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Author: admin | 19.12.2015 | Category: Ginkgo Biloba Tinnitus

Thyroid is a small gland situated at the front of your neck, just below the larynx about the size of two joined cherries.
The thyroid gland releases 3 important hormones- Tri-iodothyronine (T3), Thyroxine (T4) and Calcitonin. If the thyroid gland secretes a little amount of Tri-iodothyronine and Thyroxine, then we will get cold or tired, our skin gets dried and we will put on weight. If the thyroid sends out too much of T3 and T4 hormone, then it causes anxiety, sweaty and overactive and we will also lose weight. The amount of T3 and T4 send out by the thyroid depends on how much thyroid-stimulating hormone is sent to it from the pituitary gland.
If the amount of T3 and T4 drops out in the blood, then the pituitary gland sends out extra thyroid stimulating hormone to tell the thyroid to produce more.
With respect to incidence (the table above is about prevalence), Martinez et al (2015) reported that there were 5.4 new cases of tinnitus per 10,000 person-years in England.
Henry et al (2005) reported that noise was an associated factor for 22% of cases, followed by head and neck injury (17%), infections and neck illness (10%), and drugs or other medical conditions (13%).
Thus it can see that there are numerous factors that are weakly correlated with tinnitus, and that hearing impairment is the most strongly associated. Most tinnitus comes from damage to the inner ear, specifically the cochlea (the snail like thing on the right of figure 1, labeled '9').
Patients with Meniere's disease often describe a low pitched tinnitus resembling a hiss or a roar. Tinnitus can also arise from damage to the nerve between the ear and brain (8th nerve, labeled 6, auditory nerve).
Tinnitus arises more rarely from injury to the brainstem (Lanska et al, 1987), and extremely rarely, to the brain itself (e.g.
Tinnitus can be associated with Basilar Artery Migraine (BAM), and also tinnitus can be more bothersome when one is having a migraine (Volcy et al, 2005), like sound and light and smells. In our opinion, people are very quick to blame drugs for their tinnitus, but it is rare that this is borne out.
Often people bring in very long lists of medications that have been reported, once or twice, to be associated with tinnitus.
As tinnitus is essentially subjective, malingering of tinnitus as well as psychological causes of tinnitus is certainly possible.
In malingering, a person claims to have tinnitus (or more tinnitus), in an attempt to gain some benefit (such as more money in a legal case). Schecklmann et al (2014) suggested that tinnitus is associated with alterations in motor cortex excitability, by pooling several studies, and reported that there are differences in intracortical inhibition, intra-cortical facilitation, and cortical silent period. Cartoon of the middle ear showing muscles that attach to ossicles (ear bones), and ear drum. ABR (ABR) testing may show some subtle abnormalities in otherwise normal persons with tinnitus (Kehrle et al, 2008). We occasionally recommend neuropsychological testing using a simple screening questionnaire -- depression, anxiety, and OCD (obsessive compulsive disorder) are common in persons with tinnitus. Microvascular compression of the 8th nerve is not a significant cause of tinnitus (Gultekin et al.
Other entities that can sometimes be seen on radiological testing and that can cause pulsatile tinnitus, include AVM's, aneurysms, carotid artery dissection, fibromuscular dysplasia, venous hums from the jugular vein (found in half the normal population), vascular tumors such as glomus, ossifying hemangiomas of the facial nerve, osseous dysplasias such as otosclerosis and Paget's, elevated intracranial pressure.
Disrupted sleep is the most significant complaint, and affects between 25-50% of tinnitus patients. The algorithm that we use in our practice to diagnose and treat tinnitus is here (a PDF graphic). The bottom line is that it is unusual (although not impossible) for people to get substantial relief from medication, devices, or surgery.
Pan et al (2015) reported in a survey of 258 patients with tinnitus, that 38% reported that noise made tinnitus better, and 15% that relaxation made it better. There is a small literature concerning use of intravenous and local anesthesia for tinnitus. Liu et al (2011) reported use of botox for tinnitus due to tensor tympani myoclonus, by inserting gelfoam with botox through a perforation in the tympanic membrane. Pramipexole was recently reported effective for tinnitus in a study of 40 patients with age related hearing loss in Hungary. While Hearing aids are often recommended as treatment of tinnitus, according to Hoare(2014) from the Cochrane Databse, the quality of evidence for their effect is so poor that no conclusion can be made. Cochlear implants, which are used for severe bilateral unaidable hearing loss, usually improve tinnitus (Amoodi et al, 2011). These are devices based on the idea that tinnitus is usually worst when things are very quiet. A discussion of the Neuromonic's masking device can be found by clicking on the link above. Friedland and associates (2008) reported results of brain electrical stimulation in 8 patients. Occasionally persons with Meniere's disease have relief or reduction of tinnitus from transtympanic gentamicin.
