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

Hi,
thanks for warning!
May I ask what device you have been using?

Greets Tom

 

30mW infrared and 90mW 808nm if I recall correctly, Chinese brand lasers I forgot the name.

 

We really don't know what it is, Danny, do we? We don't even know if Wilden's red light is the same red light as your red light. And for that matter we don't know if your vertigo is due to the effects of an actual laser or if it is due to the wavelength of the red light or possibly to the pressure of the apparatus on your head. (I get vertigo when I smell horseradish, but I certainly do not consider that to be due to the effect of the horseradish itself!)

My point in calling it a red flashlight is that since the appeal of LLLT to tinnitus sufferers cannot possibly be due to legitimate data from properly controlled reliable and verifiable studies, it must be due to the name. Take "Laser " out of the name, and nobody will use the product!

smn

 

Of course its due to the wavelength of the "red light"
We know Wilden's lasers are 10x more powerful of what I used and I know my vertigo was caused directly due to the effects of the light. Vertigo is a well documented side effect in the LLLT studies - and don't tell me it was a placebo effect LOL. I'm not a placebo type of guy.

 

Dr.Nagler, so you get vertigo from smelling Horseradish and a tinnitus spike from spicy Thai food?
I think we may be onto something here...

 

Guys im neutral in this whole debate here Im not for or against LLLT but this arguement is never going to resolve as both parties have equally good points made about LLLT.If you feel it is worth exploring then go for it and I really hope it works for you,its your decision and yours only.There are some undeniable claims made by people that this did work for them and this should be paid attention to and investigated.ATEOS has experienced some improvements and im happy for him in that respect and it does show some proof as to its effectiveness and I hope he continues to pursue this with better and better results.On the other hand you could view it as one man making unfounded claims about his new device that has really no scientific credibility whatsoever and the fact that this incredible new device has no publications in any scientific journal kind of disheartens you towards this device,it makes you wonder why this new device hasnt received more attention than it has,it raises doubts about it.If Dr.Wilden would prove without a question of doubt that his device is truly effective and does work there would be crowds of people lining up for this treatment but yet he has failed to do so and why??It would make him a milionaire nearly overnight but yet its proof of effectiveness still remains a mystery and it does slightly have a stench of scam about.But on the other hand maybe this technique by Dr.Wilden is still really in its infancy and he is still perfecting his method and doesnt want to publish data too early as it might discredit his technique who knows,all I do know is that some people have been helped by this and that can only be a good thing.Look at it like this if someone aproached you and said ive invented a new method for T treatment,it requires you to stick your finger into this electrical ball and your T will be no more,then you ask him is there any real proof that this will work and he replys no not really its going to be really hard not to be skeptical about this device and you will most likely not go ahead with it as who knows what will happen.And then there are those who will go ahead with it and their curiosity may be rewarded or it may not but you never know until you give it a try and that in my opinion is what ATEOS is doing,hes poking the electrical ball so we dont have to and if his curiousity is paying off,well we will see on his next audiogram and I wish him the best.If this proves to be of beneit then great but if it doesnt then I guess another one bites the dust.Just want to remind you guys im neither for or against LLLT this is just merely an opinion.

 

You may well be right, Danny. But we don't know if that wavelength was the direct result of Light Amplification through the Stimulated Emission of Radiation. And if it wasn't, then whatever effect it had on you, that effect could not possibly have been due to a laser.

You are a lot more trusting than I am, @dan. Maybe that's a good thing. I don't know anymore.

smn

 

Excellent fair-minded post from @bill 112.

Except, that is, where he writes: "all I do know is that some people have been helped by [LLLT]." How exactly do we know that? We know that some people believe that they have been helped by LLLT. But we don't know if their improvement is actually due to the LLLT or due to other factors. Moreover, of those who post that they have been helped, we don't know if any of them are being paid to post what they post. This is the Internet. It happens! That's why honest investigators do reliable and independently verifiable controlled studies published in juried scientific journals to support their claims.

smn

 

@bill 112 , I think Dr.Wilden is already a millionaire.

