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Tinnitus Library

Ask Barry Questions on Tinnitus - February 2014

Do you have questions about tinnitus, our products or specific treatments? Ask Barry. Arches President and tinnitus authority, Barry Keate, will select the most representative questions each month for 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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A musician affected by tinnitus and a sister’s concern

Hi Barry,

My brother Joe is a 21 year old musician, and about six months ago he went to a very loud concert and stood right in front of the stage wearing ear plugs intended for the airplane (the package says 20dB protection but my brother insists it's less and grabbed them because they looked similar to his professional ear plugs).  Since that evening more than six months ago, he has had tinnitus and hearing loss.

My question is about his perception of that hearing loss and the anguish it is causing.  Joe has taken several hearing tests this year since the concert, and he consumed by the loss of hearing.  I've attached those hearing tests for you to view.  Audiologists and ENTs say his hearing is normal.  This statement only aggravates my brother, who states his inner ear is damaged; it's clear he has loss and references the 2012 test as proof.  The test included a tympanometry and otoacoustic emissions test as well.  Through all of this, Joe has had consistent tinnitus!  My brother says he feels disoriented (perhaps due to the anxiety caused by this trauma?) and says based on the 2012 test, it's clear he has hearing loss and however small it appears on paper, it is the only thing he seems able to ruminate on.  He's consumed by it.

Have you heard of this type of situation before, and if so, what was the course of action to remedy it? Is there a specialist in the US you would refer someone like Joe to?  Is magnitude of hearing loss a matter of perception and if so, is there a way to equalize perception of hearing loss, and also tinnitus?  This has debilitated my brother, and our family, as we all try our best to keep him hopeful.

Thank you for your kind attention,

Amy

A concerned sister

Dear Amy,

I'm very sorry this has befallen your brother. I'm not sure exactly what's going on but I do have some suggestions.

Joe has some hearing loss although it is very minor. There are other conditions besides hearing loss that cause tinnitus. These include Meniere's disease, Temporo-Mandibular Joint (TMJ) dysfunction, ototoxic medications, acoustic neuroma, which is a non-malignant tumor growing on the auditory nerve, and several disease states. I think it's very important to get a complete workup by an ENT physician to determine if any of these are causing his tinnitus. A general overview of causes and treatments for tinnitus is in our article Tinnitus: The Basics.

If there is no cause identified by the workup, we can move to the possibility that Joe has tinnitus but it would be very mild except for his obsession and stress over the condition. I believe this may be what's going on here. Stress will take a level 2 tinnitus, on a scale of 10, and turn it into a level 8-9 overnight. Stress always attacks us at our weakest point and aggravates our worst fears. I have experienced this personally in the early years of my tinnitus. I am not saying his tinnitus is psychosomatic; it is very real. But, if this is the case, it can be treated by reducing Joe's stress level.

My personal favorite among the various stress reduction techniques is biofeedback. This is a training regimen where people learn to control sympathetic nervous system excitation. This results in a feeling of calm security. Techniques are available that teach us to reduce heart rate, reduce blood pressure and cool skin temperature by reducing stress. It is very powerful medicine and is also very enjoyable to practice. Training is done in a clinical situation but most of the therapy is accomplished at home. Biofeedback centers are in every major city in America.

I should not forget to mention that Arches products may be very helpful for Joe. Arches Tinnitus Formula has been clinically shown to reduce tinnitus for most people. Darius Kohan, MD states that Arches Tinnitus Formula is helpful for 75-80% of people who have tinnitus due to hearing loss. This is shown here . Arches Tinnitus Stress and B12 Formulas are also helpful in controlling stress levels and providing nutritional support for those suffering from stress.

I hope this is helpful for you and Joe.

Wishing you quiet times,

Barry Keate

Taking the lesser of two evils with Tinnitus: Benzo’s or SSRI’s?

Dear Barry,

I believe that the onset of my tinnitus was brought on by much upheaval in my personal life. I had taken SSRI's for years and went off of them gradually, as I was trying to get back on them I woke up with tinnitus one day 28 months ago.

