By Barry Keate
Barry Keate, has lived with tinnitus over 40 years and has published 150+ research articles on numerous aspects of tinnitus. He is an expert on the condition and a well-known advocate for those with tinnitus.
In the previous article on ATF we discussed the exact pharmacological actions of the ingredients used in Arches Tinnitus Formula™ that promote the reduction of tinnitus. We showed how the combined neuroprotective, antioxidant, circulation enhancing and cholesterol lowering effects of the components all help in reducing sound levels for most people with tinnitus.
In this article we continue with a discussion on the effectiveness of B vitamins and how they can also be helpful for tinnitus. While there are not as many clinical studies, there is a wealth of information about the effect of B vitamins on the nervous system, depression and cardiovascular health. There is also considerable clinical experience with this vitamin family by tinnitus health care practitioners which show the many positive effects of B vitamin supplementation.
Arches Tinnitus Stress Formula™ consists of high potency B-Complex vitamin capsules containing all the vitamins within this grouping. Arches Tinnitus B-12 Formula™ consists of high potency vitamin B-12 and folic acid lozenges designed to be dissolved under the tongue for increased absorption. Vitamin B-12 is not absorbed well through the digestive tract. When dissolved under the tongue it absorbs directly into the bloodstream, bypassing the digestive process.
The family of B vitamins is grouped together due to the interrelationships in their function with human enzyme systems. They are absolutely essential for the proper functioning of human metabolism and energy production. They maintain healthy skin, eyes, muscle tone and support the functions of the liver and central nervous system. B vitamins are known to help keep the nervous system functioning properly and have a reputation as stress relievers and energy enhancers. They are co-dependent in that they have separate functions but require the presence of other B vitamins to perform efficiently. For this reason they are generally taken together.
B vitamins are water soluble, meaning they readily pass through the system and are not stored in fat cells; they must be replaced on a daily basis. They are also easily destroyed during cooking and processing of foods. The average diet in the western hemisphere consists of a high concentration of processed and pre-packaged foods making it difficult to consume enough B vitamins from the diet. Most western diets are mildly to moderately B-vitamin deficient. Daily supplementation with B vitamins becomes even more important in this case.
Of particular importance to our readers is that deficiencies of B vitamins result in hearing loss, lethargy, anemia, nervousness, skin and hair problems, lack of appetite, and poor night vision.1 Another important study showed that deficiency of B vitamins directly resulted in tinnitus.2 A major study of tinnitus among Israeli military personnel clearly showed a relationship between vitamin B-12 deficiency and dysfunction of the auditory pathway. Some improvement in tinnitus and associated complaints were observed in patients following vitamin B-12 replacement therapy.3
Stress is the number one aggravator of tinnitus. We know from years of experience that stress will take a level three tinnitus (on a scale of 10) and turn it into a level seven, literally overnight. All people with tinnitus must learn to control stress. Stress restricts blood vessels, reducing circulation, and increases heart rate, breathing and blood pressure. These changes directly influence the degree of tinnitus that is perceived. B vitamins are consumed by the body at an accelerated rate when under stress. B vitamins can help improve energy and mood and reduce stress levels. Other beneficial effects of B vitamin supplementation are discussed below.