 

What about the LLLT offered in "normal" ENT clinics? With ENT's working there?
It's always offered as alternative treatment, so they might have some success, even if it's placebo...maybe it's the same,as somebody says, go take acupuncture.

 

ENTs here in the US frequently recommend tinnitus treatments that do not work - ginkgo, vitamin preparations, middle ear infusions, electrostimulation, etc. LLLT is no different. Just because an ENT recommends it, that does not mean that it works!

Back in the 18th century Voltaire observed that medicine is the art of entertaining a patient while nature gets him better. Well, in many ways we've come a long way since then. But in some ways I guess we haven't .

smn

 

For those who are interested in LLLT (in relation to Dr. Wilden's therapy, specifically):

1) Dr. Wilden approaches the functioning of the inner ear and audiology from a biological perspective ie. "does it work ...?"
2) An ENT approaches the functioning of the inner ear and audiology from a practical perspective ie. "can you hear...?"

The difference in the approach means that Dr. Wilden treats hearing loss as hearing which is worse than 10db (at any frequency). A regular ENT would treat hearing loss typically as hearing which is worse than 25db at any frequency in the speech frequency range (0 - 8 kHz). As is probably well known to most people on this board, human beings can hear up to about 20 kHz. For this reason, the standard audiometric tests performed by most ENTs (= 0 - 8 kHz) are obviously inadequate. Not even half of the full frequency range is examined. It is equivalent to a cardiologist who examines only the left side of a patient's heart - and based on that - determines whether the right side is also okay...

So in terms of audiology, the work of an ENT has failed before it has even begun. This is also evident from my most recent audiogram which I have previously posted on this board, but which I will attach again here:



The day I got the above audiogram done, I specifically had to go to another clinic for the test than the clinic I was already at. Indeed, had I accepted the standard 0-8 kHz test, the ENT would have concluded that my hearing is perfect. Yet, right after 8 kHz, there is a sharp drop (especially in my left ear). My hearing loss could easily be as much as 60 db at 16 kHz. The aim of my current LLLT therapy is to revisit the therapy I had last year and continue with the LLLT therapy until all of my hearing curve is brought up to approximately 10 db. This may take quite some time. Last summer, I managed to reverse hearing loss of up to 25db in 8 weeks (after which I stopped and went onto stem cell therapy (x 2), instead) . This time I will be continuing the LLLT therapy for "as long as it takes". Since it is another ½ year before my HIFU examination, the surgeon has told me to spend my time wisely (meaning: do what you can in the meantime to get better - in order to ultimately avoid brain surgery). So the aim of my current therapy is to really examine the link between audiograms and tinnitus - when done properly (ie. 0 - 16 kHz full examination). And to really see how far LLLT can reverse hearing loss. My feeling is that with last year's therapy, I may have quit a little too soon. This time, I am also experimenting with higher doses based on the Arndt-Schulz curve - which I have posted on earlier in this thread. When experimenting with higher doses, it is important to monitor the progress with audiograms closely (to ensure no detrimental effect is taking place). The progress I made last year can be found in the attachment file below. I am also in contact with other LLLT patients - and some of my decision making is based on their feedback.

Lastly, the reason I will not be disclosing my upcoming series of audiograms publicly is because the environment on this board is hostile. By "hostile" I mean the following: I have seen incorrect statements made in relation to LLLT by two members on this board whom I believe are both doctors - one of the statements read as follows:

"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!"

It is quite easy to disprove such a statement. For a start, one can get an impression by looking up the photos I have posted on this board - at least one can be found in my introduction. If a therapy is a piece of crap, then by all means, say so. But don't start blaming a therapy for the wrong reasons. A laser with the right wavelength and strength can reach the cochlea. So the person who made the statement above is either ignorant or is purposely making incorrect statements. In either case, I have no intention in pursuing a discussion with such people. And hence an offline briefing for those who are serious about LLLT is the right way forward.

 

Hi Dan,
we discuss about LLLT and it's effect on inner ear problems. There are pro/cons and people they follow this thread.
We shouldn't blame people for their opinion.
Let's take another example. If someone has another health problem where is no cure, what should a doctor do? Send him to unproven therapies? No he,won't...
Not everything is a conspiracy, pharma against alternative medicine, hearing aids industry against LLLT.
Ok, it's a lot about money and market, but it's not all about this.
But at least, every drug or therapy needs to show some form of reproducable effect, otherwise it's uncertain and there for controversial discussion.

