Questions Asked by the Tinnitus Community - Answers Provided by Arches President, Barry Keate

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.
Which COVID Vaccine is better for Tinnitus?

Hi Barry,

I regularly read your newsletter so wondered if you could give me some advice. As a tinnitus sufferer for many years, I’m concerned about taking any of the COVID vaccines as I think it may make my tinnitus worse. Is there anything I can do in order to reduce the risk of my tinnitus getting worse if I agree to the COVID jab?

Kind regards,
Loretta P.

Dear Loretta,

First, all indications are that getting tinnitus from any vaccine is very rare. There have been several reports that COVID-19 may cause tinnitus and the vaccine might also cause it. Since the disease and the vaccination are so new, there haven’t been any clinical trials on this and the incidence at which it may occur.

There are some indications however, that give us a rough idea of the very low incidence rate of the vaccine causing tinnitus.

The US Vaccine Adverse Event Reporting database cites 152 reports of tinnitus among 25,072 recipients of vaccines from Pfizer and Moderna. This represents about 0.6% of this adverse event occurring. A UK database of Astrazeneca and Pfizer vaccines reports for 54,180 recipients, there were 320 tinnitus reports. This represents a 0.59% incidence of tinnitus in this database.

These are self-reported cases of tinnitus so it may be somewhat underreported. However, even if it is only half of the cases occurring with the vaccines, the incidence would still be about 1.2%.

The vaccine is safe and should be taken as quickly as possible to protect you from the highly infectious Delta variant. The consequences of coming down with COVID-19 are very serious and can be life-threatening.

To reduce the chances of worsening your tinnitus you can take N-Acetyl Cysteine (NAC) and Ginkgo Max 26/7®, the special Ginkgo biloba, found in Arches Tinnitus Formula. Take 1,000 mg of NAC daily and 480 mg of Ginkgo daily starting a couple of weeks before the vaccination and continuing for at least a month after.

Wishing you quiet times,
Barry Keate

Will ringing in ear from COVID vaccine go away?

Hi Barry,

After taking my 2nd shot of the Pfizer vaccine, I am experiencing an increase in the ringing in my left ear. I have tinnitus only in my left ear; my right ear is OK, no ringing. I just finished reading a site where about 100 entries complained about the vaccines and the increase of ringing, fullness in the ear and ear pressure.

So what is your prediction, will it go away or is it permanent? The site I referenced had a couple of people state that in 4 to 6 weeks the ringing got better.

Robert H.

Dear Robert,

I think this is quite rare and it should resolve. I had my second vaccination two weeks ago and I got sick the day after. That cleared up within another day and I have no other side effects.

Dr. Steven Rauch, Vice Chair for Clinical Research at Harvard Medical School says he has seen some episodes of hearing loss after vaccination. But, he says, they are always seeing hearing loss and it is impossible to discern if there is any change above the normal occurrence.

Said Dr. Rauch: “These effects seem to occur within the first two weeks post-injection and sometimes within just a few days. They appear to be temporary. The actual likelihood of this phenomenon and its clinical course are not well-defined — it’s just too soon to know.”

I hope your condition resolves and returns to its previous level. You can read our recent article based on Fall 2020 research on the COVID virus, hearing loss and tinnitus.

Wishing you quiet times,
Barry Keate

Inner Ear Spasm or Pulsatile Tinnitus?

Hi Barry,

A physical therapist gave me the following information. Is this true?

“Muscle spasms in the inner ear can tense up (spasm) which can result in tinnitus, hearing loss and a feeling of fullness in the ear.” And “ In rare cases, tinnitus is caused by a blood vessel disorder. This type of tinnitus is called pulsatile tinnitus.”

This physical therapist wants me to see another therapist who specializes in helping to relieve ear ringing. I don’t know what to do, and I don’t someone hurting me further.

Your thoughts please.
Teresa M.

Dear Teresa,

Thanks you for sending these questions.

Both statements you quoted are mostly correct but they refer to two different types of tinnitus.

Muscle spasm in the middle ear can result in tinnitus, hearing loss and fullness. Please note these are muscles in the middle ear between the eardrum and cochlea. There are no muscles in the inner ear, which is the cochlea. These muscles connect to the eardrum and as they spasm a doctor can actually observe the eardrum moving.

