Hyperbaric Oxygen Therapy

HBOT had no effect on me after a handful of sessions.

 

May I ask you how long after the onset of tinnitus did you have HBOT? And what caused the tinnitus for you?

 

Within a couple of months.

Acoustic trauma.

 

I started HBOT a few days ago. I have completed 3 sessions so far. I haven't noticed any change in tinnitus - maybe a small spike but that's it. Ears seem to be clicking a bit more when I swallow if that makes sense.

At first I was really scared I would damage my ears during the dives and get barotrauma, but I seem to be good so far. I plan to do two more sessions tomorrow and the day after and see where I'm at, currently planning to stop at 5. I found a Private Clinic in the Bay Area that does it at around $200 per session. All out of pocket by me. I will be at 8 since my Acoustic Trauma on Monday. I will report back soon.

 

I have decided to stop HBOT after 5 sessions. I haven't noticed much change at all and my tinnitus might've gotten a little worse since I first started.

I reasoned that at 8 weeks there probably isn't much room for improvement with HBOT and that it is probably not worth the cost at this point for me.

 

I recently developed ISSNHL and tinnitus immediately following COVID-19 vaccination leaving me with 30-50 dB loss above 750 Hz in one ear. After a week on Prednisone I had recovered the lower ranges but still missing above 6 kHz and tinnitus. My doctor, Daniel Zeitler, is one of the co-authors of the 2019 Clinical Practice Guidelines to treat Sudden Hearing Loss. This guideline was updated in 2019 from the previous 2012 version after reviewing all the latest literature. It is critical for the HBOT discussion to note that much of the RCTs of HBOT have taken place in the last 10 years, so this is a major review of HBOT trials. The bottom line is that HBOT is one of the few treatment options to have shown effectiveness, but still not enough to be a recommendation.

This document gives the full list of recommendations to all doctors on how to treat SSHL including a helpful flowchart. While tinnitus is different from SSHL, almost all SSHL is accompanied by tinnitus, so it may be useful to people even without SSHL. Their list of "recommendations" is largely diagnostic - get an audiogram, rule out tumors with MRI, educate. There are only 4 "optional" treatments for SSHL - primary oral steroids like Prednisone, primary HBOT, salvage HBOT, and salvage Intratympanic steroids.

Speaking of MRIs, the research showed about 10% of SSHL revealed tumors in the MRI which were otherwise undetected and did not correlate with whether the SSHL improved or not. But there's a 10x price difference. At Virginia Mason Hospital in Seattle my insurance through Premera would have cost me almost $2000, but Premera's website helped me find Bellevue Medical Imaging which did the same procedure for $600. It was awful - literally 75 minutes lying absolutely still with a jackhammer going on. That itself is a traumatic experience for anyone, especially if you're claustrophobic.

CPG recommends HBOT if it's done early, and while this document doesn't show it, this study which I think is referenced shows that when used as salvage treatment, 1.5 ATM is barely any better (but some) than doing nothing compared to dramatic improvements at 2.5 ATM. The studies also show that it's more effective on "younger" patients of under 50 or 60. The gains are mostly for higher hearing loss like >70 dB. If you really like to read, then check out this meta-study of 160 HBOT trials. Actually I found reading all of those easier than reading the 40-page history of this 10-year-old thread!

Since I did read all 10 years of this thread as well as the excellent 5000 person survey I would say the experience here is less than would be indicated by the studies. I was particularly struck that 70% of people who had tried HBOT found no change. And I saw a summary by a member showing that most anecdotal users here did not improve. But there's likely a huge variation in how long people have had tinnitus before undergoing HBOT, what pressure (which apparently makes a huge world of difference), and whether it was primary or salvage HBOT. These RCTs in the studies incorporated into the CPG do take these into account and while not stellar, the analysis supported HBOT. I take away that HBOT is not recommended by the CPG and is only an option. Also, realize this is for treating hearing loss, not tinnitus.

