Tinnitus is not a disease but actually a symptom that can have many different causes.  The symptom which is tinnitus is hearing sound when there is no external source for the sound.  The actual sound can be difficult to categorize and specific sounds do not necessarily point to a cause.  On top of this, because there is no external stimulation, testing to verify tinnitus is virtually impossible.  The only thing that can be done is categorize how bad the sound is based on how much it affects the person and their daily life. 

What Causes Tinnitus

Most cases of Tinnitus are subjective tinnitus, where there is no clinical test for the symptoms.  The causes of this type of tinnitus vary but the most common is noise-induced hearing loss.  For example, virtually everyone will have ringing in their ears for a few days after a loud concert.  Another common cause is actually impacted earwax in the ear canals.  Ear infections and middle effusion can also cause Tinnitus. 

Another common cause of tinnitus is the aging process.  Aging causes hearing loss and hearing loss can sometimes lead to tinnitus.  Tinnitus is also a common symptom of lead and mercury poisoning but can also be caused by a number of medications, including aspirin, some antibiotics, some diuretics, anti-depressants, quinine and other medications as well. 

The final cause of tinnitus is those that cause the much more rare objective tinnitus.  In these cases, a doctor can actually hear sound coming from the ears of the patient.  This type of tinnitus can be caused by altered blood flow around the ear that causes the person to be able to hear their pulse or blood flowing.  Occasionally, this type of tinnitus can be the symptom that leads to diagnosis of serious and dangerous conditions such as aneurysm and dissection of the carotid artery or vasculitis. 

What Does Tinnitus Sound Like?

Tinnitus sounds different from everyone, even if two people have the same cause of their tinnitus.  It can happen in just one ear or both and is most commonly described as a ringing noise.  However, it can sound like a buzz, hum, whistle, click, crickets, music and many more different sounds.  The sound can be constant or can be one that just pops up then goes away later.  Certain tinnitus suffers find they can set it off by moving part of their body, typically their head, tongue, jaw or eyes.  The intensity can vary from only noticeable in quiet surroundings to a howl that cannot be ignored. 

Ironically, the iPod is both a cause of tinnitus and potentially a way to help alleviate tinnitus sufferer’s symptoms.  For the average person with an iPod though, it is far more likely to be a cause than a way to alleviate the symptoms.  Some of the treatments that utilize an iPod to treat tinnitus are utilizing the most advanced research to help alleviate tinnitus symptoms. 

iPod’s Roles in Causing Tinnitus

The iPod and many other MP3 players cause tinnitus in two different ways.  First of all, they produce output that is the equivalent to a jet engine.  While not the blanket roar of the jet, the music piped through a set of headphones can easily hit decibel levels that can cause permanent hearing damage.  Hearing damage is the single most likely cause of tinnitus symptoms and iPods and MP3 players lack even basic protection to keep the output from exceeding the threshold for permanent hearing damage. 

The second and less talked about way that an iPod can potentially cause tinnitus is through infection.  The person who wears the ear bud style headphones, especially the most modern renditions that boast noise blocking silicone rubber ear pieces, can cause infection if left in for too long.  Bacteria love dark, moist environments and an ear sealed up with a silicon ear bud is a great environment for bacteria growth.  The bacteria begin taking hold and a middle or outer ear infection settles in which can cause tinnitus as well.  Most of the time, treating the infection will make the tinnitus go away; however, the root cause is often ignored. 

In both cases, using speakers for an iPod or MP3 player rather than earphones as much as possible will reduce or eliminate both of these potential iPod related tinnitus causes.  However, for many, earphones are the only option.  In this case, being sure to keep the volume as low as possible and using open ear headphones rather than ear buds will help in both preventing hearing loss as well as inhibiting infection potentials. 

iPods to Treat Tinnitus

The most common treatment for most tinnitus is to produce white noise or play music which masks the tinnitus sounds for the person suffering.  This allows them to function during the day and fall asleep without being distracted by the tinnitus noises.  An iPod can either play white noise MP3’s or there are programs that are designed to produce more random white noise rather than looping an MP3 of the same white noise.  

On top of this, there are special treatments that utilize an iPod to play specially modified songs that have tinnitus frequencies blocked.  This helps the brain turn off the sensitivity to those frequencies making the symptoms less or go away completely. 

While not typically debilitating, many people suffer from the effects of tinnitus.  For some of them, tinnitus makes falling asleep more difficult or at times causes their work to suffer when they have a period where the tinnitus is loud.  Because tinnitus affects so many people, it is very well researched and methods for alleviating tinnitus symptoms have come a long way in the past few years.  Going forward, there is research into many different ways of getting rid of tinnitus and some of these will soon be available to the general public. 