This is called Middle Ear Myoclonus and usually produces thumping, clicking or buzzing sounds. Sometimes it can sound like a typewriter. Treatment options include acupuncture, biofeedback and sometimes the use of anti-anxiety medication.

In the case of pulsatile tinnitus, a blood vessel disorder, such as blockage or twisting can cause the problem. The blood becomes turbulent and causes a whooshing or pulsing sound in synch with the heartbeat. There are several possible causes of this but the result is always turbulent blood flow.

In most cases a vascular surgeon can identify the cause of the turbulence and successfully treat it. Please see our article on Pulsatile Tinnitus.

It should be fairly easy to determine if you have one of these conditions. In one the doctor can observe the eardrum moving. In the other the sound corresponds to your heartbeat.

Both of these conditions are fairly rare. The majority of tinnitus cases are due to hearing loss. In this case Arches Tinnitus Formula can be helpful in reducing the sound level and aggravation of tinnitus.

Wishing you quiet times,
Barry Keate

Did ED Meds help his Tinnitus?

Hi Barry

I have had tinnitus since 2010. In 2014 I was in Colombia with my wife. My wife bought a Cialis tablet. I took the tablet and as a side effect the hissing sound almost completely disappeared.

I thought I discovered a treatment for this hissing sound, and after 2 – 3 days slowly the hissing sound came back. When I got home in Amsterdam and checked the internet for Cialis in relation to tinnitus. Much to my horror I only find negative stories about Viagra and tinnitus.

Since then I am scared to try again and still hear the hissing sound. Have you ever heard an equal story about Cialis in relation to tinnitus?

I am a former user of your product. Is it recommendable to use your product lifelong? Do you think it can prevent tinnitus?


Dear Bas,

Yes, it is true that Cialis and Viagra can cause tinnitus. However, this is fairly rare, occurring in 0.1 to 1% of people. Most do not get tinnitus from these drugs. I have used them fairly often in the past with no problem.

However, what they do to all people is lower blood pressure. In fact, Viagra was initially developed as a drug to lower blood pressure before they found this other side effect, better erections.

It appears that lowering your blood pressure has the effect of also lowering your tinnitus. This makes sense as high blood pressure worsens tinnitus.

I would not worry too much and would continue with the Cialis. If your tinnitus does worsen, stop using it immediately and the tinnitus should recede. You can also combine it with NAC and/or Arches Tinnitus Formula, which protect the neurons in the inner ear and help prevent tinnitus.

People who achieve tinnitus reduction with Arches Tinnitus Formula usually continue using it consistently over many years. It is possible to reduce the dosage and still get the desired effect. We do not recommend reducing the dosage below 1/2 the recommended dosage on the label.

Wishing you quiet times,
Barry Keate

The COVID Vaccine and Tinnitus

Hi Barry,

I was wondering if you can comment on the possible ototoxicity of the COVID vaccine or is it too soon to tell? If those of us have had problems with hearing loss and increase in tinnitus from the flu shot in the past, would you recommend that we did NOT get the COVID vaccine? Are there similarities?

I realize COVID itself can possibly cause hearing loss, tinnitus and dizziness as can the medicine used to treat it. It’s a real dilemma.

Thank you,

Dear Jory,

I cannot comment on this because I don’t know. There has not been any research I’m aware of that indicates whether or not the vaccine causes tinnitus. I believe it acts a lot like the flu vaccine. I’m surprised you have had a problem with the flu vaccine. It’s the first I’ve heard.

I would not advise you to avoid the COVID vaccine(s). You can prepare yourself by taking antioxidants before and after the vaccine. I recommend 1,000 mg NAC, taken twice daily. Magnesium is also been shown to prevent hearing loss and tinnitus. Take a good quality product, not magnesium oxide but one chelated for easier absorption. Magnesium aspartate or magnesium citrate are good products. Take about 400 mg twice daily. Start two weeks before the vaccination and continue for a month afterward.