Numerous clinical studies show that homocysteine is a strong marker for cardiovascular disease leading to heart attack and stroke. High homocysteine is a precursor to atherosclerosis, hardening of the arteries, which reduces blood flow to the brain and throughout the body. Supplementation with folic acid and vitamin B-12 directly influences homocysteine levels and decreases them by up to 30%. A six year study in Canada found that folic acid reduced the risk of coronary artery disease among men by 69%.4 A combination of folic acid, vitamin B-12 and vitamin B-6 reduced homocysteine levels and reversed narrowing of blood vessels.5 In women who consumed more than one alcoholic drink per day the risk of coronary heart disease was reduced by 73%.6
Two well documented studies show a direct link between folic acid, vitamin B-12 and vitamin B-6 and cognitive functions, particularly in the elderly. One study shows the associations between loss of cognitive function or Alzheimer’s disease and inadequate B vitamin status.7 The other study states that deficiencies in these vitamins are thought to be relatively common in the general population and in older adults in particular. Even subclinical differences in nutritional status have influence on cognitive performance.8
Vitamin B-6 has also been found to be an effective treatment for depression because it is a cofactor in the tryptophan-serotonin pathway. In one study a low blood level of vitamin B-6 was associated with people who scored high on the Major Depression Inventory while no association was found in those who were not depressed.9
Below is a breakdown of some of the major individual B vitamins and their functions in human metabolism. Much of this information comes from a paper published by Michael Seidman, MD who is one of the foremost tinnitus specialists in the US.10
Thiamine has a critical role in maintaining a healthy nervous system. Adequate thiamine levels dramatically affect cognitive levels by maintaining positive mental attitude and enhancing learning abilities. Thiamine levels can be negatively affected by ingestion of antibiotics, caffeine, antacids and oral contraceptives. These products and a diet high in carbohydrates increase the requirement for thiamine.
Some tinnitus patients have noted that vitamin B-1 supplements relieved their tinnitus. The mechanism of action seems to be a stabilization of the nervous system, especially in the inner ear. Dosages ranging from 25 mg to 500 mg per day have been used.
Riboflavin is known as the energy vitamin. It is the component of B vitamins that gives urine a yellow-green color. It is a co-factor in facilitating the production of energy from foods.
Riboflavin helps in reducing stress and fatigue. Used with Pyridoxine (B-6), it can also help lift the mood and fight depression.
Niacin is an essential nutrient required for proper metabolism of carbohydrates, fats and proteins. It also supports circulation and aids in the functioning of the central nervous system. Because of its role in supporting the higher functions of the brain and cognition, Niacin also plays an important role in the treatment of schizophrenia and other mental illnesses and in stabilizing cognitive functions. Adequate levels of Niacin are vital for the proper synthesis of insulin and the sex hormones estrogen, testosterone and progesterone.
Niacin is also used as a natural medication to lower cholesterol levels. It is the most cost-effective and safest treatment for lowering bad LDL cholesterol and increasing good HDL cholesterol in the blood.
There are anecdotal reports of Niacin helping with tinnitus. While there is no standard dosing for Niacin, Dr. Seidman recommends the following procedure.
- Begin with 50 mg Niacin twice daily.
- After two weeks, increase dosage by 50 mg each interval.
- Continue increasing by 50 mg each interval every two weeks until a maximum dose of 500 mg twice daily is reached.
- If it does not prove helpful after 3-4 months, it will probably not improve tinnitus.
Niacin may result in what is called “niacin flush”. This is unpleasant for some people and results in a burning or tingling sensation and a reddening flush that spreads across the skin of the face, arms and chest. It typically lasts for 5 to 60 minutes and is totally harmless. It is the result of vascular stimulation of the small capillaries close to the surface of the skin.
Many B supplements, including our Stress Formula, use a form of niacin called niacinamide that does not cause flushing and is very safe at normal dosages. At higher doses it is recommeneded to use niacin (flush form) versus niacinamide.
Pyridoxine is often considered the most important B vitamin. It is a coenzyme involved in the metabolism of carbohydrates, fats and proteins. It is also required for the production of serotonin, a neurotransmitter that controls our moods, appetite, sleep patterns and sensitivity to pain. A deficiency of Pyridoxine can quickly lead to insomnia and profound malfunctioning of the central nervous system.
Pyridoxine is one of the few vitamins that can be toxic. Doses up to 500 mg per day are uncommon but safe. Doses above 2 grams per day can lead to irreversible neurological damage.
Pyridoxine supplements appear to be helpful for some tinnitus patients by providing a stabilizing effect on the nerves, both centrally and peripherally.
The name of folic acid is derived from the Latin word “folium,” since this essential nutrient was first extracted from green leafy vegetables, or foliage. It was originally extracted from spinach in 1941.
