Video summary
Although there is currently no cure for tinnitus, effective and non-invasive management strategies are available to help individuals cope with the condition. While conventional treatments such as hearing aids, behavioral therapies, and medications have been discussed previously, alternative approaches like acupuncture have also been investigated. A meta-analysis of over 30 trials revealed that most lacked rigorous scientific standards, but one prospective randomized controlled study offered promising insights. In this study, participants received either real acupuncture or sham acupuncture over five weeks, followed by a three-month monitoring period. The results showed that the acupuncture group experienced a significant 30-point decrease in Tinnitus Handicap Inventory (THI) scores during treatment, whereas the sham group saw no improvement. However, THI scores for the acupuncture group increased slightly after treatment stopped, suggesting that ongoing therapy might be necessary to maintain benefits.
Beyond physical interventions like acupuncture, mind-body therapies such as yoga and meditation have shown potential in reducing tinnitus severity, stress, and overall handicap scores. A systematic review highlighted the positive effects of yoga, though it noted a lack of randomized control trials for this specific practice except in one instance involving mindfulness meditation without yoga. That particular study demonstrated that five sessions of mindfulness meditation successfully reduced tinnitus symptoms more effectively than relaxation-only sessions. Given the low cost and minimal risks associated with these mind-body practices, they present a viable option worth considering for those seeking relief. Additionally, physical activity has emerged as a significant factor; observational data indicates that meeting guidelines for at least 150 minutes of exercise per week is linked to a lower likelihood of having tinnitus, although establishing causality requires further testing.
To better understand the impact of lifestyle changes, a randomized clinical trial involving individuals with obesity instructed them to take 10,000 steps daily, aiming for weight loss through diet and exercise. Despite averaging only 7,500 steps by the end of the 12-week trial, participants reported significantly lower tinnitus distress, reduced annoyance, and improved quality of life scores. The study found that for every additional thousand steps taken, quality of life scores increased by 1.5 points while THI scores decreased by 0.75 points. Furthermore, groups combining diet with physical activity experienced greater boosts in quality of life and reductions in tinnitus severity compared to those following diet or exercise alone. Weight loss was observed across all groups, with individuals losing more than 5% of their body weight experiencing the most substantial improvements in tinnitus frequency and severity.
Dietary factors also play a role in managing tinnitus, with observational studies suggesting that fruit and fiber intake may help prevent the condition, while caffeine consumption is unlikely to increase risk. Contrary to common advice, a rigorous triple-blind placebo-controlled trial found that consuming 300 milligrams of caffeine did not worsen acoustic measures or tinnitus-related discomfort. Instead, caffeine consumption was associated with improved mood and reduced feelings of tension, anxiety, depression, and hostility. A longer-term study reinforced these findings, concluding that abstaining from caffeine offers little benefit for tinnitus sufferers and may even be distressing. Since approximately 85% of adults consume caffeine daily, most people with tinnitus could benefit from ignoring outdated advice to avoid coffee, tea, and other caffeinated products, reserving dietary restrictions for specific supplements which will be explored in future discussions.
Read the full video transcript
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There's no cure for tinitus yet, but
effective and non-invasive management
strategies are available. We covered
more conventional approaches like
hearing aids, behavioral therapies, and
medications in the previous video. Might
any alternative therapies help? Some
physical interventions like acupuncture
may reduce the burden of tinitus,
but given the low quality of evidence
and inconsistency among the trials,
results should be interpreted with
caution. Of over 30 trials included in
this meta analysis, only two had no
major red flags.
Let's take a closer look at one of them.
In a prospective randomized controlled
study of acupuncture treatment, people
were given either 10 acupuncture
sessions or 10 sham acupuncture sessions
over 5 weeks. And after these treatments
were monitored for 3 months. Over the 5
weeks of treatment, the acupuncture
group had a 30 point decrease in THI
score, while the sham group had none.
Three months after the last treatment,
THI scores crept up about 10 points,
suggesting you might have to keep doing
acupuncture therapy to continue seeing
effects.
Yoga and meditation may also help
reducing THI scores, stress, and tinitus
severity.
The authors of this systematic review go
on to praise the effects of yoga on
tinitus.
But wait, none of these were actually
randomized control trials except the
study without any yoga.
The non- yoga study comprised of five
sessions of mindfulness meditation
successfully reduce tenitus symptoms and
severity over and above the group who
had five relaxationonly sessions. Given
mindbody therapies like meditation are
relatively low cost and come with
minimal risks, might be worth giving it
a try. Yoga didn't make the cut, but
what about good old physical activity?
In a US survey of about 3,800 people,
those who met US physical activity
guidelines of at least 150 minutes per
week were less likely to have tinitus.
But since this was cross-sectional, just
a snapshot in time, we can't get at
cause and effect. For that, we need to
put it to the test. In a randomized
clinical trial of diet and physical
activity, people with obesity were
instructed to take 10,000 steps a day.
Although they ended up averaging only
7,500 steps at the end of the 12week
trial, they had significantly lower
tinitus distress, including measures of
severity and annoyance along with higher
quality of life scores.
For every increase in a thousand steps,
quality of life scores increased by 1.5
points and THI scores decreased by 75
points.
The trial also included two diet groups
aiming to achieve 5 to 10% weight loss.
One instructed to follow a diet and the
other to follow a diet plus physical
activity plan. While the diet alone and
physical activity alone groups had
similar improvements, the group who
followed the diet plus did physical
activity saw a greater boost in quality
of life and reduced tenitus severity
measures.
All three groups, diet plus physical
activity, diet alone, and physical
activity alone, all lost weight with
those losing more than 5% of their body
weight experiencing greater improvements
in tinitis frequency and severity.
Observational studies suggest that fruit
and fiber may help prevent tinitis and
caffeine is unlikely to increase risk.
But what if you already have tinitus?
Does caffeine make it worse? In a
randomized triple blind placeboc
controlled clinical trial, a 300 mgram
dose of caffeine was put to the test and
did not alter any of the acoustic
measures or tinitis related discomfort.
On the plus side, it did result in a
mood boost about an hour after caffeine
consumption along with a reduction in
feelings of tension, anxiety,
depression, and hostility. A longer
trial found something similar. The title
says it all. caffeine abstinence and
ineffective and potentially distressing
tinitus therapy. Roughly 85% of adults
consume caffeine on a daily basis.
Therefore, roughly 85% of people with
tinitus could benefit by freedom from
useless, perhaps distressing advice to
abstain from their usual tea, coffee,
and other caffeinated products. Are
there some things tinitus sufferers
should abstain from, like dietary
supplements? We'll find out next.