Tinnitus Trouble

By: 

ION Archives

Issue: 
Summer
Year of publication: 
2001

According to Professor Adrian Davis, at Queen's Medical Centre in Nottingham, 10% of the UK adult population experiences prolonged, spontaneous tinnitus, 5% has tinnitus which is either moderately or severely annoying and 5% experience sleep disturbance because of tinnitus. Cristina Howard, BA Hons, MA, Raw.Dip, VAI, unravels the many causes behind this modern day malady and provides nutritional recommendations for its prevention and control.

Tinnitus (lat. “to tinkle” or “to ring like a bell”) is the medical term for ringing or buzzing in one or both ears, with no obvious cause. Rarely, tinnitus is due to an actual sound such as blood rushing through an enlarged vein – a problem that requires medical treatment. More commonly the problem is due to nerve irritation from an unknown source, or an underlying ear problem often induced by noise damage. The ringing can range from barely audible to distressingly loud.

In the early stages, the “sound attacks” may occur at varying intervals spaced out over days, weeks or months. However, if the cause of the problem is not addressed, tinnitus can progress to an advanced stage, where the ringing is experienced constantly, both day and night. Rather than being classified as a medical condition, tinnitus is considered a symptom of a disorder, which occurs in one of the three chambers of the auditory pathway in the inner ear. Left unchecked, it can result in years of unnecessary misery and frustration or in a total loss of hearing.

TINNITUS - AN OBJECTIVE OR A SUBJECTIVE PERSPECTIVE

Depending on the cause of the ringing, the medical approach to tinnitus is to classify it as either of an objective or subjective nature.

Objective tinnitus

Objective tinnitus refers to ringing that originates from within the body of the sufferer but outside the auditory system. Frequent causes found following medical investigations include an aneurysm, repetitive contractions of the roof of the mouth muscles or, in some cases, an abnormally open Eustachian tube.

Subjective tinnitus

In the case of subjective tinnitus, medical investigations cannot detect an internal, physical cause for the noise. Subjective tinnitus is usually attributed to damage sustained by the delicate hair cells of the inner ear. This can be due to a variety of causes such as physical injury (e.g. head trauma), exposure to high levels of toxins (e.g. solvents, ototoxic drugs), medical conditions (e.g. Mernière's disease) and noise-induced hearing loss. In some cases it may be caused by viral infections (e.g. mumps, rubella, scarlet fever), bacterial or fungal infections (e.g. ear infections, kidney infections), dental work, accidents, flying, sneezing, swimming, neck exercise and even childbirth. By assessing this type of information what becomes clear is that subjective tinnitus can be caused either by external or internal causative agents.

EXTERNAL CAUSATIVE AGENTS OF SUBJECTIVE TINNITUS

Noise, chemicals, toxins, drugs and poor nutrition may all lead to the development of subjective tinnitus.

Noise

Tinnitus caused by either very loud or long-term exposure to noise is an insidious process that these days is on the increase as a result of our modern life style. Loud noise wears down the delicate hair cells in the inner ear, which translates sound into nerve impulse. If the noise is very loud as in an explosion, it can destroy the hair cells outright. At slightly lower levels - a rock concert, for instance, or a noisy industrial job - the damage is low but steady. (1)

When the fragile and vulnerable mechanisms of the inner ear are exposed to loud noise, a “temporary threshold shift” or a temporary loss of the ability to hear faint sounds occurs, resulting in a desensitisation of the ear. Anyone who has ever walked away from a concert or a workplace with “buzzing” or “hissing” in their ears would have experienced a temporary threshold shift. Although a return to normal sound-environment and overnight rest usually appears to restore full hearing, the hair cells in the inner ear have nevertheless sustained irreparable damage. If exposure to this type of noise is repeated or lengthy, there may be a sudden failure to make complete recovery and acoustic trauma may result in pain, “blocked ears”, tinnitus or hearing loss. Ways to prevent such consequences - also known as “noise induced permanent threshold” - include wearing protective devices such as custom made ear moulds, earplugs and muffs and re- evaluating lifestyle, work and hobbies.

