A lady wrote,

I have had tinnitus for several years. It seems to be a genetic disorder as my mother and brother both suffered from it as well. I worked in the music business for years and always attributed it to the exposure to loud music and extended use of Aspirin. Both my brother and mother had heart issues. Is tinnitus related to heart disease? Also, what would cause an increase in the sound of tinnitus?

I’ve never heard of tinnitus being genetic. Rather than your family’s tinnitus being genetic, you could all have tinnitus because of similarities in your environments, lifestyles or upbringing that result in tinnitus. When that happens, it is easy to think that tinnitus might be genetic.

Being around loud music can and does cause tinnitus. So can taking a lot of Aspirin. Fortunately, tinnitus caused by Aspirin is typically temporary.

Furthermore, tinnitus can be related to heart issues—depending on the type of your tinnitus. For example, if your tinnitus pulses in unison to your heartbeat, you have a vascular kind of tinnitus called pulsatile tinnitus. High blood pressure or clogged arteries in your neck and head can cause this kind of tinnitus.

If you have heart disease and take heart medications, one of the side effects of the heart drugs can be tinnitus.

There are many factors that can cause your tinnitus to increase in volume. For example:

— being around louder sounds
— taking any of the more than 500 drugs known to cause tinnitus
— increasing hearing loss
— stress
— anxiety
— eating certain foods
— various diseases such as allergies and diabetes
— ear infections and other ear conditions, and so on.

If you want to learn more about tinnitus and a number of things you can do to help bring it under your control,  check out the new 5th edition of “When Your Ears Ring! Cope with Your Tinnitus—Here’s How“.

For the last number of years, we have been bombarded with hype from the hearing aid manufacturers extolling the virtues of digital hearing aids and how much better they are than analog hearing aids. Thus, I was surprised to see some very interesting information showing that analog technology is actually superior to digital technology under certain conditions.

Let me quote the pertinent part of this article. “Data…have shown that an analog single-microphone single-channel hearing aid can outperform today’s most expensive fully digital hearing aids with a myriad of noise reduction features, provided the analog hearing aids are set to real-ear verified NAL-R [National Acoustic Laboratories—Revised—a linear analog hearing aid fitting protocol] and the digital hearing aids are set according to the manufacturers ‘best fit’ algorithm.

This finding suggests that real-ear programming and aided speech audibility are more important than today’s state-of-the-art hearing aid noise-reduction features when those hearing aids are set using only the manufacturers best-fit algorithms.” (1)

What this really means is that digital hearing aids set according to the manufacturer’s suggested fitting for your hearing loss are not superior to the older linear analog hearing aids that have been set using real-ear measurements and then tweaked by a skilled audiologist that knows how to adjust them for your particular hearing loss.

Note: The NAL-R fitting is aimed at maximizing speech intelligibility, rather than restoring loudness at each frequency to normal. The former is what we desperately want—to understand more of speech, not just hear more sound.

Here’s another interesting piece of information from the same article regarding the differences between a manufacturer’s top line of hearing aids vs. their entry level (read cheap) line of hearing aids. Knowing this can save you a bunch of bucks.

“Further, it has not been demonstrated in double-blinded, randomized, placebo-controlled studies that today’s most expensive contemporary digital hearing aids provide better speech recognition in noise than each company’s least expensive hearing aid models. Until these studies are forthcoming, we cannot assume significantly better hearing aid performance will be obtained with today’s most expensive hearing aids.” (1)

Again, what they are saying here is that you can save yourself a bundle of money by buying the cheapest hearing aid in a given manufacturer’s line rather than buying their most expensive hearing aid in that line line because there is no proven difference in how well you will hear in noise.

The bottom line is that you need the services of a skilled audiologist or hearing aid dispenser rather than expensive hearing aids in order to get the most benefit from your hearing aids. All things being equal, a cheaper hearing aid in the hands of a skilled dispenser will easily outperform expensive hearing aids that were just set to the manufacturer’s “best fit” algorithm.

