Can Someone Clarify This: What's The Difference Between Fleeting, Reactive, and Spiking Tinnitus?

Sorry if it's been asked but I did a search. What is the difference between fleeting T, reactive T and spiking T. Since they all sound higher than normal do they all at some point come back down to baseline?
I was just in a meeting and there was alot of people talking over each other and it was like vibrating in my right T ear so I left the room but now my T seems louder in that ear. Please tell me it goes back down as it felt low the past 2 days.

 

Fleeting tinnitus is a tone in one or both ears that generally lasts 15 seconds give or take. It is almost ubiquitous in the population at large and is of no clinical consequence whatsoever save for the fact that Dr. Jack Vernon observed that fleeting tinnitus, when present, can actually mask other tinnitus. Fleeting tinnitus can occur once day, once a week, once a month, once a year, or once a decade.

Regarding "reactive tinnitus" and "spiking tinnitus," as far as I'm concerned it's all just tinnitus. I think far too much is made of such terms. But maybe that's just me.

Dr. Stephen Nagler

 

Thanks. Dr. Nagler. My T in right ear just went up as a result of this meeting and I'm just hoping it comes back to baseline. Seems like it just spiked up as a result of louder sounds/Voices And My ear feels more full than usual now.

 

I think a lot of people on this site consider "spiking" tinnitus to be when your T suddenly sounds much louder. Spikes, according to people's testimony here, can be brief or last for awhile (days, weeks). But what makes them "spikes" is eventually, your loudness perception goes back down.

It helps me stay calmer to realize, in my experience, my loudness perception level indeed rises and falls. So if I find its loud and annoying me, I remind myself this will change and do some masking if it really is bugging me.

I try not to pay much attention to my loudness level. I figure it's like the stock market; it goes up, it goes down. If I continually monitored the market, where the majority of my retirement money lives, it would make me crazy. I figure the same with my T.

 

@Rube
Just to add to all that, reactive tinnitus has been defined as t reacting to outside sounds and then staying up for more than 24 hours after the outside sound has been removed.
I have t that reacts to outside sounds such as fans, traffic, well the list is endless, but it goes back down once the outside source is removed.

 

@Lisa88 @LadyDi thanks for the info. I think what I'm experiencing now is reactive T then. It went up in volume when I was in that room listening to everyone talk over each other. It wasn't super loud just annoyed me enough to leave. I sure hope it comes back down the last 2 days it felt nice and low and my H Seems to be less as well.

 

@Rube
Yes, it will go down.
The good news is that many with reactive t report less reactivity as time goes on. Still waiting for that. Even more report a fade in hyperacusis, which I have already experienced - that gets better month by month. Hang in there, Rube!

 

so is it considered reactive T if it goes back down right away?

I have the same kind of T you're describing...

 

In the literature, they don't define our kind of t as reactive t, because of the 24 hour rule. But, it is t that quite clearly reacts.
See that you have had t since 2007. Has it reacted this way since then? Or have you felt it back off a bit re reacting to outside sounds?

 

FWIW, @Rube, I've never heard of a 24-hour rule as the basis for defining "reactive" tinnitus in the literature. There's a 24-hour rule used in TRT categorization, but the term "reactive" tinnitus is not used in that context.

To the best of my knowledge the term "reactive" tinnitus had its origins on Internet tinnitus boards. A few clinicians have picked it up from their patients, but it is not part of the formal scientific tinnitus lexicon and has no diagnostic, prognostic, therapeutic, or clinical relevance. What it does do ... is cause unnecessary concern.

That's my understanding, anyway.

Dr. Stephen Nagler

 

@Lisa88 it reacted at onset, for abotu 3-4 months.. then the reactive component went away 100% for 7 years. Since the increase, it's back...but it was gone down a bit since May.

 

Yeah my T is reactive as well; it sucks. The moment I get in a car with my musicians earplugs that take things down 20dB BOOM there goes my T being louder for the rest of the day. Or if I turn on the TV (even with volume at low). The only way to have my T tones remain low is if I seclude myself in a quiet area with a little masking for an entire two days. That's the only way to get it back to baseline and that opportunity only comes about once a month if that.

 

Pretty much the same story here, although my T goes back to baseline if I get a good night sleep. At the evening I can hear the T over loud tire/engine noises when I drive back home from work.

 

Seems that everybody's tinnitus reacts to something or other. So instead of calling it reactive tinnitus, here's an idea. Why don't we just call it tinnitus?

Dr. Stephen Nagler

 

thanks @Lisa88 i feel that my H has improved over the last few days.

 

@Dr. Nagler thanks Dr! i guess it kind of makes me feel a bit better that if it reacts and increases to some sounds that it should come back to baseline....hopefully.

 

I understand that. My problem with the term "reactive tinnitus" is that it's a label without diagnostic, prognostic, or therapeutic significance. Sort of taxonomic masturbation, if you will.

That's how I see it, anyway.

Dr. Stephen Nagler

 

Me too. It's strange how it "reacts" to certain frequencies. I feel like it should be introduced as at least a term we know that doctors also know as well.

 

@LadyDi

LadyDi--I very much enjoyed your analogy!

Although the term reactive T or Spiking T is not an official medical diagnosis, it may help those with the new onset of T. If they were not able to understand that it happens off and on and it is all relative to having T, they may become more anxious thinking that it is only happening to them. Therefore, the term might be helpful to assure folks that it is okay and this too will pass. That is how it was for me. I was pretty upset by my T reacting to particular sounds and getting louder at times. These terms helped me to better understand the nature of the beast.

