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Tinnitus in a Nutshell
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Rod Moser, PA, PhD posted:
Tinnitus is the medical term for "ringing in the ears". Tinnitus can also be heard as an annoying buzzing, roaring, hissing, clicking, high-pitched whining, low-pitched hums, or even pulsing like the heart. It is estimated that over 35 million people in the United States have tinnitus (including ME).

Tinnitus is not a disease, but a symptom — a symptom of many common medical problems, such as ear infections, wax impactions, noise exposure (like rock concerts), TMJ (temporomandibular joint) disorders, cervical disc problems, or even a side effect of certain medications like aspirin, ibuprofen, caffeine, or birth control pills. Tinnitus may also be a symptom of more serious illnesses like high blood pressure, anxiety/depression, diabetes, thyroid disorders, Ménière's disease, blood vessel disorders, or tumors.

Finding a cause of tinnitus can be simple, or it may require extensive diagnostic tests, like an MRI or CAT scan. In many cases, a cause is never found — a fact that frustrates many tinnitus sufferers and their medical providers. Even if a cause is not found, there is still hope for successful treatment aimed at quieting the noise and controlling the anxiety.

Not all techniques work for everyone. Usually, it is a combination of therapies, used over time, that offer the best hope. Quieting the ringing will require a lifelong commitment to lifestyle changes, cooperative medical care, and most importantly — a positive and optimistic attitude.

Antianxiety medications, like Valium or Xanax, as well as a wide range of antidepressant medications are very helpful for tinnitus-sufferers. Other medications, such as diuretics (water pills), muscle relaxants, anticonvulsants medications, and antihistamines are also used and individually prescribed by your doctor. Choice of medication depends on the provisional cause.

Biofeedback, relaxation training, counseling, and individualized psychotherapy helps manage stress and help you change your body's reaction to the tinnitus. Tinnitus Retraining Therapy (TRT) combines counseling with special background sounds designed to help people suppress the sounds of their tinnitus.

Special hearing aids, electronic masking devices, or both, are often used when other methods have failed to achieve control. Cochlear implants and cochlear stimulation devices are being investigated for severe, intractable, long-term tinnitus cases. Surgical injections of lidocaine directly into the inner ear structure are also being used in some individual cases.

Alternative treatments such as hypnosis, acupuncture, chiropractic adjustments, vitamin/mineral supplements, herbal remedies (including Ginkgo biloba) may have some promise, but there is little, if any, meaningful research as to their individual effectiveness. Ginkgo biloba is said to improve blood flow and nerve function, but should be used with caution if you have a bleeding disorder or take blood-thinners. There are some ongoing studies to determine if Gingko biloba is safe and effective for tinnitus. It is recommended that all tinnitus-sufferers explore alternative options carefully, with the cooperation of their medical providers.

Certain lifestyle changes are very important for those that have tinnitus. Caffeine is one of the most common aggravators of tinnitus and should be very limited. Coffee, teas, caffeinated colas, and chocolate all contain significant amounts of caffeine capable of constricting blood flow to the ear. Nicotine found in tobacco also constricts blood flow and can aggravate tinnitus, so efforts should be made to stop tobacco in all forms. A low-salt diet is also recommended by many medical providers, so hide that salt shaker and watch the sodium content of foods that you eat.

Every person with tinnitus should be initially and carefully examined by an ENT who has an expertise in this area.
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