Basics of Tinnitus

Tinnitus is actually a symptom, not an actual disease.  It has many causes, from hearing loss to impacted ear wax to being a symptom of heavy metal poisoning to being a side effect of many different types of medication.  However, the single most common cause of tinnitus is hearing loss and most attempts to help correct tinnitus sufferers focus on this cause and the resulting tinnitus. 

Newest Treatment Options

Two of the newest treatment options available are tinnitus retraining therapy and additive destimulation therapy.  Tinnitus retraining therapy is a two pronged approach to dealing with tinnitus.  The first part is through the use of a sound generator to help alleviate the distraction of tinnitus.  The second part of this therapy is specialized counseling which helps retrain the brain and ear of the tinnitus sufferer to either make the sound less noticeable or to teach the person how to ignore it. 

Additive destimulation therapy is the latest and greatest though and uses a far more technological approach to helping with tinnitus.  In this therapy, the audiologist identifies the frequency or frequencies that the tinnitus sufferer hears and then modifies songs that the sufferer likes to listen to take out those frequencies.  By removing these frequencies, the brain becomes less sensitive to them and over time, hearing the tinnitus frequencies is no longer an issue because they can be more easily ignored. 

The Next Round

On the horizon are techniques that utilize electricity to achieve tinnitus relief.  The auditory nerve is the target of one such treatment, called nerve stimulation.  In this procedure, an electrode is attached to the auditory nerve and helps reset the receptors in the brain.  Because it is fairly drastic and experimental, it is reserved for only the most severe tinnitus sufferers. 

The last procedure is called repetitive transcranial magnetic stimulation.  It involves using magnets to stimulate specific spots in the brain.  In research trials it shows promise in turning off tinnitus with very few side effects and should be approved for bigger trials soon.

For the tinnitus sufferer, making the tinnitus go away or even just lessening it from severe to mild is important for them to be able to have productive days and restful nights.  One of the most common complaints of the tinnitus sufferer is that they have difficulty falling asleep because of the sounds.  Treating tinnitus is often a two pronged approach.  While working to treat the symptom, which is tinnitus, the sufferer and their medical professional should be looking to assess what is causing the tinnitus. 

Treating the Symptom of Tinnitus

Common treatments for subjective tinnitus work to alleviate symptoms.  For many tinnitus sufferers who have trouble falling asleep, the most common method of treatment is to create white noise in the room.  This white noise can be a fan or a specifically designed white noise generator that sits beside the bed.  More recent white noise generators work with iPods and other MP3 players to provide music or constant white noise such as wind or wave sounds.  More advanced auditory stimulation includes music therapy and notched music therapy where the tinnitus frequencies are taken out of the patient’s favorite music.  This causes the brain to stop being stimulated on those frequencies making the tinnitus more tolerable. 

Other common methods of treating tinnitus include reducing or eliminating stimulants and salt.  Caffeine and nicotine reduction can help some tinnitus sufferers, however, in some it can make it worse so it is something to evaluate.  Alcohol consumption, likewise, can cause tinnitus to get better or worse and can be used, in moderation, if it helps.  Zinc supplements, as well as herbal formulas with zinc have been shown to help some sufferers of tinnitus as well because a zinc deficiency can actually be a cause of tinnitus symptoms.  Certain medications can be used, including anticonvulsants, tricyclics and benzodiazepines, however, the side effects of these medications can be more detrimental than the tinnitus itself. 

Treating Tinnitus Causes

For some, especially those with objective Tinnitus, there are treatments that actually work to fix the cause of the problem.  One of the most common is impacted ear wax.  A quick visit to a general practitioner or ENT can remove impacted earwax and provide immediate relief should this be the cause.  There are other surgical procedures available to objective tinnitus sufferers depending on the cause.  For some cases, a quick Botox injection can take care of the problem and for others a detailed surgery where the cochlea is shielded by a Teflon implant is needed.  

Cognitive Behavioral Therapy (CBT) is a widely-practised psychological treatment designed to restructure the thoughts and behavior of patients who have lifestyle and emotional difficulties. Patients are asked to question their outlook on their life, and to restructure negative associations they make towards themselves, their environment or a particular ailment from which they suffer.

