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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.
Treating Somatic Tinnitus
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. Treating Somatic Tinnitus Hi Barry,I developed tinnitus on June 4, 2009 at the age of 63 while at an indoor shooting range - yes I was wearing my over the ear protection. The guy shooting to the right of me had an overloaded 45 cal hand gun that gave my right ear some hearing loss and tinnitus. After about 3 months I developed somatic tinnitus too. Symptoms: When I turn my head or walk the ringing gets 2-3 times louder. When I walk with my head tilted up and toward my back the walking ringing goes away. I've had the MRI (no issues found). I also take Klonopin to sleep at night. What treatment is available to help reduce the symptoms of somatic tinnitus? Thanks,RonWoodstock, GA Dear Ron,When the ringing sound is made better or worse by changes in the body or neck positions, it is called somatic tinnitus. This means that signals from the body, not the ear, are modulating the tinnitus. This can be related to TMJ, dental issues or other muscular issues, such as muscle spasm. Signals from the cochlea go first to the dorsal cochlear nucleus (DCN) in the brainstem, which acts as a relay to send these signals to the auditory cortex for further processing. The DCN also receives signals from a variety of muscle position sensors in the face, neck, head, trunk, arms and the tempero-mandibular joint (TMJ). These signals are physically very close together in the nerve bundle that leads to the DCN. It is thought that if one of these somatic systems is damaged or in spasm, cross-talk occurs between the somatic and cochlear signals. This modulates the tinnitus up or down. One of the leading contenders is spasm in the sternocleidomastoid muscle. This is the large muscle below the ear which is used to flex and rotate the head. In its earliest stages, somatic tinnitus can be caused by hearing trauma, an injury, or a muscle contraction, such as grinding teeth, that compresses some part of the auditory system. Later, cross-talk occurs between the muscle signals and signals from the cochlea. Relaxation therapy and biofeedback, which allow the individual to exert conscious control over the muscle system, can be helpful. Once a person becomes aware that stretching and muscle relaxation exercises may be able to alleviate the tinnitus, many people may be able to devise a treatment on their own. There is also clinical evidence that trans-electrical nerve stimulation (TENS), using a portable stimulator in areas of the skin close to the ear, can ameliorate somatic tinnitus. This subject needs much more exposure than it has received. There will be a full article on somatic tinnitus in a coming newsletter. Wishing you quiet times,Barry Keate Ear Plugs, Loud Noise and TinnitusDear Barry,I have had tinnitus for nine weeks. It is either related to a wisdom tooth erupting, a job I got as a logger, or TMJ disorder. It is only in my left ear and I really notice it at night and in quiet environments. My ears feel full and it is hard to make them pop in the morning too, although my doctor said there is no evidence of a ear infection being the cause. I often find myself using landscaping tools (lawnmower, chainsaw, etc.) however I have always used earplugs while using these loud tools, it seems like my tinnitus gets worse after using these tools even with hearing protection. The inside of my car also measures 90 to 100 decibels on the freeway, although I usually only drive 45 minutes a day. I was wondering if earplugs may be making it worse by irritating my ears. Also is my car too loud to be driving around? It sure does not sound like 90 to 100 decibels inside, but an audiometer said it was. I take ginkgo, vinpocetine, and NAC, but the ringing seems to be getting worse not better. If it matters I have taken hearing tests at an ENT doctor and they said my hearing was fine. Thanks in advance, I know that was a lot to read but I was hoping you could shed some light on this. Most sincerely, Eric D. Dear Eric,It’s difficult to determine the cause of your tinnitus from your email. Of course exposure to loud noise could be the cause. But one thing sticks in my thoughts. You say your ears feel full and don’t pop. This could be a symptom of Eustachian Tube Dysfunction, which an ENT can diagnose. It could also be a symptom of TMJ, which you mentioned. If you have TMJ dysfunction there is hope and treatment potential. We have an article on TMJ and treatment. At the bottom of the article is a link to the American Academy of Craniofacial Pain, which specializes in TMJ. On their website you can find a TMJ specialist in your area. The specialist can tell you in one visit if you have this, how serious it may be, and treatment options. Earplugs will never make tinnitus worse. They protect your hearing. Tinnitus may seem worse when wearing them because all outside sounds are cut off and you can only hear your tinnitus. Continue wearing them whenever around loud noise. 