Wishing you quiet times,
Barry Keate

Cortisone Injections and Tinnitus

Hi Barry,

In early September, I had a Cortisone injection in my shoulder for arthritis damage that had destroyed some, but not all of the cartilage. The good news is that within 24 hours there was a marked improvement with my range of motion. The bad news is that within 12 hours my normal blood sugar early morning readings of 110 had spiked to 198 along with higher blood pressure. And to make matters worse I had a big spike in my tinnitus.

The blood sugar and blood pressure has resolved, but the tinnitus is still elevated after 2 1/2 weeks. Are you aware of other cases of these adverse effects on tinnitus?

Douglas C.

Dear Douglas,

This is a very unfortunate occurrence. Steroid shots can elevate blood pressure, blood glucose levels and tinnitus. It is not terribly common but does happen in up to 10% of people who receive cortisone shots.

I had osteoarthritis in my knee and took cortisones shots every six months until I had knee replacement therapy this August. I didn’t have any of the side effects that you mention. I would consider forgoing any further cortisones shots.

Hopefully the tinnitus spike will also resolve over time. If not, Arches Tinnitus Formula can be helpful.

Wishing you quiet times,
Barry Keate

VNG Test for Recent Tinnitus Sufferer?

Hi Barry,

I recently just suffered from what they usually called tinnitus for 5 days. I went to an ENT doctor who did a lot of tests to me. My doctor said everything turned out normal and I could clearly hear things. She referred me to take a VNG test. I don’t know if this can get rid of the sound I’ve been hearing.

Also, my ENT told me about your product that supposedly helps to get rid of the ringing thing or ease it at least. Is it possible that this could just go away?

Thanks in advance,
Gilbert A.

Dear Gilbert,

A VNG is a test called a Videonystagmography. It is used for testing inner ear and central motor functions, a process known as vestibular assessment. It involves the use of infrared goggles to trace eye movements during visual stimulation and positional changes.

This is used to determine if you have Meniere’s disease, which is characterized by periods of extreme dizziness and a low frequency buzzing or ringing in the ears. If you do not have any dizziness, the chances are you do not have Meniere’s.

It is possible the ringing could go away on its own. Many cases of short duration, within a couple of months, resolve by themselves. If it does not resolve, I recommend trying Arches Tinnitus Starter Kit, a full three-month supply of Arches Tinnitus Formula. This should reduce the sound and aggravation of the tinnitus.

Wishing you quiet times,
Barry Keate

Persistent Tinnitus after Getting COVID

Hi Barry,

In mid-July I contracted the Corona Virus. I only noticed the loss of taste/smell and had an array of headaches and mild fever for approximately 7 days.

On August 11th I took another Covid test, and as it was being administered, felt a significant discomfort and feared as to how deep that swab went into what I thought was my brain. Post the test, on the way home I played music in my car and as I arrived at home got a huge headache. When I arrived home, I took a short nap, and woke up with this ringing in my ears. It was so sudden and scary, it felt similar to the sound in your ears when you return from a concert and are about to go to sleep.

Ever since the ringing has not subsided. Sometimes the volume increases and it feels as if it travels from one ear to the other. I’ve had a very hard time accepting this, sleeping and insomnia have taken a toll on me.

I would like to know, given the fact that Corona Virus is so new, if there are other people experiencing a similar situation as mine – Did Corona weaken my hearing canals as well?

With high regards,

Dear Fernando,

I’m very sorry this happened to you. The COVID-19 is very new. There are billions of dollars being spent trying to find a vaccine but there hasn’t been enough time or money to study all the possible effects post-COVID-19.

There is a very new study conducted in the UK on the number of people who survived COVID-19 hospitalization and who reported hearing loss and/or tinnitus. About 13% of those people reported new or increased rate of hearing loss or new or increased tinnitus.

The researchers stated there was no way at this point to determine exactly what caused the hearing loss and tinnitus. It could have been the increased stress caused by being hospitalized or it could have been the ototoxic effects of the primary medicines used to treat the virus. All of the most popular treatments cause damage to hearing and tinnitus. Further studies are needed to determine cause and effect.

I hope this condition resolves itself, and it may, but we don’t know. In the meantime, it would be wise to use Arches Tinnitus Formula for your tinnitus. It takes a full three months to get the full benefit so we recommend Arches Tinnitus Starter Kit, a full three-month supply of four bottles.