A large body of evidence shows that CBT is effective in anxiety and depression management. As well as the obvious benefits this produces for tinnitus sufferers, CBT can also be successful in altering the negative feelings that are evoked by someone’s tinnitus. This form of ‘cognitive restructuring’ can reduce heightened awareness of tinnitus, which in turn paves the way towards habituation.

CBT does not consist of only one form of treatment, but includes behavioral modification, environmental and situation change, relaxation, hypnotherapy and thought-controlling exercises [[i]].

A Swedish report in 2004 demonstrated that CBT delivered via emails from therapist to patient resulted in clinically significant reduction of distress as measured for 27.4% of patients.  A three-month follow-up demonstrated that the improvements had been maintained, but there was a high drop-out rate of 30% from the treatment. Although this is a cost-effective and labor-saving form of CBT, the majority did not benefit. CBT may be best administered one-to-one or in a group setting [[ii]].

A study which reviewed a large amount of clinical data on CBT, showed that there was no significant reduction in subjective tinnitus loudness or associated depression. But they did conclude that CBT significantly improved quality of life which led to positive management of tinnitus.     

Overall, although CBT may not be conclusively proven to reduce tinnitus intensity, it is generally considered as an effective means of managing the distress provoked by tinnitus. It is also believed that CBT facilitates acceptance and alleviation of negative thoughts towards the tinnitus, which improves quality of life by reducing associated fear, anxiety and depression [[iii]].

Vitamins A, C and E

Noise-induced acoustic trauma is closely associated with free radical formation and reduced cochlear blood flow 7-10 days after noise exposure.

Animal trials have found that NIHL was preventable when the anti-oxidants Vitamin A, C and E were used with magnesium 1 hour before damaging noise exposure. Interestingly, vitamins or magnesium alone were not able to prevent NIHL or sensory cell death, but together they had a combined synergistic effect. These are encouraging results and it would be interesting to see how they translate to human NIHL trials [[i]].

Other vitamins for tinnitus

• ZInc
• Magnesium
• B12

Companies supplying Tinnitus Vitamins

• Arches
• T-gone

Clinical hypnotherapy is a common form of therapy for many emotional disorders including phobias, compulsions, unwanted habits, lack of self-confidence, or even physical conditions like irritable bowel syndrome and arthritis.

Hypnosis places the patient into a trance-like state which falls somewhere between wakefulness and sleep. It taps into the subconscious which hypnotherapists and psychologists claim is a source of many of our problems. Following the hypnotherapist’s communication with this section of the patient’s mind, it is believed that the patient can ‘unlearn’ conditioned habits which manifest in the real world as emotional or physical disorders.

As well as being a symptom of a physical condition like hearing loss, tinnitus is also deeply connected with the emotional and stress-causing centers of the brain. It seems logical to contend that if you can reduce the subconscious fear and anxiety caused by tinnitus using hypnotherapy, you can reduce the awareness of tinnitus and thus improve quality of life.

Hypnotherapists commonly quote a 70% success rate in promotional brochures, but although hypnotherapy has been used for tinnitus management for nearly 30 years, few studies have been conducted into its clinical efficacy.

A study in 2007 concluded that 5 to 10 sessions of Ericksonian hypnotherapy resulted in significant improvements in tinnitus for 35 patients with mild to severe tinnitus. These patients were also taught self-hypnosis so that they could continue therapy without a hypnotherapist[[i]].

These results have been vindicated by a larger study with 393 tinnitus sufferers who were also given Ericksonian hypnotherapy for 28 days. 88% of patients with chronic tinnitus showed improvement immediately after the sessions and 6 to 12 months after the therapy, indicating long-lasting results [[ii]].

Although both reports show a reduction in tinnitus, there were no control groups, so despite good statistics it cannot be determined whether the results are attributable to the therapeutic effects of hypnosis, or simply the counseling effect of talking to someone about their tinnitus. Indeed, a study has shown there was no difference in tinnitus reduction between patients who had three sessions of hypnotherapy compared to a single counseling session, indicating no real benefit [[iii]].

Also not all hypnotherapy is the same, ranging from traditional suggestive hypnosis to Ericksonian hypnotherapy to neuro-linguistic programming. These techniques will probably yield different results for different patients, and there is currently not enough research to ascertain which is most effective for tinnitus.

Some hypnotherapy regimes rely on self-hypnosis, which may not be a good option for everyone, particularly for the extremely elderly [[iv]]. Finally, the effectiveness of any psychological treatment will depend heavily on the person administering it, so it is worth assessing the reputation of local hypnotherapists before considering this treatment.

