Low-Level Laser Therapy (LLLT) for Tinnitus — Efficacy Debate

So I am from Germany and so is Dr. Wilden. Naturally I have spoken with quite many people who tried his treatment spent thousands of euros on this 'therapy'. And no one of those people I know has gotten any relief from it... so in my opinion stay away and save the money. just my opinion. BTW if some of you didn't know: Dr. Wilden isn't even an ENT...

 

Wow, a lot of hostility suddenly on this thread!

It's a shame as this is normally a really nice place, not like many of those other internet forums on tinnitus which I stay away from.

I went to Dr Wilden's clinic for ten days treatment in September and received one of his home laser units about three weeks ago. I used it for the first week and then went on holiday and forgot to take it and so have not been able to use it for two weeks until today.

I can't offer any 'miracle cure' story but since taking the therapy I can say that the dull pains and 'fullness' I would sometimes get in my ears now seem to have stopped, the pressure problems I had (probably coming from a barotrauma I think I incurred from taking HBOT in April) are much reduced and my hyperacausis seems to also be improving. In general my ears seem much more 'comfortable' now. Of course I can't be sure if the treatment is the cause of these improvements or not but I suspect that they are related.

My tinnitus seems to be possibly a bit softer than before, but that is a perception thing and difficult to quantify. I haven't had an audiogram recently. The one I took a couple of weeks after the treatment showed what might be a slight improvement in the lower frequencies of both ears up to 1KHz (which are indeed the ones that are supposed to be impacted first in any recovery with the higher frequencies improving later), but the changes were all of the 5db level which is not statistically significant so I will leave it for a few months and then take an audiogram again at the same audiologist. The treatment often takes a long time to work - we are talking months or years here - so positive results will come slowly, if they come at all.

I'm not bothered that Dr Wilden isn't an ENT as my experience with ENT's so far has been less than satisfactory and they seem currently to have little to offer (and surprisingly little interest in having something to offer) to people suffering from our condition. The fact that he is a genuine doctor with medical qualifications gives me some confidence and the general principle in the underlying theory that laser light stimulates the cell's mitochondira does seem to have value in certain regions of the body, and at least offers some form of 'scientific explanation' of how the process might be working in the ears, though as an Engineering graduate I cannot comment upon or debate on the specifics of it (didn't somebody win the Nobel Prize a few years ago for working out how the mitochondria electron transport chain functions?). New/different techniques are often not accepted by the mainstream (eg. the HBOT university hospital doctors I met were very frustrated that they received so few patients for the skin bacterial infections which they told me HBOT has been proven to cure) as doctors can be notoriously conservative and powerful business interests like to maintain the 'status quo' as far as many treatments are concerned until they have the opportunity and infrastructure in place to make money directly from them. My own GP's attitude was that it could work (or not) so if I was prepared to pay for it then I might as well give it a try.

We have audiograms from 'attheedgeofscience' posting on this forum, I've seen audiograms from Hansi Cross and also other people in Docter Wilden's clinic which have shown improvements in hearing that correspond with the period of treatment (though not me yet!). So it seems from this that some people seem to have responded positively to the treatment and frankly, at the current time LLLT (apart from a few vitamin supplements) seems to be about all that we have in the medical area (not talking about sound therapies here) until a few of these medical drugs in trials become approved and generally available .

I've met Dr Wilden and don't believe him to be primarily money motivated: that was my personal feeling but objectively he could probably earn more working as a normal family doctor than he does from his laser practice with much less grief (he receives a lot of negative publicity and attacks within the medical profession), and he did no 'hard' or 'soft' sell on me concerning purchasing his treatment or his laser products (and indeed he recommended I wait before deciding to buy a home laser). I'm also sure from talking to him that he genuinely believes that his treatment works - and this should be self-evident as why else would a Doctor in Germany carry on for doing it for so long otherwise in the face of such general hostility?

 

Yes, the vibe was bad. Let's keep it happy, people... the condition is miserable enough without us making it worse for ourselves!

To be honest that was the big deal for me as well. The treatment gives me HOPE and as a result I am in a much, much, much better place now than I was before I started it (no more suicide feelings and I'm finally starting to get back into my life a little).

At least I am now following a treatment that might work (it has some form of scientific basis, even if it is contentious) and I'm personally doing something positive to deal with my condition. All I can do now is zap my ears regularly and wait with my fingers crossed (and the warm feeling in my ears from the lasers is actually rather nice and comforting in the meantime!).

It's going to be months or years before the outcome of the treatment is clear and even if it doesn't work at the end of all this (though I've already noticed some improvement in the associated secondary symptoms) I will still be coming out in a far better state psychologically than I entered and who knows what new therapy might be available by then anyway!

