Sudden Sensorineural Hearing Loss and Tinnitus

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.

Sudden Sensorineural Hearing Loss (SSNHL) is characterized by a sudden decrease in hearing of at least 30 dB, affecting at least three frequencies over a 72-hour period or less. Tinnitus is an almost universal effect of SSNHL.

We will discuss here the causes of SSNHL and the treatments for it, including Arches Tinnitus Formulas and a new study from Korea using conventional steroid treatment combined with Hyperbaric Oxygen Therapy (HBOT) and acupuncture.

Prevention includes the use of B vitamins, especially B6, B12 and folate. Successful treatment consists of the components of Arches Tinnitus Combo Pack, including Arches Tinnitus Formula, Stress Formula, and B12 Formula with methylfolate and methylcobalamin, the most absorbable forms of folic acid and vitamin B12.

There are two basic types  of hearing loss, conductive and sensorineural. Conductive hearing loss occurs when sound is not conducted effectively through the outer ear canal through the eardrum and the small bones in the middle ear. This condition is generally treatable, and hearing can be restored.

Sensorineural hearing loss occurs when there is damage to the cochlea or to the nerve pathways from the inner ear to the brain. This is much more difficult to treat as it involves nerve damage. There is currently no cure for sensorineural hearing loss but there are therapies that can significantly mitigate the damage and reduce the sound level of tinnitus.

Sudden sensorineural hearing loss is a frightening subset of sensorineural hearing loss. It can occur over a few hours, a few minutes, or even instantaneously. People afflicted with SSNHL typically feel a fullness in the ear before the onset of hearing loss. They may experience a “pop” in the ear and frequently have vertigo. In most cases SSNHL affects only one ear.

Roughly one-third of those afflicted with SSNHL have a complete restoration of hearing. Another third experience a partial restoration and a third have continued hearing loss with no improvement.

Causes of SSNHL and Tinnitus

Many doctors believe SSNHL results from an auto-immune condition or a viral infection. Accordingly, they treat this with steroids or anti-viral medications. Research has not supported this belief and clinical trials have shown steroids and anti-viral meds perform no better than placebo. In about 90% of cases there is no specific cause that can be identified. This is termed idiopathic SSNHL.

However, it is widely believed that treatment should begin as early as possible, within 10 days of onset, for best results.

A study conducted in 2005 found patients with sudden hearing loss had higher homocysteine and lower methylfolate levels than healthy patients. (1)

Another study established that, “Folate levels were found to be significantly lower in SSNHL patients than controls”. And, “A significant relationship was found between low folate levels and high homocysteine levels in all patients”. (2)

Total homocysteine. Diagram showing conditions that affect homocysteine levels.

Homocysteine is an amino acid formed from the metabolism of methionine, found in high concentrations in meat and dairy products. The western diet is rich in these foods and elevated homocysteine levels are common.

Elevated homocysteine levels in the bloodstream have been shown to lead to atherosclerosis, heart disease, hearing loss, several types of cancer, and Alzheimer’s disease. Homocysteine is the agent that damages blood vessel linings and allows the formation of plaque build-up, thereby reducing circulation.

Homocysteine can be metabolized and neutralized by the vitamins B6, B12 and folate. (3)

A more recent study, published in JAMA Otolaryngology – Head & Neck Surgery investigated the association of metabolic syndrome and SSNHL. Metabolic syndrome is a cluster of conditions that occur together, increasing the likelihood of heart disease, stroke and diabetes. (4)

Metabolic syndrome includes hyperglycemia or type 2 diabetes, hypertension (high blood pressure), obesity, elevated triglycerides, and decreased High-Density Lipoprotein HDL (the “good” cholesterol). To be diagnosed with metabolic syndrome, a patient would exhibit three or more of these conditions. Metabolic syndrome is a risk factor for type 2 diabetes and cardiovascular disease, including heart attack and stroke.

This study examined 124 patients treated for SSNHL in a university hospital in South Korea. Some patients had metabolic syndrome, and some did not. The study investigated the association of metabolic syndrome with the onset, severity, and rate of recovery from SSNHL.

It showed the rate of SSNHL was 3.54 times higher for those with metabolic syndrome than among those without it. Researchers also found the rate of recovery was lower among patients with metabolic syndrome and prognosis was poorer among those patients.

Treatment of SSNHL and Tinnitus

As mentioned above, high homocysteine levels can be metabolized and neutralized by vitamins B6, B12 and folate.

Lifestyle changes can control or reverse metabolic syndrome. These changes include:

Exercise – 30 minutes per day of moderately intensive exercise. Staying physically active is key in reducing metabolic syndrome.

Weight Loss – Maintaining a healthy weight reduces insulin resistance and blood pressure and decreases the risk of type 2 diabetes.

Healthy Diet – Dietary approaches such as the DASH diet and the Mediterranean diet limit unhealthy fats and emphasize fruits, vegetables, fish and whole grains.

Smoking Cessation – Smoking worsens the consequences of metabolic syndrome.

Stress Reduction – Physical activity, meditation, yoga and other programs improve emotional and physical health.

Study Compares Steroid, Hyperbaric Oxygen Therapy and Acupuncture

A recent study was conducted in Korea and published in the Journal of Alternative and Complementary Medicine in July, 2021. (6)

This study compared steroid therapy alone, then combined with Hyperbaric Oxygen Therapy (HBOT), and then HBOT and acupuncture. The study participants were treated with steroid therapy alone (S Group), steroid combined with HBOT (S-H Group) and steroid, HBOT and acupuncture (S-H-A) Group.

