Treating Tinnitus: Part One
Treating Tinnitus: Part One
Tinnitus (“the perception of sound in the absence of any external stimulus”) may only affect 10 to 15% of the adult population, but many of those coping with this condition are facing “a severe disturbance in everyday life”. Others with tinnitus may not suffer as much, but still would do anything to eliminate the constant irritation that accompanies it.
Unfortunately, there is no drug treatment considered effective for treating tinnitus, and the cause of it remains unknown. Now, however, a natural treatment may hold some hope.
As scientists work to determine a cause, and treatment, for this ailment, newer research has pointed in the direction of oxidative stress as a possible root cause. As a result, a variety of antioxidants have been studied to determine their potential value in treating tinnitus.
Based on this previous research, the study we are to examine here also set out to assess the effect of antioxidant supplementation on tinnitus patients. However, their approach was somewhat different from other similar studies. Most previous studies used only one antioxidant, or nutrient (e.g. zinc), and found little benefit for treating tinnitus.
So, the approach taken by these researchers was based on the hypothesis “that an antioxidant combination might be more effective compared with single nutrients, since various antioxidants have a synergistic/complementary activity”. (Seems like a no-brainer for anyone familiar with how vitamins and antioxidants work, but we will forgive them for not thinking of this sooner, since it is not really their forte.)
The mechanism by which oxidative stress (i.e. free radical damage) could play a role in the development of tinnitus, is straightforward.
Oxidative stress “could lead to cellular changes in hair cells, hair cell apoptosis, cochlear degeneration, changes in supporting structures and stria vascularis, changes in nerve fibers of the acoustic nerve, irregular neural activity in the auditory pathway and dysfunction of the central cortex”. (Obviously, the “hair” discussed are the fine, tiny hairs inside our cochlea, the small, snail-shaped organ in the inner ear. Such hairs, like those in the nasal passage, lungs, and intestines, all depend on a healthy mucosal membrane. The mucosal membrane requires that we have adequate vitamins A and D, and iodine, as I covered in this blog.)
A further motivation for this particular study was the observation that “higher plasma concentrations of oxidative stress biomarkers and lower antioxidant activity have been reported in tinnitus patients compared with healthy subjects”.
The Study
“The aim of the study was to explore the efficacy of antioxidant supplementation which provides vitamins, minerals, and phytochemicals combined with ALA (the antioxidant, alpha lipoic acid) on tinnitus parameters and subjective discomfort.”
The study used seventy subjects, both men and women, aged between 25 and 75 years old, with chronic, persistent tinnitus of at least six months’ duration. Half the subjects were given the antioxidants, and half were given the placebo pills, for a period of three months.
Results
“Results of this study showed that antioxidant supplementation with vitamins, minerals, phytochemicals and ALA could exhibit favorable effects in tinnitus by reducing the subjective discomfort and tinnitus intensity.”
While, unfortunately, the frequency of tinnitus did not significantly change in either of the two groups, in the group taking the antioxidants there was a dramatic drop in the loudness of the tinnitus. “This means that antioxidant supplementation was effective in improving tinnitus’ sensory aspects, and in alleviating patients from tinnitus-related distress compared to placebo.”
However, there was a further result that bodes well for all of us, whether or not we are plagued with tinnitus.
“At the same time, this study showed that antioxidant supplementation led to significant improvements of hearing thresholds across all frequencies, with the overall changes being significantly different between the two groups at the frequencies of 250 Hz, 2000 Hz, 4000 Hz, 10,000 Hz, and 12,000 Hz. Improved thresholds at frequencies between 250 Hz and 8000 Hz is of high importance, since these are the frequencies used for speech recognition and thus tinnitus patients could benefit from a better understanding of speech and language.”
What Nutrients Were Used in the Study?
Our successful group were given one multivitamin-mineral tablet once a day, with food, along with one 300 mg tablet of alpha-lipoic acid (ALA) twice per day, taken on an empty stomach.
Many of the antioxidants used in this study had already been established, through animal studies, to protect against cochlea damage. This is especially true of ALA which has been shown to provide protection from noise-induced hearing loss.
As well, polyphenols (provided by grape seed extract in the multivitamin-mineral pill) have been found to prevent cochlear hair cell damage after intense noise exposure. And, in human studies, vitamin E has been shown effective in the treatment of sudden idiopathic (“of unknown cause”) hearing loss.
