Anyone Heard of Someone Like Me?

It depends on the tests that you've done. Some tests allow you to measure the conductive component, others don't.
It is useful to do a PTA (Pure Tone Audiometry) test with bone conduction testing, so your audiogram can show the difference between air conduction and bone conduction ("the air-bone gap").
Other tests involve forks (Rinne/Weber - look them up), and help show lateralization but not much quantification.

 

You need to realize what the TRT/CBT carousel is and how to get off it.

The average tinnitus/SNHL sufferer finds themselve repeating the previous mistakes of those before them, visiting a useless ENT that doesn't check for hearing loss correctly, buying TRT, buying CBT, buying snake oil, such as the tonaki tinnitus protocol or lipoflavonoids. Not everyone makes the exact same mistakes but there are common habits, I find these habits and try to call them out so the community can mature quicker.


There's been enough scientific research over the past 4-5 years to confirm tinnitus has something to do with neuroplasticity compensating for a loss of hearing, A lot of TRT/CBT proponents argue that tinnitus is a total mystery to modern science and there is no understanding, it is not true. Tinnitus is not entirely figured out but that's not to say nothing is known, there are working models being developed that tinnitus the audiotory equivalent to phantom limb syndrome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614665/
Hyperactivity in the audiotory brain is physically tinnitus and "loudness" hyperacusis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4208401/
Hearing loss causes hyperactivity in the audiotory brain which is physically tinnitus and "loudness" hyperacusis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921399/
Death or cochlear nervous tissue is suggested to be the root problem

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3366980/
Anything that deprives the audiotory brain of input can cause tinnitus even ear plugs! Not just SNHL as once thought, meaning if SNHL was cured tinnitus should be cured.


If tinnitus sufferers want to waste time and buy Jastreboff's TRT and enjoy the doctors giving them mal-information so be it.

my personal struggle isn't tinnitus it's actually muffled hearing and numbness/aching from noise on the right side of my face and right ear, but the whole point is that reversing cochlear nerve damage could undo tinnitus, hyperacusis and hearing loss. It's a lot better to throw all your cards on the table to research for a cure, then it is to accept and move on.

Especially if you think about the future and how much the hearing aid, TRT industrial complex will profit from a lack of scientific research.
https://www.audicus.com/who-warns-900-million-at-risk-for-hearing-loss-by-2050/

 

The pure high pitch tones are even harder to ignore than the hiss...

 

FWIW this poster is clearly confused. CBT focuses on neuroplasticity. It's more of a homeopathic approach to inducing neuroplastic changes in your brain.

 

I had some sort of tuning fork test, but I must have 'passed' because nothing else was said about it. I will speak to my doctor about the PTA test. Thanks for all the info!

 

Thank you for all the above info. I've never really considered the idea of being able to reverse hearing loss - I've always assumed the 'cure' would come more from re-wiring/re-training the brain, hence why TRT sounded like a good idea, because it's sort of supposed to do that isn't it?

I'm not sure where you're based, but here in UK TRT is offered on our National Health Service. Any newer, better treatments would probably only be available privately, and I certainly can't afford that!

I'm watching the MuteButton thread anxiously, because if that yields good results I can't see any reason why the NHS shouldn't adopt it (besides money of course!)

 

To be honest, I'm not 100% certain on the difference between TRT and CBT. MY doctor didn't seem to think that CBT would work, but that TRT would? But then I read that TRT is mostly CBT based??

I guess I will see when I get there

Thank you for telling us all about your experience with the MuteButton trial by the way. It's so encouraging to hear, and gives me a little bit of hope.

 

no TRT is all about habituation (learning to live with it)

 

Perhaps increased neuroplasticity is a byproduct of CBT, but CBT isn't really focused on neuroplasticity: it's focused on teaching you rational responses to irrational thoughts, and how to do this process yourself when you recognize a pattern.

I have no doubts that this process could enhance neuroplasticity (you're learning techniques, so clearly something has to happen in the brain), but it's quite far from being its focus.

