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16.09.2014
We hypothesize that relief in the ear with the tinnitus complaint may result from oral intake of Clear Tinnitus for patients with severe disabling tinnitus in whom the factor of aeration of the middle ear and that of eustachian tube dysfunction is identified and treated.
Interference in aeration of the middle ears accompanying allergy and inflammation of the upper respiratory tract has been identified via a medical-audiological tinnitus patient protocol (MATPP) to be a factor that can influence the clinical course of subjective idiopathic tinnitus of the severe type [6-8]. Historically, the influence of aeration of the middle ear "effecting permeability of the eustachian tube" was reported by Politzer in 1863 [9].
Since 1979, the tinnitus clinic of the Health Science Center at Brooklyn, State University of New York, and the Martha Entenmann Tinnitus Research Center, Inc., have reported on more than 10,000 patients who had subjective idiopathic tinnitus (seen in neurotological consultation) and completed the MATPP. The prospect of a trial of Clear Tinnitus to attempt tinnitus relief in a selected cohort of patients who have subjective idiopathic tinnitus and exhibit objective evidence of interference in eustachian tube function provided a clinical opportunity to use our established experience to test the efficacy claimed for this preparation. We selected 15 individuals with reported subjective, severe, disabling idiopathic tinnitus lasting at least 1 year. The parameters of the patients' tinnitus included tinnitus intensity, location, masking characteristic, and duration. All 15 subjects reported the tinnitus to be of the severe disabling type lasting for at least 1 year. The homeopathic preparation for tinnitus relief- Clear Tinnitus-was taken on a daily basis.
The patients in this study completed multiple measures for evaluating the subjective idiopathic tinnitus and the hypothesized tinnitus relief.
We identified for each patient multiple risk dimensions known to influence the clinical course of subjective, idiopathic, severe, disabling tinnitus, with a focus on fluctuation of aeration of the middle ear and eustachian tube dysfunction. We used multiple objective measures to evaluate the risk dimensions for each tinnitus patient. The measures included audiological testing via puretone audiometry and speech audiometry performed using a Beltone 2000 audiometer.
Extensive scientific research has been carried out on the preparation's chemical composition, and pharmacological and clinical research has focused on its individual herbs. We performed all statistical analyses using the Statistical Package for the Social Sciences (SPSS Release 14) [19].
Regression analysis failed to detect any trends in the change in response to audiometric tests across the hearing spectrum; thus, we could not derive coefficients of change for testing.
Ultra-high-frequency audiometry (UHFA) did not show any clinically significant change in threshold at 10,000-20,000 Hz before and after testing with airconduction high-frequency or electrical high-frequency audiometry.
In the 11 patients completing the study, all masking curves were either type I or type IV according to Feldmann's classification system.
Minimum masking level (MML) changes for the right ear before and after the study are reported for 10 individuals, as 1 had no tinnitus at the end of the study. We established LDLs at 250-8,000 Hz for the right and left ears before and after the study (Table 5). For the tympanogram type, using -100 mm H2O as abnormal, three of the seven responders went from type C tympanogram to type A. Both responders and nonresponders (N = 11) correlated to recorded MEPs before and after the study (see Table 1). We found improvement in aeration of the middle ear, as established by tympanometry and supported by physical examination of the tympanic membranes, in eight patients. Five of the seven patients reporting subjective tinnitus abatement recorded MEP improvement at the start and conclusion of the study. A nonsignificant difference occurred over time when testing for a quadratic change over the course of the study, with a lowering of the total significant abnormal recordings. We analyzed the results of the outcome questionnaires as an average for all patients who completed the study (N = 11) and separately for the responders (n = 7) and nonresponders (n = 4; Table 7). The measurement of depression test (Zung) indicated a mean change of -2.27 before and after the study, which also was not considered statistically significant.
In summary, a statistically significant improvement in one or more of the outcomes (TII, TAI, TRQ) was identified in six of seven patients reporting tinnitus relief.
This study differentiated between the efficacy of the Clear Tinnitus preparation for maintenance and improvement of MEP and the correlation of the MEP improvement with reported tinnitus relief.
Seven of the 11 patients reported relief from severe, disabling-type tinnitus after oral intake of Clear Tinnitus.
The clinical course of the tinnitus patients selected for this study was identified, by their clinical history and physical examination, to have been influenced by fluctuation of MEP. The patients' clinical history was positive for the association of tinnitus intensity fluctuation with the subjective report of ear blockage-specifically, increased tinnitus intensity with increased ear blockage and vice versa. The regression analysis failed to detect any trends in a change in response with audiometric tests across the hearing spectrum; thus, we could not derive coefficients of change from testing. The range of normal and abnormal MEP varies in reports from different investigators (from -25 mm H2O to -100 mm H2O) [20-26]. The QEEG testing was recommended in this study to improve the accuracy of the tinnitus diagnosis. Clinically, when interpreted in terms of the tinnitus dyssynchrony-synchrony theory, the QEEG data in this study are considered to provide an understanding of the clinical course of the tinnitus in the patients in this study and of the efficacy of the Clear Tinnitus therapy attempting tinnitus relief [2]. The outcome results reflect the dilemma of all professionals involved in attempting to evaluate modalities of therapy attempting tinnitus relief: specifically, how a subjective response becomes one of affect and how a subjective response might be objectified [1,13]. The 11 tinnitus patients who completed the study demonstrated with tympanometry a statistical and clinical significance in MEP improvement (n = 8) or maintenance of MEP (n = 3) or both. The subjective report of tinnitus relief in those seven patients was supported by objective measures of analysis in five patients; the remaining two responders recorded normal MEP before and after the study. We gratefully acknowledge the support of Clear Products and the Martha Entenmann Tinnitus Research Center, Inc., for this educational and research effort.