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(1) Leavitt, Ron. Cost-effective Pricing for Hearing Aids and Related Audiological Services. The Hearing Review. Vol. 18, No. 12. November, 2011. p. 32.

Numbers of people find their tinnitus, or the loudness of their tinnitus, is related to stress. I hear from people all the time who tell me that when their stress increases, so does their tinnitus.

Researchers have found the same thing. Writing about people with tinnitus, one researcher recently noted, “On a stress free day, their tinnitus may be manageable and unnoticeable. In the presence of a stressor, their tinnitus returns. It is widely known that stress, even if it may not be the main cause of tinnitus, precipitates and/or perpetuates tinnitus. Thus, teaching patients how to manage their stress more effectively is an important component of a tinnitus treatment program.” (1)

Thus, one of the effective things that you can do to help bring your tinnitus under control is to learn to control your stress. There are many different techniques you can use to help reduce your stress. Discover which works the best for yourself and watch the stress-induced component of your tinnitus “melt away” as you learn how to “hang loose”.

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(1) Herzfeld, Melanie and Francis Kuk. 2011. A Clinician’s Experience with Using Fractal Music for Tinnitus Management. The Hearing Review. Vol 18, No 11, October 2011. p. 55.

Doctors overprescribe medications, especially ototoxic ones. That is no secret. A doctor’s real job is to root out the source of your health problems and fix them. His job is not supposed to be that of a “band aid applier”—one who covers up the real problem with a band aid solution like treating the symptoms with drugs. Yet this is what the majority of doctors seem to be doing.

However, there is another side to the story, and this applies to you if you are already wolfing down a handful of drugs every day. One medical doctor explained, “I am a physician. Often, we are afraid to stop medications because if something bad happens, we could be sued for causing Mom’s stroke, heart attack or death.

I love it when my patients stop their medications themselves or refuse to take more, because then I am safe from our culture of blame. Many of my geriatric patients are on far too many medications and would be better off without them. It takes enormous moral courage to do the right thing in our current litigious environment.” (1)

If you are taking drugs, especially if you are taking several drugs for many months or years, you can make it easy for your doctor to really help you get off the myriad pills you take if you insist that he help you safely get off any unnecessary drugs. (As in the case of the above doctor, he may be secretly relieved you are taking this positive step to help yourself.)

I have said, and will continue to say, that drugs should be your last line of defense, not your first line of attack. There are many other safer and effective treatments you should try first. Not only will you help improve your health, you will not be putting your ears at risk from all the ototoxic medications out there.

Far too many older people gulp down a handful of pills every day. Often the original medication was to treat some condition. Many of the subsequent pills were prescribed to treat various unwanted side effects from that original medication. Then more drugs are added to treat the side effects of those pills, and on and on it goes.

As a result, you end up being grossly overmedicated. Taking all those extra (and largely unnecessary) drugs leads to all sorts of physical, mental and emotional problems such as depression, anxiety, confusion and a false diagnosis of dementia, especially if you also have an untreated hearing loss.

Don’t let ototoxic drugs inadvertently damage your ears and leave you with hearing loss, tinnitus or balance problems. To learn which drugs are ototoxic, get the 3rd edition of Ototoxic Drugs Exposed. This book contains information on the ototoxicity of 877 drugs, 35 herbals and 148 chemicals.

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(1) Physician Warns about Drug Dangers. The People’s Pharmacy. October 24, 2011.

A recent study, published in the Journal of Nutrition, showed that low levels of folate (one of the B vitamins found in spinach, black-eyed peas, beans and other leafy greens) are associated with a higher risk of hearing loss in people over the age of 50. (1)

“Those with the lowest levels of folate were 39% more likely to suffer hearing loss. People with the most homocysteine—an amino acid, also linked to heart disease and dementia, that’s countered by B vitamins—were at 64% greater risk.” (2)

Bamini Gopinath, Ph.D., of the University of Sidney in Australia found that a folate deficiency causes homocysteine levels to increase, which in turn, could restrict blood flow to the cochlea, resulting in hearing loss.

