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Online Library: Tinnitus

The following pages provide an overview of the most recent research and clinical studies about the health benefits of micronutrients in fighting tinnitus. This collection of scientific facts proves that anyone who privately or publicly questions the health value of micronutrients does not serve YOUR health, or the health of the people, but rather the multi-billion dollar investment 'business with disease' based on patented pharmaceutical drugs.

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Antioxidants

Antioxidant Therapy in Idiopathic Tinnitus: Preliminary Outcomes

Source: Archives of Medical Research 2007; 38(4): 456-459

Author: Savastano M., Brescia G., Marioni G.

Affiliation: Department of Otolaryngology Head Neck Surgery, Padua University, Padua, Italy.

Abstract: It has been recently observed that reactive oxygen species (ROS) are implicated in the pathology of the inner ear and the peripheral and central pathways. In a previous study we detected high serum values of ROS in subjects with idiopathic tinnitus. The purpose of the present study was to evaluate the validity of antioxidant treatment in tinnitus sufferers with high ROS values. The study considered 31 consecutive patients with unilateral idiopathic tinnitus. The mean pure tone audiometric threshold (PTA), tinnitus loudness, subjective disturbance level [visual analogue scale (VAS) determination], and the indirect ROS dosage 48 h before and after medical treatment were evaluated. Patients underwent an 18-week oral treatment with a mix of phospholipids and vitamins (glycerophosphorylcholine, glycerophosphorylethanolamine, beta-carotene, vitamin C, vitamin E). The results show that ROS levels were significantly reduced following antioxidant treatment and great improvement was observed in the reduction of tinnitus (VAS and tinnitus loudness evaluations). No significant changes in audiometric threshold occurred. The study concludes that oral antioxidant therapy in patients with idiopathic tinnitus seems to reduce the subjective discomfort and tinnitus intensity and may be considered as an additional treatment modality.

Antioxidants in Treatment of Idiopathic Sudden Hearing Loss

Source: Otology & Neurotology 2003; 24(4): 572-575

Author: Joachims H.Z., Segal J., Golz A., Netzer A., Goldenberg D.

Affiliation: Department of Otolaryngology and Head & Neck Surgery, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Abstract: Assuming that superoxide anion radicals (O(2)-) may play a role in damage to the inner ear, the authors investigated the possible benefit of vitamin E as an antioxidant in the treatment of idiopathic sudden hearing loss. A total of 66 patients, aged 15 to 70 years, with diagnoses of idiopathic sudden hearing loss of less than 7 days' duration during 1998 to 2001, were included in this double–blind the study. The setting was the Department of Otolaryngology of Rambam Medical Center which serves as a tertiary referral center for a population of 1.2 million people. All patients enrolled to the study were treated with bed rest, steroids, magnesium, and carbogen inhalation. The study group received vitamin E in addition. The recovery rate, calculated as hearing gain divided by the difference in hearing level between the affected and unaffected ear, was better than 75% in 41 of 66 (62.12%) patients. This rate was achieved in 26 (78.78%) patients in the study group treated with vitamin E, compared with 15 (45.45%) patients in the control group. The study concludes that patients treated with the addition of vitamin E achieved better recovery than did the control patients. Further studies should be directed toward a better understanding of the role of antioxidants in idiopathic sudden hearing loss.

Coenzyme Q10

Water-Soluble Coenzyme Q10 Formulation (Q-ter) Promotes Outer Hair Cell Survival in a Guinea Pig Model of Noise Induced Hearing Loss (NIHL)

Source: Brain Research 2009; 1257: 108-116

Author: Fetoni A.R., Piacentini R., Fiorita A, Paludetti G, Troiani D.

Affiliation: Institute of Otolaryngology, School of Medicine, Catholic University of Rome, Largo F. Vito 1, 00168 Rome, Italy.

Abstract: The mitochondrial respiratory chain is a powerful source of reactive oxygen species (ROS) also in noise induced hearing loss (NIHL), and anti-oxidants and free-radicals scavengers have been shown to attenuate the damage. Coenzyme Q(10) or ubiquinone has a bioenergetic role as a component of the mithocondrial respiratory chain, it inhibits mitochondrial lipid peroxidation, inducing ATP production and it is involved in ROS removal and prevention of oxidative stress-induced apoptosis. However the therapeutic application of CoQ(10) is limited by the lack of solubility and poor bio- availability, therefore it is a challenge to improve its water solubility in order to ameliorate the efficacy in tissues and fluids. This study was conducted in a model of acoustic trauma in the guinea pig where the effectiveness of CoQ(10) was compared with a soluble formulation of CoQ(10) (multicomposite CoQ(10) Terclatrate, Q-ter) given intraperitoneally 1 h before and once daily for 3 days after pure tone noise exposure (6 kHz for 1 h at 120 dB SPL). Treatments decreased active caspase 3 expression and the number of apoptotic cells, but animals injected with Q-ter showed a greater degree of activity in preventing apoptosis and thus in improving hearing. These data confirm that solubility of Coenzyme Q(10) improves the ability of CoQ(10) in preventing oxidative injuries that result from mitochondrial dysfunction.