 

Guys forget this LLLT discussion.
It does not help any bit for tinnitus or hearing. I have also went there with hope and trying everything before choosing suicide as relief. All audio grams are faked - I proved in other ENTs the results. But he still earns money of hopeless patients which makes me really sad.
I know also many other s with same experience. Dr W is only pushing your self healing motivation , mentally. In same time he guarantees success which is no go !

 

LLLT for tinnitus is a scam. Any positive effects are pure placebo and are bound to be short-lived.

Look at it this way -

They aim a "healing light" into your ear canal with the idea that it is supposed to make sick (or dead) hair cells healthy again. Problem is ... the ear canal has twists and turns, the hair cells are in the cochlea which is located at the other end of the ear canal, and the cochlea is encased in bone. So there's no way that the "healing light" can reach its intended target without burning a hole in your temporal bone!

@here2help has made a study of this rip-off. Perhaps he will chime in.

Stephen Nagler

 

The home pen goes through my hand, the ones in the clinic are 8 times more powerful, they will penetrate the skull, no issue there. There are other concerns, the ressurection of dead cells. Cant comment on T but the 5 day therapy at clinic took my constant mild pain away, higher frequency tolerance improved, some hearing too as i notice some things that i wasnt so aware up there. This spring is going to be nice, birds dont intimmidate me lol.

My little theory is that it will make the cells that are left, stronger, but there could be limit to that- how severe your hearing loss is. Ive noticed that mild cases have better results. Anyhow, id say save the money for stemcell in near future, altough Regensburg is a very nice city to chill.

 

The light from the laser headset I use at home is dispersed over quite a wide area and the higher-powered lasers in the clinic produce a pattern over the whole area so twists and turns in the ear canal cause no problems.

I can feel the warmth in my inner ear area, and there are photos on Wildern's site of the laser light penetrating a skull (I assume from a cadavre) into the inner ear area so the light does reach there. I can tell when the light has stopped on my headset before the timer bleeps and when one of the lasers at the clinic malfunctioned and stopped I felt it immediately and called the assistant who confirmed it had stopped unexpectedly.

The only question is whether the Laser light does stimulate celular regeneration or not (the theory says that it encourages the mytocondria in the cells to generate more ATP which helps repair and regeneration). That is unsure.

Be aware that there are some big money interests that do not want any form of cochlear regeneration to occur. They fund studies of LLLT which are deliberately 'created to fail' (see an example earlier in this thread) and encourage the dismissal of this technology amongst many viewers. It makes me rather concerned for the future of Stem Cell research in this field and I think any advances will have to come from countries without an estabished hearing aid industry.

 

Me too, bird calls don't hurt my ears in the way they did a year ago, but it isn't quite spring yet (the volume may go up) and maybe it is just habituation. I was able to sit in a mildly noisy coffee shop last night without earplugs as well (I put them in again after a bit just because I thought I should) which is a big improvement.

I don't get the dull pains in my ears I used to sometimes get any more, I had forgotten about that (fortunately).

I found the place dead boring... but fortunately spent my afternoons improving my German at the Berlitz school.

Nice bridge and wacky cathedral, but not much else apart from a very good indian restaurant near the station. Disappointing for a university town.

 

LLLT for tinnitus works? It really works? It's not a scam?

OK. So when does Wilden pick up his Nobel Prize? I ask because if his ridiculous claims are actually true, if he can predictably mitigate the loudness of tinnitus with his silly little red light, then it's a 100% guaranteed Nobel Prize.

And while I'm at it, what's this about things being so tough for him in Germany that he's forced to move to Spain to make a living. Germany is one of the world's centers for good science. Could it be perhaps that Wilden's "science" isn't that good?

All the man has to do is get together 40 tinnitus sufferers, randomly assign them to two groups, use his LLLT gimmick on one group and a placebo light on the other group, insure that the study is properly blinded, publish his data in a legitimate peer-reviewed juried scientific journal, buy his ticket to Oslo, and pick up his Nobel Prize. But it ain't gonna happen - because LLLT for tinnitus is a scam.

In my not-so-humble opinion, of course.

Stephen Nagler

 

I have better thing to do of my time than to go on an uphill battle to denounce all the very very dumb scams on the internet. Even those touching our tinnitus little world. The more experienced i get, the more i think people able to believe in the LLLT would fall for many other scams.

And this forum is full of them, good luck fighting that.

But just as a side remark, Germans do very serious science but are also very tolerant when it come to glorified bovine manure. For example they have a lot of private HBO centers who propose to treat tinnitus while cutting the medical tests and other security measures.