In another study looking at the same participants, Gopinath “found that those who ate two or more servings of fish a week were less likely to develop age-related hearing loss compared to people who had less than a serving a week. Plus, among participants who already had some hearing loss, those who ate more fish saw its progression slow.” (1) Gopinath thinks that the omega-3 fatty acids found in fish help to lower a person’s high blood pressure—which, in turn, could help to protect against hearing loss. (1)

This research makes sense IF your hearing loss is related to vascular issues. (To be sure, large numbers of people fit into this category.) At the same time, there are other reasons why you might lose hearing as you age. A prime example is hearing loss from side effects of all the ototoxic drugs many older people take. Another cause is from a lifetime of exposure to loud noise—and this noise exposure continues the longer you live.

Thus, to my way of thinking, there are three things you need to do in order to protect your hearing as you age: limit your exposure to loud sounds, be careful with ototoxic drugs and eat properly. When you do this, you’ll reduce your chances of getting presbycusis—the fancy word for hearing loss due to aging.

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(1) Mantica, Ana. 2011. Life Line Screening.

(2) Folate and Fish Might Protect Your Hearing. October, 2010. Tufts University Health and Nutrition Newsletter.

As changes in technology surge forward at a frenetic pace, you are bombarded with the hype that newer is better. But is this really so?

Here are some myths and their corresponding facts concerning hearing aids.

Myth No. 1: The latest hearing aids let you hear well under all listening conditions.

Brad Ingrao, Au.D., one of my favorite audiologists, wrote, “In 20 years of practicing audiology, I have almost never encountered a person whose hearing aids were unable to help them hear well, in a small, quiet room with carpet, drapes or no air-conditioning.” (1)

Notice the conditions: it is quiet, there is little reverberation and the speaker is close to the listener. Under those conditions, yes, hearing aids typically work wonderfully well.

Brad continues, “On the other hand, almost all of my hearing aid patients complain that no matter how much they spent on their hearing aids, they still struggle in noisy and reverberant rooms.” (1)

The myth breaks down here. You see, noise and distance are the two main enemies of hearing aids. As soon as you add distance and noise and all the reverberation and distortions of sounds that come with increasing noise and distance, hearing aids quickly cease to help you like they did before. This is when you need to use assistive devices. That is the reality. As Brad says, “the ideal solution in noise is a remote microphone connected to the hearing aid” via an assistive listening device.

Myth No. 2: Automatic hearing aids let you hear well because the hearing aid automatically changes the settings as the sound environment changes.

Brad explains, “Some people can do very well with a fully automatic hearing aid, assuming they spend most of their time listening to one or two kinds of sound in the same setting”. (1)

Some people do very well under these conditions. However, there is another side of the coin. Brad continues, “The more common reality is that people with hearing loss are out and about listening and living in many complex environments. They need to be able to tell their hearing aids how to behave, rather than the other way around.” (1)

To which I add, “Amen, brother.” You see, if you are like most hard of hearing people, you are better off getting hearing aids that are not fully automatic. Yes, you can have some automatic features as long as you can manually override them whenever you want. For example, I love my automatic volume controls, but I have manual volume control wheels as well and I can (and do) override my hearing aids whenever I want to. You want to be able to switch to different settings when the sound environment changes significantly.

Myth No. 3: The manufacturer’s fitting algorithm, together with the audiologists input, will give you a good fit the first time around.

You would like to think that an experienced Doctor of Audiology would be able to do this, wouldn’t you. But as Thomas Powers, Ph.D., vice-president of audiology at Siemens Hearing Instruments explains, “In general it is unreasonable to expect that even the most carefully designed prescriptive fitting method would be appropriate within plus or minus 3 dB for more than two-thirds of all patients.” (2)

In other words, you need to go back to your audiologist or hearing aid dispenser a few times to have your hearing aids tweaked until they get it right. A good fitting probably won’t happen the first time around. This is because “the prescribed gain and output is only appropriate for the average patient, and it too needs to be individualized.” (2) You are you—not Mr. Average—so you need your hearing aids specifically tweaked to fit your unique hearing needs.

Myth No. 4: The fitting that sounds the best lets you hear the best.