A Pilot Clinical Trial of the Effects of Coenzyme Q10 on Chronic Tinnitus Aurium

Source: Otolaryngology - Head & Neck Surgery 2007; 136(1): 72-77

Author: Khan M., Gross J., Haupt H., Jainz A., Niklowitz P., Scherer H, Schmidt F.P., Klapp B.F., Reisshauer A., Mazurek B.

Affiliation: Department of Otorhinolaryngology, Charité-University Medicine Berlin, Berlin, Germany.

Abstract: The objective of this 16-week prospective nonrandomized clinical trial (n = 20) was to determine the short-term effects of coenzyme Q10 (CoQ10) on the antioxidative status and tinnitus expression in patients with chronic tinnitus aurium. A Tinnitus and Short Form-36 Questionnaires (TQ/SF-36) were evaluated together with the plasma concentrations of CoQ10, malondialdehyde, and the total antioxidant status. The results indicate that the mean plasma CoQ10 concentration rose under external CoQ10 supply and remained elevated after medication stopped without overall effects on the tinnitus score. However, in a subgroup of 7 patients with low initial plasma CoQ10 concentration and significant increase in the plasma CoQ10 level, a clear decrease in the TQ score was observed. The study concludes that in patients with a low plasma CoQ10 concentration, CoQ10 supply may decrease the tinnitus expression. This is the first study to examine the effect of CoQ10 in chronic tinnitus aurium.

Protective Properties of Idebenone [A Synthetic Analogue of CoQ10] in Noise-Induced Hearing Loss in the Guinea Pig

Source: Neuroreport 2006; 17(9): 857-861

Author: Sergi B., Fetoni A.R., Paludetti G., Ferraresi A., Navarra P., Mordente A., Troiani D.

Affiliation: Institute of Otolaryngology, School of Medicine, Catholic University, Rome, Italy.

Abstract: Idebenone is a synthetic analogue of coenzyme Q10 with antioxidant properties. The present study investigated the antioxidant activity of idebenone in the rescue of acoustic trauma. Noise-induced hearing loss was induced by exposing guinea pigs to a continuous pure tone and idebenone was injected intraperitoneally 1 h before noise exposure and once daily for 3 days. Guinea pigs treated with idebenone showed significantly smaller auditory threshold shifts than unprotected control animals. Missing and apoptotic cells were identified with scanning electron microscopy and terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling assay. Protected animals presented a lesser extent of both apoptotic activation and hair cell loss in the organ of Corti. Our results suggest an antioxidant function of idebenone in protection from noise-induced hearing loss and provide a rationale for exploring therapeutic strategies in humans.

Dr. Rath Cellular Nutrient Synergy Program

Tinnitus

Source: Cellular Health Communication, Vol. 1, No.1, 2001

Author: MR Publishing, Inc., Santa Clara, CA., USA.

Affiliation:

Abstract: This pilot study has been designed to scientifically document the effects of vitamin treatment therapy in patients suffering from tinnitus. This study was conducted in collaboration with Ear, Nose & Throat specialists. A total of 18 patients, ranging in age from 44-85 years old and suffering from chronic tinnitus (ear ringing for more than three consecutive months), took part in the study. The patients took a daily dosage of specific vitamins for four months. They continued to take the medications prescribed by their physicians. The patients’ hearing was measured at regular monthly intervals using a standard medical sound audiometer. The hearing improvement achieved after four months of following vitamin intake is documented below. The study results show that after only four months of taking vitamins and other micronutrients in 30% of patients, hearing improved slightly (up to 10 dB), in 45% of patients, hearing improved clearly (up to10-20 dB) and in 25% of patients, hearing improved strongly (up to 20-50dB), which is near normal hearing ability. More than three-fourths of the patients experienced at least some reduction in ear ringing. For more than 50% of them, ear ringing was significantly reduced or completely eliminated.

Magnesium

Magnesium Therapy in Acoustic Trauma

Source: Magnesium Research 2006; 19(4): 244-54

Author: Sendowski I.

