by Barry Keate
Over the last several years researching tinnitus, it has become apparent to me that there are many basic health factors, which contribute to the intensity of tinnitus and a seed of a thought has been growing: Whatever improves health in general, also contributes to the management and reduction of tinnitus.
Now there is new clinical evidence that lowering cholesterol can also reduce tinnitus for many people. But first it is important to discuss other healthful practices (and some things to avoid) that that will improve tinnitus.
Editor’s Note: Many of the links to articles sited below cross-reference each other. It is part of our on-going effort to establish a library of “general health” articles designed specifically for people with tinnitus.
Diet and Exercise
Inner ear specialist and tinnitus authority, Michael Seidman, MD states that it is imperative for people with tinnitus to reduce or eliminate their use of salt, simple sugars, saturated and trans-fats, nicotine, caffeine and alcohol.
This is sage advice and one of the fundamental principles of tinnitus management. All food affects health, either positively or negatively, and also affects tinnitus. It is very important to understand which foods to avoid and which to consume. For more information you can read our article on the importance of proper diet for tinnitus.
Regular, vigorous exercise is one of the best ways to stay healthy and improve tinnitus. Exercise is medicine. It promotes circulation, protects the heart, prevents Type II Diabetes, and acts to preserve the body in many ways. If the exercise involves exposure to loud sound, remember to protect your ears with earplugs or ear muffs. Some individuals say that exertion makes their tinnitus louder, however only temporarily.
Stress is all around us. It can result from both positive and negative experiences. Anything from a wedding, to a new job, or an illness can produce stress. In response to a stressful or threatening situation, chemical changes occur which, in turn, cause physical changes in the body. Blood vessels constrict, raising blood pressure and reducing circulation, and breathing and heart rate increase.
With tinnitus, the body often reacts as if being threatened. When the tinnitus is constant and prolonged, the physical responses, such as anxiety, depression and insomnia, aggravate the tinnitus. Prolonged stress will make the tinnitus noises much louder than they would be in a relaxed state.For more information please see our article on ways to cope with and reduce stress.
Inflammation is the body’s response to damage. It causes swelling and pain. In most cases, this is a good thing. If you bang your thumb with a hammer, the immune system sends white blood cells and other hormone-like substances to help start the healing process. As a result, your thumb swells.
However, chronic inflammation can lead to diseases such as arthritis, heart disease, Inflammatory Bowel disease, even cancer, and numerous neuro-degenerative diseases including tinnitus, Alzheimer’s disease, Parkinson’s disease, etc. Ear infections and illnesses such as a cold or flu as well as blows to the head can also cause inflammation and effect tinnitus.
Most over-the-counter and prescription pain medications were developed to reduce inflammation, thereby reducing pain. Many of these medications are problematic, producing side effects that are still not completely understood. Others, including Vioxx, have been taken off the market, with more to follow.
Proper diet can aid in reducing chronic inflammation, leading to lowered use of pain medication. Specifically, Omega-3 polyunsaturated fatty acids top the list for effective inflammation control. These compounds are found in fish oils, especially in cold-water fish such as salmon, lake trout, mackerel, albacore tuna and swordfish.
Although there has been increasing concern about contaminants in fish, such as mercury, and infants and pregnant women have been warned about consuming too much fish, most of the better supplements containing fish oils are free of contaminants and heavy metals. The story on fish oil and importance of Omega-3 can be seen in our Tinnitus Library.
The inner ear, like the brain, is totally without energy reserves. Its metabolism depends directly on the supply of oxygen and glucose (sugar) from the blood supply. Alterations in glucose metabolism therefore have great potential for disturbing the workings of the inner ear.
Researchers at the School of Medicine in Brazil found studies showing that between 84% and 92% of tinnitus patients were shown to have a metabolic disorder called hyperinsulinemia.
Hyperinsulinemia is an elevation of insulin levels in the bloodstream. It is a direct consequence of a metabolic disorder known as Insulin Resistance, which is characterized by a reduced response to insulin at the cellular level. In response, the pancreas produces more insulin in order to lower blood glucose levels. Hyperinsulinemia is the first stage of the long slide into Type II Diabetes.
The researchers placed tinnitus patients with hyperinsulinemia on a diet suitable for diabetics. Over a two-year period, over 50% of the patients who adhered to the diet had significant improvement in their tinnitus or complete resolution. Read more on sugar metabolism and tinnitus in our Tinnitus Library.
During the last half-century, there have been increasing amounts of food additives in the American food supply. Two of these are aspartame, used to artificially sweeten foods, and monosodium glutamate (MSD), used to enhance flavors.
Both of these additives are excitatory neurotoxins. That is, they excite brain neurons and increase levels of electrical activity in the brain and the auditory cortex, thereby increasing tinnitus.. We know that people with tinnitus have an elevated level of electrical activity and reducing this activity is helpful for tinnitus. Increasing electrical activity increases tinnitus. They also cause neurons to fire until they become chemically depleted and die. This leads to many neurodegenerative diseases. This article on neurotoxins and tinnitus is a must read for anyone who consumes diet colas or diet food products and any pre-processed, packaged food.
Cholesterol - New Findings
Now we get to the most recent findings about the effects of high cholesterol on tinnitus. Cholesterol has three primary components; Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL) and Triglycerides.