This sounds logical, but it is often not true. You see, what sounds the best is what sounds comfortable to you—but you may not hear (understand) the best at that setting.

Dr. Powers again explains, “In many cases better hearing audibility compromises sound comfort and vice versa. In some cases the prescribed high-frequency gain may improve speech intelligibility [so you understand more of what you hear], but the patients perceive the sound quality as too shrill and unacceptable [and if you have recruitment, certain louder sounds may even hurt]. As a result, they will turn down overall gain, resulting in reduced overall audibility.

The fitting challenge therefore is to find the right balance among desired loudness, good audibility, and sound comfort for every patient.” (2) This can be a definite challenge, especially if you have recruitment issues, or have a more unusual hearing loss (e.g. cookie-bite loss, reverse cookie-bite loss, reverse-slope loss). Thus, you may end up with less than optimal hearing (understanding) in order that what you do hear is not too uncomfortable. That is the reality of wearing hearing aids. You need to make trade-offs to best fit your lifestyle to your hearing aids.

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(1) Brad Ingrao, Au.D., Decibels and Dollars. Hearing Loss Magazine. September/October 2011. p. 32.

(2) Powers, Thomas, Ph.D., Finding Optimum Gain, Compression, and Frequency Shape in Different Listening Situations. Hearing Review Products. Fall 2011. p. 14.

A lady asked,

What options do those of us have when we have pain but have a significant history of problems with ototoxic drugs?

This is a common question people ask me. For minor aches and pains, we just need to tough it out. That is what I do. For more intense pain, there are a number of alternative treatments including chiropractic, physiotherapy, acupuncture, etc.

Here are a few other solutions that some people use. For example, “Sally” wrote, “When I get a headache, I just use a cold pack, and it actually works pretty well. No Ibuprofen, no Tylenol, no this and that. I’m getting by just fine using no medication for various aches and pains, but it’s not a good feeling to have such limited options.”

“Helen” explained, “There are some great natural anti-inflammatories out there. I’m allergic to pretty much all the over-the-counter pain-killers. I’ve found that Zymactive by Natural Factors has been a life-saver for me. Zymactive are enzymes that digest the proteins causing inflammation. They work very well. They are not quite strong enough for surgery pain, but are great for sprains, and aches and pains. Of course, I’m also a great fan of ice packs and heating pads ”

“Phoebe” found another solution. She wrote, “I have found homeopathic Mag Phos 30c a great pain reliever. When I was first told about it, I was very skeptical to say the least. However, having tried it 10 yrs ago, it has been my first line of defense for pain relief ever since. I give it to my daughter for her monthly pains and it works great. She says the pain just melts away.”

So there are some more things you might want to investigate. See what works for you. Don’t be afraid to look for other natural solutions before turning to drugs (with their harmful side effects). You may be surprised how well other pain “treatments” work.

A man wrote,

I noticed an ad in the current issue of Hearing Health magazine for Arches Tinnitus Formula. Has anyone had success with this product? The absence of a company address in the advertisement makes me wary.

It seems any magazine ad I see for a tinnitus remedy offers only a toll free number. When I call the number, my experience is that the price of the product is sky high and any questions about the formula will be brushed off because the formula is proprietary.

I realize some people do experience success using a homeopathic product, yet I’m also aware that the American Tinnitus Association has stated there is no medical cure for tinnitus.

I agree with you. I like to see people stand behind their products with full contact information prominently displayed. However, sometimes ads are cramped for space so they leave this information off. The good news in this case is that if you go to the Arches website you will find their contact information—name, address, phone number and the name of the person behind this product—namely, Barry Keate. (I’m well aware that there are other tinnitus products being hawked that have no such contact information on their websites—and of those I am really leery.)

More good news. The ingredients for Arches Tinnitus Formula are not proprietary. In fact, there are only three common ingredients in the Arches Tinnitus Formula, namely, zinc, garlic and Ginkgo biloba.