Affiliation: Departement de Radiobiologie, Centre de Recherches du Service de Sante des Armrees (CRSSA), 24 av. des Maquis du Gresivaudan, BP 87, 38702 La Tronche Cedex, France.

Abstract: Acoustic trauma is one of the major causes of hearing loss and tinnitus, particularly in industrial environments. The efficacy of magnesium, administered either to prevent or to treat NIHL has been demonstrated in several studies in animals and in humans. Magnesium, which easily crosses the hematocochlear barrier, presents neuroprotective and vasodilatory effects, and thus, is able to limit the cochlear damage. Magnesium therapy is well documented because it is usually prescribed in other pathologies. Its side effects and contraindications are few and it is cheap. This article presents also some arguments that emphasize the interest of magnesium therapy in acoustic trauma.

Therapeutic Efficacy of Magnesium in Acoustic Trauma in the Guinea Pig

Source: ORL - Journal for Oto-rhino-laryngology and Its Related Specialties 2003; 65(3): 134-139

Author: Haupt H., Scheibe F., Mazurek B.

Affiliation: Department of Otorhinolaryngology, Charite Hospital, Humboldt University, Schumannstrasse 20-21, DE-10177 Berlin, Germany.

Abstract: Comparative functional and morphological tests were performed in two groups of impulse noise-exposed guinea pigs treated either with magnesium (Mg) or isotonic saline as a placebo to extend the knowledge on the therapeutic efficacy of Mg in acoustic trauma demonstrated recently. The permanent threshold shifts were significantly lower in the Mg than in the placebo group as measured by auditory brainstem response audiometry, distortion product otoacoustic emissions and compound action potentials (CAPs) 1 week after exposure. This also applies to the damage to hair cell stereocilia tested with scanning electron microscopy. There were frequency-related differences in the individual functional responses. The CAP threshold shifts reflected the morphological damage most obviously.

Magnesium: a New Therapy for Idiopathic Sudden Sensorineural Hearing Loss

Source: Otology & Neurotology 2002; 23(4): 447-51

Author: Gordin A., Goldenberg D., Golz A., Netzer A., Joachims H.Z.

Affiliation: Department of Otolaryngology-Head and Neck Surgery, Rambam Medical Center, PO Box 9602 Haifa, Israel.

Abstract: The objective of this randomized study was to determine whether treatment with Mg(2+) improves the outcome of idiopathic sudden hearing loss and to investigate which variables influence its prognosis. The setting was the Department of Otolaryngology-Head and Neck Surgery, Rambam Medical Center, Haifa, Israel. The study group included 133 patients. Sixty patients were treated with carbogen inhalation, and 73 were treated with a combination of carbogen inhalation and intravenous MgSO(4). The results show that the mean improvement rate was 66.4% in the Mg(2+) group and 49.9% in the carbogen group (p < 0.01). Recovery was achieved in 35 patients (48%) in the Mg(2+) group and only in 19 patients (31.6%) in the carbogen group (p < 0.01). Significant improvement was seen in 20 patients (27.4%) in the Mg(2+) group and in 14 patients (23.3%) in the carbogen group. The study found that Mg(2+) improved hearing recovery in cases of idiopathic sudden hearing loss. Vertigo and treatment delay beyond 8 days were poor prognostic factors for recovery.

Vitamin B

Vitamin B12 Deficiency in Patients with Chronic-Tinnitus and Noise-Induced Hearing Loss

Source: American Journal of Otolaryngology 1993; 14(2): 94-99

Author: Shemesh Z., Attias J., Ornan M., Shapira N., Shahar A.

Affiliation: Institute of Noise Hazards Research and Evoked Potentials Laboratory, IDF, Chaim-Sheba Medical Center, Ramat-Gan, Israel.

Abstract: This study examines the incidence of vitamin B12 deficiency in three groups of noise-exposed subjects: patients with chronic tinnitus and noise-induced hearing loss (NIHL), patients with NIHL only, and subjects demonstrating normal hearing. A group of 113 army personnel exposed to military noise was studied. The mean age was 39 years. Chronic tinnitus and NIHL existed in 57 subjects. NIHL alone was observed in 29 subjects, and 27 subjects had normal audiograms. All subjects were queried about noise exposure and dietary habits. Vitamin B12 serum levels were measured. The results show that patients with tinnitus and NIHL exhibited vitamin B12 deficiency in 47% of cases (blood levels < or = 250 pg/mL). This was significantly more (P < .023) compared with NIHL and normal subjects who exhibited vitamin B12 deficiency in 27% and 19%, respectively. These observations suggest a relationship between vitamin B12 deficiency and dysfunction of the auditory pathway. Some improvement in tinnitus and associated complaints were observed in 12 patients following vitamin B12 replacement therapy. The authors recommend that routine vitamin B12 serum levels be determined when evaluating patients for chronic tinnitus.