In my particular case, Dr. Zeitler told me that my improvement already put me beyond the recommendations for HBOT. If I had not responded to steroids or still had a large 70 dB loss, then HBOT would have been his recommendation. But he left it up to me to try or not, and I decided to be aggressive. I didn't want to regret having tinnitus forever over a few thousand $. The doctor was very clear that the guidelines are to try 10 sessions, then have hearing re-measured, and if there is improvement, do another 10 sessions. This goes against most of this thread recommending 15 minutes, and up to 40 sessions. Guidelines also don't recommend HBOT after 1 month.

I've been on 4 dives so far starting at 1.3 ATM working up to 2.0 ATM today which is as far as they want to take me. Virginia Mason Seattle offers 10 sessions / $20k to insurance but Premera denied. VM also offered 10 sessions / $6k, uninsured price. I found the Pro Club in Bellevue, WA offered 2.0 ATM for $300/session. But I then found Washington Hyperbarics using the Fortius 420 hard chamber at 2.0 ATM for $219/session but I stumbled upon a special for $179/session. So far I have found no changes, but no problems either. I'm a diver so diving at 40 feet is no big deal and I know how to clear my ears. I actually love doing it in this small 1 person chamber because they let me bring in any electronics I want although I limit it to my Apple iPhone and AirPods to reduce the chances of a battery problem and I bring in a hard metal case just in the remote case of a fire. I wear an oxygen helmet and remove it for 5 minutes which any diver will tell you is necessary to avoid oxygen toxicity. I liked reading that many people found improvement towards the end of the 10 sessions and remain hopeful. I test my hearing each day using iOS MD Health app with AirPods Pro. I found that closely matched the professional audiogram and at $420 for Virginia Mason audiograms I can buy a lot of AirPods Pros for that much. BTW, AirPods Pro are excellent for the chamber & helmet because they have active noise cancellation but can be controlled from the iPhone while the helmet is on! It cuts the noise way down to a very relaxing amount and with music it's easy.

I'm also taking Ginkgo Biloba and just ordered NAC after reading this thread.

I will update after my 10 sessions are up.

 

HBOT seems very much all or nothing and needs to be done early.

 

I completed my 10 dives but unfortunately there was no effect on either my hearing loss or tinnitus. I used Washington Hyperbaric Therapy Center in Redmond, WA. They are a standalone clinic but they operate pretty professionally with comfortable Fortius 420 chambers and oxygen helmets.

My next stop is the Costco hearing aid center. I hear there are hearing aids with sound generators for tinnitus.

 

How were your dives? Any side effects? I feel like I was dealing with a good amount of side effects after 5 dives at 2.4 ATM.

 

I have a question. Those who've been to the HBOT only talk about instant results.

However, there is one thread on Tinnitus Talk called "70% people eventually recover" or so, and it was about some study done on soldiers that suffered from massive acoustic traumas having even ruptured eardrums, and they all were treated with HBOT and the result was that in one year 70% got better and some even fully recovered.

Is there any long term effect of HBOT on spontaneous recovery? Is there sone study that would compare two groups one treated with HBOT another one not and compare how many % of each group got better by one year?

If I understand the idea of HBOT correctly, it gives inner ear more oxygen to either start healing or make it faster. So is it possible one can heal in a year due to HBOT?

 

I don’t know about studies, but I spoke to someone who went through HBOT 3 years after his tinnitus onset, and he recovered completely after 20-30 sessions.

 

Hyperbaric Oxygen Therapy is also insanely dangerous in my opinion, but what do I know. I only got worse from it.

If you completely recover with HBOT, you can completely recover with vasodilators/blood thinners and pure oxygen.

The pressure and crazy oxygen saturations is straight out dangerous depending on what you are taking medically. Free radicals are a real thing and any nerves that are damaged don't have the capacity to deal with it before dying. Maybe you'll kill the tinnitus nerves, maybe not, at any rate I don't think it helps, we get plenty of oxygen from blood saturation of hemoglobin. There's a reason our bodies don't "try" to absorb more. Even astronauts don't use pure O2 under pressure, making the concentration crazy high in the blood.