Source: I've done CBT (but not for T).

More info at:
https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy

 

There is a component of TRT that is related to counseling, and that counseling does intersect with some of the CBT precepts, but I wouldn't necessarily call it CBT.

 

I think neuroplasticity is how/why CBT works. I think research is just starting to point in this direction. What wires together, fires together. Neuroplasticity is a constant and ever changing reaction between our thoughts, inputs, and interactions with the outside world. Bi-Modal stimulation is like a "jump start". Here is a fairly recent study to look at neuroplastic induced changes in the brain from CBT: https://www.ncbi.nlm.nih.gov/pubmed/26836415

The main take away being: "Further analysis indicated that diminished amygdala GM volume mediated the relationship between decreased neural responsivity and reduced social anxiety after treatment (P=0.007). Thus, our results suggest that improvement-related structural plasticity impacts neural responsiveness within the amygdala, which could be essential for achieving anxiety reduction with CBT."

CBT actually changed the size of a cohorts amygdala!

as always...I appreciate your pushback @GregCA

 

I don't disagree with any of the things you wrote or quoted... but how about "CBT triggers neuroplasticity" rather than "CBT focuses on neuroplasticity"? It's a subtle difference, I'll admit.

 

Haha touche! Triggers is more accurate.

 

In terms of the different treatments likely to be available in the UK. Tinnitus Retraining Therapy is basically CBT-style counselling plus wearing white noise generators to help habituate to the sound. @Contrast is correct that it is fundamentally about habituation.

The traditional protocol for TRT from Jastreboff involves counselling on a much more frequent basis than you are likely to get from an NHS hospital so the TRT they offer is a modified version. Some NHS hospitals no longer offer white noise generators in which case the treatment you get will be some sort of CBT rather than TRT. Hope this helps.

Of course none of the treatments on offer currently are much more effective than the usual habituation over time - and we are all looking to MuteButton etc in the hope that it might offer a more effective treatment.

 

@GregCA @kelpiemsp Thanks both - glad to hear it may hopefully have some benefit! Didn't quite understand some of the science-y stuff, but basically by doing CBT you're helping increase the plasticity of the brain?

Anyway, I'm going to give it a go, as there's not really anything else on offer for Tinnitus right at the moment. Hopefully some exciting things coming soon though!

 

Thanks David.

Yes, that's the problem really - it's this or nothing at the moment. I'll be really disappointed if they don't offer any white noise generators though - I was sort of counting on having those in the hope they may drown out a particularly horrible tone I have. If I could stop hearing that tone I'd be alright with the rest of it.

I had a look at the cost for going private, and it's a shocking amount of money - certainly more than I can afford. But they seem to offer a couple of other things, like hypnosis.

 

You're welcome Tanni. I hope that when you do get NHS treatment for tinnitus you find it of some help - to be honest it is very variable across the country. It's definitely worth your asking for white noise generators if they don't offer them to you.

 

If you're interested in looking at other possible options, you may want to check out THIS POST which describes how a man from London got rid of his tinnitus after 14 years by using Traditional Chinese Medicine (TCM).

 

CBT and TRT are habituation based methods, not designed to cure tinnitus but learn to ignore it.

 

It tells us somehting about the world, although I've yet to figure out exactly what.

Take all advice to mind. Challenge authority for your health if needed.
In the end, we here want to help, although many of us are simply waiting.

 

Had my first TRT session, and had to persuade her to order in some White Noise Generators for me. She didn't want to at all - she's of the belief that you shouldn't try to mask the sound as otherwise your brain won't get used to it. I'm getting them fitted in a couple of weeks, so I'll see how it goes.

All in all, Contrast was right - she was basically advising me to get used to it, which I suppose is all they can do at this point.

