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Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

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Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#91

Post by tptacek »

jader201 wrote: post #16

Not sure why I click into comment threads on HN about tinnitus, hoping for positive news or anecdotes, but it’s almost always the opposite. So I’ll share my positive anecdote. I’ve dealt with it for over 10 years, and while I can’t imagine how happy I would be to find an effective treatment, I’ve learned to cope, and do what I can to protect hearing going forward. And once you realize you can cope with it, it makes f…

Had it since childhood, both ears. My impression is that it's on the upper middle class end of the loudness spectrum. I'll notice it if I have a cold sometimes, or if a story about tinnitus hits the front page of HN, but otherwise I'm mostly never thinking about it --- except that I've always got a fan going when I'm sleeping.

It's easy to wind yourself up about, so I think most of what I've done to cope is just learn not to wind myself up about it.

Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#92

Post by The_rationalist »

FollowingTheDao wrote: post #88
The_rationalist wrote: post #77

Earlier quoted context omitted.

No, your answer makes sense but your are being fooled. Tofisopam is not a benzodiazepine. It is what we call a 2,3 benzodiazepine. This is an exception that makes it radically different than any other benzo. It does not directly bind at GABA-A like e.g klonopin and is a weaker anxyolitic. It's action mechanisms is very atypical, it acts as a PDE inhibitor, as a GABA PAM and as a dopamine presynaptic antagonist, makin…

Tofisopam is a type of benzodiazepine, yes? Benzodiazepines are depressants that enhance the effect of the GABA, and the literature suggests that tofisopam does not act on the GABA-A receptor but it does enhance the binding of other benzodiazepines to their binding sites. Any increase in GABA will counteract the excitatory transmission of Glutamate. That is all that matters. But I know klonopin can eliminate my Tinni…

> Any increase in GABA will counteract the excitatory transmission of Glutamate. That is all that matters. No that is not all that matters. The main effect of tofizopam is unrelated to GABAergy, the fact it indirectly modulate GABA-A and potentiate benzos is a plus but its main effect come from atypical PDE inhibition. Look if klonopin is viable for you and solve your tinnitus that's great to hear. But for many people regular benzos are not a complete solution. Tinnitus is a multi-factorial condition and some people might get better results that other with a given medication.

> if you can explain how that works go right ahead Tinnitus is an excitatory overload localized in audition related neuron circuits. AKA too much glutamate (mGLURs, AMPA, NMDA, kainate). The brain is mostly a mixture of excitation (GLUT) and inhibition (GABA-A, B). By taking a classical benzo like klonopin you increase your GABA-A level which inhibit the overload of excitation (GLUT). That is why it works. You can also lower you glutamate levels independently of you GABA via an NMDA antagonist such as memantine. Those two mechanisms are the basic treatments to tinnitus. However there are more specific mechanisms (PDE, synaptotophics, calcium blockers, anti oxidants, bioenergetics) that can be complementary. Classical benzos and NMDA antagonists are not enough for some people with tinnitus.

Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#93

Post by foxbarrington »

vprcic wrote: post #33
mettamage wrote: post #32

Are there any people with tinnitus that have figured out how to sleep with earplugs on? My tinnitus gets worse when I try to sleep with earplugs on. I currently use my Airpods Max (at home) or Bose QC 35 (when traveling) to mask noise. Now that I've read that noise cancelling doesn't protect from sound, I'll only use this for sleeping and use actual earplugs in other situations.

My tinnitus also gets worse with earplugs, and I wear them since I'm a light sleeper, with a bedroom close to a somewhat busy road. What I've managed to convince myself is that if I focus on in, instead of ignoring it, I can "use" it as an inbuilt white noise generator. I've probably conditioned myself to get a reassuring feeling out of it, but I guess that's what counts. I know it sounds ridiculous, and it might be…

I use sleep headphones with brain.fm playing. I used to listen to pink noise (similar to white, but more waterfall and less static).

I use acoustic sheep headphones, but I wish there were more options out there.

Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#94

Post by jerf »

BossingAround wrote: post #22
bryans wrote: post #15

Tinnitus is usually only described as a high-pitched ringing, but I think it gets far worse when it's on the lower end of the frequency spectrum. It's much more noticeable and can make discerning speech very difficult at times. But while the higher frequencies can be somewhat easily tuned out using white noise (like a fan), the lower frequencies are just always there, even when you're listening to music -- there is a…

> remember that noise-cancelling is NOT hearing protection I fell for this one as well. I wouldn't be to surprised if noise-cancelling could actually cause tinnitus, or make an onset of it worse (though I haven nothing but biased anecdata to argue the opinion).

Noise cancelling headphones have always hurt my ears after a relatively short time using them. One of the ways they work is to shove some of their inevitable distortion up into the high frequencies, above what anyone can hear. I've never heard anything, but they definitely hurt my ears. I don't trust them. This is data. It isn't very solid data, because I can't give you sound pressure levels or anything, and it isn't a lot of data. But normal headphones simply don't make my ears hurt, even after hours and hours of usage in a day, which is most every work day for me now.

(I mean active, "true" noise cancellation generating "anti-sound" for your eardrums, not the passive things labelled as "noise cancelling" because there's apparently no legal definition of the term and anyone can call anything "noise cancelling".)

Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#95

Post by VeninVidiaVicii »

Serious question I’ve avoided googling:

Does anyone else have tinnitus in specific locations?

For me, I swear I am constantly hearing high-pitched screeching, but only in apartments or offices. If I’m outside it goes away — even if it’s very quiet.

Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#96

Post by The_rationalist »

tptacek wrote: post #90
FollowingTheDao wrote: post #72

Earlier quoted context omitted.

Yes, klonopin helps reduce my tinnitus. And Tofisopam drug is a different type of benzodiazepine (not for sale in the U.S. or Canada) which blocks the glutamate AMPA receptor. Glutamate excitotoxicity is at the core of tinnitus, and this is why diet also effects the strength and appearance of my tinnitus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458046/ https://www.sciencedirect.com/science/article/abs/pii/S0378…

As I understand it, diet has not all that much to do with glutamate levels. Your body very rapidly metabolizes it (they do studies where they stuff people full of glutamate while repeatedly checking their blood, and it takes a nauseating amount to see a plasma glutamate spike), and the blood-brain barrier is impermeable to glutamate.

intermitent fasting can reduce base metabolic rate which can in theory downregulate glut. moreover diet alter many signaling pathways, including reduced oxidative stress, which are beneficial to some extent for tinnitus.

Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#97

Post by astura »

pickledcods wrote: post #31

It also heavily stresses relationships. I have the equivalent of two jet engines in my ears, including the characteristic phase shifting. Managing it is basically mentally "locking it out", which has the side effect of becoming insensitive to real-world audio stimuli. So when my SO talks to me when I'm off guard, I only realise that mid-sentence before I "unlock" my perception. The first few words are usually the ess…

Sounds like your gf is just a jerk, you don't need to have personal experience with tinnitus to "understand" it or be polite and make accommodations for it.

I have great hearing. My mother in law is very hard of hearing and it's the same way - unless you're actively engaging in a face to face conversation with her it doesn't 'click' that you're talking to her until mid sentence. It's so just not a big deal - I learned really early (like the first day I met her) that if I want to say something to her I just have to pause and make sure I have her attention first. I couldn't imagine acting like your girlfriend if I forgot to get her attention first.

Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#98

Post by tim333 »

bryans wrote: post #15

Tinnitus is usually only described as a high-pitched ringing, but I think it gets far worse when it's on the lower end of the frequency spectrum. It's much more noticeable and can make discerning speech very difficult at times. But while the higher frequencies can be somewhat easily tuned out using white noise (like a fan), the lower frequencies are just always there, even when you're listening to music -- there is a…

>Buy some musician-quality earplugs ...Use them even when you think it makes you look dorky

Or as a mild sufferer myself, use cheap wax ear plugs which is what I do. No one actually notices them and you can vary the sound blocking by how much you squish them in. I use a key ring thing to carry them https://www.ebay.co.uk/itm/131545172517?hash=item1ea0b40a25:...

Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#99

Post by tptacek »

The_rationalist wrote: post #96
tptacek wrote: post #90

Earlier quoted context omitted.

As I understand it, diet has not all that much to do with glutamate levels. Your body very rapidly metabolizes it (they do studies where they stuff people full of glutamate while repeatedly checking their blood, and it takes a nauseating amount to see a plasma glutamate spike), and the blood-brain barrier is impermeable to glutamate.

intermitent fasting can reduce base metabolic rate which can in theory downregulate glut. moreover diet alter many signaling pathways, including reduced oxidative stress, which are beneficial to some extent for tinnitus.

I've been IF for several years now (for whatever good it's done me!), sometimes very strictly and sometimes casually, and I've noticed no correlation whatsoever to my tinnitus. I do buy that anything that really reduces inflammation or anything like that could help, because my tinnitus is definitely correlated to ear congestion and sinus inflammation (but it's always there at some level no matter what).

Basically, my understanding is that the human body is, for basic evolutionary reasons, really efficient at dealing with glutamate.

Re: Treatment for Tinnitus with Stimulation of Auditory and Non-Auditory Nerves

#100

Post by ASalazarMX »

P_I_Staker wrote: post #75
traceroute66 wrote: post #45

Earlier quoted context omitted.

> Use them even when you think it makes you look dorky at the club or concert or sporting event. Yeah, but that's the problem, just like the Western world attitude to masks and COVID. With COVID, all those Western big babies referring to masks as muzzles, nappies etc. and shouting about "muh freedom". All this despite indisputable objective scientific evidence to the contrary that masks work, let alone all the subjec…

Um, yes it actually does have to be that loud sometimes. Some venues have taken your advice and it's lead to lame events where some people can barely hear the music in certain parts of the venue and there's no punch, even right next to the speakers. It's even noticeable, because a lot of venues have this really annoying practice of turning the system way down for the openers, thus hamstringing their set, and making t…

> lame events where some people can barely hear the music in certain parts of the venue and there's no punch, even right next to the speakers

Isn't this a good thing? I'd work with the speaker arrangement to improve perception, it might be more expensive to have more, quieter speakers than a few ear popping loud ones. My ideal venue would have the same loudness in every point, just not loud enough that you have to scream to the ears of your companions.

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