Microvascular compression syndrome, in theory, may cause tinnitus, but we have had very little success when the few patients we have seen with this syndrome have undergone surgery.
Tinnitus usually improves in profoundly deaf individuals who undergo cochlear implantion (Olze, 2015).
Avoid exposure to loud noises and sounds, avoid environments that are very quiet (as this makes tinnitus more noticeable). Internet based psychological treatments have been available for about 15 years, and have considerable promise (Andersson et al, 2015). Tinnitus Retraining Therapy (TRT) is a method of treating tinnitus helpful for some (Wang et al, 2003). We sometimes refer patients for TRT, but the time required and general lack of health insurance support for long term psychotherapy are significant barriers.
Plein et al (2015) suggested that the quality of published studies concerning clinical trials for tinnitus were suboptimal, and in fact, only 20% of 147 had a low risk of bias. Dawes P, Fortnum H, Moore DR, Emsley R, Norman P, Cruickshanks K, Davis A, Edmondson-Jones M, McCormack A, Lutman M, Munro K.
Hoare DJ, Kowalkowski VL, Kang S, Hall DA.Systematic review and meta-analyses of randomized controlled trials examining tinnitus management. Mahboubi H, Ziai K, Brunworth J, Djalilian HR.Accuracy of tinnitus pitch matching using a web-based protocol. Piccirillo JF, Garcia KS, Nicklaus J, Pierce K, Burton H, Vlassenko AG, Mintun M, Duddy D, Kallogjeri D, Spitznagel EL Jr.Low-frequency repetitive transcranial magnetic stimulation to the temporoparietal junction for tinnitus Arch Otolaryngol Head Neck Surg. Schecklmann M1, Landgrebe M2, Kleinjung T3, Frank E1, Rupprecht R1, Sand PG1, Eichhammer P1, Hajak G2, Langguth B1. Wineland AM, Burton H, Piccirillo J.Functional Connectivity Networks in Nonbothersome Tinnitus.
John, a sixty-seven-year-old man, recently retired from teaching high school, then went back to work as a security guard at the school gate. I determined that John probably had tinnitus, the symptoms of which are hearing phantom sounds in the ear, including buzzing, clicking, hissing, ringing, or whistling, when there is no external noise. Subjective tinnitus is the most common form, and only the person can hear or feel it in this type. Objective tinnitus is the type where both the patient and the doctor doing the examination can feel the sound. The above depicts the organ of corti of inner ear, there are about 15,000 micorscopic sensory hair cells, which are very fragile and easily damaged.
For this type of tinnitus, the treatment might be lidocaine injections to the inner ear, and benzodiazepine to calm the person and decrease his or her anxiety, tricyclic antidepressants to decrease depression, or carbamazepine and melatonin to help decrease the tinnitus.
John underwent TCM treatment for reducing excessive heat with SI 19 Ting Gong and GB 2 Ting Hui points on both sides, and Liv 3 Tai Chong and St 36 Zu San Li, all of which were utilized to decrease excessive heat in the kidney and to improve his kidney and stomach function. In my personal experience, the Ting Gong, Ting Hui, and Er Meng are the most important points, and by using this acupuncture treatment plus electrical stimulation each session for 30 minutes three times a week for one to two months, the tinnitus symptoms will most likely greatly decrease.
Always massage points SJ 21, SI 19, and GB 2 for 30 minutes each session, 2 sessions per day. Because Chinese medicine treats the body as a whole organism, rather than treating one symptom at a time, acupressure points that cure tinnitus can be found in all corners of your body- your feet, abdomen, wrist, back, and head all have specific grid points that when triggered will cure whatever ailments are causing your tinnitus.


To locate your Bai Hui, imagine a line running on top of your head, forward to back, between your ears, sort of like a Mohawk.  The point that is directly on top of your head in the middle is your Bai Hui. GB 20 is another powerful point for curing illnesses of the head like tinnitus and headaches.
