Nearly 50 million people in the U.S.A. have tinnitus. Tinnitus may be described as a ringing, hissing or other noise heard in the ears or head -- when there is no outside source for the sound. Tinnitus is not a disease but a symptom of an underlying condition in some part of the body ? the ear, the auditory nerve, the brain, or elsewhere.

Fortunately, the majority of people who experience tinnitus are able to ignore or dismiss the internal noise they hear as nothing more than a nuisance. But for about 12 million Americans, the noises are unrelenting and distressing. When tinnitus is that severe, it can interfere with one?s ability to sleep, concentrate, hold a job, and interact socially.

Since 1979, the American Tinnitus Association (ATA) has been an advocate and resource for millions of people who have troubling tinnitus and who need answers. ATA is a donation-supported organization that leads the nation in funding tinnitus research. ATA educates patients ? adults and children alike ? their families, doctors, and all hearing health professionals regarding the causes of tinnitus and the many ways to relieve it. ATA produces clear and helpful informational brochures for tinnitus patients on coping strategies, treatments, the effects of loud noise on hearing, and the first steps to take.

ATA?s Web site (www.ata.org) is a current and ready resource for anyone seeking tinnitus answers and information today. ATA provides local self-help group and professional resource lists, elementary school hearing conservation programs, the quarterly journal Tinnitus Today, and, perhaps most importantly, hope to thousands of Americans with tinnitus.

CAUSES of TINNITUS

For millions of people, the cause (or etiology) of their tinnitus is unknown. The most common known cause of tinnitus is exposure to loud noise -- usually either a single intense blast (like from a shotgun blast) or a long-term noise exposure (such as from working in a factory for many years).

Tinnitus can also be caused by:

ear infections

ear wax (cerumen) buildup

use of aspirin, quinine, alcohol, certain antibiotics, and other drugs

underactive thyroid gland

allergies

middle ear disorders (such as otosclerosis)

M??'s disease

disorders of the temporomandibular joint (TMJ)

injury involving the neck or head, like whiplash

acoustic neuroma, a tumor on the auditory nerve

Certain prescription drugs (such as "mycin" antibiotics) and non-prescription drugs (such as aspirin) can cause tinnitus in susceptible people. Tinnitus-causing drugs might also make existing tinnitus louder. Ask your doctor or pharmacist, or look on the PDR side effects list for tinnitus-causing drugs. If you are prescribed one of those drugs, ask about a substitute medication.

DIAGNOSIS of TINNITUS

Many people ask, "Do I have tinnitus?" The simple answer is, "If you hear it, you have it." The not-so-simple answer is, "Tinnitus is a symptom of something that has gone wrong somewhere in the body ? maybe in the ear, or along the auditory pathway to the brain, or in the brain, or elsewhere." In the majority of cases, the source of the tinnitus is idiopathic ? that is, without a known source. Nevertheless, many physical disorders do include tinnitus as a primary or secondary symptom, and these physical disorders can only be addressed and "ruled out" by professionals.

If you have tinnitus, get a thorough medical and audiological examination. These examinations may uncover a treatable cause and point you to the most appropriate treatment. ATA can give you the names and phone numbers of ENT physicians, audiologists, and other health professionals in your area who are versed in tinnitus management.

TREATMENT of TINNITUS

There are many treatments that help people manage their tinnitus. Some common treatment protocols are outlined below:

Masking is the introduction of an external, pleasant, low-volume sound that reduces the perception of the tinnitus. Maskers (or sound generators) are as small as hearing aids and can be worn the same way. New digital and programmable masking devices are available. These are specialty devices manufactured by hearing aid manufacturers, and can be "tuned" to help mask the sounds of your tinnitus. Masking can also be achieved with environmental tabletop sound machines and special tinnitus masking recordings. Some patients use creative homemade maskers, such as fans, or radios "de-tuned" between stations, or soft music, or even CDs (or cassettes), which play the sounds of a rain forest or a waterfall.

"Tinnitus retraining therapy (TRT) is a treatment that combines the introduction of sound (usually with masker-like sound generators set to a non-masking level) with specialized and highly beneficial patient education and directive counseling. The goal of TRT is to reduce the patient?s awareness of his or her tinnitus. TRT is available through many audiology offices."

Amplification with hearing aids helps to bring back environmental sounds that can naturally mask tinnitus. Since many people with tinnitus have hearing loss, there is often a double benefit for those patients. For example, patients with hearing loss and tinnitus may discover hearing aids help them hear more easily, which can -- in and of itself -- reduce stress and make the tinnitus more tolerable. In some cases, the amplified sounds heard through hearing aids mask the tinnitus.

Several medications have shown limited, but positive effects on tinnitus. Xanax, Neurontin, Pamelor, Klonopin, and dozens of other prescription drugs are helping people cope more effectively with their tinnitus. All medications have the potential for unwanted side effects. These side effects need to be weighed against the possible benefit they might deliver. Of course, all medical options should be reviewed with your physician.

Some herbs have been reported to help manage or reduce tinnitus. While there is little scientific evidence of these successes, there are many anecdotal and individual reports of success. Herbs can behave like medicines in the body and interact with other medicines being taken. As a precaution, always talk with your doctor before trying herbal preparations.

Acupuncture, biofeedback, and hypnosis have also been used with anecdotal success. Relaxation and stress-reduction exercises (such as progressive relaxation) can help make tinnitus more tolerable. It is well known by professionals that stress and anxiety can exacerbate (or worsen) tinnitus.