 

Also, spoke to TRT therapist in a bit more depth about my hearing tests, and it turns out I actually have low frequency hearing loss, not high! I must have confused it with the fact that my Tinnitus is high pitched or something. I think it's in the 30 - 50 db range, if that makes sense. Getting a copy next time I see her. It doesn't affect hearing any letters apparently, which is why I don't notice it when speaking to people.

 

It (T) varies a lot and I notice many posters have T that differs/varies from others but I think Contrast is on the right track for what is going on. TRT and CBT is just for ignoring it and if it's mild or moderate, it might help but it's only temporary and just masks/distracts to some extent. I doubt any of these tools were tried on those who were severe - because, they just won't work and the person will give up but the TRT/CBT people won't record those failures.

They sell/promote to those with mild T so they can pretend they are successful 'treatements' but they are nothing close to cures.

A cure would be something that deals with the overall problem and address the various auditory/brain interaction (imho) and hearing loss is the central component, in my view.

Contrast posted: "There's been enough scientific research over the past 4-5 years to confirm tinnitus has something to do with neuroplasticity compensating for a loss of hearing."
What I'm not sure of or would be inviting more theories on is why stress, anxiety etc. seems to provoke t symptoms more and not just some 'loud sound' or 'loud noise.' I thought that certain sounds are being interpreted by the brain and the brain is malfunctioning/misfiring since 'all the tools' are not there now or there's enough 'wrong' - in which it is misfiring or whatever.

But, stress/anxiety is also said to be a factor to some extent and the TRT/CBT groups use that as their 'proof' or reasoning that it is an effective treatment. But, I know that my T can spike and I have tried to meditate or I was not feeling stressed or I was relaxed and it just spiked/intensified for no reason. Wait, the reason could be that some 'sound' was heard and the brain malfunctioned. Perhaps, it doesn't always 'malfunction' because there are traces of the cochlear nucleus/structure still working to some extent but it's still damaged so the T is affected by noise sometimes and sometimes not.

That is just a theory, yes, but I think it's more plausible than just trying to promote TRT/CBT as treatment methods that are only effective to a very small extent and to only part of the population, at best. They are not cures and are simply only money-makers. Whenever I go to hearing sites/clinics websites and look at their Tinnitus sections, they all have promotion of TRT and Jastreboff. They don't care about solving the problem, just masking the problem and as can be read/learned here, it doesn't work for many sufferers, especially if the T is worse than moderate and is considered severe.

I was willing to try both TRT (price prohibitive) and CBT because I am desperate and feeling (hopeless) but I don't have any illusions that it will be some effective/wondeful treatment. I just don't know what else to do.

 

That's interesting, I thought white noise generators were part of the TRT program. So, your treatment is only counseling?

 

Yes, I believe that most Tinnitus is caused by compensation for a loss of sound as well. In fact, I've been told that a sudden dip in sound that then returns to normal can cause Tinnitus. In other words, you can have perfectly normal hearing but still have Tinnitus caused by a temporary loss of hearing.

But @Contrast will know far more about this than me.

 

WNGs are offered as part of the program, but my therapist doesn't believe in using them so tried to persuade me not to have them. So if I had followed her advice, the TRT would be just counselling, yes.

But my TRT is on the NHS - I believe there are more options available if you go private.

 

So if you experience a fullness the next morning after being around noise.. that means you damage your ears more?? I work in a company that has running loud machines. After I got tinnitus a few months ago, I started to wear foam plugs at work. Few days ago I woke up with sensitive ears and fullness and a few days later another new roaring sound. Even if I were plugs it can affect me??

 

The symptom of ear fullness would cause me to update my beliefs about the damage to "more damage"...

That was a symptom that should have been interpreted as "something I am doing is hurting my ears, I need to stop doing it".

If you can't think of any other way that your ears could have been hurt, this is certainly a possibility...

Are you sure you haven't taken any ototoxic medication?
http://hlaa-sbc.org/wp-content/uploads/2013/11/Ototoxic_Brochure.pdf

Are you sure you don't have an ear infection (or some other ear disease)?