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Photo credit: erik forsberg licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

I think the title of this report from the Harvard Medical School is misleading. I have tinnitus so part of my response is a personal one. To me, the most important sentence in the report is this: “There are no FDA approved treatments for tinnitus.” That means that none of the many proposed treatments for tinnitus–from a variety of vitamins and drugs, to various auditory training programs–has been demonstrated to be safe and effective, the FDA’s standard for approval. Cognitive behavior therapy may improve the ability to accept or deal with a constant ringing in the ears, but it doesn’t change the underlying symptoms.

It can be difficult to live with a constant ringing in the ears. I haven’t tried any of these unapproved treatments because I believe in evidence-based medicine, both for patients and for myself. Also, I am fortunate–my tinnitus is relatively low volume, and the only time it really bothers me is when I wake at night and it’s loud enough to cause difficulty in falling back to sleep–but the symptoms can be so bad that people commit suicide because of them. I suppose that if my symptoms were worse, I might be willing to try some of the treatments mentioned. And I would add that I know people who have had success using some of them.

Perhaps most significantly, the report neglects to mention three important facts:

1. The overwhelming cause of tinnitus is noise exposure, not the many other possible causes listed in the report. I haven’t been able to find a percentage, but my estimate is at least 80% and probably 90 or 95%.

2. The article implies that temporary tinnitus after noise exposure is a normal thing. No, temporary tinnitus indicates that one has been exposed to too loud noise, and that auditory damage has occurred.

3. Avoiding loud noise exposure will most likely prevent tinnitus from ever developing.