Wishing you quiet time,
Barry Keate

Fear of MRI noise affecting Tinnitus

Hi Barry,

I am age 70 and have had tinnitus since age 20 from exposure to live music. I also developed hyperacusis. I need a brain MRI.

Any advice? I’m really petrified. Also, does doing an MRI under anesthesia prevent worsening tinnitus?

Thank you so much,

Dear Robert,

I’m sorry you developed tinnitus and hyperacusis (extreme sensitivity to sounds). The reason for an MRI is to rule out acoustic neuroma, a very rare occurrence of a non-malignant growth on the hearing nerve. The great majority of these tests turn out negative.

An MRI is fairly loud so you should take precautions. Use earplugs and ask for hearing protection during the procedure. If they have protective headphones, put them on over the earplugs. That should reduce the noise to a level that won’t be harmful.

I doubt they will provide anesthesia for this. But if you have something that can help calm you down, like a Valium or Klonopin, you may want to take one before the procedure. That should make the whole process much more relaxing.

You can also take Arches Tinnitus Formula to reduce the tinnitus sound level. It takes 3 months to get the full benefit so we recommend Arches Tinnitus Starter Kit, a complete 3-month supply of four bottles.

Wishing you quiet times,
Barry Keate

Inflammation, Infection & Antibiotics and Tinnitus

Dear Barry,

I`m a twenty nine year old woman, and I have problem with tinnitus. I`ve heard about your company and your remedies, so I would like to ask you some questions. By the way I will try to explain you the beginning of my tinnitus.

In 1999 I suffered from a severe inflammation of the middle ear (bilateral) which lasted for about fifteen days. After taking antibiotics, the inflammation disappeared, but soon after that I started hearing a pulsating noise, in the rhythm of my heartbeats. The lower my head was, the louder was this noise. A few days later the intensity of the noise decreased, but it remains even today; and it still gets stronger if my head is in the lower position, or if I perform any physically intensive activity.

Also, at that time I noticed faint buzzing sound in my right ear, but it was so faint that I could only hear it if I was in a very quiet, soundless room. A year later this buzz got slightly louder, and I went to see my physician again, but I was told then that it would be best to wait and see how it develops, without any medication, but under my physician`s supervision. Unfortunately, a few months later, the buzz got even louder. If I remember well, just before it I had some viral infection, but I am not quite sure. That is when I started taking Trental 400, and after about six months of using it, the condition stabilized. Even the tonal diagram showed a stable state; actually my hearing was not damaged.

About a year ago I had a strong throat inflammation, and tinnitus increased again. I received intramuscular injections of vitamin B12, I took zinc, but not Trental. This state continued for almost a year, but about two months ago I had some urological problems and I used strong antibiotics (Ofloxacin). I think that after that my tinnitus mildly worsened. Also, I was using Trental 400 as intravenous infusions, and I using Gingko biloba extract, vitamin E, and zinc (per os).

Since my tinnitus appeared I’ve had no acoustic traumas, or heavier stress. I think that the beginning of my tinnitus is connected to infections and inflammations of the ear, which is something I am quite prone to. I don`t suffer from vertigo, and my tympanogramme is OK. Sometimes, when I get up quickly, the buzz increases. It lasts for about one to two minutes, and then it goes back to usual level. I have low blood pressure and according to my physician`s opinion it contributes to my bad blood circulation and tinnitus.

When I recently checked my hearing again, the results showed that there was no damage at all. So I believe that my tinnitus is connected with inflammations in ear and throat, and I suppose that my low blood pressure and my bad peripheral circulation also contribute to it significantly.

I need to inform you that I finished with using homeopathy remedies two weeks ago, but it didn`t have any improvement in my occasions.

Please Barry, can you tell me, what sort of remedies will you recommend to me (combo pack or something else), and what will you generally recommend to me?

Yours sincerely,
Dalibor M.

Dear Dalibor,

Thank you for your message. Everything you mention, inflammation, infection and antibiotics, are known to cause tinnitus. Ofloxacin is an antibiotic that can cause or increase tinnitus, however in only about 1% of people who use it.

