Dr. Nagler's Tinnitus Corner
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Dr. Nagler

Posts: 1,764
Hello Friends -

So you developed tinnitus a few weeks ago. You think it may have been due to a medication you were taking, a loud concert you attended, or possibly stress related to the recent loss of your job. Maybe you just don't know. You have seen an ENT who after evaluating you thoroughly told you it might go away on its own, but sometimes it doesn't. You are becoming increasingly anxious. You have read a number of very disturbing Internet posts from tinnitus sufferers, and you are concerned - possibly even frightened. You wonder: "What should I do now?"

Below are ten messages that comprise my take on this important question ...

Message Number One: Your tinnitus horse has left the barn. And while there is much you can do to achieve meaningful lasting relief, wondering who left the barn door open and how the horse got out is not going to get you anywhere. You have already seen an ENT who has evaluated you thoroughly and as a result of that evaluation has determined two things. First, your tinnitus has not been caused by one of the (relatively rare) causes of tinnitus that can be fixed and in-so-doing fix your tinnitus - or your ENT would have fixed it. And second, your tinnitus has not been caused by one of the (even rarer) causes of tinnitus that represent a threat to health or life - or your ENT would have told you. Now since neither of those is the case, continuing to wonder what caused it is pointless. More than pointless, it is actually counterproductive ... because dwelling on the past will serve only to keep you from moving forward. [But that said, everybody still wonders for a while; it's only human nature!]

Message Number Two: The barn again. Very important. More often than not - much more often than not - the horse goes back into the barn of its own accord. That's right. In the majority of cases within the first several months after onset tinnitus just seems to fade away as mysteriously as it appeared. Indeed, it can even happen after years! You don't read about it on tinnitus support boards - because by and large those folks whose tinnitus fades away on its own accord have no reason to post on such boards in the first place. Additionally, most of those whose tinnitus does not fade away on its own just tend to accommodate to it over time. And you don't read about that much either - for the same reason. Tinnitus support boards can be a good thing. But they can also be a real problem. Why? Well, while tinnitus support boards do provide information, not all of it is good information. Just because a piece of information makes good sense, that does not necessarily make it good information. Moreover, tinnitus support boards tend to be dominated by individuals who have not yet overcome their tinnitus - or they wouldn’t be there in the first place! So you need to ask yourself how healthy it is to be continually exposed to postings from the distinct minority of tinnitus sufferers who have not yet managed to figure out how to achieve for themselves precisely that which you desire to achieve for yourself. In short, if you do wish to visit the support boards from time to time, please do not take everything you read at face value.

Message Number Three: Your brain. Your brain is doing what it is supposed to do, and you have no say in the matter. As far as your brain is concerned, your head has been invaded by "The Guest from Hell." An uncle you dislike has come for a visit and will not leave. So, of course, your brain reacts! And you simply cannot will your brain not to react to this invasion. Why? Because your brain's reaction to your tinnitus is largely mediated by your autonomic nervous system, your “fight-or-flight” mechanism, which is not under your conscious control but is rather predominately under the control of your hypothalamus. The primary function of your autonomic nervous system is to protect you. But unfortunately in order to protect you, your autonomic nervous system relies on the only resource afforded to it by your auditory system: It monitors your tinnitus. So while you do not want to be monitoring your tinnitus … in doing what it is supposed to do, your brain does precisely that. It monitors your tinnitus. The message? Stop consciously trying not to monitor your tinnitus; it will not work.

Message Number Four: Your auditory system. Your auditory system exists to detect, perceive, and evaluate external sounds. And in the absence of external sound, your auditory system will "turn up the gain" in order to seek out any external sound it can possibly find. Well, if there is no external sound for your auditory system to access, then turning up the gain will serve only to unnecessarily magnify your internal sound: your tinnitus. The message? Avoid silence. There is no need to purposely cover your tinnitus with external sound (i.e., "mask" your tinnitus), but do try to have some soft sound around you most of the time - especially at night when you are alone with your thoughts and when the very last thing you need is for your tinnitus to be unnecessarily magnified. What about hearing aids? If you have a clinically significant hearing loss, their use specifically in tinnitus may be worth pursuing with a knowledgeable and experienced audiologist - but that is a topic beyond the scope of this very basic discussion. Also, of course, you should do your best to limit your exposure to sounds that are loud enough to cause auditory damage. Dr. Jack Vernon (1922-2010) used to recommend that if you find yourself in an environment wherein you must raise your own voice in order to be heard by a person standing next to you, then you ought to use earplugs or leave. And that "Rule of Thumb" holds true regardless of whether or not you have tinnitus! Importantly, you should also try to limit use of earplugs when the noise level in the environment does not reach that threshold. So as best you can within reason: (1) Avoid silence, (2) Avoid dangerously loud sounds, and (3) Avoid over-protection.

Message Number Five: Drugs to avoid. For all you need to know, CLICK HERE.

Message Number Six: Foods. Every tinnitus sufferer can name some foods that seem to aggravate his or her tinnitus. You can make yourself dizzy trying to keep track of it all. The important thing to remember is that there are no foods that have a lasting adverse effect on tinnitus. So you can let your tinnitus run your life and avoid eating or drinking anything and everything that might, just might, temporarily aggravate your tinnitus. Or you can take hold of your life and eat what you want to eat. Me? I am definitely in the latter camp.

Message Number Seven: Drugs again. There has yet to be found a medicine, herb, potion, or elixir that will safely and predictably cure tinnitus or lastingly decrease its loudness. Anecdotal success reports abound. But when it comes to reliable and verifiable controlled studies, nothing has been found with efficacy any greater than placebo.

Message Number Eight: Miracle cures. If something sounds too good to be true, likely there is a reason! No, if a true cure for tinnitus comes along someday, you will know it. Trust me on that. You will be able to read about it on the front page of every major newspaper in the world.

Message Number Nine: Strategy. When faced with a challenge, it is helpful to empower yourself with a strategy for overcoming it. My suggestion for a reasonably effective sensible strategy early on, a strategy that will cost you not a penny, is encompassed in the book Tinnitus: A Self-Management Guide for the Ringing in Your Ears by Jane Henry and Peter Wilson. To download the book for free and read how I would recommend using it, CLICK HERE.

Message Number Ten: Professional help. Sometimes working with a knowledgeable and experienced tinnitus clinician can make a huge difference. Often the problem is finding the right fit! For some thoughts on one way to go about it, CLICK HERE.

And there you have it: Tinnitus 101

Here's to quieter days ahead for all -

Dr. Stephen Nagler
Atlanta Tinnitus Consultants, LLC


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.