Chemicals, toxins & drugs

Exposure to chemicals and drugs (both pharmaceutical and recreational) during the last 50 years or so has become a standard feature of modern daily life. There is continuous exposure to a barrage of toxins detrimental to human health. Some of these include:

Work place (e.g. photocopiers, ink, formaldehyde)
Home (e.g. chemical fumes from wall-to-wall carpets and soft furnishings, cleaning agents, vinyl floors)
Food and drink (e.g. pesticides, preservatives, artificial colourings and flavours)
Recreational choices (e.g. smoking, drinking and recreational drugs)
Cosmetic products such as aniline used in hair sprays and perfumes
Ongoing exposure to both internal and environmental toxins results in a weak immune system that succumbs easily to viral, bacterial and fungal infections (e.g. ear infections), which can lead to the possible development of tinnitus. Moreover, in order to restore both health and the feeling of well-being a lot of people turn to prescription or over-the-counter medical drugs. The American Tinnitus Association cites around 200 medical drugs that may be responsible for causing tinnitus with the most common one being aspirin! Ototoxicity or hearing loss due to medication is a medically acknowledged condition that occurs when the hair cells of the inner ear are damaged by pharmaceutical drugs; in many instances followed by nerve degeneration as a secondary phase. Some of the ototoxic drugs that are frequently blamed for the onset of tinnitus are antibiotics (e.g. neomycin, kanamycin, vancomycin, streptomycin), diuretics (e.g. furosemide, thiazides), oral contraceptive pills, anti-malarial drugs, quinidine and tranquillisers (e.g. valium, librium).

Poor nutrition

In order to work effectively and transfer complete electrical information to the cortex, the thousands of specialised sensory cells that form the auditory system need water, oxygen and a combination of over 40 nutrients. A poor diet, lacking in the necessary nutrients can be the main cause alone for the onset of tinnitus.

 

 

INTERNAL CAUSATIVE AGENTS OF SUBJECTIVE TINNITUS

Several medical conditions may be responsible for the onset or deterioration of an already existing level of tinnitus.

Food Allergies

Allergies may directly or indirectly affect any of the three parts of the ear (external, middle or the inner ear) resulting in a blocked Eustachian tube. This can lead to tinnitus. Major allergenic culprits are dairy produce, wheat, caffeine, alcohol and chocolate. Avoiding or limiting some of these foods has shown to be successful in relieving tinnitus.

Aneurysm

There is only one artery to the ear. Therefore an aneurysm (a ballooning of an artery due to the pressure of blood flowing through a weakened area), or any other impairment in the circulation to the auditory pathway can have a profound impact on the body's ability to oxygenate ear tissue. This can manifest itself in a continual “buzzing” noise, which increases as the heart pumps blood out and decreases when the heart relaxes.

High blood pressure and atherosclerosis

These conditions may lead to a high-pitched, continuous noise that is usually due to fatty cholesterol deposits that occur in the arteries. This may obstruct the blood circulation to the ear or to the region between the ear and brain, resulting in tinnitus.

Infections and inflammations

Labyrinthitis (inflammation of the inner ear) occurs when the ear canal is invaded by bacteria or a virus and can affect the sensory elements of the cochlea (the spiral organ of the labyrinth of the ear, which is concerned with the reception and analysis of sound) leading to tinnitus or in susceptible individuals, hearing-loss.

Hypoglycaemia or low blood sugar reduces the amount of energy-releasing glucose available to the ear tissue, which in turn can result in tinnitus
Hypoglycaemia

The ear has a delicate circulation network and one of the highest energy requirements in relation to other body systems. Hypoglycaemia or low blood sugar reduces the amount of energy-releasing glucose available to the ear tissue, which in turn can result in tinnitus.

Ménière's disease

Ménière's disease is a condition characterised by tinnitus, vertigo and hearing loss. The condition can be brought on by acute or chronic infections, allergy, toxins, hardening of the arteries, abnormal regulation of blood sugar or blood disorders such as leukaemia.

Stress

The auditory system is a sensitive and complex mechanism linked to the general nervous system. Physiological changes caused by the “fight or flight” reaction result in a state of distress, with the patient constantly mobilised for action. This state of tension affects the neuromuscular system and can be responsible for the onset or exacerbation of tinnitus.

TREATMENT

MEDICAL INTERVENTION

A number of prescription drugs have been successful in decreasing the symptoms of tinnitus, in particular anti-histamines and terfenadine (another drug indicated for allergy relief). However, an increasing amount of both medical and nutritional information suggests that many sufferers are now turning to a complementary approach as a way of easing their tinnitus symptoms. This usually incorporates a combination of dietary and lifestyle modifications or changes.

DIET AND NUTRITIONAL FACTORS

The American Tinnitus Association warns against diets high in fat, sugar, salt, dairy products and processed foods, as possible aggravating causes of tinnitus. It emphasises that foods such as fresh fruit and vegetables, raw foods and good quality protein sources should be eaten on a regular basis.

