[IanB52]

From my reading on the matter, you're correct in that medical science has no answers as to what tinnitus actually is or the range of contributing factors that can effect it or cause it. There is a well known correlation to increased blood pressure within the ear and in this case, which can sometimes actually be cured, the source of "the sound" actually does originate in the ear, though not as incoming audible frequencies.

So increased blood pressure or imbalance of blood pressure in the head/neck/ear area due to trauma certainly sounds like a reasonable origin for sudden tinnitus.

In the absence of this, though, there is no clear indication that general tinnitus has anything to do with the ears. It is very clearly a brain issue. I mean, there IS NO such sound, therefore it can't be heard by the ear and, barring damage to the ear, what is generating the electrical stimuli to the "hearing center" of the brain which tricks the brain into thinking there is a sound?

I don't think it's accurate to say medical science has zero understanding of tinnitus. I do think it's safe to say it's an area of study where they recognize they have barely scratched the surface in beginning to understand even the scope. It's a mistake to lump in sound-bite comments of medical adjacent practitioners with medical research professionals actually involved in research.

Cheers,
Robert

Well, I wish you good luck. Tinnitus sucks.

 

[blaked]

I have thoughts on this, but I want to emphasize that I can only speak from my personal experience and have absolutely no expertise to back me up. Take everything I am about to write with something way bigger than a grain of salt... maybe, like, a giant salt lick.

I have tinnitus, fortunately not too overwhelming most of the time. It's usually relatively quiet and ignorable and hovers around 3.8 - 4 KHz in both ears (estimate using a tone generator to get as close as possible to the ringing I hear).

I'm fortunate that headphones usually don't aggravate my tinnitus, although not listening too loudly probably helps. That said, there's an exception: I rarely break out my Grado headphones anymore because I've found that, for me, they do seem to cause my tinnitus to temporarily worsen. Why? I don't know for sure, but I have a guess. One of the peaks that many of Grado's headphones are infamous for is right around the frequency of my tinnitus. I've wondered for a while if higher volumes at the same tone can aggravate the issue. That's speculation on my part, but it seems to fit.

Meanwhile, I can listen to my beyerdynamic DT 770 headphones with no apparent issues, and they're known for having quite a peak around 6 KHz or so. Maybe if my tinnitus was around that frequency I would have a problem? I don't know.

These days I mainly listen with headphones EQ'ed to the Harman curve or sometimes with an additional high shelf filter to lower the treble by about 4 dB, just to tame any brightness a little. Seems to work well for me.

YMMV, of course, and I'm making no claims that any of the above has any basis in medical fact. Just my own personal experiences.

Replying to myself here for context.

I'm due for a hearing aid refresh and, in the process of researching a bit, discovered that the manufacturer of my current hearing aids, Signia, promotes something called "notch therapy" for tinnitus. As I understand it, they amplify the things that need amplifying based on your particular audiogram, but they "notch out" a narrow band around your tinnitus tone (assuming your tinnitus is tonal, as mine is). They claim this can provide long term relief of tinnitus.

I haven't found a lot of research on the topic yet, and most of what I've found seems to be sponsored by Signia, so I'm still approaching the concept with a bit of skepticism, but I'm intrigued. If a notch in the frequency response can help relieve tinnitus, then my hypothesis that tinnitus can be aggravated by a peak at the same frequency seems reasonable.

I found a couple of links here and here. (The first one looks like an as-yet-unfinished clinical trial. That last one is sponsored by Signia, but at least they don't hide it.)

I mentioned my beyerdynamic DT 770, which has a notch around 4 KHz, which might make it more or less perfect for me even without EQ (and I've always liked it anyway).

I usually listen on my DCA Aeon RT Closed with EQ, but I was just playing with adding a notch filter in Equalizer APO, and I don't actually notice it much, if at all. I may play with it some more.

Standard disclaimer: This is not meant to be medical advice, talk to your audiologist, YMMV, contents may have settled during shipment, void in Kentucky if it's a Wednesday during a leap year, etc.

 

[bigshot]

A good parametric equalizer might help you arrive at a response that works for you. I would think you could experiment and see what mitigates the problem the best.

