If you have tinnitus, you know how annoying it is to be the
only person in the room who "hears" an unwanted sound, such as
ringing, buzzing, hissing or roaring. Up to 50 million Americans
are bothered by this condition.
Latest thinking: Even though
tinnitus is often associated with age-related hearing loss,
researchers are now discovering that the telltale "ringing in the
ears" and other sounds are probably generated by abnormal activity
in the brain regions that are responsible for perceiving auditory
sound.
What role does the brain play in tinnitus? It is now thought
that because of hearing loss, the brain’s auditory system does not
receive the sensory input it expects, so the brain compensates by
activating brain cells (neurons) to create a perception of
sound. Another reason: Tinnitus is also commonly
linked to long-term exposure to very loud noises, which may alter
brain function in a way that leads to the unwanted sounds that
characterize the condition.
Good news: Fortunately, a number
of recent therapies now offer new hope to tinnitus sufferers.
WHAT WILL WORK BEST FOR YOU?
What works for one tinnitus sufferer won’t help everyone with
the disorder.Simple steps you can try on your own...
Review all medications you’re taking. More
than 200 medications can cause temporary tinnitus in some people --
even aspirin or other nonsteroidal anti-inflammatory drugs
(NSAIDs), such as ibuprofen (Motrin).
Prescription drugs that have been linked to tinnitus include
diuretics (water pills) and certain antibiotics and cancer
medications. If medication is the culprit, stopping or changing the
drug usually eliminates symptoms.
Important: If you believe a
prescription drug may be causing tinnitus, consult your doctor
before decreasing the dose or discontinuing it.
Eliminate caffeine. Caffeine in all forms
(including coffee, many teas, some sodas and chocolate) makes
tinnitus significantly worse for many people.
Try vitamin B-12. Although the research is
mixed, some people have found relief by increasing their intake of
certain minerals (such as magnesium or zinc) or B vitamins
(especially vitamin B-12) according to the American Tinnitus
Association. If you would like to try this approach, talk to your
doctor for advice on the supplement (and dosage) that would be best
for you.
Get checked for earwax. Ask your doctor to
check your ears for earwax -- wax buildup commonly causes
tinnitus.
Override the sounds. Besides masking the
sounds, this can also reduce the brain activity believed to trigger
tinnitus. For example...
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Background noise, such as
music, a humidifier, a fan or a white-noise device, can be
especially helpful at night if your tinnitus makes it hard to fall
asleep.
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A hearing aid or cochlear
implant (an implanted electrode and external electronic receiver
for people with too much hearing loss to benefit from a hearing
aid) may help reduce tinnitus symptoms in people with significant
hearing loss.
NEWEST TREATMENTS
If the strategies described above don’t relieve your tinnitus
symptoms within three to six months... or if your tinnitus is in
only one ear (possibly indicating an underlying condition such as a
benign tumor) or symptoms are bothersome enough to interfere with
daily activities and/or sleep, consult your primary care doctor or
an otolaryngologist (ear, nose and throat specialist) for an
evaluation.
The physician may refer you to an audiologist (a health-care
professional who specializes in hearing loss, tinnitus and balance
disorders) for advice.
If you would like to try one of the breakthrough therapies
described below, consider consulting an otolaryngologist or
audiologist at a tinnitus treatment program at a university-based
medical center (these therapies are typically not covered by health
insurance)...
Tinnitus retraining therapy
(TRT). Counseling and sound therapy (whereby patients
hear steady, low-level background sound, often from in-ear sound
generators) help make people unaware of tinnitus.
This therapy is currently being studied in a large clinical
trial. Several smaller studies have reported success rates of about
80%. To find an audiologist trained in TRT, contact the American
Tinnitus Association (800-634-8978).
Music therapy. Music is used in at least
two tinnitus treatments...
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Neuromonics Tinnitus
Treatment involves the use of an FDA-approved
prescription device that plays music (through earphones) embedded
with sound that is customized to the person’s tinnitus sound
frequency. The device can be worn during most activities and is
designed to help "retrain" the brain so it filters out the
disturbing sounds associated with tinnitus.
There is no independent research on this treatment, but a study
conducted by the device manufacturer found that 91% of tinnitus
sufferers experienced an improvement of at least 40% in symptoms
after six months. To find a provider, contact Neuromonics, Inc.
(866-606-3876, www.Neuromonics.com).
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"Notched" music
therapy uses a form of tailor-made music modified to
remove the sound frequency of the individual’s tinnitus. This
targets the part of the brain associated with tinnitus. In a recent
German study, notched music was found to reduce tinnitus symptoms
after 12 months.
Acupuncture. In a Brazilian study
conducted on 76 tinnitus patients, acupuncture was found to provide
immediate reduction in tinnitus symptoms, but the research is mixed
on the long-term efficacy of this therapy.
Hypnosis. Among 49 tinnitus patients who
were introduced to hypnosis and taught basic methods of
self-hypnosis, 35 completed the therapy and experienced relief from
tinnitus symptoms after five to 10 sessions, according to research
conducted at the University of Liège in Belgium.
Biofeedback. Some patients have benefited
from this therapy, in which monitoring devices are used to give
immediate feedback on involuntary bodily responses, such as
breathing. This helps patients have some control over negative
physical reactions that often accompany tinnitus, such as increased
heart rate.
Medication. The drugs below, which are now
being evaluated to reduce tinnitus symptoms, are designed to treat
other conditions but can be prescribed by doctors "off label" for
tinnitus treatment.
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Acamprosate (Campral) is
used to treat alcohol addiction but has been shown to help some
tinnitus patients.
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Tricyclic and
selective serotonin reuptake inhibitor (SSRI)
antidepressants may help relieve severe tinnitus,
with possible side effects including dry mouth and
constipation.
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Alprazolam (Xanax) is an
anti-anxiety medication that appears to improve symptoms
temporarily in some patients but hasn’t been shown to offer
long-term benefits. Possible side effects include nausea and
drowsiness.
ON THE HORIZON
Another potentially promising treatment is transcranial
magnetic stimulation, in which a weak electric current is sent
through the brain. A small magnetic coil is placed on the scalp --
in this case, near the brain’s auditory cortex. Current from the
coil stimulates neurons in the targeted area. Studies have shown
significant reduction in some patients’ tinnitus symptoms, and this
therapy is now regularly used in Europe.
Transcranial magnetic stimulation was recently approved by the
FDA as a treatment for depression. At this point, it’s available to
tinnitus sufferers only through clinical trials. To learn more,
consult the National Institutes of Health Web
site, www.ClinicalTrials.gov.