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morphs

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 #1 
Hi Dr. Nagler,
I would appreciate your insight on my situation. I am a 56 year old male who developed loud, persistent Tinnitus for no discernible reason 5 years ago. I wouldn't say I've ever completely habituated to it but I have self medicated with alcohol on an almost daily basis in order to help cope with the noise. I would put myself in the moderate drinker category (4-5 units per night, more on weekends).

Although the alcohol helps me "forget" my Tinnitus for short periods, I am not particularly happy with it's overall effects on my physical and mental health. I have quit "cold turkey" on several occasions but it seemed to spike my Tinnitus so I always went back to it. I decided to have a more serious attempt recently and have not had any alcohol for about 10 weeks. I didn't find it that hard to quit and after a couple of weeks of disturbed sleep the physical effects were gone. However, my Tinnitus perception has gone up significantly and has not gone back down, sending me back into the cycle of Tinnitus distress similar to the early days. I am now rather depressed because I would like to stop drinking alcohol but feel like that is the only thing that gives me a break from Tinnitus. 

I've looked into the brain chemistry of alcohol withdrawal and it seems possibly related to the GABA receptors that have been damaged by the years of regular alcohol consumption. Things might rebalance themselves but I have no idea how long that will take or if it will ever occur. I had hoped that after 10 weeks this would have normalised by now.

Co-incidentally it was after a period of alcohol abstinence (around 6 weeks) that my Tinnitus first developed, so there seems to be a pattern here. 

Do you have any comments on the role of alcohol withdrawal in the perception of Tinnitus?

Many Thanks,
Geoff






Dr. Nagler

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 #2 
Hi Geoff -

Welcome to this site, and thank you for your interesting question.

In addressing the wide variety of tinnitus-related concerns, I have found it helpful to keep things as simple as possible.

Basically, you have had "loud, persistent Tinnitus" for approximately five years and in an attempt to control your tinnitus have been self-medicating with alcohol. You would like to stop drinking and are interested in knowing more about tinnitus, alcohol, GABA receptors, withdrawal, perception, etc.

Well my first thought is here's a fellow who - for whatever reason - has been consuming 4-5 drinks a night and more on weekends and wishes to stop drinking. To that I say "Bravo" because whatever the relationship might be among alcohol, GABA, withdrawal, etc., what you have been doing in drinking that much is incredibly unhealthy. Perhaps look at it this way. If I were to tell you that sticking a needle in your eye is incredibly unhealthy so you shouldn't do it, you would follow my advice in a heartbeat. Well, the only difference between that and your drinking is that the needle hurts your eye and can blind you while the drinking does not hurt your eye but can kill you. So, yes, regardless of the relationship among alcohol, GABA, withdrawal, etc., you need to stop drinking, and you are to be commended for deciding to do so. (Incidentally, 4-5 drinks a night and more on weekends is not "moderate" drinking.)

As I see it, then, the issue really comes down to what to do about your tinnitus instead of drinking - because drinking more than a single cocktail before dinner every once in a while or a glass or two of wine with dinner every once in a while is a complete non-starter as far as I am concerned.

So I know that you have tinnitus, Geoff, but I do not have a feel for the degree to which the tinnitus that you do have affects your life. Taking alcohol totally out of the equation, tell me this ...

On a scale of 1 to 10 where 1 is "I have tinnitus and I would prefer not to have tinnitus but in the grand scheme of things I don't care much one way or the other because my tinnitus does not bother me much," and 10 is "I have tinnitus and my tinnitus has totally, completely, permanently, and irrevocably destroyed my life," where would you put yourself on that huge continuum overall these days?

Dr. Stephen Nagler
Atlanta Tinnitus Consultants, LLC



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The best way to find yourself is to lose yourself in the service of others.
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No bird ever soared in a calm. Adversity is what lifts us.
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morphs

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 #3 
Hi Dr Nagler,
Thank you for engaging with me and asking for more detail. I would say at the moment I am somewhere around 6 or 7 on the scale that you mention. I was a 10 when the condition first developed. I have probably been as low as 2 or 3 at various times but only when using alcohol as a relief mechanism. The "drinks" that I referred to are standard units, so typically I could consume 2-3 beers containing around 1.3 standard drinks each. I have the type A "control freak" personality which I believe can make Tinnitus more difficult to accept. I also live in New Zealand and am from the UK where regular alcohol consumption is more widely accepted than in the US (I have lived there too).

I am quite frustrated that I have a desire to stop alcohol use but it appears that I have to find a different way to manage my Tinnitus. I have an appointment with my GP tomorrow to discuss this and am considering asking for some Clonazepam for short term relief. This doesn't seem to be any better a solution than alcohol though.

Regards, Geoff
Dr. Nagler

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 #4 
Quote:
Originally Posted by Geoff
Thank you for engaging with me and asking for more detail.

You are welcome.

Quote:
I would say at the moment I am somewhere around 6 or 7 on the scale that you mention.


So the way I see it, as a 6 or 7 your tinnitus is enough of a problem for you that you should do something about it. Up to now your strategy has been to use alcohol as a way to decrease the loudness of your tinnitus, but you have wisely determined that there are a lot of reasons that that is not a particularly effective long-term solution. Indeed it is not a wise short-term solution either, but I digress.

Here's the problem: There has get to be found a predictably effective method for lastingly mitigating tinnitus loudness that does not in-and-of-itself present unacceptable risks to overall health and well-being.

And the solution? The solution lies in the fact that the primary determinant of tinnitus severity is not loudness to begin with! After all, there are people with incredibly loud tinnitus who are hardly bothered by it at all, while there are people with rather soft tinnitus who are all but incapacitated by it.

Perhaps look at it this way. The reason you sought out this board in the first place is not because you have tinnitus. No, the reason you sought out this board is because you have tinnitus and it makes you feel bad. Indeed, if your tinnitus did not make you feel bad in some way or other - then you would still have tinnitus, but you wouldn't have a problem. And that is true regardless of how LOUD or soft your tinnitus might be. Well, feeling bad is a reaction. So instead of trying to lastingly mitigate your tinnitus loudness (a strategy doomed to failure), then perhaps consider strategies directed at mitigating your reaction to your tinnitus.

Quote:
I have the type A "control freak" personality which I believe can make Tinnitus more difficult to accept.

So maybe you need some help instead of trying to go it alone? That's what I did anyway - I got help.

Quote:
I also live in New Zealand ...

... and one of the world's leading authorities on tinnitus, Dr. Grant Searchfield, happens to live in New Zealand as well. How fortunate for you!

Quote:
I have an appointment with my GP tomorrow to discuss this and am considering asking for some Clonazepam for short term relief. This doesn't seem to be any better a solution than alcohol though.

I agree. So why not contact Dr. Searchfield and make an appointment with him or one of his colleagues in the Audiology Section at the University of Auckland!

All the best with it -

stephen nagler

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
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Dr. Nagler's Tinnitus Corner is provided for education and information only. It is not intended for the purpose of providing medical care and should in no way substitute for appropriate in-person consultations with qualified healthcare professionals. By using this site, participants agree to hold Dr. Nagler and Atlanta Tinnitus Consultants, LLC harmless with respect to any loss, injury, claim, liability, or damage arising from following the postings herein.