It seems to me, as you suggest, the infections and antibiotics in combination with poor circulation are the cause of your tinnitus. Trental (pentoxifylline) is helpful for this as it increases circulation in much the same way as Ginkgo biloba. It decreases blood viscosity and allows the blood to flow easier into the microcapillaries that feed the eyes, ears and brain. Many European doctors use this treatment for tinnitus but not so many here in the US.

Ginkgo has the added advantages of being a powerful antioxidant and glutamate inhibitor. When the cochlea is damaged, as in most cases of tinnitus, it produces an excess of glutamate which becomes toxic to the neuro-receptors in the auditory nerve. These receptors begin to die and produce large amounts of free radicals, which cause most of the damage. Ginkgo helps reduce the amount of glutamate produced and also fights the ensuing free radicals. Trental does not have this capability. There have been clinical studies which show the superiority of Ginkgo over prescription medications that reduce blood viscosity.

We published an article earlier this year on Antioxidants, Health and Tinnitus which explains the role of free radicals in the creation of tinnitus in more detail.

The basic problem is the frequency of inflammation and infections that seems to plague you. Modern allopathic medicine is very good at treating the symptoms and ignoring the causes of problems such as this. If you can increase the effectiveness of your immune system, your body will fight off these infections before it becomes necessary for medical intervention. This is much easier said than done as the immune system is a complex mystery to even the best minds. The basics, of course, are good diet, plenty of exercise and high quality supplements, such as multivitamins and antioxidants, to provide the nutrients we don’t receive in our diet.

There has never been a single clinical study conducted on the effects of homeopathy on tinnitus. This is because there have never been any anecdotal stories of success. Clinical trials are very expensive and time consuming. Doctors and researchers are only interested in conducting clinical trials if they have a reason to believe it will be successful. I believe the main benefit of selling homeopathic remedies is that they are extremely inexpensive to manufacture. I have never heard of a single person with tinnitus who has been helped by homeopathy. They certainly sell a lot of their products though.

I recommend primarily Arches Tinnitus Formula and trying antioxidant vitamins (see article link above).  ATF provides therapeutic doses of our pharmaceutical-grade Ginkgo extract, Ginkgo Max 26/7, zinc picolinate and deodorized garlic. It must be used for three months (4 bottles) before it can be determined how effective it will be for tinnitus. We recommend Arches Tinnitus Starter Kit, which is a 100 day supply.

Wishing you quiet times,
Barry Keate

Tinnitus caused by medication?

Hi Barry,

I started taking Ultram last year due to a herniated disk at L5/S1. It really helps the pain but, since last January, I’ve been experiencing the hissing sound of tinnitus in my right ear. My left ear has only had a touch of this but I wonder if it will get worse over time.

My pharmacist said that the medicine that I’ve been prescribed could very well have caused or, at least, contributed greatly to the tinnitus. Do you have any information connecting this particular medication to tinnitus?

I appreciate your newsletter and I want you to know that you’re doing a good thing by bringing this information to the masses. It lets all of us that have this problem know that we’re not “crazy” or imagining things. Thank you so much.

Warm Regards,
Stacy P.

Dear Stacy,

Thank you for your kind words. This job brings a lot of satisfaction to me, especially when I receive feedback like yours.

Ultram can cause or worsen tinnitus in less than 1% of people. This sounds small, but if you’re in that 1%, you don’t care that the other 99% didn’t get it. I recommend you discuss with your doctor whether there’s another, equally effective, painkiller without the possible side effect of tinnitus. You can view a list of prescription drugs that cause tinnitus .

Studies show that those people who have tinnitus primarily in one ear and who have had it for less than one year respond much better to Ginkgo biloba. One researcher stated that not only should all people with tinnitus use Ginkgo but they should begin as soon as symptoms are present. Our proprietary ginkgo, Ginkgo Max 26/7 is one of the primary ingredients in Arches Tinnitus Formula.

Wishing you quiet times,
Barry Keate

Phantom pressure in the ear?

Hi Barry,

I have been loyal to Arches Tinnitus Formula since the onset of my tinnitus. For 2 years now I am a tinnitus patient. My question is in two parts:

I have had bad fullness/pressure in my ears for 2 months now. After an appointment with an ENT, he examined me and said there was no indication of infection, blockage, or irritation in my ears, nose and throat. He said that he didn’t know what was causing the pressure in my Eustachian tubes. Do you know of any remedies to relieve this? I have not been in any altitude or pressure changes for 7 months.