 

What was the cause of their tinnitus?

 

Agree 100%. Only two sessions wrecked my Eustachian tubes and gave me a condition called Patulous Eustachian Tube. Just like tinnitus, there is no cure for PET.

 

He doesn’t know what caused it; he said he didn’t have hearing loss and his tinnitus was unilateral. Yesterday I met the same doctor who cured him; he’s been working in the HBOT centre for 30 years and, although he cannot guarantee any results, he said he saw many cases of improvement. I am thinking of giving it a try.

 

There are some people who have had a worsening like @Matchbox but I honestly believe it's rare. It is also likely that depending on the underlying cause/condition, people may react differently. There is also places offering mHBOT which could likely be safer due to less pressure.

I spoke to a friend who is a diver and says that HBOT is pretty prevalent in Italy so I'm not surprised that you have found a doctor with experience in treating tinnitus.

Another thing to consider is that most people say that HBOT must be done almost immediately following injury but I have seen some data and anecdotal stories to the contrary. @Lane knows a bit about mHBOT and could probably give some guidance on this as well.

If you decide to move ahead, please keep us updated. Maybe @Matchbox can give some recommendations on what to look out for or what to avoid.

 

I’ve read about bad experiences with HBOT on here and I am definitely worried about the potential risks. However, I am so desperate at this point that I am willing to try anything hoping for a bit of relief. I will keep you posted. Thanks.

 

Have you ever tried Patulend? Apparently it’s like a miracle for people suffering from PET.

Also, how are you getting along with the Stamets Protocol?

 

I tried Patulend. It's like snorting battery acid mixed with chili flakes. All for a few minutes of relief. And you thought tinnitus was bad?

Stamets Protocol has done zero for my tinnitus.

 

Sorry to hear. All the anecdotal reports I’ve read seem to say you need a macro dose for Psilocybin to work. Some even say a heroic dose (5 g+). It’s disappointing that nothing is working for you.

 

Thanks. I've been going the other way starting at 0.1 g to 0.05 g and now maybe 0.025 g. Most I've done is 0.15 g. I find I get fatigued later in the day even if I take it in the morning. Macro would mean a trip and I'm not sure if I can go there. But with Psilocybin being in the news as of late, one thing I learned is that it's impossible to OD from it.

 

This is something I try and suggest to the really desperate as a last ditch effort but it seems like the remission is in the higher doses. You really can't OD on Psilocybin on a practical dose, it's a matter of the after effects. I think this is the same with LSD and MDMA; microdosing doesn't do enough to provide the "reset" that is often talked about.

 

Following my friend’s positive experience with HBOT after 3 years of tinnitus, I decided to give it a go.

I had 6 sessions (pressure 2.5/1.9 ATM) out of the 20 recommended, and I’m done already. The pressure was pure violence on my ears, even though I was able to equalize, my eardrums felt like they were about to explode. It caused me a barotrauma after only 3 sessions. Other people in the chamber didn’t seem to have any issue with the pressure and compensating, so it must be just my stupid ears. No changes in my tinnitus, although the doctors said that 20 sessions was the minimum recommended to see (maybe) an improvement.

Another failure.

 

I urge this community to be more careful about the propagation of unsubstantiated claims, such as "microdosing doesn't do enough to provide the 'reset'..."

There are multiple citations in support of the concept that low-dose administration of THC may promote brain plasticity via neurogenesis:

Reversal of age-related cognitive impairments in mice by an extremely low dose of tetrahydrocannabinol

Presuming that neurogenesis lies at the heart of why psychotropics might alleviate tinnitus symptoms at all, then perhaps long-term microdosing is in fact key to achieving a beneficial reset. If neurogenesis is not the expected mode of action with psychotropics, I'm interested to hear about informed thinking regarding what might be the mode of action. I have yet to see a paper that systematically evaluates dose-response effects of Psilocybin or other hallucinogens. I'm not a medical doctor, so I won't prescribe anything, but getting bombed on heavy doses of hallucinogens with the expectation of a quick fix for a chronic problem like tinnitus seems like wishful thinking.

