Tinnitus, hearing aids, and the ear/brain system

[mtdoc]

Tinnitus, like many conditions that traditional, allopathic medicine has no good solution for, tends to attract all kinds of alternative therapies and theories.   Sometimes those things pan out and are proven effective but often they don't.  There may be a theoretical basis for thinking NAC might help tinnitus but AFAIK - and despite what some of the companies marketing it may say - it has not been shown to be effective in any controlled studies.  It would be great if it did work, but...

Now whether it has an oto-protective  effect is a different question and one that is harder to prove or disprove. But there are well known, effective oto-protective methods so .....

And in case anyone thinks there is some medical conspiracy to deprive the world of the benefits of NAC - that's just not true. It is already used exensively in medicine -to treat acetaminophen overdoses, to protect the kidneys from effects of radio-contrast dye, and as a mucolytic

[cdev]

I'm looking for this study but can't find it on pubmed.

Do you remember any more info on it?


Quote from: VK5RC on Yesterday at 23:17:39

Antioxidants are not a panacea - in smokers they actually increase the risk of lung cancer.
If hearing loss really bad - cochlear implants can help a bit.

[cdev]

Indeed there are well-known otoprotective methods!

https://www.ncbi.nlm.nih.gov/pubmed?term=acetylcysteine+otoprotective&cmd=DetailsSearch

(not the best search term to find stuff about it - related links bring up a LOT more - but specific to the conversation)

Now whether it has an oto-protective  effect is a different question and one that is harder to prove or disprove. But there are well known, effective oto-protective methods so .....

[Richard Crowley]

Tinnitus and hearing-loss are two completely separate and independent symptoms.  Amplification (hearing-aids) is the obvious solution to hearing-loss (i.e. decline of sensitivity in engineering terms.)  It has nothing to do with tinnitus.  It is the same solution whether you suffer from tinnitus or not.

I suffer from tinnitus and it is definitely not a single discrete frequency, or a fixed harmonically-related cluster of frequencies.  It has characteristics of a non-specific chronic drone pitch, but with features of randomness like white/pink noise thrown in.  It seems unlikely that one could counteract it with an external signal (like popular "noise-cancelling" headphones/earbuds).

With aging, I find myself more and more saying "what did you say?".  But in my perception it isn't that I didn't hear them the first time, I was just tuning them out and thinking about or paying attention to something else.  Or at least that is my story and I'm sticking to it.

[MT]

Hi all-
The audiologist flatly said the only available treatment was hearing aids.

Assar Bjorne, a Phd doctor and dentist at YTS unit in Sweden discovered that some of his patients when
undergoing a local anesthesia the tinnitus disappear'ed. Other studies have shown that some tinnitus cases
could be related to squeezed nerves in the neck. Audiologists are the last people you should ask for help.

Some papers about this at their site:
http://yts.se/forskning-och-publikationer/

[cdev]

Just found this when I varied my search term a bit..

http://www.medscimonit.com/download/index/idArt/869487

 Different strategies in treating noise-induced hearing loss with N-acetylcysteine Guiscardo  Lorito, Pietro  Giordano, Joseph Petruccelli, Alessandro Martini , Stavros Hatzopoulos
Med Sci Monit 2008; 14(: BR159-164
ID: 869487
 
Background: The cellular mechanisms leading to noise-induced hearing loss (NIHL) involve the generation of reactive oxygen species (ROS). Recent studies on glutathione (GSH) and N-acetylcysteine (NAC) show that they can protect the cochlea from ROS-derived damage, increasing the levels of endogenous cellular defences. The purpose of this study was to verify NAC's oto-protective efficacy and determine if drug administration timing influences the degree of oto-protection.
 Material and Method: Forty male Sprague Dawley albino rats were divided in four groups exposed to 8-kHz 105-dB SPL continuous noise. The groups were treated with diverse NAC administration modalities: group A received 4 injections during 48 hours (pre- and post-noise exposure), group B 1 injection prior to exposure, group C 1 injection 24 h after exposure, and group D served as untreated controls. The single injection dosage was 375 mg/kg; the controls received an equal volume of saline solution. Cochlear function was assessed by pre- and post-noise (after 168 hours) recordings of distortion product otoacoustic emissions (DPOAEs) and auditory brainstem responses (ABR). DPOAEs were obtained by three different asymmetric protocols (P1=60-50, P2=50-40, P3=40-30 dB SPL) for frequencies of 4-16 kHz. ABR responses were elicited by tone-bursts at 8 and 16 kHz.
 Results: The most important outcome of the study was that the administration of NAC significantly reduced the threshold shifts in the treated animals. NAC provided different degrees of threshold reduction according to the timing of the drug injection.
 Conclusions: The role played by the timing of NAC injection was important for the OHC protection index. From a DPOAE perspective, the best protection scheme was observed in the group receiving NAC after noise exposure, but full recovery of cochlear function was not observed in any of the tested groups. http://www.medscimonit.com/download/getFreePdf/l/EN