SI 19 is used in Chinese medicine to calm the spirit and treat ear problems, including tinnitus and deafness. Ting Gong is located in the hollow directly in front of each ear.  To access, open your mouth, and feel the depression where your jaws meet. GB 2 particularly helpful for treating all ailments related to the ear such as tinnitus and hearing loss. GB 8 is beneficial for treating damage caused by toxins.  This is especially helpful for curing tinnitus caused by long-time use of painkillers, antidepressants, birth control, and quinine. Do you believe that using natural supplements can reduce tinnitus triggers, when used in conjunction with acupressure for tinnitus? If you are new here, you might want to subscribe to the RSS feed for updates on this topic.
It is controlled by the pituitary gland, which is the master gland for all other glands and hormones in our body. These hormones play a prominent role in controlling the entire body’s metabolism rate by circulating into the blood and stimulating cells to convert more glucose.
Over iodine intake leads to increased secretion of hormones in thyroid gland which brings lot of disorders in the metabolism rate. Musical hallucinations in patients without psychiatric disturbance is most often described in older persons, years after hearing loss, but they have also been reported in lesions of the dorsal pons (Schielke et al, 2000).
We don't find this statistic much use as tinnitus is highly prevalent in otherwise normal persons.
It is surprising that TMJ's correlation is nearly as high as hearing impairment, and more than depression or stress.
Considering other parts of the brain, Ueyama et al (2013) reported that there was increased fMRI activity in the bilateral rectus gyri, as well as cingulate gyri correlating with distress. Distinct causes are microvascular compression syndrome, viral infections of the 8th nerve, and tumors of the 8th nerve. For example, Tandon (1987) reported that 1% of those taking imiprimine complained of tinnitus.
This unfortunate behavior makes it very hard to care for these patients -- as it puts one into an impossible situation where the patient is in great distress but is also unwilling to attempt any treatment.
We doubt that this means that motor cortex excitability causes tinnitus, but rather we suspect that these findings reflect features of brain organization that may predispose certain persons to develop tinnitus over someone else.
Wax should be removed, and the examiner should note whether the ear drum is intact, inflamed, scarred, or whether it is moving. Because papilloedema is so rare, and tinnitus is so common, it is very unusual to find this dangerous condition.
The stapedius is attached to the stapes (of course -- horseshoe object above), while the tensor tympani is attached to the ear drum.
A brain MRI is used for the same general purpose and covers far more territory, but is roughly 3 times more expensive. This is not surprising considering how disturbing tinnitus may be to ones life (Holmes and Padgham, 2009).
One would think that tinnitus would obscure perception of sound at the frequency of tinnitus, and thus be measurable through an internal masking procedure, but this approach has not been helpful. Things that made it worse included being in a quiet place (48%), stress (36%), being in a noisy place (32%), and lack of sleep (27%). This is because of the very high correlation between anxiety and depression with tinnitus-related annoyance and severity (Pinto et al, 2014).
At that date there were 4 double-blind placebo controlled trials of antidepressants for tinnitus. Stidham et al (2005) injected botox into the area of the ear(above, and 2 places behind), the arm, and compared with placebo. A recent trial in older people showed that atorvastatin had no effect on the rate of hearing deterioration but there was a trend toward improvement in tinnitus scores over several years. This is a drug designed for heart disease, that is marketed in Europe for vertigo and tinnitus.
That being said, we think If you have tinnitus associated with a hearing loss, a hearing aid is a reasonable thing to try.
Nearly all states mandate a 1-month money-back guarantee built into hearing aid dispensing. Listening to the interstation static on the FM radio, tapes of ocean surf, fans, and the like may be helpful. Briefly, we think that smartphone apps are a much more efficient method of doing much the same thing. For venous tinnitus, possibilities include jugular vein ligation, occlusion of the sigmoid sinus, or closure of a dural fistula. Cochlear nerve section is reported effective in 50%, with the inevitable consequence of irreversible deafness.
Rationally, the choice of treatment should depend on personality style and ones ability to suppress unwanted thoughts.
This is aimed both at improving sleep and reducing anxiety, as both of these factors make tinnitus even worse. Joining of these sorts of organizations intrinsically draws more attention to ones illness. The author of this page feels happy that at least someone is doing trials on this difficult situation ! The effects of unilateral cochlear implantation on the tinnitus handicap inventory and the influence on quality of life.
Medium-term results of combined treatment with transcranial magnetic stimulation and antidepressant drug for chronic tinnitus. Comparison of auditory brainstem response results in normal-hearing patients with and without tinnitus.