There are also the country of the "half-doctorate", part-time "thesis" you write in two years at home and voila ! You can be called "herr doktor" too !

So i think if some German wants to develop a scam he is not at all forced to move to the southern countries.

 

I have no glue, what i know is that it helps with hyperacusis, somewhat.

to Owch... i loved the old city, many parallels with my little home oldtown in Tallinn. Well preserved and i can walk easily from one edge of the old town to other, i walk a lot, usually with my dog. Nice market, it was christmas time then. I didnt like the Munchen, overloaded with people and boring/usual kebabs everywhere. People are different...

 

@rainman -

How do you know that LLLT helps with hyperacusis? Time helps with hyperacusis. Exposure to environmental sound helps with hyperacusis. Avoiding overprotection helps with hyperacusis. How do you know that in your particular case it was LLLT?

Stephen Nagler

 

@Owch posted [in part]

I think you have taken TRT treatment?

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Yes. In 1995.

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How did it work for you,

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It worked great. Restored my life to me. Thanks for asking.

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do you feel you are cured?

..........................

Of course not. TRT doesn't cure anybody. And TRT doesn't claim to cure anybody. (By the way, LLLT doesn't cure anybody either. They just lie about it. If LLLT were a cure, Wilden would be getting a Nobel Prize instead of moving to Spain because he can't make a living in Germany anymore.)

......................

Do you know what caused your tinnitus,

......................

Possibly noise exposure. Possibly a medication. Doesn't matter really. What's done is done - so I don't give it a thought.

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did you also have hyperacusis?

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No, but I do have a cat!

....................

I'm sorry if I don't recognise you ...

.....................

We have something in common, then. I don't recognize you either. But you do seem like a very nice person!

All the best -

Stephen Nagler

 

And to you!

Thank you for sharing your experience of TRT

 

Daedalus wrote:
But just as a side remark, Germans do very serious science but are also very tolerant when it come to glorified bovine manure. For example they have a lot of private HBO centers who propose to treat tinnitus while cutting the medical tests and other security measures.

Actually HBO has a scientific basis in treating sudden hearing loss and hence tinnitus, but there is a very short window of opportunity, usually within 48 hours. Gorified bovine manure??? I don't think so.

LLLT maybe have some therapeutic effects on the inner ear (but it can go horribly wrong too).
I say that because I personally tried LLLT at home and it made my tinnitus worse and caused vertigo that I never had before. So you might ask - how does a "stupid light" could ever possibly cause a person severe vertigo!
It did not work for me, but I did find that my hyperacusis slightly improved.
I also read a post once about a girl's testimony with Dr.Wilden. She had mild/moderate tinnitus before and severe tinnitus post-treatment. So make your own conclusions, but lasers are NOT flashlights as some "experts" will have you believe. If it was a flashlight I would not drop to the floor with vertigo after a home session.

Cheers.

 

This is a useful warning! The lasers do seem to have an effect, for good or for ill. Lasers are certainly not flashlights... they are coherent light sources which deliver high doses of visible spectra radiation to the parts of the body which the coherent light comes into contact with. Our bodies did not evolve to handle such radiation - only the skin and eyes normally come into contact with it and they then block it from entering the interior of the body.

I sometimes wonder about the safety of the treatment as the lasers are a lot stronger now than they were a few years ago when the FDA declared them as 'safe'. I realise that we are probably irradiating our brain stems with this laser radiation as well as our inner ears and I have no idea what the effects of that might be, particularly in the longer term.

I do 30 minutes of exposure in both ears a night for three, four or five days in a row and then I take a 'break' for two or three days (sometimes longer, because I forget!) so as not to overdo things (or 'habituate' the ears to the radiation too much), this was the recommendation I received. I have no idea if this is safe or not. No vertigo spells so far, but I am aware of Dan's awful experience and I hope I don't suffer similar at any point.

Unfortuantely we all need to try to balance the risks vs. benefits of these treatment options, and in the absence of any trusted medical advice 'guess' what the best course of action is

PS. I thought the window of opportunity for HBOT was three weeks? I started my course at exactly the three week point (the doctors at Geneva said this was the limit) - maybe that is why it didn't work for me?

 

I believe, from reading about noise induced damage, the optimal window is 48hours post trauma - its is also documented somewhere I believe. After this time chances for success begin to sharply diminish.
This is why sudden hearing loss is considered a medical emergency in Germany and some other European countries, where immediate administration of HBOT, steroids and vitamins are infused in hospital.

 

Some of the following information about Low Level Laser Therapy (LLLT) is courtesy of Dr. Tobias Kleinjung, Department of Otorhinolaryngology, University Hospital of Regensburg, Germany.