Vitamin E

Vitamin E and Vitamin C in the Treatment of Idiopathic Sudden Sensorineural Hearing Loss

Source: Acta Oto-laryngologica 2008; 128(2): 116-121

Author: Hatano M., Uramoto N., Okabe Y., Furukawa M., Ito M.

Affiliation: Department of Otolaryngology-Head and Neck Surgery, Kouseiren Takaoka Hospital, Takaoka, Japan.

Abstract: The results of this study suggest that the administration of vitamin E and vitamin C to patients with idiopathic sudden sensorineural hearing loss (ISSHL) has beneficial effects by reducing the level of reactive oxygen metabolites produced by inner ear ischaemia and reperfusion injury after treatment. The purpose of this study was to investigate the efficacy of antioxidant vitamin E and vitamin C in the treatment of ISSHL. In a retrospective chart review, a total of 87 patients were enrolled who fulfilled the following inclusion criteria: 1) sudden onset of sensorineural hearing loss, 2) cause of hearing loss unknown, 3) hearing loss did not fluctuate, 4) arithmetic mean of hearing levels at 250, 500, 1000, 2000 and 4000 Hz exceeded 40 dB and 5) treatment was started within 14 days from the onset of hearing loss. All the patients were treated with steroids and/or alprostadil. In the study group, patients additionally received vitamin E (tocopherol nicotinate, 600 mg/day) and vitamin C (1200 mg/day) orally. The results show that the hearing gain after therapy was 29.4 dB and the improvement rate was 63.3% in the study group, compared with 18.5 dB and 44.0% in the control group. Significant improvement was seen in the hearing gain and recovery rate in the study group.

Antioxidant Protection Against Acoustic Trauma by Coadministration of Idebenone and Vitamin E

Source: Neuroreport 2008; 19(3): 277-81

Author: Fetoni A.R., Ferraresi A., Greca C.L., Rizzo D, Sergi B., Tringali G., Piacentini R., Troiani D.

Affiliation: Institute of Human Physiology , Catholic University of Rome (UCSC), Italy.

Abstract: Idebenone, a synthetic analogue of coenzyme Q, attenuates noise-induced hearing loss by virtue of its antioxidant properties. This study involves a guinea pig model of acoustic trauma where the effectiveness of idebenone is analyzed in comparison with Vitamin E (alpha-tocopherol) that exhibits a potent antioxidant activity in the inner ear. Idebenone and vitamin E were injected intraperitoneally 1 h before noise exposure and once daily for three days; functional and morphological studies were then carried out, respectively, by auditory brainstem responses evaluation, scanning electron microscopy and terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling assay identification of missing and apoptotic cells was also performed. The results showed that the protective effects of idebenone and vitamin E were not additive implying that the two antioxidants may share competitive mechanisms.

Antioxidants [Vitamin E] in Treatment of Idiopathic Sudden Hearing Loss

Source: Otology & Neurotology 2003; 24(4): 572-5

Author: Joachims H.Z., Segal J., Golz A., Netzer A., Goldenberg D.

Affiliation: Department of Otolaryngology and Head & Neck Surgery, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Abstract: Assuming that superoxide anion radicals (O(2)-) may play a role in damage to the inner ear, the authors investigated the possible benefit of vitamin E as an antioxidant in the treatment of idiopathic sudden hearing loss. PATIENTS: A total of 66 patients, aged 15 to 70 years, with diagnoses of idiopathic sudden hearing loss of less than 7 days' duration during 1998 to 2001, were included in the double–blind study study. The setting was the Department of Otolaryngology of Rambam Medical Center which serves as a tertiary referral center for a population of 1.2 million people. All study participants were treated with bed rest, steroids, magnesium, and carbogen inhalation. The study group received vitamin E in addition. The results show that the recovery rate, calculated as hearing gain divided by the difference in hearing level between the affected and unaffected ear, was better than 75% in 41 of 66 (62.12%) patients. This rate was achieved in 26 (78.78%) patients in the study group treated with vitamin E, compared with 15 (45.45%) patients in the control group. Patients treated with the addition of vitamin E achieved better recovery than did the control patients. Further studies should be directed toward a better understanding of the role of antioxidants in idiopathic sudden hearing loss.

