Do you have questions about tinnitus, our products or specific treatments? Ask Barry. Arches President Barry Keate will select the most representative questions each month publication. Regardless all questions will receive a personal reply from Barry.

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Barry Keate answers your questions
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NOTE: Ask Barry is pleased to be able to answer your questions based upon the information we have available. Our answers to your email inquiries are not substitutes for a physician's advice nor are they reviewed by a physician. If you are under a physician's care, please share with your doctor any suggestions you have received from Ask Barry.

This month's questions:

Eustachian tubes and tinnitus.
Hi Barry,
I've suspected for some time that part of my virtually constant tinnitus, 2 1/2 years now and it began after an extreme 6 to 8 weeks of vertigo, might be partially or completely from a failure of proper Eustachian tube function.

I have been to an ENT once, but he was a bit more focused on my sinus issues with drainage problems. I also told him about the tinnitus, but that seemed to get totally ignored and I'm not sure why -- perhaps they just don't have much they know to do for it?

Anyhow, just recently I read that if Eustachian tubes are functioning properly, you should be able to hold your nose closed, swallow a few times, and wind up with negative pressure in the ears that is relieved when you let go of your nose and yawn or stretch the jaws.

Well, when I try it, I seem to get quite a bit of negative pressure in my NOSE -- but little or nothing changes in the ears and it quickly gets difficult to swallow because of the negative pressure in the nose (it pinches the nasal passageways together tightly).

Do you know if this implies that Eustachian tubes are either blocked or not functioning correctly? Could that cause the constant tinnitus? The only thing that seemed to significantly reduce the volume, down to just barely there, was a very short course of steroids.... so it would seem that inflammation of some sort is involved, and yet even prescription strength NSAIDs taken religiously for a few weeks makes no difference in the volume at all.

Any thoughts on these issues? Eustachian tubes, why some improvement with steroids but not NSAIDs, and so on? I'd be most interested to hear your thoughts!

Thanks!
Robin

Dear Robin;
I believe the symptoms you describe show a blocked eustachian tube and that can definitely be the cause of your tinnitus. Steroids are much more powerful than NSAID medications and probably clear it up much better, on a temporary basis.

I asked Dr. Seidman about this and here is his take on it. He says it may be caused by allergies and is a very common problem. In his patients with normal looking ears, no infection and negative pressure tests for Meniere’s, he treats for allergies. He starts with a steroid-based nasal spray such as Flonase or Rhinocort. Sometimes he couples this with an antihistamine, depending on the existence of other medical problems. He says that 60 out of 100 patients will improve and 40 will continue to have persistent symptoms.

For these 40 he reluctantly offers to install a Pressure Equalizing tube in their ears. Twenty people of the 40 will agree. Of those 20, 10 are thrilled and wonder why he didn’t do it 6 months earlier and 10 are wildly upset. They usually make funny movements in their mouths and ask him to remove the tube immediately. That’s why he is reluctant to offer the tubes in the first place but it does help some people.

I hope this is helpful. I recommend you visit another ENT and have the problem checked more thoroughly.

Wishing you quiet times,
Barry Keate

Ringing worse after exercise or nap.
Dear Barry,
I've had occasional ringing in my left ear for several years. This past September I began noticing the ringing more so I went to an ear, nose and throat doctor to have it checked. He did a hearing test and asked me a few questions and said that since I'd had it a long time it was tinnitus and that other than lowering my stress level there wasn't much more to do. When I asked him for any explanation of what may cause the ringing or whistling to come when I do my morning run (I had just started two mile morning runs a few months earlier) he had no answer. Do you? I also noticed that if I take a nap during the day I'll wake up with the noise but usually not after a whole nights sleep. Is this strange? I don't have this noise everyday or all day and I can live with it by ignoring it but I do wonder about some of the activities that set it off and if the doctor did enough to be certain that what I have is tinnitus.

I should tell you that the doctor did give me your web site to learn more about this and I have enjoyed reading the newsletter. Thank you for your time.

Jenny Snyder

Dear Jenny;

If you have sounds in your ear that do not come from outside stimulus, it is tinnitus. This is the definition. Physical exercise can make tinnitus louder but only for the period when your heart rate is increased. It is one of the best ways to reduce stress, improve health and overall, reduce tinnitus symptoms.

The vagaries of why tinnitus is louder at some times than others is extremely difficult to determine. Diet, exercise and stress levels are some of the greatest influences on tinnitus. Diet is extremely important. Salt is a major aggravator as it restricts blood vessels and reduces blood flow. Food additives such as Aspartame and Monosodium Glutamate are potent neurotoxins and can cause tinnitus or worsen it. Aspartame is found in popular diet colas and low-sugar foods and MSG is disguised as various food additives in processed and pre-packaged foods. It is extremely important to attempt to consume a diet consisting of whole, unprocessed foods, and lowered fat, sugar and salt. We published a series of articles on these food additives (neurotoxins) that can be found at:

Neurotoxins - Part 1
Neurotoxins - Part 2
Neurotoxins - Part 3

Arches Tinnitus Formulas have been clinically proven to reduce tinnitus loudness for most people. You may want to look at them with an eye to using them for 3-4 months to see if they can help.

Wishing you quiet times,
Barry Keate

NOTE: Ask Barry is pleased to be able to answer your questions based upon the information we have available. Our answers to your email inquiries are not substitutes for a physician's advice nor are they reviewed by a physician. If you are under a physician's care, please share with your doctor any suggestions you have received from Ask Barry.