Other nutrients provided by the multivitamin-mineral complex also are related to improving hearing, and aspects of tinnitus. For example, the “vitamin B complex plays a key role in the functioning of nerve tissue, cellular metabolism, vascular function, and myelin synthesis”. Myelin is the sheath that surrounds our nerve endings, and a lack of this protection has been linked to tinnitus. Vitamin B12 and folic acid are also required for maintaining myelin, and, as well, a deficiency in these two nutrients has been linked to hearing loss along with increased levels of oxidative stress. (Study)
For those interested in a detailed examination of the nutrients used, here is the composition of the multivitamin-mineral supplement actually used in this study.
Vitamin A…………………………………………….2600 IU
Vitamin D3…………………………………………….400 IU
Vitamin E (synthetic)……………………………………….150 IU
Vitamin C…………………………………………….150 mg
Vitamin B1…………………………………………….25 mg
Vitamin B2…………………………………………….25 mg
Vitamin B3 (niacin)…………………………………………..25 mg
Vitamin B6……………………………………………..10 mg
Vitamin B12…………………………………………..10 mcg
Folic Acid……………………………………………200 mcg
Choline………………………………………………….25 mg
Inositol…………………………………………………..25 mg
Biotin…………………………………………………150 mcg
PABA……………………………………………..…….25 mg
Pantothenic Acid………………………………………25 mg
Magnesium (oxide)…………………………………………..50 mg
Calcium (phosphate)………………………………………..62 mg
Chromium (picolinate)……………………………………200 mcg
Copper (gluconate)………………………………………….1.2 mg
Iodine (potassium iodide)……………………………….150 mcg
Iron (ferrous fumarate)……………………………………..14 mg
Manganese (gluconate)………………………………………4 mg
Molybdenum………………………………………..500 mcg
Selenium (selenomethionine)………………………….100 mcg
Grapeseed Extract (500:1 extract)……………………….1 mg
Conclusion
I’ll close with a few comments on the formula used in this study.
First off, the authors attribute the benefits of the antioxidant compounds known as polyphenols, to be a result of the inclusion of standardized grape seed extract in the formula. However, they use only 1 mg of a 500 to one concentrate, making the assumption that this is equivalent to 500 mg of grape seed. I would warrant that this one milligram is insignificant, since all grape seed products are made from standardized grape seed, and are usually available in 50 to 100 mg, far closer to a therapeutic dose than what was used here.
In fact, many of the nutrients in their formula are in amounts less than therapeutic, perhaps one reason why there was no reduction in frequency of tinnitus, only in volume of noise. If subjects had received a larger dose of some of the primary nutrients, results may have been more impressive.
For example, as I mentioned earlier, maintaining the mucosal membrane, and the fine “hairs”, is dependent on adequate amounts of vitamins A and D, along with iodine. All of these nutrients are present in insignificant amounts in the multivitamin-mineral used.
One needs at least 50,000 IU of vitamin A weekly just to equal one serving of cow liver (a normal food-intake standard); this product provides only 18,200 IU weekly. Vitamin D, I believe, should be ingested at a rate of about 25,000 IU weekly, and their product provided only 2800 IU per week. As for iodine, they have only potassium iodide which serves the thyroid, but no actual iodine was included, which is required for mucosal membrane maintenance.
The vitamin B12 is insufficient for repairing myelin, and most likely was not provided in the methylcobalamin form, and the same holds true for the use of common folic acid, instead of methylfolate, also required for repairing nerve endings.
Vitamin E, a premium antioxidant, was in the fairly useless synthetic form, and at a dose too low to be of much value (150 IU), as one usually wants at least 400 IU daily. And, the vitamin C at only 150 mg is not sufficient to elevate glutathione levels. We require at least 500 mg of vitamin C in order to elevate levels of this powerful antioxidant.
Which is why I am comfortable recommending our NutriPods product to anyone seeking to follow a similar protocol for treating tinnitus. NutriPods offer 400 IU of vitamin E, 500 mg of vitamin C, and contains the methylated forms of vitamin B12 and folic acid.
NutriPods contain 5,000 IU of vitamin A, backed up with natural beta carotene, which while not quite sufficient for those who do not eat liver, is at least twice as much as what their product provided. The iodine present is only potassium iodide, as that is the only form available for encapsulation, so I would suggest that anyone looking to treat their tinnitus also take a separate iodine supplement (e.g. Lugol’s Solution or Nascent iodine).
NutriPods do provide a modicum of ALA (25 mg), but not sufficient for treating advanced tinnitus, so that is another supplement that one should add to the regimen. Finally, NutriPods also offer 25 mg of standardized grape seed extract, far more than the 1 mg used in this study. (Those who wish a more detailed comparison can follow the link above to NutriPods and examine the ingredient list.)
All in all, what we have here is the beginnings of an idea on how to treat tinnitus. Building on the doses used in this study could offer a far better outcome, and next week we will look at one other nutrient critical to rectifying this problem, and examine what role our diet plays.