Maintenance repetitive transcranial magnetic stimulation can inhibit the return of tinnitus. Whenever he begins to read, he starts to experiences sound within his ear, though there is no corresponding external sound. The sounds may vary in pitch from a low roar to a high squeal, and the person may hear it in one or both ears. About one fifth of the population complains of this kind of tinnitus, which can be caused by ear problems in the outer, middle, or inner ear. As people age, they lose hearing because of tremors to the ear through noise, drugs, or chemicals, which damage the portion of the ear that allows them to hear. The hair cells detect any tiny movement of the body in any direction,  after activation of the hair cells by the wave of the body movement,  the hair cells send signals to the underlining tectorial membrane generating an electrical impulse which the brian interprets as sound.  If the hair cells  constant send out the signals after damage,  the patients usually feel contant noise, called tinnutis. If there is an acoustic tumor or an infection, the tumor should be removed, or the infection alleviated.
The gallbladder meridians go up to the top of the head and around the ear; if there is excessive heat, this will go through the ear and cause blockage of energy, so the meridians cannot transmit normal sound to the inner ear. The person feels weak and has a pale face, and the tinnitus is slow and low in pitch; sometimes it is off and on, with the pitch sound decreasing when the person holds her or his breath.
After one month, John reported that he began to experience a decrease in the pitch of the tinnitus, and after two months, he reported that he heard no sounds about 70 percent of the time. Acupressure the points with your thumb or knuckle, pressing with comfortable pressure on the points. It seems to us that their study is more about how many persons with tinnitus were detected by the health care system -- and that it is more a study of England's health care system than of tinnitus.
According to Park and Moon (2004), hearing impairment roughly doubles the odds of having tinnitus, and triples the odds of having annoying tinnitus. Loudness was correlated with values in the thalamus, bilateral hippocampus and left caudate.
Somatic tinnitus means that the tinnitus is coming from something other than the inner ear. In a double-blind trial of paroxetine for tinnitus, 3% discontinued due to a perceived worsening of tinnitus (Robinson, 2007).


Specialists who care for patients with ear disease, usually know very well which drugs are problems (such as those noted above), and which ones are nearly always safe. It seems to us that response to carbamazepine is not a reliable indicator of microvascular compression as this drug stabilizes nerves and lowers serum sodium. While useful, be aware that there are multiple errors in this illustration from Loyola Medical School. Of course, tumors are a very rare cause of tinnitus, as tinnitus is at least 100 times more common than tumors of the inner ear area. Thus paradoxically enough, doctors tend to discourage reading of web pages like this one, or joining of support groups.
Three out of four trials resulted in a favorable outcoume (Nortriptyline, Paroxetine, Sertraline). On the other hand, Hoekstrat et al (2011) suggested that in general these drugs do not work for tinnitus. This study suggested that Botox might improve tinnitus to a small extent (7 improved with active, 2 improved with placebo). Be sure that you try the hearing aid before buying one, as tinnitus is not always helped by an aid.
Given that smartphone apps do the same thing as tinnitus maskers, and that most newer hearing aids are blu-tooth capable, we see little reason to pay for a masker-hearing aid when one already owns a cell phone.
Generally though, hearing aids or implantable devices are much more successful than surgery. Surgery seems worth considering only in extreme situations - -the tinnitus is extremely loud, very distressing, and there is a methodology to decide whether or not the tinnitus can be improved with surgery.
On the other hand, very few individuals with tinnitus are deaf enough to qualify for cochlear implants. The off-and-on sound can be a strong ringing noise in his right ear, a high-pitched whining noise, buzzing, or hissing.
The sound is sometimes continuous, sometimes intermittent, and it may interfere with the ability to concentrate. It can also be caused by problems with the auditory nerves or the brain stem, which can interrupt the nerve signals as sound. It can be a muscular issue, or it can be caused by blood vessel or inner-ear bone problems. Examples include acoustic shock, external ear infection, ear-wax impaction, lead or mercury poisoning, Meniere’s disease, or such toxic medications as aspirin, erythromycin, or tetracycline. This triggers ear cells to release an electrical signal through a nerve from your ear (auditory nerve) to your brain. Other methods include electrical stimulation, such as transcranial direct current stimulation, or direct stimulation to the auditory cortex by implanting electrodes. This type of tinnitus is high pitched, usually accompanied by anxiety, headaches, and sometimes fear, dry mouth, constipation, yellowish urine, and red face; sometimes the chest feels uncomfortable and painful, with red tongue body and yellow tongue coating. This form of tinnitus is often accompanied by dizziness, faintness, shortness of breath, tiredness, and weakness of the legs; sometimes there is a low-grade fever, the palms are hot, there is no taste in the mouth, with a very thin coating on the tongue and a weak pulse.
