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Questions asked by real people with tinnitus. Answered by tinnitus authority Barry Keate.

Arches Natural Products President, Barry Keate, understands the suffering caused by tinnitus. Having lived with tinnitus for over five decades, Barry is an expert on the condition and has made the recovery from tinnitus his life’s work.
NOTE: Ask Barry is pleased to be able to answer your questions based upon the information we have available. Our answers to inquiries are not substitutes for a physician’s advice nor are they reviewed by a physician. We encourage you to share any suggestions you have received from Ask Barry with your doctor.

March 2023 Ask Barry

Over-the-counter Pain Meds and Tinnitus

Dear Barry,

Is there anything else to take besides ibuprofen for inflammation of the joints? When I take this it makes my tinnitus louder.

Thank you,
Esther B.

Dear Esther,

Over-the-counter pain medications present a real problem for those of us with tinnitus. Most of them will cause an increase in tinnitus. Aspirin in small amounts is probably OK but may not provide enough relief. Acetaminophen, found in Tylenol, will not increase tinnitus but can be poisonous and hard on the liver if too much is taken. You have to carefully read the label and make absolutely certain you are not taking too much.

Something that may reduce the need for painkillers is fish oil containing omega 3. This fights inflammation naturally. I don’t know if you can completely stop taking pain medication but you can probably reduce the need for it.

Wishing you quiet times,
Barry Keate

Treating Tinnitus with Klonopin (clonazepam)


I was recently prescribed clonazepam as a treatment for anxiety which my doc felt led to my depression and IBS. After venlafaxine seemed to cause my tinnitus back in 2019, I’m scared to death of these drugs – a fear not shared by doctors for some reason.

Anyway, in trying to find out if this drug could further cause exacerbation of my tinnitus problem, I’ve come across a study that shows significant broad based improvement in tinnitus from using clonazepam (2mgs for 180 days). My docs appear to be wholly unaware of the study and not interested. What gives? Not crazy about playing Russian roulette with another drug – but if this can treat tinnitus, IBS (irritable bowel syndrome) and depression, it seems like it is worth the risk. What would you do in my shoes and what’s your read on this study (which I’m sure you are of from 2012)?

Lee W.

Dear Lee,

Thanks for your question. The short answer is, yes, clonazepam (trade name Klonopin) can be very helpful for reducing the sound level of tinnitus and alleviate depression and other anxiety induced conditions.

Unfortunately, it’s not all that simple. Klonopin and the other benzodiazepine medications, Xanax, Valium, etc., are very addicting. They were originally intended to be used for only a short duration, a few weeks. There is a hidden time bomb in these medications. They are so addicting that the dosage needs to be increased at regular intervals to achieve the same effect. If the dosage is not increased, the same symptoms the drug was prescribed for in the first place can come back and can be even worse than in the beginning. Withdrawal from these drugs can be a nightmare of withdrawal symptoms that some people cannot live with. The success rate of a medically supervised withdrawal, after long-term use, is only 65%.

Having given you the bad news I need to say that not all people will become this addicted. When I was first diagnosed with tinnitus I spent three years on and off again with Valium. When it came time to stop, I didn’t have a problem. My sister also spent several years on one of the benzos and came off fairly easily. You should be aware of the danger, though, and try to not use any of these for longer periods than absolutely necessary.

So what would I do? I have some personal knowledge of anxiety and what it can do to you and I do have some suggestions. If you read the article you will see the benzo medications act on GABA (gamma-aminobutyric acid) which is a calming neurotransmitter in the brain. GABA is available as an over-the-counter medication and is quite inexpensive. You can begin taking this at the dosage suggested in the article and it should be helpful. Don’t expect it to work like the prescription drug as it is a supplement. However, it can calm you down and even make you drowsy so you should be careful driving until you know how it affects you.

I am also a huge fan of hypnotherapy for tinnitus. I tried quitting smoking for years before I finally visited a hypnotherapist. I have not had a single cigarette since though it did take a couple of follow-up visits to really get it fixed in my brain. More recently I was in a situation that generated high levels of stress in my life. Once again, hypnotherapy calmed me down and helped me to deal with the situation.

Another avenue to try is acupuncture for tinnitus. This ancient Chinese tradition offers a variety of therapies that help put the body back in balance and positively affect anxiety and tinnitus.