In this procedure, the patient is placed in a 100% oxygen pressurised chamber to improve oxygenation in the blood. It is used to treat decompression sickness (‘the bends’) and embolism and has also been used to treat tinnitus for many years. The theory of administering oxygen is based on experimental evidence that noise exposure causes hypoxia (reduced oxygen) in the cochlea which can be reversed by HBOT protecting sensory hair cells.

A review of 22 studies from 1960 to 2007 showed no significant difference between HBOT and placebo as treatment for tinnitus.  However, a clinical trial conducted last year at the University of Helsinki found that HBOT significantly improved the recovery of hearing with reduced tinnitus persistence in patients who received HBOT when compared to a sham-pressurised chamber which had normal atmospheric oxygen. Both this study and earlier work found HBOT is most effective when used to treat patients with acute-onset tinnitus [[i]].

‘Banish Tinnitus’ is a very well known tinnitus which often advertises in the paid adverts section of most Google searches into tinnitus or related searches.

The creator of the site, Paul Carrington offers a book which he claims reveals three natural steps that will cure your tinnitus, using no drugs or vitamins. There are probably no reliable cures for tinnitus, and so someone who suggests that there are may be making an unsubstantiated claim.

The language of the website is orientated towards “hard selling” making a number of claims that do not appear to be logical.

He alludes to the idea that doctors and the entire pharmaceutical industry are potentially involved in a conspiracy to profit from unfounded medication, while withholding critical information about natural remedies which work just as well. All this serves to do is fuel distrust of the medical community and gain the trust of tinnitus sufferers, some of whom may believe Paul Carrington has the answer. Below is an excerpt from the Banish Tinnitus website:

“Whether or not you like it the drug industry (and that includes doctors) are in it to make money. And while you're health is a large priority, the fat cats in the industry and even the doctors themselves hope and prey that you will never discover this information. What's more, they do everything in their power to make sure information like this never sees the light of day! They'd rather keep selling you and me half-ass solutions that deliver severely lacking results...if any...so that you have no choice but to keep coming back to them.”

Doctors are sometimes not the best people to provide advice on tinnitus as some are unaware of the large number of treatment options available, but to accuse of them of deliberately causing harm to patients by withholding information is simply untrue and dangerous.

There are a number of supposed review sites evaluating whether the ‘Banish Tinnitus’ formula is a scam or a reputable form of treatment. Although, they all give Banish Tinnitus a glowing review, it is possible that these review sites might have been written by the company behind Banish Tinnitus or their affiliates.

Respected Books on Tinnitus

There are a number of other books on the market claiming they can cure your tinnitus. Again to re-iterate, to date, there is no scientifically-based cure for tinnitus, but if you are looking to learn more about tinnitus, it is advisable that you buy a book written by a well-respected scientist in the field of tinnitus. Two recommend books are:

 Tinnitus Retraining Therapy: Implementing the Neurophysiological Model by Pawel J. Jastreboff and Jonathan W. P. Hazell.

And

Tinnitus: Questions and Answers by Jack A. Vernon and Barbara Tabachnick Sanders.

Clinical biofeedback is widely used to treat large variety of conditions ranging from migraines to paralysis, to disability associated with stroke. It involves using specific biofeedback instruments which detect physical and chemical signals in the body. By understanding the processes in your body in real time, it is proposed that you can self-regulate your emotional and physical problems which lead to these stress signals.

For example, the GSR2 is a biofeedback device which detects stress levels by monitoring electrical conductivity in the skin and emitting a pitched tone when it senses this physiological marker of stress. By being aware of small changes to which you are normally oblivious, you can self-promote relaxation and prevent the onset of stress. Also available is Camlink software which provides graphical readouts of the GSR2 on your computer.  The price of one of these devices is around $190 [[i]][[ii]].   

There is a wide range of biofeedback devices, each measuring a different bodily signal of stress. The two most popular devices detect temperature and skin conductance.

A recent study was conducted on 130 tinnitus sufferers who received 12 sessions of a biofeedback-based behavioral therapy. Results showed a clear reduction in tinnitus annoyance and tinnitus loudness and improvement in overall control of the condition. In addition, there was a decrease in depressive symptoms. The same findings were maintained 6 months after follow-up suggesting long-term improvement in tinnitus management. 

The same research group has repeated this study with similarly positive results. However, it must be added that in both trials biofeedback was used in combination with CBT, so it is impossible to determine which was the most effective in tinnitus reduction. Nevertheless, it can be assumed that the combined therapy works quite well [[iii]][[iv]].