 

Hey, maybe read this thread about this topic, might be useful for you

https://www.tinnitustalk.com/threads/tinnitus-vs-tinnitus-hyperacusis-some-basic-differences.5110/

 

T that reacts to an outside stimuli sound vs t that spikes to a single event, well these seem very different behaviors.
When my t reacts to outside static sounds around the same frequency as my t for example, it is almost as if, besides the tinnitus itself - a compensation for a frequency that is not there, there is also a neural interpretation of this outside sound going on.

 

I fully understand your point, doctor, but I still see the "reactiveness" of my tinnitus as a crucial aspect of it that therefore needs to be addressed (and I would really love to be wrong in this). As I was writing before (and thank you once again for your answer), it reacts even to my own voice - and it just destroys me, I can't communicate without having tinnitus "underlining" every louder word I say. I could habituate to tinnitus that just "is there", I did once before - but this new "reactive aspect" (after acoustic shock) is something I just can't get over. If I could just habituate to it... which I can't imagine now, being 2 months in it... I would call it just tinnitus. I would love to. I just can't imagine how I could habituate to this reactiveness to my voice (and all the other noises as well).

 

Maybe because it may get confused with tinnitus which does not react to external sounds?

I understand your point of view as you are healthcare professional but for us common people it is much easier to talk about reactive tinnitus than of "tinnitus which get louder during the day if I hear loud sounds or sounds of certain frequency and after a night sleep gets back to baseline".

And imo, this term could have therapeutic significance atleast mentally (if I understand the concept "therapeutic significance" correctly).

 

Hi @Barrowww and @Zechariah -

I read your posts carefully and understand your thinking. Thank you for explaining your positions.

Now here is my own thinking on the matter ...

I come at it from a problem-solving perspective. I figure that if my tinnitus were severe enough to significantly affect my life, then "reactive" or not I would DO SOMETHING about it. I would not hang out on a tinnitus support board and post about this that and the other thing. In fact that's about the last thing I'd do. I realize that others see it differently, but that's how I see it. Once I gathered information, I would ACT.

And the DO SOMETHING I personally would do would be TRT with a top drawer TRT clinician. It's what I did after carefully researching my options back in 1994 - and it's what I would do today. And as I wrote HERE ... if I could not afford it, I would beg, borrow, or steal the money.

Well, as it turns out, in TRT the success rates are the same regardless of whether or not your tinnitus is "reactive." The only thing that matters in that regard is whether or not the increase in loudness lasts more than 24 hrs. And even in such cases TRT is still very successful, just less so.

Which is why from a practical I see the term "reactive" tinnitus as a term that serves only to keep folks from moving ahead with their lives.

I mean no disrespect to those who view things differently. If I did, I would not spend so much time on this board addressing issues that have nothing whatsoever to do with moving ahead.

Dr. Stephen Nagler

 

I just wanted to say that i have T for almost a year now.. And mine use to be reactive i use to have a morsecode that would react and the past month it all stopped. The way i described my reactive T before was that when i would be out at a semi noisy place and plug my ears the noise would be blasting ( i have extremely mild T) and now when im out and plug my ears i hear nothing.. Same goes with the morsecode. I guess it could come back ofcorse but for now its been gone.. So maybe for some it takes time for it to settle or not react?

 

Thank you for your reply and your perspective, @Dr. Nagler. I like it. I will head this way.

 

Well, I did ACT when I heard of reactive tinnitus. I stopped fearing that my tinnitus keeps getting worse and started using earplugs when driving at highway etc that my T is a bit quieter at evenings. It's mentally important to understand that loudness will come down and having words for this "reactive behaviour" comforts ppl or atleast comforts me. So this is purely mental thing in my opinion and leads to easier/faster habituation.

And yes, ppl should get TRT but tbh, here in Finland, tinnitus knowledge among healthcare professionals is near to zero. Even ENTs Ive seen just say that "you should get used to it, sorry, can't help". Doctors here are quite stubborn. If the therapy/medicine etc. isn't clinically tested and 100% working, they will not give even a thought for those and they don't usually see into mental side of issues when there is one (which somewhat explains unavailability of TRT here even though we have superior healthcare system). People get treated here as physical organisms, not as human beings with feelings and stuff. These matters are largely criticized here but this is already a bit offtopic.

But I'm alright with current situation with my T so I don't feel like needing TRT.

In my case talking about reactive tinnitus does not prevent me moving ahead with my life but that's just me. Most of the actions I've have taken have come from this forum (supplements, sound therapy, info how top cope with certain situations etc.)

Thanks for responses even though we seem to disagree in this matter

 

TRT is for people who are not OK with their tinnitus.

If you are OK with your tinnitus, you are way way ahead of the game. I am happy for you.

By the way, there is excellent TRT available to people who live in Finland.

Dr. Stephen Nagler

 

Sure. You make an appointment with Jacqui Shekdrake. You get on a plane. You fly to London. And you pay her.

Just like I did in 1994 when I made an appointment with Pawel Jastreboff. I got on a plane. I flew to Baltimore. And I paid him.

I'm not trying to be a wise-guy here, @Markku. Just want to point out that in the final analysis, it's all about priorities. TRT is cheaper today and much more convenient than it was back when I did it. Travel included.

Dr. Stephen Nagler