My name is Stephen Geller Katz and I have and over the last 10 years I have developed a highly successful therapy for tinnitus which I have named Tinnitus Cognitive Retraining Therapy or TCRT.
This blog’s mission is to provide you with hope.  Maybe you have been told there is nothing you can do or that you just have to get used to it. I am telling you right now that there is plenty you can do and you don’t have to just get used to it.
Many people who come to me are desperate for hope and are even more stressed by the “doom and gloom” they encounter on the internet and from many of their doctors.  It’s this type of negative information that makes people feel helpless and even increases the tinnitus symptoms.
The mechanisms of hearing are complex and our understanding of them is continually evolving. After air vibrations reach the eardrum, delicate bones transcribe them to the fluid-filled chambers of the inner ear. These afferent (to the brain) nerves carry impulses through the brainstem to the “auditory belt” which decides which signals are important. Considering this elaborate chain of events, it’s easy to see how a hiccup at any point could create noise. A dietary deficiency is, by definition, when a specific nutrient is consistently low enough that it leads to a disease process. Individuals supplemented immediately after an event that could cause hearing loss did show improvement. As with any idiopathic disorder, it’s unclear as to what effect nutrients play in its development and treatment. Idiopathic means “unknown” and for most of us this also implies, “It could be anything!” – which is not entirely accurate. Some research has shown that people clinically deficient in some nutrients (like B12 or Zinc) may be more prone to develop tinnitus when exposed to acoustic trauma. When tinnitus cannot be associated with a diagnosable disorder, the general recommendation leans toward improvement in overall health, especially inner ear health. Many of the same dietary recommendations for cardiovascular disease are recommended for tinnitus. It’s always best to consult a doctor before embarking on any major lifestyle change involving diet or exercise. Researchers at Berkeley recently published an article in the Proceedings of the National Academy of Sciences offering insight and new hope into the phenomena that is hearing loss induced tinnitus.
Co-author Shaowen Bao and his team support the idea that neural cells of the auditory cortex strive to maintain a constant rate of firing regardless of the level of sound. The idea is that the overactive neurons can be convinced to “calm down” by offering them input from alternative sources. In recent years much discussion has surrounded micro-nutrients’ and the essential fatty acids’ role in reducing degenerative disease.
Free radicals (reactive oxygen species or ROS) have also been implicated in damage to the sound producing hair cells of the inner ear, and use of radical scavengers such as Pycnogenol and other antioxidants may be beneficial.
In addition to the herbal supplements, vitamin deficiency may also potentially lead to tinnitus – with reduced B-vitamins being particularly suspect. While vitamin supplementation is likely only valuable in cases of medically identifiable deficiencies, there is no evidence that an excess of B-vitamins have harmful effects and some argue the recommended levels may be too low.
When an underlying medical cause cannot be found the approach of improving general ear health is usually taken, although “healthy” can become an area of debate as different researchers come to different conclusions. There has been research into many supplements and non-traditional therapies for tinnitus, each showing varying levels of effectiveness. Nutrition and dietary deficiencies can play a very real role in heath and the progression of disease.
It’s actually hard to define a “vitamin” as they’re classified by what they do in the body vs.
Vitamin deficiency is when the levels of available vitamin, as measured in the blood, are below a standard set by the medical and biochemistry community. One point of debate is whether the current markers for high and low are really sufficient for preventing disease.
Vitamin deficiencies can arise from diet, metabolic problems or a failure to absorb a nutrient properly. The majority of dietary Cobalamin is found in meat, egg and fish products – and a diet low in these can make it difficult to keep B-12 levels normal. These proteins carry it through to the small intestine where the haptocorrins are degraded and the B-12 binds to “intrinsic factor”.
A failure of any of these proteins or receptor complexes can result in a failure to absorb or transport B-12. To date, there has been one formalized study showing that individuals already deficient in B-12 are more likely to suffer noise induced hearing loss with tinnitus after exposure to loud noise. If the deficiency is an absorptive problem (which can be confirmed by your doctor), B-12 shots are a well recognized therapy. It’s important to note that the liver stores enough B-12 to supply all the body’s need for 2 to 3 years. If you suffer from tinnitus, call our office today to schedule a consultation with the best tinnitus treatment center in NYC. Tinnitus affects an estimated 50,000 Americans and can be a very real source of frustration and stress in their lives.
Many people have had the experience of ringing ears and dizziness when fasting for long periods of time. One of the most common findings was a correlation between hyperinsulinemia (chronically high blood insulin) and inner ear disorders. Second, the correlation between insulinemia and inner ear problems is most strongly indicated in metabolic disorders that affect both hearing (auditory) and balance (vestibular).
Pro-Fono Revista de Atualizacao Cientifica did a direct study on the relationship of diet to tinnitus symptoms. What effect blood levels of glucose, insulin, triglycerides and cholesterol will have on tinnitus is still unknown, however there’s a rising body of evidence that they may have an effect on hearing and balance.
The Vagus nerve (also known as the 10th cranial nerve) supplies parasympathetic information to and from the medulla. Vagus nerve stimulation has long been used for the treatment of epilepsy and depression, however new studies have shown that it may also reduce symptoms of tinnitus.
Four of the patients in the study experienced a clinically significant reduction in tinnitus by as much as 26 decibels. The team is already working on a larger study where they hope to use more convenient implanted pulse generators so subjects need not come to the clinic for treatments. Hearing loss is often, but not always accompanied by tinnitus and in most cases the ringing is an independent issue caused by the factors that led to the hearing loss itself. Things such as the repetitive pounding of a jackhammer or constant hum of an engine create a sort of blunt trauma within the inner ear, damaging the delicate hair cells that transcribe sound waves into neural signals.