Part of the trick with tinnitus is knowing the cause. I think it is often times difficult to do this as several items are at play.

I do think that SSRI's are a last resort but if you are trying to take care of your family and trying to keep your job, it seems a little far-fetched that Vitamin B will help my anxiety which drives my tinnitus. So I would like to get off my medicine but realize this may be difficult and will only do so after I have been stable for some time.

So here are my questions.

Will most people experience their tinnitus being worse when coming off of benzo's or SSRI's?

If you slowly start to have some days that are quieter and some days that are still very loud is this habituation?

Do you believe that your Tinnitus Formula works better for certain tinnitus conditions, so for instance does your formula maybe work better for those with tinnitus brought on by loud sounds vs. those that are brought on by emotional distress?

I am trying your Arches Formula again. I did try it for 6 months during the worst of the emotional times and did not get much relief from anxiety or tinnitus.

What is your advice for those who want to get off their SSRI or Benzo? Any particular order which to go off of first?

Thank you, Tim B.

Dear Tim,

SSRI anti-depressants and benzodiazepine anti-anxiety medications both present with several problems for those of us with tinnitus. They can both cause tinnitus and often, getting off them can also cause tinnitus. They both have analogous actions.

SSRIs potentiate the serotonin that is in the system. Eventually the brain learns there is plenty of serotonin and stops making it. Benzos potentiate GABA in the brain. GABA is the calming neurotransmitter. The same thing happens over time; the brain learns there is plenty of GABA and stops making it. Then when you go off either medication, you become severely depleted of either serotonin or GABA.

The answer is to get off these medications very slowly. Sometimes it can take up to a year or more. You can also try to build serotonin or GABA in the body nutritionally. In the case of serotonin, tryptophan is the precursor and can be added in gradually to make more serotonin. In the case of GABA, the product itself is on health food store shelves and is quite inexpensive.

Here are two articles about both classes of medications:

Tryptophan, Serotonin and Tinnitus

Benzodiazepine Withdrawal Syndrome and Tinnitus

I would also advise you not to discount the importance of B Vitamins in your daily routine. Though they are not a “silver bullet” they are very important in managing stress. Here’s what tinnitus authority and ENT surgeon, Dr. Michael Siedman, has to say about them: “Most B-complex vitamins cannot be stored in the body and must be replaced daily from food sources or supplements. B vitamins help maintain healthy skin, eyes, muscle tone and support the functions of the liver and central nervous system. They are also extremely important in helping to deal with depression, stress and anxiety… Vitamin B-complex supplements appear to be effective in some patients with tinnitus by providing a stabilizing effect on the nerves."

I hope this is helpful and you're able to get off these medications. I wouldn't try to get off both at the same time. I don't know what to advise about which one to start with.

Wishing you quiet times,

Barry Keate

If not Arches, then what?

Dear Barry,

I recently completed the entire protocol of your products and I'm extremely disappointed that there was no change in my tinnitus, which first began last July. Any suggestions?

Ron K.

Dear Ron,

I'm sorry you didn't have better results using our products. Most people do but not all. In a survey of our customers, who, like you, tried the Tinnitus Combo Pack or at least 4 bottles of Tinnitus Formula, 70% reported they experienced an improvement of symptoms. That being said, the hard truth is that there is no "cure" for tinnitus and no valid protocol works a 100% of the time.

I do have some suggestions but they depend on the cause of your tinnitus. If you have tinnitus due to noise exposure and also have hearing loss, you may benefit quite a bit from biofeedback, acupuncture or hypnotism. These treatments are discussed in the following articles:

Biofeedback for Tinnitus: My Personal Journey

Acupuncture and Tinnitus

Hypnotherapy and Tinnitus

However, if your tinnitus is due to other causes, there are other treatments available. There are many causes of tinnitus including Meniere's disease, thyroid problems, TMJ, dental problems, and many more. In this case you should get examined by an ENT physician to try and determine the original cause. The proper treatment will most likely arise out of that diagnosis.

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. We encourage you to share any suggestions you have received from Ask Barry with your doctor.