[Habropoda]

In many cases tinnitus is related to hearing loss.  In my case it seems to be similar to phantom limb syndrome, where the brain fills in for a missing limb, or the blind spot in our eyes, where the brain fills in with a matching background or even completes a line (http://serendip.brynmawr.edu/bb/blindspot4.html).  In this case my lower brain seems to fill in some of the missing part of my hearing completely on its own, whether I pay attention to it or not

While ignoring it is a good thing to do, some sounds break it up or make it vary at that “fill in the blind spot” level.  Even if I pay attention to it, cricket sounds break it up and some tones make it vary. 

I keep thinking there might be a way to trick that low level part of the brain similar to the way they treat phantom limb pain by having someone clench and unclench a mirror image of their limb:  https://en.wikipedia.org/wiki/Mirror_box  Perhaps the notch therapy mentioned above or something where the brain tells itself “now everything is noisy” and then “now everything is quiet”.

Of course a pill would be preferable.

[rs20]

Just found this when I varied my search term a bit..

http://www.medscimonit.com/download/index/idArt/869487

 Different strategies in treating noise-induced hearing loss with N-acetylcysteine Guiscardo  Lorito, Pietro  Giordano, Joseph Petruccelli, Alessandro Martini , Stavros Hatzopoulos
Med Sci Monit 2008; 14(: BR159-164
ID: 869487

Interesting results; the first that you have presented that are remotely positive with respect to the benefit of N-acetylcysteine to hearing loss. However,
a) This thread is about tinnitus, so not relevant
b) The study is on mice, unlike humans that were used in the first study you presented which showed no benefit to N-acetylcysteine
c) The post-treatment in the study was injected 24 hours after exposure, where it plausibly has far more opportunity to help than an injection years later as would be the case for tinnitus treatment (again, the first negative study you presented is more useful in this respect)

In short, the first study you presented was such a slam dunk dismissal of N-acetylcysteine as applied to real humans in realistic circumstances that your attempts to find other studies to back up your pre-held beliefs are pretty crystal clear case of motivated reasoning/confirmation bias.

The sum total of the research you have presented so far still combines to this: the idea of using N-acetylcysteine as a years-later remedy for humans seems extremely poorly backed up (if not dismissed by your first reference), to the extent that it is irresponsible to give people false hope by pushing it as a suggestion.

[cdev]

rs20, please don't put words in my mouth.

Those otoprotecton papers are specific to the situations they describe.

Since the 1940s, its been illegal under international law to perform medical experiments on humans without informed consent, and a clear plan likely to bring benefits to both the patient(s) and all humanity.
Experiments have to be approved by panels (and be likely to work, or at least plausible.).

Also it is and should remain illegal to behead human beings and analyze the relative density of different kinds of cells in their ears after subjecting them to various experimental conditions.

(/sarcasm)

All this said, occasionally I do get tinnitus, and its always caused by something. Mold is a common causative agent, and Ive learned that its a reliable indicator of hidden mold for me.

When I get that ringing, loud sounds become painful. This is almost certainly due to low glutathione and indeed, that ringing seems to be prevented by NAC.  I know this from personal experience. It happens all the time. Its almost as if I have a sixth sense, my ringing ears.

Its been shown that a great many common toxicants share this same pathway BTW,

[rs20]

All I'm saying is; there's a massive disconnect between A) the claims/anecdotal evidence you're presenting (including in your most recent message), and B) the research papers you're presenting. Since the latter ostensibly are presented to support the former, I feel it's only right for me to point this out -- for the benefit of those who may be convinced/wowed by journal references without taking the time to dig deeper.

I am by no means any sort of expert in this field; I just call out taken-out-of-context and BS research when I see it.

Again, the first study you present was performed on humans, and failed to find any benefit.

[cdev]

rs20, I'm very sorry but you're totally misunderstanding what I posted and and what I was trying to say.