The interesting thing about their Ginkgo content is that this is one tinnitus formula that actually contains a therapeutic dose of Ginkgo, in contrast to many other tinnitus formulas out there that only contain a token amount of Ginkgo. (This is one reason that so many studies of Ginkgo as a remedy for tinnitus have not shown positive results—the researchers deliberately or through ignorance used an inadequate dose in their studies.)

For example, a German Commission did a detailed study on Ginkgo and determined that the therapeutic dose was 480 mg a day—and that the Ginkgo had to be standardized to 24% flavone glycosides and 6% terpene lactones.

Guess what? The Ginkgo content in Arches Tinnitus Formula is standardized to exactly that. Furthermore, their recommended dose is 480 mg per day—exactly the amount the German Commission found was needed for an effective therapeutic dose.

Even though the Arches Tinnitus Formula contains a therapeutic dose of Ginkgo, you need to realize that Ginkgo doesn’t work for everyone’s tinnitus. Ginkgo taken at the effective dose of 480 mg per day helps between 26% and 82% of the people taking it, depending on which study you look at. This is not to say that everyone’s tinnitus goes away completely, but taking a therapeutic dose of Ginkgo does help reduce the tinnitus in numbers of people—and any reduction in tinnitus volume/annoyance is a blessing to be sure.

Arches Tinnitus Formula is not a homeopathic product—it is a supplement type of product. In my opinion, it is one of the better herbal tinnitus products available. Sure it will cost you—about a dollar a day—but what drugs are that cheap?

There is no single magic pill that will cure tinnitus. The best approach is to try several things at once or sequentially—and hopefully each will help reduce your tinnitus a certain amount so that you end up with a significant reduction in your tinnitus. I give many of these tinnitus reduction strategies, including using Ginkgo and other herbals and minerals in my tinnitus book, “When Your Ears Ring! Cope with Your Tinnitus—Here’s How“.

A lady explained,

A horrible, loud explosion woke me up last night and made me scream out a bit. It was really scary! Has this ever happened to anyone else?

Fortunately, what you experienced is quite rare. It goes by the ghastly-sounding name of “Exploding Head” syndrome.

In spite of its grisly name, your head doesn’t really explode—you just hear a loud exploding sound—much like you did. This can occur as you are coming out of a deep sleep. It can certainly scare you and set your heart to pounding.

In my book, “When Your Ears Ring! Cope with Your Tinnitus—Here’s How” I explain:

“Exploding Head” syndrome is a relatively rare event in which you experience a very loud and sudden noise such as a loud bang similar to a bomb exploding, a gun going off, a clash of cymbals, a door slamming, a roaring sound, waves crashing against rocks, loud voices or screams, a ringing noise, a terrific bang on a tin tray, the sound of electrical arcing (buzzing) or any other form of loud, indecipherable noise that seems to originate from inside your head. It most often occurs just before deep sleep (and sometimes upon coming out of deep sleep) and wakes you up.

If you are interested, you can learn more about the strange kinds of tinnitus some people experience in this book. You can get your own copy here.

A lady declared,

I have the new waterproof cochlear implant, but I am certainly never going to wear it in the pool when I am taking aquasize or swimming. I do not trust the manufacturer’s claims. This cochlear implant is too expensive to take the risk of damaging it from water.

The real question is, “Can you trust the manufacturer’s claims or is it all just advertising hype?” There has been so much hype in advertising that people do well to be wary of the fantastic claims many ads proclaim.

Therefore, in order to know whether it is truth or just hype, and thus whether you can/should trust the manufacturer’s claims that your hearing aid or cochlear implant is waterproof or not, you need to check the basis of their claims. Fortunately, there is an easy way to tell.

All you need to do is check out the ISO (International Standards Organization) rating regarding “waterproofness” of your hearing aids or cochlear implants. If the manufacturer rates your hearing aid or cochlear implant as meeting the ISO IPX7 or IPX8 standard, then yes, you can trust the manufacturers claim that it is waterproof and that you can go swimming with it on knowing that the water will not damage your hearing aid or cochlear implant.