As hypoglycaemia is a common factor in tinnitus, strategies should be taken to prevent blood sugar imbalances. Consequently, refined food products and stimulants such as tea, coffee and alcohol should be avoided. Seeing a nutrition consultant to investigate possible food allergies/intolerances is advisable.

Nutritional supplements and other natural remedies that may be helpful include:

Vitamin B12. A deficiency of this vitamin has been reported to be common in people exposed to loud noise in their job who developed tinnitus and hearing loss.(2) Intramuscular injections of vitamin B12 reduced the severity of tinnitus in some of these people. Injectable B12 is available only by prescription. The effect of oral B12 on tinnitus has not been studied.
Zinc. This mineral has been used to treat individuals who had both tinnitus and hearing loss (usually age-related). Of those who had initially low serum levels of zinc, about 25% experienced an improvement in tinnitus after taking zinc for three to six months.(3) In another study, zinc was not more effective than placebo at relieving tinnitus. However, the participants in that study did not have low serum zinc levels.(4)
Ginkgo biloba has been shown as a useful agent in improving peripheral circulation and blood flow to the ear. Two studies have found that an extract of ginkgo standardised to contain 24% flavone glycosides and 6% terpene lactones in the amount of 120mg a day, useful for tinnitus sufferers (5,6), although other studies have failed to find ginkgo beneficial. (7)
The lesser periwinkle, Vinca minor, contains a compound known as vincamine. Extracts containing vincamine have been used in Germany to help decrease tinnitus. (8)
Nutritional supplements such as vitamin C, vitamin B complex, coenzyme Q10 and fish oil can improve oxygen delivery to the ear and may be useful in the reduction of tinnitus symptoms.

EXERCISE AND RELAXATION

Ginkgo biloba has been shown as a useful agent in improving peripheral circulation and blood flow to the ear Relaxation techniques, rest and adequate amounts of sleep are all significant factors in reducing symptoms of tinnitus as is regular exercise which boosts the immune system, lowers stress levels and improves blood and lymph circulation.

CONCLUSION

Coping with tinnitus is a stressful experience that can range from mild irritation to suicidal thoughts, depending on the severity of the noise, the patient's personality, or other related medical or otological problems. Pinpointing the potential cause may be like searching for the missing piece of a jigsaw puzzle. Nutritional intervention in conjunction with appropriate changes in lifestyle factors appear more and more to be a valid solution in reducing or eliminating tinnitus symptoms and helping to restore quality of life.

REFERENCES

R.D. Berendt & E.L. Charles. Quieting: A Practical Guide to Noise Control. US Dept. of Commerce, July 1976.
Shemesh Z et al. Vitamin B12 deficiency in patients with chronic tinnitus and noise-induced hearing loss. Am J Otolaryngol 1993;14:94–99.
Shambaugh GE. Zinc and presbycusis. Am J Otol 1985;6:116–17.
Paaske PB, Kjems G, Pedersen CB, Sam ILK. Zinc in the management of tinnitus. Placebo-controlled trial. Ann Otol Rhinol Laryngol 1991;100:647–49.
Meyer B. A multicentre, double-blind, drug versus placebo study of Ginkgo biloba extract in the treatment of tinnitus. Presse Med 1986;5:1562–64 (in French).
Meyer B. A multicentre randomised double-blind study of Ginkgo biloba extract versus placebo in the treatment of tinnitus. In Rokan (Ginkgo biloba): Recent Results in Pharmacology and Clinic, ed. EW Funfgeld. New York: Springer-Verlag, 1988;245–50.
Holgers K, Axelsson A, Pringle I. Ginkgo biloba extract from the treatment of tinnitus. Audiol 994;33:85–92.
Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd, 1988;181.

BIBLIOGRAPHY

Avery, P. Stop Your Tinnitus. Hygeia Publishing Company, 1997.
Kumar, P. Clar, M. Clinical Medicine. W.B. Saunders Company Ltd, 1994.
Winte, R. A Consumer's Dictionary of Cosmetic Ingredients. Crown Publishing Inc., New York, 1974.
Baloh, RW. Dizziness, Hearing Loss and Tinnitus. F.A. Davis Co., Philadelphia, 1984.

Cristina Howard is a qualified clinical nutritionist who is currently working at the University College London Hospital with leukaemia patients. She also regularly contributes articles to nutritional magazines and in-house publications.

 

 

Keywords: 
HEALTH CONDITIONS
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