Maybe seeing the wider picture would be helpful!

[Simon]

I had tinnitus for some time. Maybe years. It wasnt very loud, disturbing me or anything.
I was able to cure it. Basically, I wear ear mufflers, whenever I feel like it. Usually an hour, maybe two in a day. I wear it when I do something loud, power tools, even vacuum cleaning. I wear it, when the noise from the street is annoying me. I wear it when the neighbors do too much noise at 2 AM.
Mine is 3M Peltor X5A, this was claiming to have the best protection from their lineup, -31dB, that is a lot.

You look funny in it, sure. I dont care. Best 30 EUR I've spent in my life. Although, I also clean my ear regularly since, and I've been taking vitamins. Might have been those. In any case, I get annoyed by sounds made by other people (called misophonia*), so the ear protector is still a huge win.

Misophonia:

Misophonia, literally "hatred of sound", was proposed in 2000 as a condition in which negative emotions, thoughts, and physical reactions are triggered by specific sounds.

I hate people walking like a 2 ton cyberman, people hitting things together for no good reason other than to make the noise, smashing doors, leaving their 19 century tractor car standing below my window with running engine, motorcycles.

I have the same problems, I hate undue noise and am particularly sensitive to low frequency sounds, when i worked in a print shop the pressure waves from the large sheets of paper and worse card (300g/sqm) would leave me dazed, although not an audible sound I ws impacted. Ear muffs were a god send and I often take out the inner foam so that I can hear people talk but not the pressure waves from machinery.

My latest annoyance is hand driers work have just installed, with a non sound proof floor between the downstairs toilets and the office the sound of hand driers spinning up and down all day is very annoying, the one in our office toilet bearable as it gets less use and no doubt the resonance in the downstairs toilet creates low frequency sound tuned to the size of the room and filter by the floor.

I have tinitus that usually is of the high pitch type like a CRT HT transformer whistle, I think a jet engine at some point in it's operating range will make the exact same sound to the point I can believe that it's not my tinnitus but the engine only. Other times it can be like a car engine idling and that is really annoying.

Tinnitus is also stress related I have heard.

[cdev]

Simon,
Chemicals commonly used in printing, such as inks and 2-Isopropylthioxanthone (2-ITX) contain "agonists of the aryl hydrocarbon receptor" (AhR). (better known as the dioxin receptor)

I don't know what mechanism is involved in my own personal reaction but
sometimes reading a freshly printed document will make my ears ring like crazy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855230/

Freshly dyed clothing sometimes too.  Brand new blue jeans, for example.

[Simon]

Yes the chemicals can no doubt be a bad idea but I would also go to sleep to the sound of printing presses that were not there. I have only recently learnt the difference between and idling car outside and what sounds like an idling car. For that one turning over usually does the trick or exerting some muscle in my ear. I have have a hair lip and cleft pallet which apparently means my eustacian tubes will not be perfectly formed and will block more easily, I don't know if pressure build up's can cause noise in the ear, maybe that idling engine sound as air "bubbles" through slowly equalising the pressure.

[TheWelly888]

If hearing loss really bad - cochlear implants can help a bit.

I have a cochlear implant. I would like to point out that the hearing loss would have to be so bad that acoustic hearing aids cannot help at all - ie at least 100dB hearing loss! I was given to understand that tinnitus would not disappear completely after the implant activation, in fact it is still there but only noticeable when I don't wear the processor at night.

I have had tinnitus for as long as I can remember (I was born deaf) and I found that paying no attention to the tinnitus helped me deal with it - sometimes I made the tinnitus play a tune in my head or even imagine it was the sound of my favourite diesel locomotive!

[Dataforensics]

I can only relate my own experience. Developed tinnitus in one ear back in 2012 sounds like a noisy high pitch whistle and is 24/7.
Many doctors,tests and trial medications to no effect before I could get NHS to do hearing tests.
Was told I had age related high frequency degradation and some damage from a very loud noise in the past.
I to was reluctant to get a hearing aid possibly due to vanity or not willing to accept older age.
However the UK NHS provided me with one that is tailored to my frequency response last September.
The affect was amazing, the tinnitus was nearing unbearable before, but now I only notice it when I take the aid out or if I try to concentrate on hearing it.
And until getting the aid I never noticed how much my hearing had degraded, much easier to understand people talking in any sort of noisy environment.
Of course everybody is different so a hearing aid might not work for you.