If this community is to be more than an emotional support group, we need more sharing of evidence and less sharing of opinions. If a concept is indeed supported by evidence, we should provide a citation for it... like in any other medical and science writing. In that way, we "stand on the shoulders of giants", and not merely on our own shoulders.

 

I don't think neuroplasticity is the panacea everyone believes it is. Its likely that neuroplasticity is involved in the healing effects of these compounds but in my opinion is not the main driver. There is much more than just "neuroplasticity" at play when dealing with these compounds: you have effects on neurotransmitters, anti-inflammatory markers, etc.

As per this article, Johns Hopkins has tested dose-response. "Treatment research with moderate to high doses of psychedelics may uncover entirely new paradigms for understanding and improving mood and mind." Also, although its anecdotal, there are many reports of betterment of tinnitus and associated symptoms by using macro doses, as opposed to microdoses where there seems to be only a worsening of symptoms.

So the claims are not unsubstantiated, they are made based on the experience of multiple users who have either not improved, or worsened due to microdosing. If you look up the cluster headache protocol that is promoted by MAPS, you will also see that they support macro dosing of Psilocybin exclusively. As a matter of fact, MAPS has taken the stance recently that the majority of funding for psychedelic research should not be used for microdosing studies.

 

Awesome.

Thank you for the reply, and for providing the link. This is exactly the kind of constructive dialogue I was hoping to stimulate. I maintain that until citations/evidence is presented, a claim remains unsubstantiated. So, thanks for substantiating your earlier statement so I can learn more from the source.

Cheers.

 

Blessing in disguise. Don't push barotrauma!

Good to stop if it hurts or you can't keep up equalizing. Vacuum pressure will cause bleeding, fixation and granulomas to insidiously form over time, so lots of fun uncorrectable damage.

Also, no non-vented ear plugs in the chamber. Stupidly important it turns out.

Would be better to not wake up deaf.

I believe why I did so badly was my tubes have always been shit all my life and wearing earplugs... I just didn't realize how bad it was.

I literally believe it's only any good for the ringing type tinnitus or sudden deafness and only within the first week. It took me only 2 sessions to know it helped then. Not worth the barotrauma. Helped the ringing... which wasn't that bad anyways. Left me very much worse off. It dd not help the ringing that had been going on for months.

Not being able to equalize can give you NEW tinnitus and leave you with ears that will come back to haunt you.

I feel permanently maimed by the private clinic chamber operators, who are at best, a joke.

They let me wear earplugs and claimed it causes stem cells to turn into hair cells in the ear. Then they wanted to use a little red LED on my mastoid bone and put ozone in my ear... to help...

Yeah... I gave up on them.

 

I am trying HBOT now. One session done, no noticeable change in tinnitus/hearing loss, but I had a nice energy boost afterwards. Equalising pressures was not a problem for me (I can simply do it at will, no need to do Valsalva), I will see what happens with the next 10 sessions. At least I got a good deal - €29 per one session.

@Matchbox sorry to hear about your experience, looks like your operators were complete idiots. This one is run by an MD who seems to know his stuff, he only lets people wear musicians' earplugs that have a hole to equalise pressure.

 

That's an insanely good deal.

Yah give it a shot, just be careful. You should notice if there's any effect by that many sessions.

 

Update: 5 sessions done. No change in my tinnitus or hearing loss. Tinnitus increases after each session, but drops down to baseline in half a day.

My ears ache very slightly after each session, but my doctor thinks it's fine, so I will continue with the treatment.

The most annoying thing is their pump sounds. I can hear a buzzsaw over them, that's probably compensation for my dead synapses. It happens with earplugs, too.