The pathology of tinnitus can stem from any point in the hearing chain starting with the ear canal and ending centrally with the brain. Illnesses of the inner like Meniere’s disease, perilymphatic fistula and infection often also result in tinnitus.
Less well understood causes of tinnitus may include blood supply and blood pressure, dysfunction of the brain’s hearing centers, allergy, diet and exogenous chemicals like drugs or alcohol.
Tinnitus Cognitive Retraining Therapy supports the latest research pointing to the role of neuroplasticity in helping to lower tinnitus level and intensity.
If you suffer from tinnitus call today for a free phone consultation to find the best tinnitus treatment that is right for you.
Call at 646-213-2321 to schedule a FREE 15 Min phone consultation with Stephen Geller Katz LCSW-R. Our goal was to establish the efficacy, in a 12-week period, of Clear Tinnitus for tinnitus relief in patients with tinnitus of the severe, disabling type.
We employed a descriptive data analysis method across dimensions of risk to evaluate a base of multidimensional evidence to support our hypothesis. We clinically identified all patients in this study as having subjective idiopathic tinnitus of the severe type lasting at least 1 year.
A focus on risk factors for each tinnitus patient provides an increased level of flexibility for interpretation of the clinical significance of the results of a treatment method and its future application for tinnitus relief.
Its application for hearing improvement and tinnitus relief has been reported in his classic textbook: "When there are accumulations of secretion in the middle ear, or anomalies of tension in the sound conducting apparatus which bring about an increased pressure in the labyrinth, it has been found inflations of air into the middle ear and rarefaction of air in the external meatus are often the most effectual means by which these subjective noises are overcome" [10]. Significant tinnitus relief was obtained in approximately 10-15% of tinnitus patients in whom identification of and satisfactory treatment for the factor of aeration of the middle ear and of eustachian tube dysfunction was completed [6-8,11,12]. Using multiple measures of analysis of risk factors, this study presents the results and conclusions of attempted tinnitus relief with Clear Tinnitus. The 15 patients variously reported a bilateral tinnitus location (n = 12), a unilateral tinnitus in the right ear (n = 2), bilateral tinnitus in the head and ears (n = 1), a tonal quality to the tinnitus (n = 11), a noise band (n = 1), a combination tone and noise band (n = 3), and high frequency (n = 15; Table 1).
All tinnitus patients completed an MATPP to identify the clinical type of tinnitus and factors influencing the clinical course of their tinnitus [6-8,11,12].
The specific regimen consisted of three capsules taken with food two times daily for 3 months. The answer to the final question was whether the reported tinnitus relief was considered significant to the patient.
We originally planned to use the data obtained to provide a base for a multivariate risk-benefit stratified analysis of the significance of the reported tinnitus relief. Conventional pure-tone audiometry conducted at 250-8,000 Hz (including 3,000 and 6,000 Hz) showed no significant difference in thresholds for either ear at any of the frequencies before and after testing all 11 subjects. Among our 15 patients, 12 originally reported tinnitus in the ears bilaterally, 2 originally reported unilateral tinnitus in the right ear, and 1 reported tinnitus in the head and ears bilaterally. Five were type I before the study, four were type IV before the study, and two were mixed (type I for one ear and type IV for the other ear).
No clear trend in the data for either ear was demonstrated by the mean change in LDL before and after the study. Two patients with a normal starting MEP that remained unchanged reported a positive tinnitus relief outcome, whereas one patient with a normal starting MEP that remained unchanged reported negative tinnitus relief. MEP improvement was recorded in three patients and remained unchanged in one, who had a normal MEP both before and after the study. Results of quantitative electroencephalography (QEEG) recordings of the four EEG frequency bands for the 11 patients completing the study. Results of quantitative electroencephalography (QEEG) recordings of the four EEG frequency bands for the seven responders. Five responders reported positive significance of the tinnitus relief, and two reported it as negative (see Table 6). An improvement in the TII and TAI scores of 2 units or more was reported by four of the seven.
All patients who completed the study demonstrated via tympanometry a statistical and clinical significance in MEP improvement (n = 8) or maintenance of MEP (n = 3) or both (see Table 1). As identified with tympanometry, five demonstrated a significant improvement in MEP, and two showed maintenance of a normal MEP (see Table 1). This clinical medical-audiological approach provided a basis for objective interpretation of the reported subjective tinnitus relief with the Clear Tinnitus treatment. The MATPP electrodiagnostic cochleovestibular test battery identified the tinnitus to be predominantly a cochlear type, bilateral and unilateral, with a middle-ear and central component. Physical examination of the tympanic membranes before and at the conclusion of the study identified mild to moderate scarring of the tympanic membranes consistent with eustachian tube dysfunction.


Clinically, this suggests to the limits of examination that the site of Clear Tinnitus action is not cochlear in location.
Pitch match did not correlate with outcome measurements, masking curve type, MMLs, or LDLs.
Clinically for this study, tympanometry values for a normal range of MEP were established to be from 0 to -50 mm H2O. It could function as a monitor for establishing the efficacy of the therapeutic modality-Clear Tinnitus-attempting tinnitus relief and aid in understanding the clinical course of the tinnitus as reflected in brain function of memory, consciousness, attention, and affect [3,12]. The low power of the analysis for the nonresponders (n = 4) precluded any conclusion or clinical correlation.