Not to be left out of the discussion is the use of biofeedback and neurofeedback for tinnitus. This feedback system helps the person learn to control basic bodily functions. People who become adept at this can actually reduce their blood pressure and heart rate. They can also reduce skin temperature and enter a state of perfect calm. It takes time and work but is very effective.

Last but certainly not least is the use of Arches Tinnitus Formulas. These will not directly work as an anti-anxiety medication but they can be very helpful in reducing tinnitus. I’ll bet if your tinnitus was improved your nervous system would be very happy.

All of these complementary therapies I’ve mentioned can be used alone or in conjunction with each other. You should begin working with some and see which ones resonate with you. You won’t have immediate relief in one hour, as with a prescription drug, but these therapies can give you a long and much happier life and are much healthier than the alternative.

Wishing you quiet times,
Barry Keate

Mother-daughter Hyperacusis… with Tinnitus

Hello Barry,

Both my daughter and I have tinnitus and hyperacusis, and the latter is the big worry. We are both sensitive to noise and this has curbed our daily lives. My daughter has been unemployed for 15 months because of her hyperacusis.

Is there any medication that might help?

Thanking you.
Jenny W.

Dear Jenny,

Hyperacusis is the collapse of loudness tolerance so that almost any sound creates loudness discomfort even if it is below the threshold that others deem uncomfortable. Most people with hyperacusis try to protect their ears from all sounds by staying in quiet environments, wearing ear plugs, etc. This is not the way to treat this and it increases the loudness intolerance. Instead, treatment options consist of gradually retraining the ear to accommodate sounds better. There are two ways to accomplish this and both have overlapping techniques.

The first is Tinnitus Retraining Therapy, which works with both tinnitus and hyperacusis. The second utilizes some of the same procedures but also involves wearing a hearing device that equalizes all sounds to similar loudness that is controlled by the patient. Either one of these therapies can be very helpful for hyperacusis patients over time.

Arches Tinnitus Formulas can also be helpful in reducing the tinnitus sound and stabilizing hearing.

Wishing you quiet times,
Barry Keate

February 2023 Ask Barry

Aspirin for Pulsatile Tinnitus?

Hi Barry,

Can taking low dose aspirin, (75 mg gastro-resistant tablets) help against pulsatile tinnitus? I have tinnitus constantly, and on top of this, I experience pulsatile tinnitus usually at night.

I also take one 50 mg doxycycline daily to manage rosacea, would this medication, which I have been taking for three years, have an effect on my tinnitus? I am 66 years of age. I have seen an ENT specialist, had a CT scan and have been told that nothing can be done, and the pulsatile tinnitus is most likely due to hardening of an artery near the ears.

I would be grateful for any advice you could give me.

Kind regards,
Graham H.
Dorset, UK.

Dear Graham,

Low dose aspirin could be helpful for pulsatile tinnitus. The mechanism of action would be to thin the blood and make the pulsing less noticeable. Another product that does this is Arches Tinnitus Formula, which we produce. We have heard numerous accounts that it has helped pulsatile tinnitus. It is also helpful for continuous tinnitus.

Doxycycline can cause hearing loss and tinnitus. It doesn’t do this to everyone but does have the capacity to do so. If you feel it is worsening yours, you should contact your doctor.

It sounds as though your ENT is guessing. Arteriosclerosis is certainly one possibility but there are many others. Essentially, pulsatile tinnitus is caused by turbulent blood flow in the artery close to the cochlea. Please read our article on Pulsatile Tinnitus. The specialist to see for this condition is a vascular surgeon. Once the direct cause of the pulsing can be determined, it is frequently very treatable.

Wishing you quiet times,
Barry Keate

Crying uncle… after a bad night’s sleep?

Dear Barry,

I have bought the Tinnitus Combo Pack for my uncle. But after 10 days he had a very bad night, he could not sleep because of the noise he had inside his head.

What do you recommend in this case?

Thank you in advance,
Maria R.

Hi Maria,

Sleeping can become very difficult for those with tinnitus. It used to wake me up from a dead sleep in the middle of the night so I can sympathize with your uncle.