Acupuncture is believed to stimulate complex biomechanical and biochemical processes with healing effects. These include promoting blood circulation, reducing blood viscosity and relieving or preventing local ischemic and anaerobic conditions (lack of oxygen to the tissues).

Results showed the S-H-A group had improved hearing outcomes. They had greater hearing gain and had more favorable outcomes in hearing recovery compared with the S and S-H groups. The S+S-H group had better recovery than the S group.

Ginkgo Biloba for SSNHL and Tinnitus

Ginkgo has been shown in a clinical study to be effective in treating patients with SSNHL. (5) German researchers used oral ginkgo biloba on patients whose hearing loss occurred less than 10 days before they were included in the study. The researchers used two dosages of 24mg and 240mg daily and compared the groups in a randomized, double-blind study. They found large majorities of both groups recovered completely but patients on the higher dose recovered better overall than those on the lower dose. They concluded, “A higher dosage of EGb 761 (ginkgo biloba) appears to speed up and secure the recovery of SSNHL patients, with a good chance they will recover completely, even with little treatment.”

Arches Tinnitus Formulas for SSNHL and Tinnitus

Arches Tinnitus Formula contains our proprietary ginkgo extract, Ginkgo Max 26/7. This has a higher and more concentrated amount of ginkgo extract than the standardized EGb 761. It was designed specifically for people with tinnitus and has elevated levels of ginkgo flavone glycosides, terpene lactones and bilobalide. In a comparison with standardized ginkgo, Ginkgo Max comes out way ahead.

It also contains a therapeutic amount of zinc picolinate, shown in studies to be effective in reducing tinnitus.

Arches Tinnitus Stress Formula contains therapeutic amounts of most of the major B vitamins. B vitamins are absolutely essential for the proper functioning of human metabolism and energy production. They are known to keep the nervous system operating properly and act as stress relievers and energy enhancers. The family of B vitamins is grouped together due to the interrelationships in their functioning with human enzyme systems.Folic Acid and Folate Metabolism diagram

Arches Tinnitus Stress Formula also contains the important B6, necessary to metabolize homocysteine.

Arches Tinnitus B12 Formula contains vitamin B12 and methylfolate, which does not need conversion, and which is the most viable form of folate available. This is in a separate bottle because it is a sublingual lozenge, designed to be dissolved under the tongue. Vitamin B12 is destroyed during digestion. By dissolving it under the tongue it goes directly into the bloodstream from the mouth.

Vitamin B12 is usually combined with folate because taking folate alone can mask a B12 deficiency. This deficiency is known as “pernicious anemia” which results in low red blood cells counts and can lead to numerous and severe complications.

The great majority of B12 supplements on the market are combined with folic acid. Folic acid is recommended for pregnant women to reduce chances of neural tube defects. It is also recommended by the World Health Organization and is incorporated into most grains and cereals produced in the US and many other countries. Folic acid is metabolized in the body to form methylfolate, which is the form used by humans.

However, there is a problem with folic acid. It is synthetic and requires a 5-step conversion before it forms methylfolate. About half the population has a genetic variation that prevents this conversion. In this case unmetabolized folic acid circulates in the bloodstream and harms health, including compromising the immune system.

Arches Tinnitus Combo PackArches Tinnitus Formulas Combo Pack

Arches Combo Pack includes a three-month supply of all Arches products for tinnitus treatment. It contains 4 bottles of the Tinnitus Formula with Ginkgo Max 26/7 and zinc picolinate. It also includes a three-month bottle of Arches Stress Formula with all major B vitamins and vitamin B6. Additionally, there is a three-month bottle of Arches B12 Formula with vitamin B12 and methylfolate.

Arches Combo Pack combines essential components to reduce tinnitus, prevent hearing loss and restore loss if it recently occurred. Combined with a good diet and regular exercise, this regimen will keep you hearing well and feeling well. It will dramatically reduce chances of experiencing high homocysteine and metabolic syndrome with their associated effects, such as atherosclerosis, heart disease, diabetes and other complications.


1 – Hall J. Sudden Hearing Loss and Folic Acid. Journal Watch Pediatrics and Adolescent Medicine.June 13, 2005.

2 – Cadoni G, Agostino S. et. al. Low Serum Folate Levels; a Risk factor for Sudden Sensorineural Hearing Loss? Acta Oto-Laryngologica. 2004, Vol. 124, No.5, 608-611.

3 – New Eng J Med 345:1593-1600, 2001.

4 – Jung S, Shim H, Hah Y, et. al. Association of Metabolic Syndrome with Sudden Sensorineural Hearing Loss. JAMA Otolaryngol Head Neck Surg. 2018;144(4):308-314.

5 – Burschka MA, Hassan HA, et. al. Effect of Treatment with Ginkgo Biloba Extract EGb 761 (oral) on Unilateral Idiopathic Sudden Hearing Loss in a Prospective Randomized Double-Blind Study of 106 Outpatients. Eur Arch Otorhinolaryngol. 2001 Jul; 258)5): 213-9.

6 – Che-Jui Lee, Hsin-Chien Chen, et al. Combined Acupuncture – Hyperbaric Oxygen – Steroids Therapy for Idiopathic Sudden Sensorineural Hearing Loss: A Retrospective Observational Therapy. The Journal of Alternative and Complementary Medicine. Vol 27, No.7, 12 Jul 2021.