To determine patients' baseline responses, we administered questionnaires to record subjective tinnitus at the outset of the study and again at the conclusion. If the reality of the absence of a tinnitus cure at this time is accepted and tinnitus relief is the goal, is relief expected for the tinnitus sensation or for the annoyance and intrusion into one's lifestyle, as manifested in the behavioral response of affected patients to the presence of the tinnitus? Of the 11 patients, 7 with severe, disabling tinnitus and fluctuation of aeration of the middle ears (diagnosed with the MATPP as a factor influencing the clinical course of their tinnitus) reported tinnitus relief with Clear Tinnitus. These results indicate that a slightly larger sample size might have changed the outcome of this analysis. That little opening in the side of your head has a surprisingly significant impact on how you hear. Similar to tapping the skin of a water balloon, the sound ripples through the perilymph to a second fluid-filled chamber containing endolymph where things get really interesting. These marvels of evolution translate fluid vibrations into nerve impulses that get carried to the brain. The “important” signals continue on to the cortices of the brain and our conscious hearing while others – don’t.
The constant ringing and buzzing sound can be maddening, and research continues to search for causes and resolutions. A study published in the American Journal of Otolaryngololgy found a correlation between an existing deficiency in B12 and the tendency to develop hearing loss and tinnitus after exposure to loud noise. Zinc is related to neurotransmission and is found in very high concentrations in the inner ear. Most of these were directed at magnesium administration immediately following an acoustic trauma (loud noise) or sudden sensorineural hearing loss (when the hearing goes away suddenly for no known reason). This implies magnesium may play a role in inner ear function; or at least in those healing processes of the ear after an acoustic trauma.
It’s clear that nutrient deficiencies play a role in the development of disease including tinnitus. The cause is frequently unknown, which makes treatment a struggle to separate what works from what doesn’t.
With the exception of autoimmune or allergic inner ear disorders (which do exist) the answer to “Can foods cause tinnitus?” is maybe…but it’s pretty unlikely. Hyperinsulemia and unhealthy fluctuations in blood glucose have also been implicated in some inner ear disorders which can result in tinnitus.
In almost all circumstances, an improvement in one’s general health will have a positive effect on reducing symptoms. The inner ear and the stria vascularis are big energy users; needing a constant heavy supply of oxygen and nutrients to generate ATP.
Fewer caffeinated beverages, increasing essential fatty acids (EFAs), and supplements which have been shown to increase vasodilatation (such as Ginko Biloba and Niacin) may also have positive effects. It increases oxygenation to all tissues including the inner ear, creates a more flexible vasculature and an improved circulation overall. With your doctor’s guidance you can improve your diet and health, which will likely improve everything else including your tinnitus symptoms. A constant ringing in the ears, it can vary from little more than an irritation to a debilitating condition. In their paper they claim tinnitus is the result of acoustic cortex neurons attempting to “fill in the gap” of missing sound. The balance between this constant rate and the actual input from the inner ear is part of hearing homeostasis. However, this new information has created a paradigm shift in the way hearing specialists view the process.
Michael Merzenich, professor emeritus of otolaryngology at UCSF and chief scientific officer at Posit Science. This is similar to treatments for phantom limb syndrome where the brain is convinced to substitute different input (such as from a finger next to the missing finger) to correct its sensory gap.
Neurotransmitters are chemicals in the brain which both excite and dampen neuron signaling.
Arguments can be made that foods with less processing and a more organic lifecycle may be richer in these. N-acetylcysteine has received quite a bit of attention for its protective capacity from sound induced hearing loss which can lead to tinnitus. B12 is critical for maintaining the nerve’s protective myelin sheath as well as for the production of Epinephrine, Creatine, Methylated Nucleotides and Phosphatidylcholine for cell walls.
There is a rising body of research into the efficacy, and potential hazards, of supplementation for tinnitus. Contact us, the top tinnitus treatment center in the New York area, for answers and treatment options to quiet the ringing. Some of the suspected causes of tinnitus include blood flow disorders, inflammation, mechanical disruptions (such as in the neck, jaw or ear), chemical contact and prolonged exposure to noise. Weight loss, a more nutritious and balanced diet, and exercise will reduce inflammation, increase blood flow and improve overall functioning of the whole body. It can be related to a diagnosed medical condition or be completely idiopathic; and when the cause is unknown finding solutions is an exhausting process. The herbal and vitamin market abounds with claims, both supported and anecdotal, for the benefits of supplementation. The aforementioned problems certainly arise when levels of B-12 are significantly low, for a long time. B-12 can’t be manufactured by either plants or animals, and is actually formed by bacteria. Vegans must pay special attention to ensure their diets have a full complement of nutrients including B-12. Pancreatic insufficiency or a high (basic) intestinal pH can lead to problems with this step. It’s common for the production of intrinsic factor to diminish with age, which is why we hear so much about B-12 shots for the elderly. It is known that deficiencies in B-12 can cause neurological symptoms due to hypomethylation within the nervous system (resulting from an inability to recycle homocysteine to methionine and ultimately to S-adenosylmethionine).
While one study does not a scientific truth make, this is a good place to start the investigation.
If the failure is with B-12 usage from the blood stream, there are lifestyle changes that can maximize the value of the vitamin that is being absorbed such as maintaining adequate cysteine in the diet. This is why symptoms of B-12 deficiency are slow to develop, and a single low blood test is not necessarily time to panic. When a medical treatment cannot be found, many turn to holistic and other lifestyle changes to help control the ringing. Because the inner ear (especially the stria vascularis) is so heavily energy dependent, the assumption is that any reductions in blood flow, oxygen or glucose can result in disturbances to homeostasis resulting in tinnitus. Metabolic disorders have long been suspect in diseases of the inner ear, and some recent studies indicate that high levels of insulin may have a strong correlating factor. There is speculation amongst investigators as to whether high insulin is a direct cause of disease processes or just an indicator. In one study, up to 25% of participants with insulinemia were also diagnosed with Meniere’s disease.