He said I had quite a bit of ear wax in my ear. He attempted to remove it with a long, metal stick that really hurt my ear canal. I actually screamed and pulled away. I have heard many horror stories of people getting tinnitus from sticking things in their ears. Do you think he exacerbated my tinnitus from this? How do people get tinnitus from sticking objects into their ear canal when tinnitus is a disorder of the middle ear?

Always thanking you,

Dear Luana,

To answer your first question, you probably have some inflammation in your Eustachian tube. Inflammation can be caused by many things including infection, blockage and allergies.

It’s possible the fullness is simply generic inflammation. Inflammation is rampant in our society and causes many diseases. You may have seen the article we published on Omega-3 fatty acids and fish oil. I have determined to use fish oil forever.

Fish oil will take quite a while to reduce inflammation. In the short term, pain relievers may work. They relieve pain by reducing inflammation and are called NSAID for Non-Steroidal Anti-Inflammation Drugs. Such medications as aspirin, ibuprofen and acetaminophen fall into this category. Be careful of ibuprofen; when I take it my tinnitus goes through the roof.

To your second question, I don’t believe he exacerbated your tinnitus. If he did, you would have known it by now. I have also heard many horror stories about removing ear wax. It is possible but highly unlikely that this procedure would cause or worsen tinnitus. Generally speaking, it doesn’t unless you perforate an ear drum, which usually does not cause tinnitus anyway.

Wishing you quiet times,
Barry Keate

Rockin’ a full ear with Tinnitus

Hi Barry,

I was a rock musician for many years, and am suffering with a “hssssssss” in my left ear. Yes, I do do have substantial hearing loss in that ear (the right one is normal). The thing that’s causing me the most suffering is a stuffed up “fullness” in the affected ear. Is this another symptom of tinnitus?

I have seen an ear doctor, and he couldn’t find any obstructions (wax) in the ear. He said I should have an MRI examination to rule out the possibility of a tumor! First, I have no health insurance and can’t afford this procedure. Needless to say I’m scared stiff! I just want to know if ear “fullness” can be another symptom of tinnitus.

Thank you,
Fred W.

Dear Fred,

Ear fullness is not a symptom of tinnitus but tinnitus can be a symptom of ear fullness. It’s quite possible your Eustachian tubes are plugged which will cause or add to tinnitus.

MRIs are used to rule out tumors on the auditory nerve, which are extremely rare. When they do occur, they are always benign and slow growing. I would not suggest that you not get one but it’s not something I would worry about too much.

Ask your doctor if he will treat the fullness. Many typically prescribe a steroid-based nasal spray, such as Flonase or Rhinocort, and possibly an anti-histamine. This takes care of most ear fullness problems and should help the tinnitus. Also since you report having both hearing loss and tinnitus, I suggest trying Arches Tinnitus Formula which was developed specifically for these conditions and should help reduce sound levels.

Wishing you quiet times,
Barry Keate

Can cotton swabs affect tinnitus?

Hi Barry,

I have had tinnitus for as long as I can remember. I recently read that using cotton swabs to remove ear wax can damage the cochlea and cause tinnitus. I use cotton swabs almost daily as it seems as if my ear canals itch a lot, especially after a shower. Could I be actively making my tinnitus worse on a daily basis? If so, is there a fix?


Christopher P.
San Diego, CA

Hi Christopher,

In general most physicians will tell you not to stick anything in your ears… That said, using cotton swabs doesn’t actually damage the cochlea, which is pretty far removed from the ear drum. There is the danger you can damage your ear drum though and that can worsen the tinnitus. If you damage your ear drum, you’ll know it, it will be very painful. Ear wax build-up is a possible cause for tinnitus.

The American Academy of Otolaryngology suggests using mineral oil, baby oil or glycerin to remove wax. They have a complete “plain language” description of the ear wax problem and how to handle it at:  You can also read our article on 10 causes of ear fullness.

Wishing you quiet times,
Barry Keate

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