Adequate levels of folic acid are essential for energy production, protein metabolism and the formation of red blood cells. Deficiency quickly leads to anemia. As shown above, several studies have shown that folic acid reduces homocysteine levels and therefore the risk of heart attack and stroke.
The use of high dose folic acid supplements for major medical depression is very promising. Furthermore, deficiency impairs the repair of nerve cells in the brain making them susceptible to damage and the onset of Alzheimer’s disease. Additional studies have shown that folic acid intake leads to a substantial reduction of birth defects such as spina bifida. Pregnant women are now encouraged by their doctors to take extra folic acid.
Folic acid supplementation can mask a deficiency of methylmethylcobalamin (B-12). This is why the two are normally supplied together.
It is estimated that 15-20% of the population is deficient in methylcobalamin. This deficiency state is most likely secondary to absorption difficulties as well as deficient nutritional intake. Strict vegetarians (vegans) who do not consume any foods of animal origin need to supplement with methylcobalamin since it comes almost exclusively from animal sources.
Methylcobalamin is a type of Vitamin B12. Vitamin B12 comes in several kinds including hydroxy-, cyano-, and adenosyl-cobalamin, but only the methyl form is used in the central nervous system. Deficiency states are fairly common and vitamin B12 deficiency mimics many other disease states of a neurological or psychological kind, and it causes anemia. Cyanocobalamin (the kind in most vitamin supplements) is converted by the liver into methylcobalamin but not in therapeutically significant amounts.
WHAT DOES METHYL B12 DO?
Methylcobalamin has been shown to protect against glutamate-induced excitotoxic neuronal damage. Neuronal damage caused by excess glutamate is one of the primary causes of tinnitus and worsens existing tinnitus.
Methylcobalamin is immediately active upon absorption while other forms (e.g. cyanocobalamin) need to be converted first into methylcobalamin in a two step process.Methylcobalamin donates methyl groups to the myelin sheath that insulates nerve fibers and regenerates damaged neurons. In a B12 deficiency, toxic fatty acids destroy the myelin sheath but high enough doses of B12 can repair it.
Methylcobalamin works synergistically with vitamin C to aid in proper digestion and absorption of foods. Additionally, it prevents nerve damage by contributing to the formation of the myelin sheath, which covers and insulates neurons from excessive electrical activity.
B12 has poor gastric absorption. Therefore it is best taken as a sublingual lozenge, which dissolves under the tongue, or as an injection. Clinicians use methylmethylcobalamin as an injection for a wide range of neurological problems relating to energy level, weight and nervous disorders.
Arches Tinnitus Stress Formula™ and Arches Tinnitus B-12 Formula™ are designed to provide high potency B-Complex vitamins to people with tinnitus and related neuro-degenerative conditions. They are an excellent complement to Arches Tinnitus Relief Formula® for the reduction of tinnitus and the healthy operation of the nervous system. As stated by Dr. Seidman, “I also recommend Arches Tinnitus Stress and B-12 Formulas to patients in order to alleviate stress which will enhance their experience using Arches Tinnitus Relief Formula®”
1. National Research Council: Subcommittee on the Eleventh Edition of Recommended Dietary Allowances. National Academy Press, Washington DC, 1997.
2. Ann of Otolaryngol 1980; 103:185-188.
3. Am J Otolaryngol 1993; Mar-Apr; 14(2):94-9.
4. Clinical Cardiology 12:930-34, 1996.
5. New Eng J Med 345:1593-1600, 2001.
6. J Am Med Assn 279:359-64, 1998.
7. Am J Clin Nutrition Vol. 71,No.2, 614S-620S, Feb. 2000.
8. Journals of Gerontology Series B: Psychological Sciences and Social Sciences 56:P327-P339, 2001.
9. Psychother Psychosom, 2004 nov-Dec;73(6):340-3.
10. Otolaryngol Clinic North Am 2003; 36:359-81 Alternative medications and other treatments for tinnitus: facts from fiction.