Their suspicion was that triglycerides and cholesterol, as well as glucose and insulin, may have an impact on tinnitus and hearing. The study also reported a statistically significant number of patients taking the cholesterol drug Atorvastatin showed improvements in tinnitus, although not an improvement in overall hearing levels. The initial research indicates that having healthier serum levels may improve symptoms of tinnitus. It communicates in one way or another with nearly every part of the neck, face and torso including portions of the Glossopharyngeal nerve (throat and swallowing) and the seventh facial nerve which carries impulses of facial sensation. In VNS, small electrical pulses are delivered to the Vagus nerve via a pulse generator implanted in the neck. Three of these sufferers had a 44% reduction in the impact the illness was having on their daily lives. This study is one of many showing that nerve stimulation, when used in conjunction with cognitive and behavioral retraining, may be the golden ticket for new treatments to relieve the symptoms of tinnitus. Sound is ultimately a neurological process stimulated by the mechanical movements in the middle and inner ear. While a single sound event has been known to cause tinnitus, it most commonly results from long-term exposure to loud noises, especially “impact sounds”. It is not clear whether the resulting ringing comes from a malfunction of the hair cell itself, damage to the underlying nerve or both, but the results are the same; a constant, potentially maddening buzz. The eardrum and bones of the middle ear translate the air vibrations into movements of the inner ear membranes. In some cases it arises from interference of the mechanical movement of the inner ear, while in others it directly affects the hair cells or nerves. Aspirin and other non-steroidal anti-inflammatories (NSAIDs) have a long standing reputation for causing transient tinnitus, as do sedatives, anti-depressants, quinines and over 200 other medications.
In other words, changing your thought patterns over time actually has the effect of rearranging neurons. The benefits of a risk-stratified multivariate analysis across dimensions of risk, originally planned for this study, could not be achieved owing to an insufficient final sample size [4]. We hypothesize in this study that relief occurs by identifying and treating the factor of aeration of the middle ear. The clinical history of each tinnitus patient reflected periods of tinnitus relief associated with fluctuation of tinnitus intensity and the location and degree of ear blockage. Such an analysis provided information of both the sensory and affect components of the tinnitus complaint [15].
Tinnitus evaluation included pitch and loudness matching, masking curves, and loudness discomfort levels (LDLs).
A copy of the manufacturer's cGMP certification and standard operating procedures used in the production of Clear Tinnitus is maintained by Clear Products, Inc. We modeled recordings of audiometric tests across the hearing spectrum using nonlinear regression. The adverse reactions included gastrointestinal complaints (one with gastroesophageal reflux disease and one with bloating and constipation) and ear complaints (one with "ear spasms"). Likewise, speech audiometry did not show any significant difference for speech reception threshold or word discrimination scores before and after testing. The quality was reported as tonal in 11 patients, as noise band in 1, as combined tone and noise band in 3, and as high-frequency in all 15. After the study, five with type I remained unchanged, and three of the four with type IV remained unchanged.
For the left ear, the eight patients who had tinnitus after the study exhibited a reduction in the masking level of - 11.25 dB at 8,000 Hz (Tables 3 and 4).
Of the four who did not report improvement, three went from type C to type A (one on both ears, the other two on one of the two ears; see Table 1). Two patients whose MEP was abnormal to start but changed to normal reported positive tinnitus relief, whereas three patients whose MEP was abnormal to start but changed to normal reported negative tinnitus relief. The number of significant abnormal power recordings was identified with a normative database and analyzed by the Lexicor Corporation. When tested by a paired Student's t-test for change over the course of the study, only the TII, the TAI, and the TRQ demonstrated a significant decrease in the patients' responses.
One patient reported tinnitus relief, improvement in MEP, and no improvement in outcome measures.
A multidimensional method of analysis across dimensions of risk is recommended for all clinical studies attempting to evaluate the efficacy of therapeutic modalities attempting tinnitus relief.
The clinical type of this tinnitus correlates with the patients' reports of tinnitus relief in five of seven.
The reported improvement in MEP with tympanometry was associated with reported subjective abatement in ear blockage in the tinnitus ear and with evidence of increased aeration of the middle ear on physical examination of the tympanic membrane. Otoacoustic emission tests in the future may provide a basis for audiological coefficients of change. In the 11 patients completing the study, all masking curves were either type I or type IV, according to Feldmann's classification system. The Clear Tinnitus preparation did not significantly influence the tinnitus evaluation measures consisting of pitch match, masking curves, MMLs, or LDLs.
The QEEG results are considered to be electrophysiological brain function responses hypothesized to reflect a synchrony of responses at the cortex in the central nervous system (see Fig.
The delta band was significantly higher than the alpha and beta bands both for the overall cohort of 11 patients and for the 7 reporting tinnitus relief (see Table 5; see Figs.
In only one patient in this study, demonstration of the theta and its increase may reflect the persistence of the tinnitus and the ongoing development of a paradoxical memory for the dyssynchronous auditory signal-tinnitus [2,3,27-29].
Of the six outcome measures, only the TII, TIA, and TRQ reported the data to be statistically significant (as noted by the asterisk in the top row of Table 7).
This study supports the hypothesis that identifying and treating the MEP fluctuation factor may provide tinnitus relief from a predominantly cochlear-type tinnitus. Quantitative electroencephalography - power analysis: An electrophysiologic correlate of brain function in subjective idiopathic tinnitus patients. Tinnitus reaction questionnaire-psychometric properties of a measure of distress associated with tinnitus. He discovered that by helping people to retrain and reinterpret the thoughts around their Tinnitus, anxiety and depression symptoms began to improve. These impulses are then further processed based on things like location to the listener, volume and quality to determine what’s “important” and what can be ignored.
