Ask Barry - February 2011

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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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:

Vagus nerve "cure" for tinnitus?

Dear Barry, I have just read a news item in my daily paper concerning VNS treatment for tinnitus. Apparently it works by stimulating a nerve in the neck. Scientists at the University of Texas bombarded rats with various frequencies of sound to retrain their brains, eliminating the tinnitus. They say it is like pressing a reset button in the brain. 

What are your thoughts on this treatment, please? Is it similar to Tinnitus Retraining Therapy, which I have tried, with a far amount of success, I might add? The thing is, I would still like to get rid of the ringing for good, and experience complete silence again.

I live in London, and wonder when this treatment might become available.

Yours sincerely, Andrea R.

Dear Andrea, A report published online in the journal Nature on January 12, 2011 purports to show that tinnitus can be cured, or at least significantly reduced, in laboratory rats through Vagus Nerve Stimulation (VNS). The vagus nerve reaches from the brain to the abdomen. Researchers electrically stimulated the vagus nerve while exposing the rats to a variety of sound tones over an extended period of time. At the end of the study, rats who experienced both the electrical stimulation and the sound tones appeared to overcome their tinnitus while rats who only had the electrical stimulation or the sound tones, but not both, did not recover. 

The rationale for this treatment method makes sense. Researchers believe that the brain changes in response to nerve damage or cochlear trauma. The auditory cortex delegates too many neurons to the frequencies where there is hearing loss. These neurons become overexcited and cause the phenomenon known as tinnitus.

By stimulating the vagus nerve electrically, the auditory cortex seems to be able to reconstruct and reorganize itself by neuronal plasticity. The addition of the sound tones, which are presumable different from the tinnitus sounds, stimulates the auditory cortex at frequencies other than tinnitus and retrains the brain to become more synchronous and regulated.

There are several potential setbacks to this therapy and only time will tell how effective it may be. Currently, VNS therapy is used successfully for intractable epilepsy and treatment resistant depression. It is accomplished by means of an implantable electronic device, much like a heart pacemaker, that powers electrodes connected to the vagus nerve. In the future, less invasive power supplies and electrodes will probably be used.

Another thing to consider is that there are many successful experiments in animal models that simply don't pan out when they are applied to humans. Electrical stimulation for the relief of tinnitus is nothing new. In fact, there are several applications of this from cochlear implants, which are implanted electronic devices, to electrodes implanted directly into the auditory cortex.

VNS appears similar to using a Transcutaneous Electrical Nerve Stimulator that we discussed in Somatic Tinnitus. It's purpose is to stimulate the dorsal cochlear nucleus. This article can be seen here

No matter what the outcome, it will be several years before we know how well this treatment may work. Then there will be more time needed to refine the procedure. When cochlear implants were first introduced, it was another 10 years before they were refined to the point they could become implanted.

So we don't know how this will work in the end, however there is much good work being done by fine researchers such as these.

Wishing you quiet times, Barry Keate

Told nothing she can do for her tinnitus 

Dear Barry, I have had tinnitus for 11 years now and as I get older I find it more of a challenge to cope with the ringing. How my tinnitus began was when I had a clogged right ear, you know how it is when after flying. Well, after a couple of days it didn't clear up so I thought if I hold my nose and blow that it should open it up, as I had done in the past. That was the biggest mistake that I had ever made in my life. It did help open up my ear but I immediately had ringing in my ear. I have lived with this because of what I did. I have sought help from multiple specialists and each time I walk out of an office I break down and sob after being told there is nothing that can be done for the ringing. I feel that I must have damaged something. Are there any options for me at this point?

Regards, Connie

Dear Connie, I’m sorry to hear this. The doctors who tell you there is nothing that can be done are simply showing their own ignorance. It’s true there is no cure for tinnitus but there are many things that can be done to help reduce the sound and aggravation. 

Arches Tinnitus Formulas have helped thousands of people, including me, reduce their tinnitus sounds. It doesn’t work for everyone but about 50-60% of people who use our products correctly have a significant reduction. I noticed you tried one bottle of Arches Tinnitus Formula™ about 3 ½ years ago. You must use this continuously for 3-4 months before it becomes fully effective. One bottle is a 25 day supply. No one has good results after only 25 days.

So, my recommendation is to give it another try and stay with it. If it doesn’t help after 3-4 months, discontinue the product. Dr. Michael Seidman states that he employs a number of protocols for tinnitus and that he can help up to 90% of his patients.

Wishing you quiet times, Barry Keate

Vicodin, Red Bull and Tinnitus 

Dear Barry, I just discovered your website and I have a couple questions. I have two physical issues, spondylosis (spinal osteoarthritis) and a torn plantar fascia tendon; I have been using a Vicodin related medication for a while with good results. However, over the last week I developed a constant tinnitus. Could this be the cause? Would it take months to show up? Acetaminophen in large doses once caused this for me four years ago, but that ringing was more pronounced-louder bell like.

I also drink Red Bull (diet), and use earplugs EVERY night for the last four months due to noisy neighbors. How does one know what causes tinnitus? I did have same ear damage with scuba diving four years ago, stage three barotrauma, and it healed up. It is the same ear that is constantly low grade high pitch whining (slightly like a TV set high pitch tone).

Thanks for any ideas! Tony

Dear Tony, One of the possible side-effects of Vicodin is tinnitus. Vicodin is a mixture of hydrocodone and acetaminophen. While tinnitus is described as being a rare side-effect, it does occur. And yes, it can occur after several months. I advise you to consult with your doctor and find an alternative that won’t cause tinnitus for you. Be wary of ibuprofen also. I cannot take a single ibuprofen without it sending my tinnitus through the roof. The same may not be true for you but you should be careful. Generally, pure hydrocodone and other analgesics won’t cause tinnitus. 

In the meantime you should do what you can to reduce the damage that has occurred. Since your tinnitus is quite recent, there is an excellent chance of reducing it significantly or eliminating it completely. Use of Arches Tinnitus Formula should be very helpful. Also, over-the-counter N-Acetyl Cysteine (NAC) is helpful in preventing damage in the first place.

Tinnitus is a complex array of symptoms with many possible causes. One of the largest is noise-related hearing loss. Another is prescription and over-the-counter medications, with about 200 that are ototoxic, or toxic to the ears. Many disease states contribute to tinnitus as well.

Red Bull is a popular “energy" drink. Its sugar-free version contains aspartame, a known neurotoxin, which can exacerbate tinnitus. It is also high in caffeine. I have always recommended avoiding diet drinks (especially aspartame) and moderating caffeine intake.