Although not exactly a tinnitus treatment, the use of hearing protection is an important part of any tinnitus treatment plan. Existing tinnitus is often made worse by exposure to loud noise. The ATA suggests that earplugs, protective earmuffs, or a combination of the two be worn in very noisy situations. Foam earplugs are relatively inexpensive (less than two dollars a pair at most pharmacies) and, if properly situated in the ear, can cut out 15 to 20 decibels of sound. "Musicians?s Earplugs" are customized earplugs that can cut out 15 decibels across all frequencies, which enables the wearer to hear music and conversations, just at a quieter level. Customized earplugs are more expensive, but they are made to comfortably and exactly fit the wearer?s ears. .

Since a combination of treatments is often what a patient needs to obtain relief, it usually takes persistence and patience to find the right tinnitus management therapy for each individual.

Tinnitus Research

There are dozens of tinnitus-specific research studies in progress around the world. The American Tinnitus Association, the Tinnitus Research Consortium, the National Institute of Deafness and Other Communication Disorders, and various universities have funded these studies. Some of the research projects are examining the benefits of cochlear implants, electrical stimulation, and experimental drug therapies for tinnitus patients, and at brain scanning to see which parts of the brain "light up" when tinnitus is present.

Education and Support for Patients

While the search for a cure continues, ATA?s educational programs and support networks help fill in the gaps for tinnitus patients. ATA sponsors a national network of health professionals ? ENTs, audiologists, mental health professionals, and hearing aid specialists ? all who treat tinnitus patients. ATA also sponsors a national self-help network. Lists of local support groups and tinnitus health professionals are available from ATA. Many audiologists assist or become tinnitus support group leaders.

ATA reaches out to children with our Hear for a Lifetime program. Hear for a Lifetime helps 1st through 3rd graders understand that they can walk away from loud noise, turn it down, or cover their ears to conserve their good hearing.

Educating Health Professionals about Tinnitus

Tinnitus sufferers usually seek medical attention when their tinnitus first appears. Unfortunately, the majority of patients are told by their doctors that "nothing can be done" and that they need to "learn to live with it." But most are not told how to live with it, or about the many treatment options available (see above).

The impact that unremitting tinnitus has cannot always be measured or understood. Consequently, many doctors dismiss tinnitus, to the great (and sometimes tragic) dismay of the patient. ATA is committed to educating health professionals about current tinnitus treatments, the value of one-on-one support, the benefits of counseling and the unnecessary havoc created when they tell patients to live with it.

Today, more professionals than ever are taking the time to explore the myriad of tinnitus treatment options with their patients. Many understand that the solution to a particular patient?s tinnitus might lie outside their professional domain. And importantly, more are willing to work in concert with other health professionals for the benefit of the patient.

When healthcare professionals, family members, and patients learn about tinnitus ? its treatments, causes, and breakthroughs in research, ATA accomplishes the best part of its mission: to help tinnitus patients find the answers and help they seek.

Frequently Asked Questions about Tinnitus

What is tinnitus?

Tinnitus is the perception of sound when no external sound is present. The noise can be ringing, screeching, hissing, humming, clicking, chirping, buzzing, even music; constant or intermittent; subtle or perceived as incredibly loud.

Now that I have tinnitus, what is the first thing I should do?

See an ear, nose, and throat doctor (otolaryngologist) and an audiologist to rule out any serious medical problem. Next, learn about your options and get involved in choosing your treatments. Use earplugs or other hearing protection in noisy environments to possibly avoid worsening the tinnitus. Join the American Tinnitus Association to keep current on new tinnitus treatments and to support research.

Can tinnitus be prevented?

Yes, some tinnitus can be prevented. Protect your ears with earplugs and/or protective earmuffs in all loud environments! Since many drugs can cause tinnitus, ask your doctor or pharmacist about the possible side effects of medications (and herbs) before you take them.

Does having tinnitus meant I am going deaf?

No. While an estimated 80% of people with tinnitus have some hearing loss, a significant number of people with tinnitus have normal hearing. Hearing loss may often help reveal or worsen existing tinnitus since the background sounds that had previously been heard, and were helping to "mask" the tinnitus, are no longer being heard.

Is there a nutritional approach to treating tinnitus?

There is no research on this subject. However, some patients report anecdotally that their tinnitus is made worse by consuming certain foods, such as cheese, salt, caffeinated foods (coffee, tea, chocolate), red wine, and aspartame (Nutrasweet).

How can I join the American Tinnitus Association?

You can write, call, or go online to join ATA.
American Tinnitus Association
P.O. Box 5
Portland, OR 97207-0005
503-248-9985
800-634-8978
www.ata.org
tinnitus@ata.org
Annual membership is $25 in the U.S., $40 outside of the U.S.

All ATA members receive the quarterly journal, Tinnitus Today, featuring research updates, Jack Vernon?s Q & A column and articles of special interest to tinnitus patients and their families. Members also receive six educational brochures on treatments, coping, noise, and more; lists of local tinnitus support groups and health care providers; discounts on tinnitus-related books and videos; and access to the Member?s Only section on ATA?s Web site (www.ata.org).

FINAL THOUGHTS

Tinnitus can be a debilitating problem. But fortunately there are many successful treatment programs. If you have tinnitus, see an audiologist and a physician for a complete examination before starting a treatment plan. It might take a combination of treatments (for example, TRT and medication, or masking and biofeedback) and possibly some lifestyle changes (avoiding certain foods, alcohol, caffeine, or tobacco) to best manage your tinnitus.

Additionally, if a health care professional has told you to "go home and learn to live with it" without telling you HOW to live with it, seek other professional advice. And please, visit ATA?s Web site (www.ata.org) or call 800-634-8978 for the latest tinnitus information and self-help resources.