I wrote a bit about this in my May 31, 2011 article: Waterproof Hearing Aids and Cochlear Implants—Here They Come.”  Here is an extract of the above article:

If you are interested in exactly what these standards mean, IP stands for “Ingress Protection”. Ingress Protection is how well your hearing aid (or any other device) keeps foreign “stuff” out. The first number relates to solid particles (e.g. dust). A level 5—like the Aquarius hearing aid and Nucleus 5 cochlear implant—are “protected against dust, limited ingress (no harmful deposit)”, while the highest level for solid particles—6—like the Neptune cochlear implant, is “totally protected against dust”.The second number is the level of protection against water (liquids). Level 7 (Aquarius & Nucleus 5) means “protected against the effect of immersion between 15 cm [6"] and 1 m [3']“, while the highest level—8—(the Neptune) is “protected against long periods of immersion under pressure”.

Note: if the rating only relates to liquid protection then an “X” is substituted for the “dust” rating so you know you are talking about the second number (liquid) and not the first number (dust).

Thus, if you see a device rated as IP6 you know it is a dust rating only. If it is rated as IPX6, you know it is a liquid rating only. If the device is rated for both dust and liquid, it would have numbers in both positions, e.g. IP56 or IP68, etc.

Below I have listed the various ISO IPX (liquid) ratings the manufacturers use, and exactly what these ratings mean.

IPX1 No protection from water.

IPX1 Protected against condensation or dripping water falling vertically.

IPX2 Protected against spraying water when tilted up to 15° vertically.

IPX3 Protected against spraying water when tilted up to 60° vertically.

IPX4 Protected against splashing water from any angle.

IPX5 Protected against low-pressure water stream from any angle.

IPX6 Protected against high-pressure water stream from any angle.

IPX7 Protected against water immersion. Immersion for 30 minutes at a depth of up to 1 meter.

IPX8 Protected against continual water submersion in underwater conditions.

Based on the above, if your hearing aids or cochlear implants have an IPX rating of 6 or less, you do not want to go swimming with them on, but if they have a IPX rating of at least 4, splashing water won’t hurt them. If your hearing aids or cochlear implants have an IPX7 rating, you can freely swim and dive underwater up to 3 feet down and do that for to 30 minutes at a time.

However, if you have truly water proof hearing aids or cochlear implants (IPX8), feel free to go swimming and diving with them on. You can be in the water and swim underwater as long as you want, and there is no restriction on how deep you can dive. Thus you can enjoy a good time in the water and can swim underwater to your heart’s content—and never have to worry about water damaging your expensive hearing aids or cochlear implants.

In case you are interested, here are the IP ratings for solid object (dust) resistance.

IP0 No protection against ingress of objects.

IP1 Protection against ingress of objects greater than 50 mm. (approximately 2 inches).

IP2 Protection against ingress of objects greater than 12.5 mm. (Approximately half an inch).

IP3 protection against ingress of objects greater than 2.5 mm. (Approximately 1/10th of an inch).

IP4 Protection against ingress of objects greater than 1 mm. (Approximately 1/25th of an inch).

IP5 Dust protected. Ingress of dust is not entirely prevented, but it must not enter in sufficient quantity to interfere with the satisfactory operation of the equipment.

IP6 Dust tight. No ingress of dust.

How good are these standards? When Siemens tested their Aquarius hearing aid under rigorous field conditions in extreme conditions of humidity over several months, there were no failures. In fact, their field tests in Queensland, Australia from December 2010 to February 2011, in the heat of the summer included some of the strongest floods and cyclones in Australia’s history. Field study participants also continued to wear the Aquarius during showering and swimming with no failures reported. (1)

Therefore, if your hearing aid or cochlear implant is rated with an IPX8 rating for water resistance and an IP6 rating for dust resistance (in other words, it is rated as IP68), feel free to wear it any time under any conditions. You do not have to worry about dust, water or moisture causing your hearing aid or cochlear implant to fail. That is how good those ratings are.

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(1) Chalupper, Josef. 2011. Beneath the Surface: Understanding the Terms “Water Resistant” and “Waterproof”. The Hearing Review. Vol 18. No 11. October 2011. p. 60.