He should continue the Tinnitus Combo Pack until finished before he can determine how helpful it will be for him. In the meantime there are several strategies to use to help him sleep better. One of the best for tinnitus sufferers is the use of an ambient sound generator or download an app on your smart phone. Stand alone sound generators are inexpensive, and generate several different sounds of moving water, from crashing surf to bubbling creek to falling rain. It has been known for a couple of decades that the sound of moving water is the best way to mask tinnitus. It helps cover the tinnitus sounds and is also very relaxing. Ask your uncle if he notices his tinnitus when he’s in the shower. If the answer is no, it will be effective for him.

Getting a good night’s sleep is important for all of us but more so for those with tinnitus. If they don’t sleep well they end up exhausted, with reduced energy reserves and worse tinnitus. I recommend ensuring a good night’s sleep using almost whatever method works. Vigorous exercise is very helpful and will also help reduce stress and tinnitus. Even a walk in the evening can make the difference.

Melatonin has been shown in clinical studies to be very helpful for people with tinnitus. I use a 10 mg timed-release melatonin. When taken an hour before bed it can make falling asleep easier and then allow one to maintain that sleep throughout the night without feeling groggy the next day. In cases where this doesn’t help, I recommend a sleeping pill or even a prescription medication like Klonopin or Xanax. These are benzodiazepine drugs that many doctors prescribe for tinnitus but are addicting to varying degrees and cannot be used continuously for a long period of time. They are helpful in reducing tinnitus symptoms and aid in sleeping short term. Try the other methods first but if they’re not effective, get your uncle to a doctor for help.

Hopefully our tinnitus products along with melatonin will reduce his tinnitus and his sleeplessness will be a thing of the past.

Wishing you quiet times,
Barry Keate

Tinnitus without Hearing Loss

Hello Barry,

I was diagnosed with tinnitus over one year ago and have taken at least four bottles of the Tinnitus Formula without success. My left ear has frying/hissing noise with “bom-bom” sounds and my right ear has light frying/hissing noise in it. Also, on occasions, in my left ear there is a loud screeching sound and when I pop my ear the noise goes away.

According to my doctor, I should be experiencing hearing problems if I have tinnitus; however, I have had two hearing tests and my hearing is quite good – I can hear a pin drop. The doctor has also stated that I probably have TMJ dysfunction because of the tenderness in my jaw bone areas. Since tinnitus has become your lifetime work, what suggestions do you have? I really need some serious help.

Please help!
Martha D.

Dear Martha,

The majority of people with tinnitus have it due to a degree of hearing loss. However, not everyone with tinnitus has hearing loss. There are many conditions that contribute to tinnitus. Your mention of screeching sounds that stop when you pop your ears indicates you may have Eustachian Tube Dysfunction (ETD). This occurs when the Eustachian tube is not functioning properly. It can be caused by sinus problems, colds and flu, allergies and other conditions that cause the Eustachian tube to become blocked.

I recommend you consult an Ear, Nose & Throat physician about this. Typical treatments involve a prescription nasal spray and an antihistamine. The great majority of cases are cleared up.

TMJ dysfunction is the other possibility here. This occurs when the temporomandibular joint (TMJ), which hinges the jaw into the skull, is knocked out of place. Tenderness in the jaw areas is one symptom of this as is tinnitus. The good news is TMJ can be treated and tinnitus caused by it is almost always improved. Treatment therapies are all painless and non-invasive. I recommend you see a TMJ specialist in your area. To find a TMJ specialist in your area go to: American Academy of Craniofacial Pain.

Please investigate both of these conditions. I feel you have a high degree of improving your condition with treatment for one or both of these.

Wishing you quiet times,
Barry Keate

January 2023 Ask Barry

Salt and Tinnitus Roller Coaster

Hi Barry,

After much detailed experimentation, following your literature’s advice, I have determined that an ultra-low sodium diet reduces the ear ringing substantially. My question is, if I do have a higher sodium diet one day, why am I OK the rest of that day, but wake up with the increased ringing which lasts 24 hours? Then, approximately 40 hours later after the high sodium food, I wake up and the ringing is back in lower levels. It’s a maddening roller coaster.

Why does it take so long for the increased ringing to start up and why does it last so long before quieting down? Ultra low sodium for me is less than 400 mg a day. The higher sodium diet in question was about 800 mg in one day. What was added was a cup of cottage cheese! Also I am not overweight or have any health problems.

Or, am I imagining this cause and effect?

Thank you!
Lesley R.

