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Tinnitus Library

Ask Barry: December 2009

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.

Reflexology, Wobenzym and Tinnitus

Hello Barry,

First off thanks for your website. It's a pleasure reading the information you have provided. I wanted to ask you about tinnitus if no ear damage is the cause. I can manipulate the sound of the pitch by stretching, bending and pushing muscles on the neck/face. I have your supplements and I feel good however you may be know if there are other treatments available today that might suit my case.

I read about a simple therapy primarily involving high doses of potent enzymes has been found to be quite effective in curing tinnitus by German ENT specialist Dr. Michael Schedler. This should be supplemented with dietary changes and proven nutrients to achieve the best results. And what do you know about reflexology therapy? Not really sure where to search for good doctors.

Thanks David

Dear David,

Thanks for your question. Generally speaking, tinnitus without damage to the cochlea is due to an organic condition. Such conditions can include hormonal imbalances, low thyroid, vitamin and mineral deficiencies, TMJ dysfunction, and many others. Typically, when the organic condition is resolved, tinnitus will be greatly reduced or eliminated.

I approve of the two methods you mention. Dr. Schedler offers many good, common sense recommendations. He even discusses zinc and Ginkgo biloba extract (found in Arches Tinnitus Relief Formula). While I haven't heard of success using Wobenzym, my exposure to it has been very limited and I remain open.

Reflexology is similar to acupressure, using the same energy meridians as acupuncture. It is a very credible therapy and I wholeheartedly approve it. Tinnitus authority, Dr .Michael Seidman states that acupuncture can reduce tinnitus in up to 40% of his patients. He adds the caveat that it must be used regularly and for a period of at least 6 weeks.

One possibility you may explore is TMJ dysfunction. The fact that pushing muscles in the face and neck changes your tinnitus indicates your temporomandibular joint may not be functioning properly. If this is the case, our products should help but you should also seek treatment. A TMJ specialist can immediately tell you if there is a problem there. If so, it is very treatable. The American Academy of Craniofacial Pain can help you find a specialist in your area.

Wishing you quiet times, Barry Keate


Miracle "Cure" for Tinnitus?

Hi Barry,

I have come across information about Neramexane and how Merz Pharmaceutical is testing it as a drug to relieve tinnitus. I couldn't find anything about Neramexane in your library nor in American Tinnitus Association's files as well. Neramexane is in Phase III clinical testing, and I assume that this is the last phase, and if it is proven to relieve tinnitus, it will be offered in 2010. If Neramexane seems to be such a miracle drug, then why can't I find anything in your site nor ATA's site. Is Neramexane cut out to be the answer for a tinnitus "cure"? Thanks so much for any information you may send my way on this topic.

All the best, Alec Marshall

Dear Alec,

Neramexane is an NMDA antagonist, closely related to Memantine. By blocking the NMDA receptor channel in the brain, it reduces the effects of glutamate, an excitatory neurotransmitter. It is thought by many, including me, that excess glutamate is the primary cause of tinnitus.

Neramexane is being developed and tested to aid in a number of conditions including Alzheimer's disease, tinnitus, drug addiction and as an analgesic (pain reducer). Animal studies also suggest applications as an antidepressant and nootropic (memory and cognitive enhancer).

There are many medications that are NMDA antagonists and block glutamate. This does not guarantee that any of them are the answer to tinnitus or a cure.

Studies conducted on Memantine show it has a strong suppression effect on glutamate but only if the medication is applied by transtympanic perfusion, where it is applied directly to the cochlea by a catheter inserted through the ear drum. Memantine is also metabolized quickly and has short-term effects.

Other NMDA antagonists include Caroverine, AM-101 and Campral. Campral is currently approved by the FDA to treat alcohol dependence. A very small Brazilian study showed effectiveness against tinnitus but the study had several problems. One of the larger ones was the patients were aware if they took Campral or a placebo because Campral causes drowsiness. This skews data by as much as 40%. Larger more in-depth studies are needed.

Dr. Michael Seidman has treated some patients with Campral and reports it has helped 15-20%. He has also used Memantine and has had a 15% response rate.

It should be noted that, among other functions beneficial for tinnitus patients, Ginkgo biloba extract is also a powerful glutamate antagonist. The bilobalide component is the one responsible for this. Arches Tinnitus Relief Formula contains the world's best ginkgo extract with a minimum of 3.6% Bilobalide content. This is 1.5 to 3 times more Bilobalide contained in any other ginkgo formulation.

While these medications hold some promise, and I believe they should be investigated further, I'm not holding my breath. One thing that bothers me about the new Neramexane study is it is limited those those who have had tinnitus for one year or less. This is the group most likely to show some improvement so I believe whatever they come up with will have benefits limited to this group.

Wishing you quiet times, Barry Keate


Fluttering in the Ear?

Dear Barry,

I have had "fluttering" of the ears since January 2009. I am being treated by an ENT at Eastern Virginia Medical School. He has tried several types of medication but none seem to be reducing or eliminating the condition.

This started after two very bad colds and of course I have tinnitus and hyperacusis. I have read where there have been treatments involving "botox" type injections as well as surgeries that cut the tensor tympani muscle/tendons.

Would you be able to inform me as to where I can find an ENT that is familiar with the "botox" injections? I would rather try this treatment before considering any type of surgery.

Thank you, Susan K.

Dear Susan,

What you are most likely dealing with is called tonic tensor tympani syndrome (TTTS). The tensor tympani muscle is the larger of two muscles in the tympanic cavity. The purpose of this muscle is to dampen vibration in the ear and thereby reduce the amplitude of sounds. It is contracted primarily to reduce the sounds of chewing.

In people with hyperacusis (extreme sensitivity to sound), the tensor tympani muscle has increased activity. Contractions can be activated by the perception or even anticipation of loud sound. In some people with hyperacusis, the tensor tympani muscle can contract just by thinking of a loud sound. The contraction of this muscle tightens the ear drum and can lead to symptoms of ear pain, fluttering, or a sensation of fullness in the ear. I am not aware of any ENTs that practice Botox injections for this condition. I searched medical databases and even the website of the American Academy of Otolaryngology, without finding any references.

However, I can offer some assistance from Murray Grossan, MD, whom I know personally. Dr. Grossan is retired now but I visit with him every year at the Otolaryngology convention. He was instrumental in the development of biofeedback for tinnitus patients and has developed an at-home treatment therapy for TMJ, which he states will also be effective for TTTS.

Please visit Dr. Grossan’s TMJ treatment page, which could be very helpful. He states that if this treatment doesn’t work, a clinic that performs EMG (electromyography) biofeedback, with sensors placed on the frontalis muscle is extremely effective. I hope this is helpful and you can reduce the activity of the tensor tympani muscle without botox or surgery.

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.