He was advised to do some exercises and learn to deal with stress, and after three months of treatment his condition was much improved. Similar statistics are found in England (Dawes et al, 2014) and Korea (Park and Moon, 2014). Practically, as there is only a tiny proportion of the population with objective tinnitus, this method of categorizing tinnitus is rarely of any help. In other words, the changes in the brain associated with tinnitus seem to be associated with emotional reaction (e.g. In a large study of tinnitus, avoidance of occupational noise was one of two factors most important in preventing tinnitus (Sindhusake et al.
Tinnitus from a clear cut inner ear disorder frequently changes loudness or pitch when one simply touches the area around the ear. The muscles that open the jaw are innervated by the same nerve, the motor branch of 5, that controls the tensor tympani in the ear. There are case reports concerning tinnitus as a withdrawal symptom from Venlafaxine and sertraline (Robinson, 2007). Nevertheless, this quality of tinnitus probably justifies a trial of oxcarbamazine (a less toxic version of carbamazepine).
Lainez and Piera suggested that the mechanism was reduction of peripheral inputs from cervical, temporal, frontal and periauricular pathways. TMS seems to be somewhat helpful for depression and migraine, and one would think that a modality that worked for these, would also work to some extent for tinnitus. If tinnitus is reduced by intratympanic lidocaine injection, it seems reasonable to us that surgical treatment may also be effective (for unilateral tinnitus). According to the inventor of TRT, the goal of counseling is to reclassify tinnitus into the category of a neutral stimulus. If he pays attention to something else, he does not experience the tinnitus, but if he is idle or preparing to go to sleep, the sound recurs and can interfere with his ability to either concentrate or hear, which is very frustrating.
There are also neurological disorders, such as head injuries, psychiatric disorders, such as depression and anxiety, sclerosis, or metabolic disorders, such as thyroid problems, hyperlipidemia, and vitamin B12 deficiency. While there are many different treatments for tinnitus, none has proven to be entirely reliable.
The treatments mostly used are SJ 5 Wai Guan, SJ 17 Yi Feng, SI 19 Ting Gong, SJ 21 Er Meng, UB 18 Gan Shu, and Liv 3 Tai Chong. This type belongs to a yin deficiency and the treatment should be to tonify the yin and enhance the kidney. It seems to us that it should be possible to separate out tinnitus into inner ear vs everything else using some of the large array of audiologic testing available today. The exact prevalence of TMJ associated tinnitus is not established, but presumably it is rather high too.
In our clinical practice, we have occasionally encountered patients reporting worsening of tinnitus with an antidepressant, generally in the SSRI family.
When this doesn't happen, the treatments that work the best for tinnitus are those that alter ones emotional state -- antidepressants and antianxiety drugs, and ones that allow you to get a full night's sleep. Robinson reported that tinnitus in depressed patients appears more responsive to antidepressants than in non-depressed patients. Because it is easily available in the US, and has a rather benign side effect profile, we think that it is a good candidate for medication trials.
The goal of sound therapy is to decrease the strength of tinnitus-related neuronal activities (Jastreboff, 2015). Western medicine treats this condition with gamma knife radiosurgery, cochlear implants, Botox, or medications, such as propanol and clonazepam. The acupuncture points are UB 23 Sheng Shu, Kid 4 Tai Xi, SJ 17 Yi Feng, SJ 21 Er Meng, SI 19 Ting Gong, GB 2 Ting Hui, SJ 5 Wai Guan, and UB 18 Gan Shu.
We have encountered patients who have excellent responses to cervical epidural steroids, and in persons who have both severe tinnitus and significant cervical nerve root compression, we think this is worth trying as treatment. Having TMJ increases the odds that you have tinnitus too, by about a factor of 1.6 (Park and Moon, 2014). Mechanisms for impovement were suggested to be direct effects of increased serotonin on auditory pathways, or indirect effects of tinnitus on depression or anxiety. The ENT doctor checked his outer, middle, and inner ears, and found no infection or allergies, and no edema in the ear.
The neurologist ordered a CT scan and an MRI, which did not show a tumor or any problem with the brain. He was prescribed such medications as Xanax and tricyclic antidepressants, as well as niacin, all to no avail. This makes a more sense than the Wineland result, but of course, they were measuring different things. MRI studies related to audition or dizziness must be interpreted with great caution as the magnetic field of the MRI stimulates the inner ear, and because MRI scanners are noisy.



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