Like a subwoofer, the canal itself creates resonances which amplify or reduce specific frequencies.
This is one reason we can locate sound and “tune-out” background noise like ignoring someone else’s conversation at a party. When an obvious link in the chain is disrupted, for example with acoustic neuroma, the targeting of treatment is relatively straightforward. Much study has gone into whether vitamins, minerals and other dietary issues can lead to tinnitus. Research has looked into nutrient levels as they relate to tinnitus and into supplementation as a solution to its frustrating symptoms. While the evidence for supplementation to improve tinnitus was not examined in this particular study, maintaining healthy levels of B12 may be helpful for avoiding the illness and preventing it from worsening. The studies however have not been able to come to a consensus as to a relationship between zinc and tinnitus. The goal was to investigate hearing loss prevention and the subsequent development of tinnitus. Studies regarding magnesium as a treatment for existing tinnitus have not shown much benefit to date but research continues. Certainly, a healthier lifestyle including improved diet and exercise is always beneficial to those suffering chronic illness. Whether or not diet is the source, the good news is that what you eat may help improve your symptoms. Some suspect tinnitus results from restrictions to blood flow, whether from blockage or genetically small blood vessels. Reductions in salt are a common recommendation for some illnesses such as Meniere’s disease, and may have benefits for peripheral blood flow as well. The hormones triggered by exercise have growth and healing effects for tissues that have been or are being damaged. Tinnitus is caused from a variety of problems ranging from hearing loss to injury, and has been the subject of extensive research into both its causes and potential treatments. In hearing loss induced tinnitus, the sound transcribing hair cells of the ear are destroyed and stop sending their signal to the brain.
Serotonin and glutamate are well known excitatory neurotransmitters, with GABA (gamma-aminobutyric acid) being one of the common inhibitory neurotransmitters. Some of these include enhancing GABA receptor function in the auditory cortex, increasing GABA synthesis, and slowing re-uptake or enzymatic degradation of the neurotransmitter. While the effect on chronic illness of the steroids, antibacterials and artificial feeds often found in factory farming is still unclear, choosing to avoid these can be a healthy precaution.


Other anti-inflammatory nutrients under investigation include turmeric, ginger, dandelion, oregano, garlic and green tea.
B12 is also a cog in the creation of Melatonin, which may improve tinnitus symptoms and provide better sleep. It’s important when beginning any regime of holistic medicine to do your research and investigate both the good and the bad.
As with most idiopathic nerve problems, the cause of one person’s tinnitus may differ completely from another’s. Treatments directed at each of these causes can be found in traditional and holistic medicine – the benefits of which are subjective to the sufferer. As an example (and to our great fortune) aspirin (salicylic acid) was discovered in the home remedy brews made from willow bark. Vitamin B-12 has been getting a lot of press lately regarding tinnitus and it’s hard to make sense of all the new information. But some argue that more mild insufficiencies may contribute subtly to degenerative illnesses.
Cobalamin must be bound to protein during digestion, absorption and transportation through the blood. It should also be noted that the study did not address whether supplementing with B-12 is protective or restorative, or if deficient B-12 simply left the hearing more vulnerable.
While the journals report no evidence that taking excessive B-12 is hazardous, a person is concerned about B-12 should work with their doctor and a nutritional specialist to determine the concern, cause and the need to take action. Recent research has identified some of the potential relationships between tinnitus and diet.
Research has been progressing on this subject and has been coming to some surprising and some not-so-surprising conclusions. It’s difficult to say if insulinemia is related in the same way to hearing loss and tinnitus alone. Improving one’s diet will certainly have a positive effect on blood flow and energy which is always a positive in any chronic health condition.
Researchers have been investigating the possibility that tinnitus may be related to a disparity in the brain’s processing of hearing and tactile (touch) nerve impulses.
During one study conducted by the University Hospital Antwerp, Belgium, tinnitus patients received two and a half hours of VNS every day for 20 days.
By definition tinnitus is a false signal sent to the brain, and as with any complicated biological mechanism there are multiple points of failure that can create the phantom noise. Problems such as infections, cholestomas (growths in the middle ear) and eustachian tube dysfunction can all lead to tinnitus.
The nerves leading from the inner ear to the brain may also be directly influenced by things such as acoustic neuroma, a small benign tumor that presses against them. This might seem surprising; however, this is the very same mechanism through which all learning occurs. We hypothesized that tinnitus relief with Clear Tinnitus reflects improvement in the sensory component of the tinnitus complaint by controlling the factor of aeration of the middle ears and improving eustachian tube function. The designers of Clear Tinnitus have claimed that this blend of homeopathic remedies and herbal medicine, when taken on a daily basis for 3 months, has resulted in significant tinnitus relief [5].
We used quantitative electroencephalography (QEEG) as a monitor at the start and conclusion of the study to identify patterns of electrical activity of brain function hypothesized to reflect tinnitus relief [16]. We performed ultra-highfrequency audiometry using the Tonndorf audiometer for electrical high-frequency audiometry and the Beltone 2000 audiometer for air-conduction high-frequency audiometry.
We correlated the physical examination of the tympanic membrane with the tympanometry result. We used within-group repeated-measures analysis of variance (RMANOVA) to assess the differences in the TAI, the TST, the TII, the THI, the stress test, and the depression scale. The remaining patient dropped out after 1 week in the study because of difficulty in adhering to the regimen, even though subjectively reporting tinnitus relief through the use of Clear Tinnitus. For 10 of the 11 patients who completed the study, tinnitus location was unchanged; the remaining patient had no tinnitus at the end of the study. Of the remaining three, one with type IV went to type I for both ears; the other two with type IV in both ears went from type IV to type I for one ear and remained at type IV for the other.