Dear Leslie,

Thank you for your message; this is very important to many people who suffer from tinnitus.

You are not imagining this. It is common knowledge among tinnitus professionals that increased sodium intake exacerbates tinnitus and reducing sodium is helpful in reducing the sound level. Why it takes until the next day to affect you is beyond me. We all process things differently and your metabolism of sodium must be fairly slow. If I have a salty meal, it only takes a couple of hours to increase my tinnitus and the increase only lasts until the next day, when it is generally returned to normal.

You can reduce the amount of time tinnitus is increased by drinking lots of water. This should flush the excess sodium through your system faster.

Wishing you quiet times,
Barry Keate

Zoloft for Tinnitus: Help or Hurt?

Hi Barry,

I am struggling with tinnitus. I started taking 50mg of Zoloft and it does help a lot though I am concerned it can, and is, making my tinnitus worse. Is this possible?


Dear Jim,

I’m sorry you’re having a difficult time. Zoloft is frequently prescribed for people with tinnitus. All SSRI antidepressants have the potential of causing or worsening tinnitus. For most people, this doesn’t happen but for up to about 8% it does. If it does make your tinnitus worse, stop using it immediately. If it doesn’t, you can probably continue to use it and hopefully it will make you feel better.

There is another worry about SSRI antidepressants of which you should be aware. They all potentiate serotonin, which is the neurotransmitter that fights depression. SSRI is an acronym for Selective Serotonin Re-uptake Inhibitor. So these medications ensure that serotonin stays in the system longer, making the patient feel better.

The problem with this is after an amount of time, varying by the individual, the brain is fooled into thinking there is plenty of serotonin and stops making any more of it. Then the patient becomes dependent on the medication to keep serotonin available. If a lot of dependence occurs, it becomes extremely difficult to withdraw. Some people are trapped into using these medications for the rest of their lives. I advise to not use it for more than a few months. Hopefully your condition will improve by then and you’ll be able to slowly reduce dosage.

You can read more about this conundrum in the article Tryptophan, Serotonin and Tinnitus .

Wishing you quiet times,

Barry Keate

Tinnitus after Crash

Dear Barry,

I just placed my order for the Arches Tinnitus Formula today. It was recommended to me by my ENT doctor.

I had the onset of loud ringing in my right ear 2-3 days after being rear-ended in an auto collision. I experienced a whiplash as my head snapped backward then forward sharply. My ENT doctor vacuumed away some wax that seemed compressed within my inner ear that gave me immediate and substantial relief until I laid my head down on the pillow that night. It was as if a switch was thrown immediately initiating an even louder and more persistent ringing. Then my ENT ordered a brain MRI which was inconclusive. He has no idea what is causing the tinnitus ringing.

Do you have any ideas and where I should go from here? The ringing is the worst when I wake up in the mornings. I’ve started calling it my “mini alarm clock” in my ear.

I appreciate any words of wisdom you may have for me.

David H.

Dear David,

I’m very sorry this happened to you. I agree that the tinnitus was most likely caused by whiplash; this is often the case. Most results from whiplash will resolve after a few months. You didn’t mention how long ago this happened so I cannot comment on whether you are inside this window.

Ginkgo biloba, found in Arches Tinnitus Formula as Ginkgo Max 26/7 can be very helpful in cases of whiplash and tinnitus. It brings more blood flow to the damaged area of the brain and helps heal tissues. It also calms the neuro-excitability of the damaged areas by antagonizing the effect of glutamate, an excitatory neurotransmitter that plays a central role in tinnitus.

One common effect of whiplash is TMJ dysfunction. This is where the Temporo-Mandibular joint, which holds the jaw in place relative to the skull, is knocked out of alignment. This will definitely cause tinnitus. Your comment that it’s worse in the morning leads me to believe that, when sleeping, you are applying pressure on the joint, causing the tinnitus to worsen. The good news is, TMJ is treatable. Most treatments are painless and non-invasive and may amount to nothing more than a mouth guard at night.

Please read the above TMJ dysfunction article carefully. I believe it will give you hope for an improvement. At the end of the article is a link to the association of TMJ specialists, who come out of the dental profession, and a page where you can find a specialist in your area. I advise you to contact a TMJ specialist for an evaluation.

I hope this is helpful and your tinnitus improves greatly.

Wishing you quiet times,
Barry Keate

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