I want to focus in this post on the issue of tinnitus scams, as this can be a problem for any tinnitus suffer who turns to the media for advice, as well as for people and institutions who offer genuine advice and services regarding tinnitus, be they paid or free ones likes this blog or my own tinnitus advice website and tinnitus forum. For everybody who starts suffering from Tinnitus, the most pressing question is how to cure the condition as quickly as possible. Doctors usually can't help, as there is no acknowledged treatment or therapy for it, so the tinnitus sufferer is left to his/her own devices to treat the condition. Naturally, these days he/she turns first to the world wide web, and here one can find a bewildering number of various medicines, therapies, books and e-books being offered, all claiming to result if not in a complete cure then at least a substantial improvement. The question arises which of these offers are genuine and which are mere scams aimed at making money out of essentially worthless and useless items and services. This is in most cases difficult to say, as there is no guaranteed (and medically or scientifically acknowledged) method of cure for tinnitus. There are certainly ways and treatments to at least improve the condition, if only temporarily. But which ones work for a certain person can not be said in advance but has to be found out by trial and error. It is therefore fair to say that offers promising 90% or even 100% success rate are scams, as such a claim is exaggerated at best and a completely fabricated lie at worst. An example in this respect is the 'Tinnitus Miracle', an e-book by Thomas Coleman that is aggressively marketed on the world-wide web, with dozens (if not hundreds) of websites having been set up to dominate the search engines and drive traffic to their Tinnitus Miracle site to download the e-book for a payment of $37. They also regularly post spam entries in my Tinnitus Forum to directly drive people to their site, often claiming to be tinnitus patients that have been cured by the 'Tinnitus Miracle' book. Of course, one could argue that this is not a scam as people get something for their money (an e-book), but the question is whether it is worth the money. And in this respect it is fair to say that this is not so. I haven't read the book myself, but from several other reviews I know that it contains little more than information and common sense advice that can be found for free on many other websites on the internet. Certainly not anything in the way of miracles. I do not want to question that Thomas Coleman (the author of the Tinnitus Miracle book) or other doctors, practitioners or researchers who offer books, medicines or on-site therapies against tinnitus are in the genuine belief that their product may help some clients/patients, but they are clearly misleading in their claim that everybody will be cured by it. This is not possible in the case of tinnitus with any therapy, even medically acknowledged ones. The tinnitus is simply too different from person to person for this. Unfortunately, some people simply try to exploit the fact that no reliable medication, therapy or treatment against tinnitus exists, and they try to make money on the back of claims to offer something that actually works reliably for everybody. It is like with most things: if it sounds too good to be true then it probably is a scam. So you should be careful where to put your money. Before spending it on something questionable, search the internet for independent reports about the product (be aware though that the Tinnitus Miracle have set up many fake sites that appear to give independent reviews supporting their claim). If you have any comments or even your own experiences regarding the Tinnitus Miracle or other medicines, treatments or therapies you suspect or know to be a scam, you are welcome to post them here or in my Tinnitus Forum. Thomas

I had recently in my Tinnitus Forum a few people who are suffering from pulsatile Tinnitus.I have personally no experience with this, so I have to rely on the publicly available information here. And this suggests that pulsatile tinnitus is actually quite different from 'normal' Tinnitus, as it is not so much a nervous condition but due to physiological causes like restricted blood vessels in the ear/neck region. This causes then the (pulsatile) blood flow in this region to become audible. So pulsatile tinnitus is in these cases actually an 'objective' tinnitus that can be heard by the ENT- doctor with suitable instruments as well (see the Tinnitus.org.uk Website and the Whooshers Website for more). Chiropractical treatment or surgery could help in these cases, but since not many doctors are familiar with this, it might take some time to find somebody to do this, or even diagnose it with certainty (and for this a CT or MRI scan would be required). Not any pulsatile tinnitus would fall under this, but if it is pulsating in the rythm of your heartbeat, you should try to clarify this, as the measures for normal (subjective i.e. nervously conditioned) tinnitus would be rather unsuitable here. Thomas

I just found the following press release of the University of Leicester that was already published a few months ago:

University of Leicester study identifies key cellular mechanisms behind the onset of tinnitus Research into hearing loss after exposure to loud noises could lead to the first drug treatments to prevent the development of tinnitus Issued by University of Leicester Press Office on 10 May 2012 Researchers in the University of Leicester's Department of Cell Physiology and Pharmacology have identified a cellular mechanism that could underlie the development of tinnitus following exposure to loud noises. The discovery could lead to novel tinnitus treatments, and investigations into potential drugs to prevent tinnitus are currently underway. Tinnitus is a sensation of phantom sounds, usually ringing or buzzing, heard in the ears when no external noise is present. It commonly develops after exposure to loud noises (acoustic over-exposure), and scientists have speculated that it results from damage to nerve cells connected to the ears. Although hearing loss and tinnitus affect around ten percent of the population, there are currently no drugs available to treat or prevent tinnitus. University of Leicester researcher Dr Martine Hamann, who led the study published in the journal Hearing Research, said: "We need to know the implications of acoustic over exposure, not only in terms of hearing loss but also what's happening in the brain and central nervous system. It's believed that tinnitus results from changes in excitability in cells in the brain - cells become more reactive, in this case more reactive to an unknown sound." Dr Hamann and her team, including PhD student Nadia Pilati, looked at cells in an area of the brain called the dorsal cochlear nucleus - the relay carrying signals from nerve cells in the ear to the parts of the brain that decode and make sense of sounds. Following exposure to loud noises, some of the nerve cells (neurons) in the dorsal cochlear nucleus start to fire erratically, and this uncontrolled activity eventually leads to tinnitus. Dr Hamann said “We showed that exposure to loud sound triggers hearing loss a few days after the exposure to the sound. It also triggers this uncontrolled activity in the neurons of the dorsal cochlear nucleus. This is all happening very quickly, in a matter of days” In a key breakthrough in collaboration with GSK who sponsored Dr Pilati’s PhD, the team also discovered the specific cellular mechanism that leads to the neurons' over-activity. Malfunctions in specific potassium channels that help regulate the nerve cell's electrical activity mean the neurons cannot return to an equilibrium resting state. Ordinarily, these cells only fire regularly and therefore regularly return to a rest state. However, if the potassium channels are not working properly, the cells cannot return to a rest state and instead fire continuously in random bursts, creating the sensation of constant noise when none exists. Dr Hamann explained: "In normal conditions the channel helps to drag down the cellular electrical activity to its resting state and this allows the cell to function with a regular pattern. After exposure to loud sound, the channel is functioning less and therefore the cell is constantly active, being unable to reach its resting state and displaying those irregular bursts.” Although many researchers have investigated the mechanisms underlying tinnitus, this is the first time that cellular bursting activity has been characterised and linked to specific potassium channels. Identifying the potassium channels involved in the early stages of tinnitus opens up new possibilities for preventing tinnitus with early drug treatments. Dr Hamann's team is currently investigating potential drugs that could regulate the damaged cells, preventing their erratic firing and returning them to a resting state. If suitable drug compounds are discovered, they could be given to patients who have been exposed to loud noises to protect them against the onset of tinnitus. These investigations are still in the preliminary stages, and any drug treatment would still be years away. The research was funded by a Research Councils UK fellowship to Dr Hamann, a grant from the Wellcome Trust and a PhD studentship from GlaxoSmithKline, with follow-up investigations funded by a three-month grant from Deafness Research UK. Further pharmaceutical research will be carried out by the University of Leicester in collaboration with Autifony Therapeutics Ltd via a Medical Research Council Case studentship due to start in October 2012. Vivienne Michael, Chief Executive of Deafness Research UK, said "We’re pleased to hear about this progress in such a debilitating hearing impairment. The charity continues to fund research into better treatments for tinnitus, with the ultimate aim of a cure. Our free information leaflets offer immediate help to sufferers and our national helpline provides additional support. Regularly tinnitus generates the most requests for help.

As stated in the article, new studies will start next month, but this is all still in the preliminary stages, and a drug is not expected for the next couple of years. Thomas

Sleep problems are probably the most important ones in case of tinnitus, and the ones that people mostly complain about. It is quite obvious that with ear noises suddenly being present, the sleep quality will be affected. However, to a certain degree these problems might actually be self-imposed. This is because many people have certain idealistic notions about sleep, like 'I need eight hours of sleep' and 'I have to sleep through without waking up'. And then in case of not being able to fulfill these ideals, they feel guilty and inferior because of it, which however only will aggravate the problems and the suffering associated with the sleeplessness. So my advice would be not to dwell so much in your mind on the sleep problem, but just try to cope with it as best as you can on a day to day basis. My doctor told me that for quite a while one can manage with 5-6 hours of sleep per night, so one shouldn't feel bad if one only gets this amount. If it causes too much stress to lie awake each night for an hour or two, then consider going to bed correspondingly later. This won't give you more sleep but reduce the amount of time you are lying awake (and thus the stress associated with this). Only as a last resort you should consider sleeping tablets or tranquilizers for a while. In any case, don't worry, for most people the acute sleep problems only occur for the first 6 months at most. The sleep will then return to a more normal (in any case more manageable) pattern again. Thomas

A question I come across quite frequently is whether it is advisable to go on holiday with a tinnitus. Many people fear apparently that it could get aggravated. According to my own experience and those of others I have spoken to, this is an unfounded fear. On the contrary, in many cases the holiday will have a positive effect due to the generally relaxing nature of a holiday and the fact that, with the new environment, one does not concentrate so much on the condition. Still, one should obviously take some precautions and also avoid overly loud environments on holiday (or use earplugs in corresponding situations). Flying by airplane is usually not a problem either, but also here one might want to use earplugs in order to reduce the engine noise (there are also special earplugs called 'Earplanes' that help to reduce the pressure equalization problems (fullness in the ears) which some people have during flights). Thomas