental problems such as grinding and TMJ. Slouching before a computer screen or having your nose buried in your smartphone can trigger tinnitus by affecting the muscle-nerve connections in your neck. Aligning your ears over your shoulders and hips can make a difference. Treating tooth grinding and TMJ may also alleviate tinnitus.

Nutritional Interventions

A number of nutritional interventions may also be useful, including the following:

Valerian root — a natural sedative, valerian may ease tinnitus by affecting the neurotransmitter GABA, which plays a role in mediating sound receptors in your brain.
Ginkgo biloba — While research findings are mixed, several studies have found ginkgo can be helpful for tinnitus. Quality and dosage plays a significant role, however.

In one systematic review10 of the available research, studies using the Gingko biloba extract EGb 761 found positive results, while those using other preparations did not. According to the authors, “Of note, all trials using this extract consistently demonstrate its superiority over placebo.”

Zinc and vitamin B12 — A deficiency in either of these may trigger or aggravate tinnitus, as both are needed for normal nerve function.
Magnesium — Studies have demonstrated an improvement in hearing when participants suffering from noise-induced hearing loss are supplemented with magnesium. In one,11 patients with moderate to severe tinnitus achieved significant improvement when taking a daily dose of 532 milligrams of magnesium for three months.
Coenzyme Q10CoQ10 or its reduced form, ubiquinol, support mitochondrial function and may reduce noise-induced hearing loss. It and other antioxidants also help neutralize reactive oxygen species involved in the progression of tinnitus.
Taurine — May help reduce the severity of tinnitus and has demonstrated a protective effect in hearing loss associated with medication use.

Prevention Is the Best Solution to Tinnitus

Auditory nerve injury that’s associated with tinnitus and heightened sensitivity to loud noises cannot be detected by typical hearing tests, which is why it’s sometimes called “hidden hearing loss.” Further, such damage is permanent and tends to worsen over time, causing increasing hearing loss later in life. Because there is no known cure, the best solution is prevention.

Study author Larry Roberts, Ph.D., of McMaster University’s department of psychology, neuroscience and behavior has, compared the emerging risks from loud noises to early warnings about smoking. Remarkable as it may seem, many are still unaware that listening to loud music via earbuds or at parties may be permanently damaging their hearing, particularly since they may still hear normally at this point in time. If more people were aware of the risks, more would take steps to turn down the volume and give their ears a break.

I recently had the opportunity to attend a Boy George concert, as this is one of my girlfriend’s favorite artists. We had the best seats in the house, first row center, but being that close to the stage I did not neglect to bring ear plugs and was very grateful to have them to preserve my hearing. I also wore my blue-blockers as the event ended well past sundown. Roberts told Science Daily:12

“It’s a growing problem and I think it’s going to get worse … My personal view is that there is a major public health challenge coming down the road in terms of difficulties with hearing … The levels of sound exposure that are quite commonplace in our environment, particularly among youth, appear to be sufficient to produce hidden cochlear injuries … The message is, ‘Protect your ears.'”

As mentioned earlier, EMF exposure is another significant contributor to tinnitus, and we’re all getting a soundless “EMF bath” on a daily basis. There are many reasons for limiting your EMF exposure, which I’ve written about extensively in other articles.

One of the reasons EMFs can cause so much harm is because it triggers free radical damage that in turn causes mitochondrial dysfunction. As noted in the study above, EMF exposure can also overactivate your cortical distress network, thereby triggering or contributing to tinnitus. For guidance on how to minimize your exposure, see “How to Reduce EMF Exposure.”

How to Protect Your Hearing

In its “Make Listening Safe” report, the World Health Organization recommends teens and young people take the following steps to protect their hearing and avoid hearing loss (although the advice applies to people of all ages):13

Turn down the volume on personal audio devices
Add a decibel meter app for your smartphone, which will flash a warning if the volume is turned up to a potentially damaging level
Wear earplugs when you visit noisy venues (or when using loud equipment like lawnmowers or leaf blowers)
Use carefully fitted noise-canceling earphones/headphones, which may allow you to listen comfortably at a lower volume
Limit the amount of time you spend engaged in noisy activities
Take regular listening breaks when using personal audio devices
Restrict the daily use of personal audio devices to less than one hour

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