90 to 100 dB does seem pretty loud for an auto. I don’t think this will cause hearing loss unless it is for several hours a day. You may want to wear one earplug, in your left ear, while driving. I don’t recommend earplugs in both ears because you will need to hear car horns, sirens, etc. You say you take ginkgo but don’t mention a brand or dosage. You should know that 75% of all ginkgo found in American stores has been adulterated and is not high quality. Arches Tinnitus Relief Formula uses the highest quality ginkgo found anywhere. You may want to try it at the recommended dosage and see if it can be helpful for you. Wishing you quiet times,Barry Keate B Vitamins, Drugs and TinnitusDear Barry,I have had tinnitus for three years. I saw an ENT doctor and was treated for a bacterial infection and it was thought that the tinnitus would resolve which it didn’t. During the summer of 2008 the tinnitus was really loud and I went through a period of six months with not sleeping well. My family physician thought that I was bordering on depression. I saw a psychiatrist who recommended Klonopin for and sleep and it worked well. My doctor wanted me to try an antidepressant named Clonazapam which I also now take daily. You once talked about certain medications sometimes worsening tinnitus, so I switched to Remeron and I didn't like it. The level of tinnitus did not change. My doctor preferred Clonazapam due to anti-anxiety and I switched back. Leading up to this email; another contributing factor was taking an online computer class plus lack of full body excercise. Extreme tightness is a problem and I have lost a lot of flexibility. Then spring hit with lots of pollen in Charleston. I take a One a Day vitamin for women, the two prescription medications on a daily basis. I think part of the increased ringing is lack of flexibility and I am starting a stretching program. Plus I'm hoping that the spring pollens are part of it and will soon resolve. My question: I just started the Combo Pack, with the B supplements. I weigh 100 pounds and wonder if the high levels of vitamins in the Stress Formula are too much for me. Thank you for you kind response to people who suffer from tinnitus. Candice S.Charleston, SC Dear Candice,If you have had a bacterial infection in your sinus cavities, it could well be the cause of your tinnitus. It's possible that you still have some congestion, which is adding to it. I suggest you see an ENT physician, not a general practitioner, to evaluate your sinuses. Sometimes they will prescribe a steroid-based nasal spray, such as Rhinocort, and it will clear out the congestion. Clonazepam and Klonopin are the same drug. Clonazepam is the name of the generic drug while Klonopin is the trade name. It is not an antidepressant but rather an anti-anxiety medication, what they call anxiolytic. Clonazepam will not cause tinnitus. However, there are some others in the same category that do make tinnitus worse for some people, such as Xanax. Clonazepam for anxiety can be very helpful. Remeron is an older generation antidepressant. It's not as effective as the newer SSRI antidepressants but has the advantage of not causing tinnitus, as a number of the new antidepressants do.Full body exercise, such as yoga, can be very helpful in making you more limber. Springtime pollen can be a serious aggravating factor if you have allergies and I think the pollen may be the culprit here. Again, a visit to a good ENT physician may be well worth the effort. Arches Stress Formula contains only B vitamins. These are water soluble vitamins and flush through the body daily, they don't build up. You cannot overdose on B vitamins. In fact, most people are B vitamin deficient. The vitamins are easily destroyed during cooking and food processing. If a person doesn't take a strong B-complex vitamin, such as our Stress Formula, they are most likely B vitamin deficient. The B vitamins found in one-a-day type vitamins are in extremely small doses, such as 5 mg. Our Stress Formula contains 100 mg of most of the major B vitamins. You could take several times this amount with no bad effects. B vitamins will turn your urine bright yellow. This is normal so please don't be alarmed. It is just the extra vitamins flushing through. 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.