Two patients with a borderline MEP at the outset that changed to normal reported a positive tinnitus relief outcome, and a single patient with an originally abnormal MEP that changed to borderline also reported positive tinnitus relief.
Comparison QEEGs of the seven responders and four nonresponders demonstrated similar patterns. The TST indicated a mean change before and after the study of -4.18, which was not statistically significant. Owing to small sample size, statistical analysis was limited to univariate and repeated-measures statistical procedures. The correlation of the nonresponders (n = 4) and the responders with the recorded fluctuation in MEP is considered significant.
The tympanogram findings of improvement in MEP function in responders is considered to support the hypothesis that improvement in MEP underlies Clear Tinnitus resultant efficacy for tinnitus relief by influencing the transduction mechanism of the middle and inner ear. The similarity of the mean delta QEEG response in the 11 patients and the 7 individual responders and the relative lack of correlation of the delta response to the remaining theta, alpha, and beta find clinical support for consideration that the action of the Clear Tinnitus preparation is predominantly its peripheral MEP effect, with secondary tinnitus relief as reported by the responders, and not specifically its effect on the tinnitus. No significance appeared in comparing the results of responders to those of nonresponders but, again, this could be owing to the small sample size when separating the patients into independent groups. The vibration causes change in the intracellular (inside the cell) potassium and calcium levels, releasing neurotransmitters that stimulate electro-chemical impulses down the hearing nerves.
As a part of this process, the brain also sends impulses back to the ear (efferent impulses) which change how the hair cells respond to sound by physically changing their shape and how they respond to ions. While the jury is still out, there is a growing body of evidence that maintaining a healthy diet with a full complement of nutrients is beneficial. It’s rare that supplementing is harmful and many doctors recommend daily supplementation for improved general health.
For idiopathic (unknown) tinnitus, lifestyle changes including exercise and diet are often effective.
In the brain’s attempt to reconcile this loss the cortex neurons become hyperactive – creating the sensation of constant sound (tinnitus). Blood flow restriction and inflammation are common suspects in tinnitus and a number of vitamins and lifestyle recommendations address this. B6 is well known for its role in energy production, while the other B-vitamins are needed to assemble proteins and nucleic acids.
With this said, many non-traditional treatments are showing solid potential for relief of your ringing ears. For this reason therapy plans are usually dictated by the underlying medical condition leading to tinnitus – whether from injury, an inner ear disorder or any of dozens of other pathologies.
Enzymes and their co-factors are not destroyed when they do their work, nor are they added to the final product, so they can be reused until they break down. Being below this level for long-term can lead to symptoms including megaloblastic anemia and neurological symptoms like numbness in the hands and feet, gait disturbances (problems walking) and even changes to taste and vision.
A transcobalamin II receptor is used by peripheral cells to take it from the bloodstream, with about 50% of B-12 ending up in the liver for storage. Some believe the real culprit is chronic high or low glucose levels with insulinemia either leading to the fluctuations or resulting from it. Volunteers were placed on a diet plan tailored for them individually which was intended to reduce serum cholesterol, triglycerides and maintain more consistent glucose levels. Treatments based on external stimulation of these nerves have shown promise for a return to silence. The electrical stimulation was paired with audible tones that excluded the hearing frequencies where the tinnitus was active. Otosclerosis for example is an illness affecting as many as 1% of the people in the United States.
This interference leads to specific frequency of tinnitus that is often helpful in its diagnosis. And Tinnitus Cognitive Retraining Therapy harnesses your brain’s learning power by directing it to follow new adaptive pathways that in turn lead to significant relief from tinnitus symptoms over the course of treatment. At the start and conclusion of the study, we performed QEEG testing using a Neurosearch 24 Instrument (Lexicor Medical Technology, Inc., Colorado) to measure objectively a spectral analysis of electrical activity of the brain.
Type I masking curves are considered consistent with peripheral tinnitus and type IV with central tinnitus (Table 2). Of the seven responders, two reported no MEP change; one nonresponder also reported no MEP change. At the conclusion of the study, 10 of the 11 patients had normal to borderline MEPs, and 1 had an abnormal MEP. No significant main effects arose for either changes in the number of abnormal QEEGs over time or the interaction of the EEG band by time.
In a comparison of the change in response between responders (n = 7) and nonresponders (n = 4), we observed no significant differences. The THI indicated a mean pre- and post-study change of -11.73, which was not considered to be statistically significant. In both groups, MEP fluctuation or maintenance of normal pressure was and was not (respectively) correlated with positive tinnitus relief.
Significant for this study is the correlation of -100 mm H2O as abnormal with the tympanogram results: Of the seven patients who reported subjective improvement, three went from type C tympanograms to type A. In general, it was hypothesized for this study that an alteration in an original dyssynchronous auditory signal from the peripheral auditory system, resulting from improvement in MEP, and its subsequent effect on the transduction processes of the middle and inner ear, when received by the thalamus, would be synchronized at brain cortex in the form of different brain rhythms. A reduction in the number of significant delta band recordings occurred over the time course of the study; however, the reduction was not statistically significant. We recommend a larger patient sample over a longer interval of Clear Tinnitus treatment to determine whether the delta rhythm data, although not significant at this time, may reflect a trend of a positive response to therapy when correlated with the remaining theta, alpha and beta frequencies. For the tinnitus outcome tests that were statistically significant, the key question to be asked is whether the reported tinnitus relief is clinically significant to the patients. For still others, a combination of these factors or other issues are the goals of treatment.
