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Tinnitus Library

Ask Barry: August 2008

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.

ASK BARRY Tinnitus expert, Barry Keate, answers your questions about Tinnitus Send your question to:  Ask Barry

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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.

Can earplugs make tinnitus louder?

Barry,

I have been using your Arches Relief Formula for over two years recommended by my doctor. I have really seen a dramatic decrease in tinnitus since I have been using your product.

Question; I had some custom ear plugs fitted five years ago that I use in certain situations where potential loud noises may be present. It seems like even when I use the ear plugs in a louder environment the tinnitus seems to be more noticeable afterward. I have debated whether I should go back, have new plugs fitted, or if really the issue may be that I just become more aware of tinnitus after being in “certain” situations?

To help clarify, we went to Universal Studios and visited the Terminator 3-d show which had explosions and special effects. I choose to wear my ear plugs during the show where as my wife felt the noise level really wasn’t too loud. It seemed like afterwards I was more aware of ringing?

Thanks, Kip

Dear Kip,

I’m very happy you’ve had a good response to our products. Regarding ear plugs, I strongly suggest you continue using them and you probably do not need new plugs. The ear plugs are preventing loud sounds from further damaging the hair cells in the cochlea. What is probably happening is when they are in, your auditory cortex turns up the gain, or sensitivity, on your hearing so you are more aware of your tinnitus for a time after you remove them. This is only temporary and will last until the brain responds to normal sounds by lowering the gain. The ear plugs are preventing further permanent damage.

Wishing you quiet times, Barry Keate

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Fluid in the ear, hissing and Audiograms

Dear Barry,

Can fluid in the inner ear be detected by having an audiogram performed? I have had three and my ENT says I have no fluid to cause the increase of my tinnitus after having labyrinthitis in May of this year when my sound (hissing) was increased 1000 fold. I can feel and hear the fluid when I swallow. I asked him to put a tube in my ear to reduce the fluid and perhaps allow the sound to go back to what I have been able to tolerate for the past five years.

Thank you for your response. Barbara

Dear Barbara,

Audiograms should be able to detect fluid in the middle ear provided they measure both bone conduction and air conduction. When bone conduction thresholds are normal but air conduction is worse, this generally signifies fluid build-up. Please see our article on hearing loss.

You may only have residual fluid left over from the labyrinthitis. This can usually be treated with a prescription nasal spray, such as Flonase, and an antihistamine. This is a much easier and less invasive treatment than inserting a tube and is generally effective. You should discuss these issues with your ENT doctor.

Wishing you quiet times, Barry Keate

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Wrong about anti-depressants?

Hi Barry,

I enjoy your newsletter, but you had it wrong last month on anti-depressants and anti-anxiety drugs. SSRI anti-depressants need to be titrated off slowly to prevent bad effects but it is the anti-anxiety drugs (which also cause brain changes) that can be extremely difficult to come off of. Anxiety increases when you come off of them. I used one (Clonazapine) to get through early years of tinnitus, but I would suggest it only if tinnitus is VERY SEVERE, as mine is, and with the warning that you may have very adverse effects when you come off of it, as I did. I missed my morning dose one day (extremely small) and was nearly in a fetal position by about 2pm.

The exact opposite advise you gave about these two classifications of drugs is true. You should get your drug information from mental health practitioners who know about SSRIs and tranquilizers in practice ; not in theory. Many MDs are giving people the info you gave out, and it is dead wrong. My own doctor, plus a leading tinnitus researcher who works at the OHSU Tinnitus Clinic also told me there was no problem with benzodiazepines. Most mental health professionals and their clients know this simply is not true. Benzodiazepines are one of the most widely abused prescription drugs. I hope you will send a correction out to your audience.

Thank you for the service you perform. Nila Epstein, LPC, LMFT

Dear Nila,

It seems I may have given some incorrect advice. I certainly did not want to give the opinion that benzodiazepines are not addictive; they certainly are. I do not believe that most people have had as bad an experience as you did though. My own experience was with Valium many years ago. This is also a benzodiazepine and I didn’t have any trouble getting off it when my tinnitus reduced. I remember lowering the dosage over a week or two, then stopped.

SSRI anti-depressants are not addictive in the same sense but many people cannot stop using them even after their condition has improved.We are all unique and react to every medication differently. I won’t downplay the addictiveness of benzodiazepines in the future. Thank you for helping set the record straight.

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.