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Tinnitus: Current theories, treatment failures, and a safe,

Patients with tinnitus hear sounds that generally cannot be heard by others (bar one exception to be discussed shortly) and occur without an external sound source. Often the noise is described as buzzing, ringing, roaring, screeching, whooshing or whistling in nature.

Date:   3/9/2019 12:00:46 PM   ( 3 y ) ... viewed 282 times

Patients with tinnitus hear sounds that generally cannot be heard by others (bar one exception to be discussed shortly) and occur without an external sound source. Often the noise is described as buzzing, ringing, roaring, screeching, whooshing or whistling in nature. Examples of the sounds of tinnitus can be found on the National Institute for Health Research website.

An article published in the peer-reviewed JAMA Otolaryngology-Head & Neck Surgery estimated that 9.6 percent of Americans had experienced tinnitus during the past 12 months. Twenty-seven percent of this population had symptoms for over 15 years and more than one-third (36%) noted almost constant symptoms. (1) This study also found the 7.2 percent of sufferers described their tinnitus as being a big or a very big problem and 20.2% found it a moderate problem. This can lead to further health challenges which will be detailed soon.

tinnitus

The experience can vary between individuals regarding intensity, form, and location. Often as hearing loss increases so, too, does that experience of phantom noise. If a sufferer has unilateral (one-sided) tinnitus, plus hearing loss or dizziness, it is important to eliminate the presence of the benign but important acoustic neuroma.

There are a range of accepted causes and exacerbating factors in tinnitus. These include:

- A single exposure to a loud sound such as a gunshot

- The presence of chronic noise

- Hearing loss

- Medications including antibiotics, aspirin, cancer medications, certain antidepressants, diuretics and quinine (2)

- Compacted ear wax

- Stress

- Increasing age

- Menièrè’s disease

- Temporomandibular joint dysfunction

- Tumors such as an acoustic neuroma

- Head or neck injuries

- Infectious causes including otitis media (middle ear infection), Lyme disease, meningitis or syphilis

Traditionally, explanations for this phantom noise have revolved around two scenarios; 1) destruction of the hair cells of the inner ear or 2) damage to the nerves that transmit signals from the inner ear to the brain.

Plus the cause that may be heard by others. This is pulsatile or intermittent in nature and usually created by either normal vessels with an increased or turbulent flow (such an is present in atherosclerosis) or by abnormal blood vessels (when a tumor is present, for example). A health professional and a stethoscope may detect this underlying source.

In more recent years, a gamut of additional causative theories has begun to gain traction. The result has been a greater understanding, as continuing research joins the pieces of this complex puzzle. But there is still much to discover as targeted, effective treatments remain elusive. Current theories include:

Oxidative stress: Exploration of oxidative stress as an underlying cause or contributor to illness is increasing, including in this important field. Defined by DJ Betteridge as a “disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses”, oxidative stress may trigger ringing ears by reducing blood flow and causing general cerebrovascular endothelial dysfunction. This may alter inner ear microcirculation and so cause tinnitus. (3)

Limbic stress involvement: It appears humans naturally produce tinnitus-like messages within the grey matter. But the limbic system - the gatekeeper - halts transmission before conscious awareness. This part of the brain, therefore, acts in a defensive role to stop the signals from passing through to conscious experience. So if the gatekeeper fails, tinnitus can result. The limbic system is also an integral part of the emotion center, which may explain why stress can exacerbate tinnitus severity.

The dorsal cochlear nucleus (DCN): This part of the brainstem has possible implications for tinnitus generation. Why? When the outer hair cells involved in the traditional view of tinnitus are damaged, it sparks neuroplastic adaptation in the DCN resulting in hyperactivity of this area. DCN hyperactivity occurs after exposure to known tinnitus-inducing agents so a link may exist.

Somatosensory system involvement: The article Similarities Between Severe Tinnitus and Chronic Pain (4) sheds some new light on a further potential tinnitus trigger and widens the view of the potential factors involved. Some sufferers perceive tinnitus to be painful, just as those with chronic pain may discern gentle touch as tender. In chronic pain, continued stimulation results in worsened discomfort, colloquially known as ‘the wind-up.’ For those with severe tinnitus a similar result occurs, with repeated sounds becoming increasingly unpleasant. With continual input, neuroplastic changes occur. As the author Moller says, “It is believed that severe tinnitus in many cases is caused by changes in the nervous system that occur as a result of neural plasticity.” If proven true, these insights embed the central nervous system involvement firmly in the middle of this condition.

There are a variety of likely causes for tinnitus, some known and others yet to be confirmed. With this said, it is important to consider the ramifications of this condition.

Non-sufferers and health professionals may consider tinnitus to be merely an annoyance, but its complications can be life-altering. As the published article Relationships Between Tinnitus and the Prevalence of Anxiety and Depression states: (5)

Tinnitus symptoms are closely associated with anxiety, depression, shorter sleep duration, and greater workdays missed.

Additionally, difficulty concentrating, decreased speech discrimination, and insomnia are potential accepted sequelae of tinnitus.

Therefore it is important to search through the evidence in order to combat tinnitus appropriately. However, mainstream approaches fail many sufferers as a study published in the Journal of Clinical Neurology notes. “The only medication providing a reliable reduction of tinnitus is intravenous lidocaine… Unfortunately, lidocaine cannot be used clinically because it must be injected, its effects are of short duration, and it frequently produces adverse side effects.” Clearly, we need to look at non-pharmaceutical, safe and effective options.

Evidence shows that natural approaches may deliver tinnitus relief for sufferers. In this article, we share three approaches that may provide much-needed relief.

Mindfulness meditation hones “emotion regulation skills [and] the tendency to respond mindfully to emotional challenges.” This is, in part, by impacting limbic system function. As noted earlier, the limbic stress is important in the experience of tinnitus on two counts. Reducing stress can, therefore, play an important therapeutic role.

Exercise has a role to play in both stress reduction and increased brain health. In fact, regular practice can change our brain structure and ease neurological health conditions like tinnitus.

Key supplementation with a focus on regenerating brain pathways, reducing inflammation and decreasing altered blood vessel turgidity may assist in the reduction of symptoms. Tinnitus 911™ is a specifically formulated blend designed to provide calm to both the ears and the brain and relief for tinnitus sufferers. Vitamin B12 has been shown to reduce tinnitus. (6) Zinc is therapeutically useful in those with this condition who have a deficiency. Olive leaf extract and hibiscus are rich in the antioxidants required to reduce the contributory oxidative stress mentioned earlier. Current research indicates that Hawthorn berry may represent a safe and effective treatment for cardiovascular disease, thus calming any underlying blood vessel involvement.

To conclude, tinnitus is a common condition with serious consequences for a significant percentage of the affected population. While pharmaceutical options and medical approaches are limited in their success, natural, evidence-based approaches such as Tinnitus 911™ are available that can bring relief, safely and effectively.

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