11 things worth trying if you suffer from tinnitus

By Dr. Ronald Hoffman

Tinnitus-or "ringing in the ears"-is the bane of many people's existences. It is thought to affect 15% of the world's adult population. Depending on who you are, it can be pronounced TIN-ni-tus (Brits and health professionals) or tin-NIGHT-us (most U.S. lay people). Both are correct, but I prefer the former.

The causes are varied: In most cases, tinnitus accompanies age-related hearing loss (presbycusis); but it can also result from high-decibel noise exposure, ear wax, fluid buildup (Meniere's disease), circulatory problems, medications, concussions, TMJ, or even a tumor (commonly, an acoustic neuroma).

One of the problems with many proposed remedies for tinnitus is that there's a huge placebo effect, suggesting a psychological component to the disorder. In fact, many tinnitus sufferers are anxious and depressed; to what extent this is a cause or an effect of this bothersome affliction is unclear. Because the placebo effect of any intervention for tinnitus looms large, clinical trials of supplement interventions often suggest promise, but the practical experience of most users is that the benefits may wane over time.

Before undertaking self-care for tinnitus, definitely get a work up by an ENT specialist to rule out remediable or dangerous causes. Unfortunately, in the likely event that all the tests prove negative, you might just end up stuck with a diagnosis of "idiopathic" tinnitus. Start investigating these strategies:

1. Check your lifestyle: Commonly, stress, anxiety, lack of sleep, and loud noises are classic instigators of tinnitus. Addressing these problems can help minimize your bouts of ear distress. If stress feels unrelenting and life-impairing, seek professional help. Since tinnitus is a real physical malady, studies of cognitive behavioral therapy don't show it reduces the frequency or intensity of tinnitus"; rather, it helps patients to better cope with symptoms.

2. Investigate dietary triggers: Keeping a food diary can help to pinpoint tinnitus precipitants which may include excess sodium, MSG, alcoholic beverages, sugary foods, aged cheeses, and/or caffeine. The overall quality of your diet matters, too. One study showed that between 84 and 92% of tinnitus patients were shown to have a metabolic disorder called hyperinsulinemia.

3. Stay mobile: Exercise has been shown in some studies to reduce the likelihood of tinnitus. For older adults with hypertension, for every 60-min increase in light-intensity physical activity, they were 21% less likely to have tinnitus.

4. Medicine cabinet makeover: Aspirin is notorious for causing or worsening tinnitus. Certain antibiotics can damage the tiny hair cells that line the inner ear. And SSRI medications, commonly prescribed for the depression that accompanies tinnitus, may increase activity in the brain region thought responsible for the condition.

5. Go Ginkgo: A meta-analysis demonstrated effectiveness of a standardized Ginkgo extract vs. tinnitus. The dosage was 120-240 mg per day of standardized Ginkgo biloba extract, EGb 761

6. Investigate vinpocetine: One of Europe's most popular tinnitus remedies is a branded vinpocetine product, Cavinton, a nootropic (smart-drug) that has been shown, like Ginkgo, to be a cognitive enhancer via its circulation-enhancing properties. But the one study that I could find on vinpocetine and tinnitus reported positive results only when it was given intravenously; to date, no double-blind placebo controlled studies have verified its efficacy when given to human subjects as an oral supplement.

7. Try CoQ10: A small 2007 clinical trial revealed that tinnitus sufferers with low blood levels of CoQ10 benefited from CoEnzyme Q10 supplementation.

8. Consider nicotinamide riboside (NR): Good research demonstrates the efficacy of NR in preventing noise-related hearing loss, which is often a precursor to tinnitus. By inference-admittedly as yet subject to definitive human trials-a two-month experiment with 250 mg of NR twice daily might be warranted to see if it relieves your ear distress.

9. Could it be EMFs? Studies suggest that long-term cellphone use may cause acoustic damage. Many sufferers of tinnitus report that hissing or whining noises are worse when in the presence of fluorescent lights, which generate barely audible high-frequency sound waves. It's estimated that around 3% of the population suffers from sensitivity to ubiquitous electromagnetic fields.

10. Tame your histamines: Research suggests that Meniere's Disease and tinnitus may be due, in part, to histamine intolerance. In a previous article, I provided suggestions on how to curb histamine overload with diet and supplements.

11. Miscellaneous: Supplementation with resveratrol, magnesium, melatonin, vitamins B12, D and E, creatine, alpha lipoic acid (ALA), n-acetyl cysteine (NAC), and acetyl-l-carnitine (ALC) have been suggested as means of forestalling hearing loss, but studies of their effects on tinnitus show only weak or inconclusive results.

While these interventions may provide some relief for tinnitus sufferers, the search for a definitive cure is still underway. Promising directions include better methods of acoustic "masking" (akin to noise-reduction ear phones), deep-brain stimulation, external electrical pulses and, ultimately, cochlear regeneration with stem cell implants. Pending these developments, lifestyle modifications and supplements offer simple, safe and readily available options.