 

[WildPhydeaux]

Interesting, the thought that removal or strong attenuation of frequencies that appear to comprise the person's tinnitus as a means of negating it, or not at least not exacerbating it.

In my own very much layman's and likely off-base thought process as to the why's of tinnitus, I postulate that the frequency range of the tinnitus phantom noise is a range that the persons ears/nerves/brain is no longer sensitive to. And the brains thinks, hey, I can't hear any 7-8kHz any longer... but that frequency must still exist, so I'll just fill in the blanks. In a simler wy to hw you cn stll read wht I typd hre, wth lttle effrt.

I'll be revisiting hearing aides again with a couple years and will be quite curious as to what can be offered.

Thanks for linking to the studies!

Cheers,
Robert

 

[WildPhydeaux]

Well, I wish you good luck. Tinnitus sucks.

Thanks for the kind wishes.

I saw your original reply and was saddened for your frustration with the medical community. I certainly understand to a degree. It's unfortunate the professionals you've seen gave you the impression they either knew very little or cared much about something as trivial as tinnitus. Or both. Just like any profession there are those who are engaged and those who are jaded.

On the other hand, in the absence of encouraging, pragmatic ways of reducing the symptoms, it's not entirely without value to learn coping mechanisms and de-focusing techniques. I believe these can have value and adopting them does not in any way suggest that tinnitus is "all in your head", so to speak.

In any case, I hope the best possible outcome for you also. Hang in there.

Cheers,
Robert

 

[old tech]

I certainly don't have expertise when it comes to these things but I thought tinnitus is inside the head and related to frequency points that are no longer heard externally because, for example, the relevant basilica hair cells in the cochlea are dead. If so, how can hearing aids help by returning those missing frequency when the hardware (ie the cochlea) doesn't respond to it? AFAIK, the main thing that helps is the addition of white noise to mask the sound that is being generated internally in the brain.

 

[blaked]

I certainly don't have expertise when it comes to these things but I thought tinnitus is inside the head and related to frequency points that are no longer heard externally because, for example, the relevant basilica hair cells in the cochlea are dead. If so, how can hearing aids help by returning those missing frequency when the hardware (ie the cochlea) doesn't respond to it? AFAIK, the main thing that helps is the addition of white noise to mask the sound that is being generated internally in the brain.

The notch therapy I mentioned above is meant to be an alternative to masking, e.g., "Notched Noise Therapy . . . presents wideband sound with the tinnitus frequency region notched out, theorized to distribute lateral inhibition into the notched frequency region to suppress neural activity believed to cause the tinnitus percept" (quote taken from one of the articles I linked above).

If I'm interpreting the articles correctly, basically the idea is that, since tinnitus is the brain's response to a lack of stimuli around the tinnitus's frequency region, by "notching out" that region, the brain can eventually be convinced that there's little to hear there anyway, so it might as well stop trying so hard, and the neural hyperactivity causing tinnitus is reduced.

I do wonder about potential side effects of that, though, depending on how it's implemented. Treatment sessions are one thing, but hearing aids set to permanently notch out relevant frequencies are another. Since my (moderate) hearing loss is centered around 3-4 KHz, and my tinnitus is around 3.8-4 KHz, it seems like notching that out will just make it so I have a harder time hearing those frequencies again, which makes distinguishing some consonants problematic. I guess I need to discuss it with my audiologist. Since they sell Signia, I'm assuming they'll be familiar with the options.

 

[PuzzledStar]

The notch therapy I mentioned above is meant to be an alternative to masking, e.g., "Notched Noise Therapy . . . presents wideband sound with the tinnitus frequency region notched out, theorized to distribute lateral inhibition into the notched frequency region to suppress neural activity believed to cause the tinnitus percept" (quote taken from one of the articles I linked above).

If I'm interpreting the articles correctly, basically the idea is that, since tinnitus is the brain's response to a lack of stimuli around the tinnitus's frequency region, by "notching out" that region, the brain can eventually be convinced that there's little to hear there anyway, so it might as well stop trying so hard, and the neural hyperactivity causing tinnitus is reduced.

