Turn down the volume on tinnitus with these tried-and-tested treatments, says Joanna Evans
Thirty-seven-year-old Chris Martin, frontman of the hugely successful British rock band Coldplay, recently revealed that he suffers from tinnitus-a nightmare condition that causes persistent phantom ringing, buzzing, hissing, whooshing or whistling noises in one or both ears. He joins a long list of other rock stars blighted with the problem, including The Who guitarist Pete Townshend, drummer and singer Phil Collins, and 'Godfather of Heavy Metal' Ozzy Osbourne.
Tinnitus is a common problem among musicians as it can be triggered by repeated exposure to loud noise. This can cause damage to the sensitive hair cells that line the inner ear, stimulating abnormal activity in the brain and ultimately resulting in the illusion of sound. A German study just published online found that professional musicians have a 57 per cent increased risk of tinnitus compared with the general population.1
But you don't have to be a music artist to get it. A whopping 10 per cent of people in the UK have tinnitus-that's around six million people-and the numbers seem to be on the rise.
MP3 players have been fingered as possible culprits. Use of the portable digital media players has increased dramatically over the last decade or so, and those
who listen to them are significantly more likely to suffer from tinnitus compared with non-users. The louder the music and the longer you listen for, the greater your risk.2
Mobile phones have also been implicated in the rising rates of tinnitus. Here it's not loud noise that's the issue, but rather the electromagnetic radiation that's emitted from them. One group of researchers in Austria-who found a higher risk of tinnitus among long-term mobile-phone users-has suggested that mobile phones could cause a calcium imbalance in the neural acoustic pathway as well as have effects on nitric oxide levels, both of which could play a role in tinnitus.3
Considering how widespread the use of mobile phones and mp3 players is, especially among young people, and how debilitating tinnitus can be, these latest findings are a massive cause for concern. But there are many other, far better established, possible causes of tinnitus, ranging from ear infections and ear wax buildup to blood vessel disorders and even prescription drugs (see box, page 47).
When tinnitus is caused by a definable problem, addressing it can often improve the condition or even get rid of it for good. Many cases of tinnitus have no obvious cause, though, and because medicine has little to offer (there are no drugs or surgical treatments), sufferers are often told they just need to learn to live
Step forward, alternative medicine. A handful of non-invasive therapies, nutritional supplements and lifestyle changes are showing promise for treating tinnitus and making life more bearable for sufferers. Here are six treatments that could help turn down the volume.
Alternatively, you could try listening to Mozart for an hour a day. A recent Italian study found that tinnitus sufferers who listened to Mozart's Sonata for Two Pianos in D major (K.448) for an hour every day for a month saw significant improvements in the intensity of their tinnitus as well as their quality of life.12
Just be sure to avoid loud music or sounds, as they could end up making tinnitus worse.
Tinnitus retraining therapy (TRT)
TRT is a combination of sound therapy and educational counselling that aims to train the brain to ignore the sounds of tinnitus. One study reported a 78 per cent improvement in tinnitus patients treated with TRT, while another suggested that this combination therapy is more effective for tinnitus than sound (masking) therapy alone.13
This technique involves the use of electrical sensors to give you real-time information (feedback) about your body (bio), so allowing you to make subtle changes until you achieve the desired effect. One study of 130 tinnitus patients found that those who had undergone 12 biofeedback sessions were less annoyed by their tinnitus and felt more in control of their condition compared with those receiving no treatment.14
A form of biofeedback called 'neurofeedback', which monitors brain waves, was also able to improve tinnitus in a small clinical trial.15
As tinnitus seems to be related to stress,16 relaxation techniques like meditation may help. Qigong, the traditional Chinese practice that combines slow, gentle movements with meditation and breath regulation, improved tinnitus in one randomized controlled trial. In 80 patients with tinnitus, regular qigong sessions dramatically reduced its severity, with effects lasting at least three months after stopping the practice.17
Although there's been some concern that caffeine might make tinnitus worse, a recent study found that higher caffeine intakes may have a protective effect against tinnitus. Those drinking the equivalent of three to four cups of coffee a day were 15 per cent less likely to develop tinnitus, while those drinking four cups or more were around 20 per cent less at risk.18
This doesn't necessarily mean that drinking coffee will improve tinnitus, but it may be worth monitoring your caffeine intake to see if it has any effect-either good or bad-on your condition.