Voice communications average around the 2000Hz range and the ear canal amplifies this peak. In these cases, it will take time to eliminate the factors leading to such strongly differing results. Bao describes this phenomenon as similar to “phantom limb syndrome” where amputees continue to feel sensation from the missing limb. Avoiding vasoconstrictors (which make blood vessels contract) such as caffeine is common, as are supplements such as the bioflavinoids and ginko biloba which both have a vasodilating effect. Others think insulin may be the cause and better blood insulin control will be an effective treatment. In otosclerosis, the bones of the middle ear grow over time to become misshapen and interfere with normal hearing function.
We placed an electrode array (consisting of 19 electrodes) on the scalp in a standard international 10-20 pattern [16]. The clinical significance to the patient of reported and recorded tinnitus relief was positive in five patients. Of the remaining three, one with type IV went to type I for both ears, and the other two who were type IV for both ears went from IV to I for one ear and remained type IV for the other. Alterations in the brain rhythms may reflect the efficacy of the Clear Tinnitus for tinnitus relief. The QEEG data suggest that a slightly larger sample size might have changed the outcome of this analysis. Of interest was the response of the seven patients who reported tinnitus relief: When asked whether their relief was "significant," the response was negative for two and positive for five. In any case , the outcome results of this study emphasizes the need for a battery of outcome measures to be included in the evaluation of therapeutic modalities attempting tinnitus relief [13]. Changes in the shape of this acoustic chamber (as well as changes to the external ear) can alter the location of this peak, causing a distortion in sound. Every day new and amazing discoveries are made although it will be some time before the mysteries of the ear, hearing and balance fully unravel. However, the trend in zinc studies so far is that (again) an existing deficiency in zinc may leave one susceptible to tinnitus (especially in the elderly) and supplementation in these cases may lead to improvement.
It’s this last observation that leads to the first of two exciting new possibilities for treatment.
The analogy here is a balance scale, where sand is constantly being added and subtracted from both sides and the overall activity of the neuron being the weight at any given moment. Research continues to determine exactly how insulin, glucose and inner ear function are related. We employed a descriptive data analysis method across dimensions of risk to evaluate a base of multidimensional evidence and establish support for our hypothesis. At the conclusion of the 12-week period, we repeated all the audiological tests administered on the initial visit. The analysis compared changes over time in the number of abnormal recordings from the main locations of the scalp recordings (frontal, temporal, parietal, and occipital). This difference, when analyzed by a general linear RMANOVA, was not significant owing to the low power and small sample size. Type I masking curves are considered consistent with peripheral tinnitus and type IV with central tinnitus. Of the four who did not report subjective improvement, three went from type C to type A (one in both ears, the other two in one ear). Efficacy of treatment was hypothesized to be reflected by a reduction in the delta or beta frequencies (or both), a minimal or unchanged theta frequency, and an increase in the alpha frequency. The reduction in the delta response was accompanied by a small increase in the theta response in one patient (not statistically significant at this time). Such a battery of outcome measures should be completed at least at the start and end of the study. A medicalaudiological tinnitus patient protocol completed by each patient identified the clinical type of tinnitus as predominantly cochlear, with a central and middle-ear component bilaterally. We used the RMANOVA to test changes in the number of abnormal recordings for the 12-week period of the study for the EEG band frequencies delta, theta, alpha, and beta. This lack of significance, due to low power (.336), estimates that there was approximately a 66% chance of missing a significant result for the change in the number of significant recordings over time. We found no statistically or clinically significant correlation of masking curve type to outcomes.
Nonresponders with normal MEP and responders with no MEP change provide an inconsistency surrounding the hypothesis.
Furthermore, the duration of clinical studies evaluating therapeutic modalities for tinnitus relief should be long-term (at least 6-12 months).
We identified fluctuation in middle-ear pressure (MEP) via patients' clinical history, supported by physical examination and established with tympanometry, as a factor influencing the clinical course of the tinnitus in each patient. No significant relationship appeared with the number of reductions of significant QEEG recordings over time and MMLs or LDLs.
In the patients reporting tinnitus relief when a tympanogram type A was identified at the start of the study and remained unchanged at the conclusion of the study, the tinnitus relief correlated more with the improvement in appearance of the tympanic membrane and the reported reduced negative MEP than with the tympanogram type (see Table 1). Descriptive data analysis failed to detect any trends in a change in response with audiometric tests across the hearing spectrum; thus, we could derive no coefficients of hearing change. The Feldmann masking curve comparison at the start and end of the study showed no significant change in the 11 patients. There was no significant alteration in the minimum masking levels or loudness discomfort levels before and after the study.
Quantitative electroencephalography analysis revealed a marked difference in the number of significant abnormal recordings between the different frequency bands, with the delta band significantly higher than the theta, alpha, and beta bands for both the overall cohort of patients (n = 11) and those reporting tinnitus relief (n = 7). The tinnitus outcome questionnaires-the tinnitus intensity index, the tinnitus annoyance index, and the tinnitus reaction questionnaire- revealed a significant difference for the patients (7 of 11) obtaining tinnitus relief. Results of the tinnitus stress test , the tinnitus handicap index, and the measurement of depression scale before and after the study were not statistically significant.
Conclusions: Patients who completed the study demonstrated with tympanometry a statistical and clinical significance in MEP improvement or maintenance of MEP (or both). Patients with tinnitus of the severe disabling type selected for this study and responding to Clear Tinnitus reported tinnitus relief accompanied by improvement in or maintenance of MEP of the middle ears. The statistical and clinical significance of Clear Tinnitus for establishing tinnitus relief remains to be established with a larger cohort of tinnitus patients.



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