I do wonder about potential side effects of that, though, depending on how it's implemented. Treatment sessions are one thing, but hearing aids set to permanently notch out relevant frequencies are another. Since my (moderate) hearing loss is centered around 3-4 KHz, and my tinnitus is around 3.8-4 KHz, it seems like notching that out will just make it so I have a harder time hearing those frequencies again, which makes distinguishing some consonants problematic. I guess I need to discuss it with my audiologist. Since they sell Signia, I'm assuming they'll be familiar with the options.

Thanks for posting the links to some research. I actually studied neuroscience for my bachelor’s degree so it was an interesting read to see what is being theorized more currently. Been so long since I’ve studied it though that I needed to refresh my knowledge on some of the terms…

I also read one of the articles cited a couple times in that Signia-sponsored article too for good measure. The number of participants in these studies seem quite small but glad research is being done. In addition to reducing the hyperactivity of the neurons for the frequency of a patient’s tinnitus, they’re also hypothesizing that lateral inhibition is another key to this since a decrease in lateral inhibition seems to correlate with many cases of tinnitus from hearing damage. Basically by using a tone close to the tinnitus frequency, it’s reteaching the nearby neurons to properly tell the neurons responsible for the tinnitus to shut up (which is what they’re supposed to do when functioning normally). At least that was my understanding. Not an expert.

I have some hesitation about the permanent notch as well. Don’t really want to add to the damage after all. But it seems like the research is actually headed towards using set treatment durations and using music rather than just letting you listen to another ringing tone until your brain adjusts. Like you said definitely more research has to be done in terms of risk factors for this therapy but controlled habituation like this method seems like it would be generally low-risk if you already have hearing damage at that frequency. And seems there is a possibility of some lasting benefits according to the study but studies would also need to be scaled to see how long benefits last.

 

[KonanAtlante]

Según mi lectura sobre el asunto, tiene razón en que la ciencia médica no tiene respuestas sobre qué es realmente el tinnitus o la gama de factores contribuyentes que pueden afectarlo o causarlo. Existe una correlación bien conocida con el aumento de la presión arterial dentro del oído y, en este caso, que a veces se puede curar, la fuente del "sonido" en realidad se origina en el oído, aunque no como frecuencias audibles entrantes.

Por lo tanto, el aumento de la presión arterial o el desequilibrio de la presión arterial en el área de la cabeza / cuello / oído debido a un trauma ciertamente suena como un origen razonable para el tinnitus repentino.

En ausencia de esto, sin embargo, no hay indicios claros de que el tinnitus general tenga algo que ver con los oídos. Es muy claramente un problema cerebral. Quiero decir, NO HAY tal sonido, por lo tanto, no se puede escuchar con el oído y, salvo el daño en el oído, lo que está generando los estímulos eléctricos en el "centro de audición" del cerebro que engaña al cerebro para que piense que hay un sonido?

No creo que sea exacto decir que la ciencia médica no comprende el tinnitus. Creo que es seguro decir que es un área de estudio donde reconocen que apenas han arañado la superficie al comenzar a comprender incluso el alcance. Es un error agrupar los comentarios de los médicos adyacentes con profesionales de investigación médica realmente involucrados en la investigación.

Salud,
Robert

Hello, I went to many concerts and listened to loud music with headphones, never a hearing problem until I inadvertently changed from large headphones to in ears, the volume was at maximum (fiio f9 pro, dac fiio x5 3rd) for this I had tinitis from 1 year and something in the left ear, then it healed, how? I'm not sure, it could be a combination of a good diet and 3-day and intermittent fasting, the last thing I had added to my diet was an algae called chlorella (consume 1g at the beginning and gradually increase up to 5 grams or more per day, I reached consume more than 10 grams). Currently I don't use in ears anymore, only over-the-ear headphones and baffles.