A number of nutritional and herbal supplements seem to improve tinnitus. It's best to see a qualified naturopath for advice on the best ones to take and at which dosages, but here's what's worked in clinical studies.
Ginkgo biloba. Traditionally used to improve blood circulation, a standard extract of this popular herb (containing 24 per cent flavone glycosides and 6 per cent terpene lactones) was better than a placebo for tackling tinnitus in eight separate trials.4
Suggested dose: 120-240 mg/day
Zinc. Evidence suggests that tinnitus sufferers, particularly the elderly, tend to be deficient in zinc, so supplementing with the essential mineral could be beneficial.5 One study reported that zinc supplements in people who were only slightly zinc-deficient improved tinnitus and hearing loss in about one-third of the elderly.6
Suggested dose: 90 mg/day (with 2-3 mg/day of copper to prevent its deficiency)
Antioxidants. These free-radical fighters are showing promise for noise-induced hearing loss and tinnitus too. In a small preliminary (pilot) trial, oral antioxidant therapy, including vitamins C and E, reduced the intensity of tinnitus and the discomfort experienced by the sufferers.7
Suggested dose: 600-1,200 mg/day vitamin C; 600 mg/day vitamin E
Coenzyme Q10. Another potent antioxidant, this vitamin-like substance improved tinnitus symptoms in people with low blood levels of the nutrient in one pilot study.8
Suggested dose: 300 mg/day
Magnesium. Another pilot trial suggests that magnesium supplements can reduce the severity of tinnitus.9 Larger controlled trials are now needed to confirm the results.
Suggested dose: 500 mg/day
One of the most commonly used treatments for tinnitus, sound therapy has three main goals: to provide a sense of relief (soothing sound), and to distract the sufferer from their tinnitus either passively (background sounds) or actively (interesting sounds).
For example, bedside sound generators producing pleasant music or background noises have been shown to improve sleep in tinnitus sufferers.10 Acoustic stimuli delivered through hearing aids can also provide relief.11
Tips for tinnitus
Look for a cause. A variety of health conditions can cause tinnitus, including M'eni`ere's disease, anaemia, temporomandibular joint (TMJ) disorders (affecting the jaw joints just in front of your ears) and even something as simple as a buildup of ear wax (see page 54 for what to do about this). Identifying and treating the underlying cause with the help of an experienced practitioner may well resolve the problem.
Check your medication. A number of prescription and non-prescription drugs can cause tinnitus or make it worse. These include non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen, certain antibiotics such as ciprofloxacin and doxycycline, antimalarial drugs like chloroquine and quinine, and loop diuretics like furosemide and torsemide.1 Check with your doctor if tinnitus might be a side-effect of any drugs you're taking and find out about alternatives.
Turn the volume down. Avoid playing music too loud or cranking up the volume on your TV. This may reduce the risk of damage (or further damage) to the sensitive hair cells in the inner ear and prevent tinnitus from getting worse.
Wear hearing protectors. If you're likely to be exposed to loud noise-say at work or at a rock concert-then wear earplugs or earmuffs to protect your hearing and avoid exacerbating your tinnitus.
1 Occup Environ Med, doi: 10.1136/oemed-2014-102172
2 Braz J Otorhinolaryngol, 2011; 77: 293-8; J Acoust Soc Am, 2010; 128: 646-53
3 Occup Environ Med, 2010; 67: 804-8
4 Neuropsychiatr Dis Treat, 2011; 7: 441-7
5 Prog Brain Res, 2007; 166: 279-85
6 Am J Otol, 1989; 10: 156-60
7 Arch Med Res, 2007; 38: 456-9
8 Otolaryngol Head Neck Surg, 2007; 136: 72-7
9 Int Tinnitus J, 2011; 16: 168-73
10 Acta Otolaryngol Suppl, 2006; 556: 59-63
11 J Am Acad Audiol, 2010; 21: 461-73
12 Acta Otolaryngol, 2012; 132: 1172-7
13 Clin Exp Otorhinolaryngol, 2014; 7: 87-93; Cochrane Database Syst Rev, 2010; 3: CD007330
14 J Consult Clin Psychol, 2008; 76: 1046-57
15 HNO, 2001; 49: 29-35
16 BMC Public Health, 2011; 11: 130
17 J Psychosom Res, 2010; 69: 299-304