LDL is known as the “bad” cholesterol. When too much LDL circulates in the blood, it can build up in the inner walls of the arteries that feed the heart and brain. It can form plaque, a thick, hard deposit that can narrow the arteries and make them less flexible. This condition is called atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can result.
HDL is known as the “good” cholesterol because high levels of HDL seem to protect against heart attack. Low levels of HDL increase the risk of heart disease. HDL tends to carry cholesterol away from the arteries and back to the liver, where it’s passed from the body. Some experts believe HDL removes excess cholesterol from arterial plaque, slowing its buildup.
Triglyceride is a form of fat made in the body. Elevated triglycerides can be due to overweight and obesity, physical inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates. People with high triglycerides often have a high total cholesterol level, including a high LDL level and a low HDL level. Many people with heart disease and/or diabetes also have high triglyceride levels.
In a clinical study published in the fall, 2007 issue of The International Tinnitus Journal (1), researchers from the Gulhane Military Medical School in Ankara, Turkey outlined the prevalence of hyperlipidemia (essentially high cholesterol) in patients who had high frequency hearing loss and tinnitus due to noise exposure.
In the study, they chose 42 male patients, all military personnel, from 120 patients, all with elevated cholesterol or triglycerides, or both. They placed all the patients on a low cholesterol diet or antihyperlipidemic therapy involving the statin drugs Zocor and Lipitor. The patients were instructed to lower their cholesterol using diet. If that failed, they were placed on statin medications. All were followed for two years.
After that time, the patients were separated into two groups: the unresponsive group consisted of 22 patients who had no response to either therapy and still had hyperlipidemia, and the responsive group, consisting of 20 patients who had lower or normal cholesterol or triglyceride levels. The patients in the two groups were then compared using tinnitus questionnaires and testing for hearing levels.
When compared, 35% of the patients in the responsive group rated their tinnitus as decreased and 20% of patients no longer had tinnitus. Fifty-five percent of the responsive group had either a significant decrease or complete resolution of their tinnitus. In the unresponsive group, 9% of patients rated their tinnitus as decreased and 1 patient reported no tinnitus.
It is obvious that lowering blood cholesterol is one more of the health-promoting therapies that can improve tinnitus. I do not advocate statin drugs for this except in extreme cases. There are dangers involving the use of these medications that include CoQ10 depletion, chronic fatigue and cardiomyopathy, which can lead to secondary heart failure. Anyone currently using statin medications should begin CoQ10 supplementation to reduce these effects. Read the complete discussion on statin drugs and the CoQ10 connection.
Natural Therapies for Cholesterol Reduction
There are many natural therapies and products that can reduce cholesterol. First and foremost, as always, is diet and exercise. A good diet coupled with regular, vigorous exercise will lower cholesterol and blood pressure, improve heart function, lead to more energy and help in managing tinnitus.
Arches Tinnitus Relief Formula® contains therapeutic doses of Ginkgo biloba and garlic. Both are known to reduce cholesterol, increase blood circulation in the micro capillaries that feed the brain, eyes and ears, and reduce tinnitus.
Numerous studies have shown the ability of ginkgo and garlic to reduce cholesterol. A European study followed people who had very high cholesterol over a two month period.(2) Half the participants were given a placebo and the other half a ginkgo-garlic combination. There was a 35% improvement in the active group. After two months treatment phase there was a two week wash-out period where cholesterol returned to its previous value. This was a short-tem study of two months. Treatment for a longer time would have resulted in increased improvement.
An Indian study assessed the blood lipid metabolism in cholesterol fed rats.(3) The rats were fed oral cholesterol for ninety days causing a significant elevation in the level of total and LDL cholesterol. Treatment with Ginkgo biloba extract showed a significant reduction in concentration of total cholesterol, LDL cholesterol, phospholipids and triglycerides in their blood.
Vitamin B-3 (Niacin) is used to lower cholesterol. Specifically, it lowers LDL and increases HDL. Niacin is known for producing the “pins and needles” sensation in the face and neck that lasts for 5-10 minutes. There are forms of niacin that do not do this but they are not recommended because they can lead to liver problems.
Artichoke leaf extract reduces cholesterol by limiting the synthesis of cholesterol in the body.
Soluble fiber lowers cholesterol by preventing absorption in the intestines. It combines with cholesterol and is excreted by the body. The most common form of soluble fiber is psyllium powder, found in many fiber laxatives.
I sincerely believe that by improving overall health tinnitus can be mitigated. Eating a diet rich in fruits and vegetables, whole grains and legumes, avoiding processed foods and reducing stress through exercise will lead to a healthier, happier life, with greater energy and reduced tinnitus.
(1) Low-Cholesterol Diet and Antilipid Therapy in Managing Tinnitus and Hearing Loss in Patients with Noise-Induced Hearing Loss and Hyperlipidemia. Sutbus, A; Yetizer, S; Satar, B; Akcam, T; Karahatey, S; Saglam, K. International Tinnitus Journal, Vol. 13, No. 2, 143-149 (2007).
(2) Limitation of the deterioration of lipid parameters by a standardized garlic-ginkgo combination product. A multicenter placebo-controlled double blind study. Kenzelmann, R; Kade, F. Arzneimittelforschung. 1993 Sept; 43(9): 978-81.
(3) Hypolipidemic Effect of Ginkgo biloba Extract in Hypercholesterolemic Rats. Gupta, UC; Jain, GC. Asian J. Exp. Sci., Vol. 20, No. 1, 2006, 69-76.