Zinc

Zinc as a Possible Treatment for Tinnitus

Source: Progress in Brain Research 2007; 166: 279-85

Author: Coelho C.B., Tyler R., Hansen M.

Affiliation: Department of Otolaryngology, Head and Neck Surgery, The University of Iowa, Iowa City, IA, USA.

Abstract: Zinc is an essential trace element present in all organs, tissues, fluids, and secretions of the body and it is widely distributed in the central nervous system, including the auditory pathway in synapses of the VIII nerve and in the cochlea. Zinc is an essential component of Cu/Zn superoxide dismutase (SOD) and in certain enzymes and it is important for proper function of the immune system. Three possible mechanisms have linked zinc to tinnitus; cochlear Cu/Zn SOD activity, synaptic transmission, and depression. Evidences in the literature suggest prevalence rates of zinc deficiency in individuals with tinnitus from 2 to 69%, affecting elderly individuals more frequently. Four among five small studies indicate that administration of zinc has a beneficial effect on tinnitus but these results still have to be confirmed in clinical trials with larger samples using a cross-over design, validated tinnitus handicap questionnaires, measurements of tinnitus magnitude, and accessing the coexistence of other symptoms such as depression, phonophobia, and hyperacusis.

The Role of Zinc in the Treatment of Tinnitus

Source: Otology & Neurotology 2003; 24(1): 86-89

Author: Arda H.N., Tuncel U., Akdogan O., Ozluoglu L.N.

Affiliation: Department of Ear, Nose, Throat, Head and Neck Surgery, Ankara Numune Research andf Education Hospital, Turkey.

Abstract: This randomized, prospective, placebo-controlled study was designed to investigate the role of zinc administration in treatment of tinnitus. Patients with tinnitus were admitted to the ear, nose, and throat clinic of the authors' hospital. Patients with tinnitus with no know pathologic conditions of the ear, nose, and throat were enrolled t in the study; the mean age of 28 patients receiving zinc was 51.2 years, and the age of 13 patients given placebo was 55 years. Blood zinc levels were measured. Frequency was detected by audiometry, and loudness of tinnitus was screened by tinnitus match test. A questionnaire that scored tinnitus subjectively between 0 and 7 was given to patients before zinc treatment. After 2 months of treatment (zinc 50 mg daily to zinc group, placebo pill containing starch to placebo group), all of the tests were performed again. There was no difference in age, sex, duration of tinnitus, and affected ears between the patients treated with zinc and those treated with placebo. The results show that clinically favorable progress was detected in 46.4% of patients given zinc. Although this decrease was not statistically significant, the severity of subjective tinnitus decreased in 82% of the patients receiving zinc. The mean of subjective tinnitus decreased from 5.25 +/- 1.08 to 2.82 +/- 1.81 ( < 0.001). However, the decrease in severity of the tinnitus was not significant in patients receiving placebo. It can be concluded that patients with tinnitus may have low blood zinc levels (31%) and clinical and subjective improvement can be achieved by oral zinc medication. However, it remains to be seen whether the longer duration of treatment has more significant results.

Zinc Deficiency and Tinnitus

Source: Auris, Nasus, Larynx 2003; 30 Suppl: S25-S28

Author: Ochi K., Kinoshita H., Kenmochi M., Nishino H., Ohashi T.

Affiliation: Department of Otolaryngology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, 216-8511, Kawasaki, Japan.

Abstract: The objective of this study was to determine if there is a correlation between serum zinc levels and audiometric performance in tinnitus patients. Seventy-three patients participated in this study. Patient's age was restricted to 20-59 years. All patients were examined at the otolaryngology outpatient clinic of the St. Marianna University Toyoko Hospital. The control group consisted of 38 age- and sex-matched healthy volunteers. A blood sample was taken to measure serum zinc levels. Hypozincemia was set at a level of the mean minus one S.D. in the control group. An average hearing sensitivity was calculated as the mean value of hearing thresholds at five frequencies: 250, 500, 1000, 2000, and 4000 Hz. Normal hearing was indicated when the hearing threshold at each of these frequencies was within 20 dB of normal thresholds. The results show that there was no significant difference in serum zinc levels between patients with tinnitus and controls. However, patients with tinnitus who had normal hearing had significantly lower serum zinc levels compared to controls. In contrast, no significant difference in serum zinc levels was found between patients with tinnitus who had hearing loss, and controls. A significant correlation between average hearing sensitivity and serum zinc level was observed. These findings suggest that zinc is involved in the generation of tinnitus, especially in patients whose hearing is relatively normal.