A New Case of Tinnitus

April 17, 2015 9:47 AM

Eight days ago, my friend started suffering from tinnitus. She hasn't yet been able to see a specialist, but her primary care provider and others suspect that it will be permanent. She would like advice, particularly about how to reduce the probability that the tinnitus will become permanent. Thank you! She lives in the SF Bay Area.
posted by HoraceH to Health & Fitness (16 answers total)

Although it can be annoying at first and can feel like something that will be hard to cope with, it usually does fade over time as a) you get used to it, and b) as I understand it, your brain learns to filter out the signal at a more basic level.

It's kind of a vicious circle condition in that the more you focus on it and obsess over it, the more constant and pervasive it is. The more you relax and accept it, the more you forget about it.

White noise is very helpful, especially for sleeping or being in quiet places. I find that lightly stroking the rim/lobe of your ear can be a useful stopgap when it's particularly annoying.

Stress, sleep loss, caffeine, and colds/congestion increase it. Rest, sleep and good health decrease it.
posted by Drexen at 9:53 AM on April 17, 2015 [5 favorites]

It might be helpful to know a little bit more, like whether she was exposed to any loud music or something before the tinnitus started.

A few years ago, I attended a very loud club. I normally wear earplugs when I go to gigs, but I didn't have any with me that night and didn't know where to get any last minute. I ended up with quite severe tinnitus for a few days, which eventually faded. I still have a very slight ringing, but it is nowhere near as bad as it was (and as bad as I had feared it would stay).

I have issues with my sinuses and get an occasional, brief, sharp sound which goes away after a moment or so. I think it's to do with changing pressure. Does you friend have a blocked nose at the moment? I'm unsure how much of a role blocked sinuses could play with tinnitus.

I think that the best thing that she can do, and maybe the only thing really, is to protect her ears from now on. That means avoiding loud noises as much as possible and wearing hearing protection when she can't avoid the noise completely.
posted by kinddieserzeit at 9:58 AM on April 17, 2015 [1 favorite]

Since she's already seen her primary care doctor, I assume he's already ruled out things like ear infections, etc., but in case not...

I often get tinnitus when I have excess ear wax or impacted ear wax. This is something a primary care doctor should be able to easily see, but it may be worth getting her ears cleaned out just in case. I've found that over the counter drops for ear wax don't work very well; it works best when the doctor cleans out my ears with water.

Also, does she wear those in the ear headphones a lot? Could she be overdoing it with volume?
posted by unannihilated at 9:59 AM on April 17, 2015 [1 favorite]

There is -some- evidence that transcranial direct current stimulation (tDCS) may help with tinnitus.

As a neuroscientist I would have to say: your brain learns what you teach it. Right now, your auditory brainstem and ascending pathways are responding to this new 'stimulus', and learning to respond to it, to attend to it, the more it is present. Thus, try to compete with both the sound (not in volume, but in variety) and your attention to it, as best you can. Try to avoid learning the new sound.
posted by Dashy at 10:28 AM on April 17, 2015 [1 favorite]

sometimes i get tinnitus, if i have had a cold, been stressed or something else. it lasts a few weeks, then goes away completely. what makes your friend think that they are going to have it forever? unless there's a known reason, this could be one of those little things that comes and goes.
posted by andreapandrea at 10:31 AM on April 17, 2015 [1 favorite]

Just an anecdote that I had tinnitus for over a year and the audiologist I saw thought it would be permanent. It did eventually go away and I credit better stress management through yoga and meditation. If she has anxiety/stress issues, lifestyle changes are really something to think about.
posted by veery at 10:49 AM on April 17, 2015 [1 favorite]

I had an on-going ear infection a couple of years ago that meds wouldn't knock out, and my GP kept trying to treat (for months). It was only after I insisted on a referral to an ENT and saw him that I realized that my GP was not really knowledgeable enough to deal with my situation.

Which is to say, if I were your friend, knowing what I know now, I would take what her GP said with a grain of salt, and wait to see what the ENT has to say about it. It could very well be a condition that can be treated and the tinnitus will go away. But it's hard for any of us internet strangers to say without knowing all of the facts, and without being trained for these sorts of things.
posted by vignettist at 11:05 AM on April 17, 2015 [3 favorites]

Hello, I'm an audiologist but this is not audiologic advice and I'm not your audiologist.

There is no way to know if the tinnitus is permanent or not, nor are there any ways to prevent it becoming permanent, beyond making sure not to expose herself to any noise. While we know relatively little about tinnitus, we believe it is generally a sign of damage to the outer hair cells or auditory nerve, usually as a result of noise exposure. I encourage her to wear earplugs in any non quiet environment, including bars and restaurants.