In general, there are two main types of lasers: hard and soft. “Hard” surgical lasers have been used by neurotologists to successfully remove tumors of the larynx and pharynx and to perform stapes surgery. "Soft” (or diode) lasers have about one hundredth of the power of a surgical laser. For this reason, the use of “soft” laser to treat various medical conditions is known as low level laser therapy (LLLT).

Soft lasers have been used to try to speed up the healing of injured peripheral nerves, cutaneous wounds, and burns; for soft-tissue injuries; to try to reduce inflammation; and to try to provide relief from chronic pain. The most important thing to understand about the use of LLLT for each of these things is that its clinical effectiveness is controversial. Some studies concluded LLLT was effective while other studies failed to show LLLT was effective in managing chronic pain.

Dr. Wilden proposed LLLT to treat chronic inner ear disease, Mirz proposed using LLLT to treat tinnitus, and Tauber recommended LLLT could be used to treat cochlear dysfunction, including chronic tinnitus and sensorineural hearing loss.

When LLLT is used to treat tinnitus, red to near infrared light is applied through the ear canal. However, we do not know if the laser light can penetrate the soft tissue or reach the cochlea and the cochlear hair cells.

Some people have argued that by increasing the strength of the laser light, LLLT could effectively penetrate these things. However, even after an increase in strength, the laser light may still be scattered and diffused by coming into contact with red blood cells and micro vessels.

Only a few reports have indicated LLLT can effectively treat tinnitus, including a study by Dr. Wilden (without placebo control), a preliminary report by Shiomi, a feasibility study by Tauber, and a study by Gungor.

Dr. Wilden is the only doctor who claims LLLT can improve hearing thresholds. Writing in a trade journal, Wilden claimed hearing improved in 80% of subjects. However, there were no improvements in hearing in several other studies by other researchers, and in one study a patient developed acute hearing loss after the third laser treatment.

LLLT for tinnitus has been around for almost 20 years, and a number of placebo-controlled clinical studies have concluded LLLT provides no benefit when used to treat tinnitus and some inner ear conditions.

Studies by Partheniadis-Stumpf, Wedel (placebo-controlled), Mirz, Nakashima, and Teggi separately concluded LLLT failed to treat tinnitus.

A review of randomized controlled clinical trials of LLLT and other alternative therapies to treat tinnitus by Meehan found no difference between laser and placebo.

In Textbook of Tinnitus,Dr. Kleinjung writes the following about LLLT. "[M]ultiple placebo-controlled clinical studies failed to demonstrate significant efficacy, [and] further studies are needed before [LLLT] can be recommended for routine clinical use."

here2help

 

Further studies are needed indeed, with using the exact method the Wilden is doing it, not directing laser on top of the ones head or ridiculous things the other studies include. The answer will never come out here, theres nothing to scienifically discuss really, until proper study is done. Until then its- you have some extra cash lying around? then try it, tell your experience but dont be overdepressed it didnt work.
my 2cents

 

Dan, which model laser did you use? I'm guessing you did a home caloric test!

 

Like LLLT?

smn

 

If I had no morals and wanted to hawk LLLT to tinnitus sufferers for a quick buck, I would just pretend that the technology only works in the context of tinnitus. Yet, it's advertised as this magical cure all to literally every ailment you can think of. It doesn't even pretend to take itself seriously.

 

I've never before seen an abstract of a randomized controlled trial without statistical significance levels.

 

Stringplayer's Second Law:

"The degree to which a person will apply common sense and logic in search of relief from a malady is inversely proportional to the square of that person's misery and desperation."

smn

 

I didn't have you in mind, when I wrote that. It has just been my experience of ENT's here. Apologies if that struck a nerve.

 

No offense taken. I'm not an ENT.

smn

 

smn? Shoot me now?

 

My initials.

 

so it says, it works right after acoustic trauma. how about some long time injured cells?
Is there also a study about?
How many watt does Mr. Wilden use to irradiate the ear? I guess also 200mW...

 

I'd rather boil my own head than watch the Oprah Winfrey show, and I have an interest in the therapy.

But I cannot be convinced by a prospective study in rats. There are studies that prove LLLT is ineffective but as I understand they have a different wavelength to Dr Wilden's clinic, so for me the question remains: Why no Dr Wilden study?

Even to start off small and organise a relatively inexpensive trial would give me some confidence. I am a skeptic, it's my nature, so I need to see conclusive proof. I need to understand that xx% of people show a statistically significant improvement, that the study accounted for factors that may have caused bias, that it was independent enough for the results to be trusted.

If I can be convinced that it works then I will consider the treatment.