 

[Steve999]

Hello, I went to many concerts and listened to loud music with headphones, never a hearing problem until I inadvertently changed from large headphones to in ears, the volume was at maximum (fiio f9 pro, dac fiio x5 3rd) for this I had tinitis from 1 year and something in the left ear, then it healed, how? I'm not sure, it could be a combination of a good diet and 3-day and intermittent fasting, the last thing I had added to my diet was an algae called chlorella (consume 1g at the beginning and gradually increase up to 5 grams or more per day, I reached consume more than 10 grams). Currently I don't use in ears anymore, only over-the-ear headphones and baffles.

It seems to me that there's no end of things that staying physically active and a good diet can help with, if not heal.

I can't find the reference on the interwebs but if I recall correctly there was a study many years ago of hearing loss among old coal miners versus young coal miners, I think it was in Ireland, and this was before the time of portable electronics so capable of ear-bleeding distortion-free volume levels. The researchers were surprised to find in the aggregate less hearing loss among the older coal miners, if I recall correctly, even though they were exposed to higher levels of occupational noise and had less hearing protection.

One proposed explanation for the findings was that the older coal miners were less susceptible to hearing loss because they were so much more physically active.

Perhaps keeping oxygen and nutrient rich blood flowing to all of that sensitive equipment is good stuff. (No jokes please.)

Just a very tentative data point for you, based on my extremely fallible human memory. : )

 

[WildPhydeaux]

Or perhaps the older coal miners were simply more focused in listening for the inevitable bump.

But seriously I would expect there are indeed general health factors which could affects one's degree of tinnitus beyond the known risks like blood pressure.

I changed my diet fairly significantly a couple years ago and had a range of unexpected health benefits which included clearer sinus passages and easier equalization of my eustachian tubes. This didn't happen overnight so I can't say for sure, but my hearing seemed to improve marginally. Not sure about the tinnitus, but it certainly didn't get worse. I'll take the slight hearing gain, along with the other health benefits, and call it a win.

Cheers,
Robert

 

[castleofargh]

I do not have any medical qualification and this post is mostly random me talking feelings and guesses.

There are various things that fall under the tinnitus umbrella and if it's directly about damaged hair cells, then there is no healing from it(unless you're a bird). If some violent shock or sound waves broke or bent those cells in some steady triggering positions, Maybe another shock or loud sound could finish to break the "hair" part, or dislodge the stuck hairs of some cells, but I'd argue that such events also make it likely for more damage to be created. And again, unless you're bird, your body doesn't grow those cells back. We have what we have.


Of course not everybody who went to a concert that was a little too loud and got out with ringing ears stays that way forever. Same thing with listening to a headphone or IEM that's too loud at some frequency and ends up causing similar issues. Most people do get second chances, sadly most people don't learn from their mistakes. IMO if an IEM or headphone causes lasting ringing, get rid or it, lower your listening level, and if another with a smoother FR does the same, maybe stop using IEMs for good.
I have had a fairly quiet tone non stop for almost a decade now. I'm lucky that it's mostly very quiet(enough for me not to hear it unless I'm in a quiet room alone). Anytime I'm tired, stressed or sick, it gets noticeably louder. If I spend too much time(several hours) with my IEMs, it gets louder. I go to bed and only sleep 5 hours, that's an extra day with the louder more annoying tone.
A lack of physical activity over a few days ends up increasing it. I've also noticed some sort of postural impact where hurting my neck somehow impacts my tinnitus.
Writing this makes it seem like it's always loud and getting worse, but it's really not. It has become one sign that helps me stay well instead. I learned how to keep it mostly quiet(I still have to live in the real world), and I think of it more as a friend than as a bother for now. I know how lucky I am that it's that quiet, and believe me, I do a lot in the hope that it stays that way.

Having something quiet and easy to mask also gave me a good sense of how noises in general and broadband noise in particular can bring relief. I don't believe it's doing anything to the tinnitus or it's origin, but auditory masking works on it like it does on any other real tone for me. So if there is a pressure from that sound always grabbing my attention and tiring me mentally, getting other sounds to distract me from it and mask it for a while, it makes a difference!
So I never doubted the potential for noise machines to help most people with tinnitus. But I also don't believe it's solving or treating anything. Based on what I know and have experienced myself, I really imagine it as a "please make it stop for a minute" solution. Which is mighty important at least in term of keeping our sanity, but is it doing more than that in the long term?