There is no real treatment for tinnitus beyond masking it with noise. The academy of otolaryngology has and continues to recommend cognitive behavioral therapy as the best treatment. Basically, you learn to accept it and not attend to it too much or let it cause too much stress and anxiety.

tCDS therapy mentioned above has shown some interesting results, with maybe a partially effective suppression of tinnitus in about half of people. But the data is equivocal, and tinnitus is a broad range of conditions, so it's too early to really recommend it as a treatment.

It's a bummer. Many people report that it goes away as you age, but why this might be we can only guess.

If she hears it only on one side, or if she is experiencing any hearing loss or difficulty processing language, do make sure she sees an ENT right away.

Don't hesitate to memail me with any other questions.
posted by Lutoslawski at 11:07 AM on April 17, 2015 [5 favorites]

Not a physician, but I work in tinnitus research. As far as what she can do now to minimize the risk of permanence, its hard to say because it can depend on the cause: if it's noise exposure, then minimize future exposures (this is probably a good idea anyways). If its medication related, then it's a big picture discussion with the relevant medical professionals (depending on what you're treating, there may or may not be alternative medications to try).

Right now seeing a specialist who can go over all the relevant options for her personal case history is probably the best next step (its important to rule out treatable medical causes). And when I say specialist, ideally it's someone who works with tinnitus specifically. Even some more general ENTs tend to brush it off and say there is nothing they can do if they can't diagnose a specific cause: in some cases they may be right in the sense that they can't prescribe a cure, but management can be helpful even if it does turn out to be permanent (a lot of good recommendations have already been mentioned, like noise machines, stress management, CBT, getting enough sleep, possible dietary triggers, etc).
posted by ghost phoneme at 11:16 AM on April 17, 2015 [2 favorites]

Oh, one thing I forgot to mention, some people with TMJ find treating that can reduce their tinnitus perception. It may not be relevant to your friend, but something she could consider looking into if her medical eval is clear.
posted by ghost phoneme at 11:29 AM on April 17, 2015 [2 favorites]

Meds can cause tinnitus (some permanently, some transient) so review current meds against one of the many web sites which provide "prescriber information" sheets or check with pharmacist.
posted by Jesse the K at 11:32 AM on April 17, 2015 [1 favorite]

I have permanent tinnitus due to hearing loss. It does not come and go -- it is always is there to varying degrees -- but I was advised when it first started (by my audiologist) to try and mask the sound - listen to music, use a white noise machine at night and try (it's hard!) to not listen to ringing and buzzing in my ears.

My advice would be if it ends up being permanent, one can learn ignore it with practice and the use of other sounds. I found I was listening to music and white noise all the time for several months before I found it seemed to be better. (But it was still there if I "listened for it" so to speak -- so I try not to ever concentrate on the sounds in my ears if I can help it.)
posted by Lescha at 1:39 PM on April 17, 2015 [2 favorites]

She would like advice, particularly about how to reduce the probability that the tinnitus will become permanent.

Some people report anecdotally that magnesium supplements help reduce their tinnitus to more manageable levels.
posted by Michele in California at 1:42 PM on April 17, 2015 [1 favorite]

Here are my experiences with this.

I first heard the sound about a year ago after playing with some music software, and it really worried me. I looked on the internet and saw stories of people discussing permanence. The more I did this, the more worried I got. I went to an audiologist, who ran a hearing test and reassured me that there was no damage to my ears and that any sound would go away. After a few months, I could still hear it. My concern was that it would interfere with my everyday life and ability to go out and listen to music.

The best thing I did was to stop going on the internet and reading about other people's experiences!

What changed my way of thinking was this fantastic post on Reddit. It links to a great medical site. The argument is essentially that everyone can hear this sound, but for some reason, in some cases, the brain fixates on it and loses the ability to filter it. Please do read the linked page as well. Once you grasp the concept, it's no longer an issue of the sound being there or not.

A couple of other points are that I talked to a number of people who told me they heard it - at least one or two told me that they had always heard it and considered it completely normal.

For sleeping purposes, I bought an excellent white noise machine and began sleeping very well again. And for going out, I bought a pair of good ear plugs, although I don't wear them as much as I used to. As I mentioned, it has been about a year for me, give or take a couple of months, and I now feel great. Hope this helps.
posted by amxr at 4:06 PM on April 17, 2015 [7 favorites]

A clock that ticks loudly next to your bed can help, just constant same-length ticks. Not sure why.
posted by meepmeow at 8:06 AM on April 18, 2015 [1 favorite]

Response by poster: Thank you so much for all your comments! My friend hasn't gotten back to me yet, but I know she's been reading the thread. I'm grateful to everyone who's commented!
posted by HoraceH at 3:22 PM on April 19, 2015