Greets Tom
(by the way, I just wish my Laser would work)

 

Hi ATEOS,
thanks for sharing. I would be very interested in your latest results.
I'm using,the home laser since two weeks and I could't find a change in hearing threshold. I will further go for it!
What minimum power is needed to reach the cochlea? I speculate, that the Tinnitool would fail with it's 5mW.
I use 50 to 90 mW.
Greets Tom

 

I get error when going to this link.


Moderator said:
ATEOS has decided not to allow incoming private conversations.

Instead, you should leave a message on his profile page. Go here.

 

@attheedgeofscience -

A few folks here (including me) are hostile towards LLLT. I hope you realize that nobody is hostile to you.

The decision to undergo or not undergo any given therapy is an individual one, and the criteria are individual as well. That decision and a person's right to make it should be respected.

As far as your audiogram goes, it is not perfect. But it is incredibly good. You are going to extraordinary lengths to try to improve an audiogram that most folks would envy. It is certainly your prerogative to do so, but may I ask why?

Thanks.

Stephen Nagler

 

Fair insight Dr.Nagler I probably should of said " all I do know is some people claim to have been helped by LLLT"claiming that something helped you and something actually helping you are obviously two different things.Im not for or against LLLT but I am extremely skeptical about the device and its unproven effectiveness but I look forward to ATEOS proving me wrong in that respect.I do however find this debate about LLLT quite pointless its just like the whole marijuana debate,some scientists say it does absolutely no good for you and others say it has great medicinal purposes and both sides are trying to prove the other wrong endlessly and for what??Nothing constructive will ever come out of it just two sides hateing one another all over a piece of grass and its the same here,some feel it may work and others are strongly against it.Its just two egos with strong opinions clashing and nothing good will come of it.Its time to lay this arguement to rest and both sides go their seperate ways,you have both proven your opinions and I think its time to leave it there.This is a support forum and it breaks my heart to see some of the comments that have been written here.

 

Hi,
I'm another "neutral" sufferer who is testing LLLT.
I do treatment everyday since 2 weeks. I made an audiogram before and will do another after some weeks using my home device. I have some hearing loss in the middle freuqencies (1-2khz) of 30dB, so I would easy recognize a 10dB shift or a decrease in T-Level.... we will see.

Greets Tom

 

Yes I'm also very "neutral" but still very interested in this treatment since some people have reported that it worked on their hyperacusis, even if it didnt worked on their tinnitus. The "successful" swedish study was also aimed towards H, not T and that was published by the official sweish medical journal. I don't really trust that study though and it has been very critisized by swedish doctors. But the main claim of the provider is that it works better for hyperacusis than tinnitus, and that's all I care about at the moment.

@dan you mentioned earlier in this thread that your hyperacusis got a little better from this. How much better?

I appreciate your updates on your treatment @tomytl and good luck

 

I would like to take a moment to make a general observation here. I apologize if it might appear to be simplistic or self-evident, but I'd like to say it anyway.

Either LLLT works for tinnitus or LLLT does not work for tinnitus. And what anybody on this board might say about LLLT has absolutely no bearing on that fact. It isn't more likely to work for tinnitus because one person posts that it works. It isn't less likely to work for tinnitus because another person posts that it doesn't work.

Stringplayer's First Law:

No tinnitus sufferer who found even a small amount of relief ever cared one iota whether or not the treatment that resulted in his or her relief was based on science.

Best to all -

Stephen Nagler

 

I wonder does he donate to the"Irish guy needs some monies"foundation??

 

Since the LLLT studies were so poorly controlled, we do not know if the vertigo was caused by the fact that the red light came from a laser or because the light being shined into the ear was red. Put an apparatus around my head, ask me to remain relatively still for half-an-hour or whatever, shine a red light in my ear - and I might get vertigo too, for any number of reasons.

Stephen Nagler

 

But what about latest research about hidden hearing loss from Massachussets? It's is said, that this newly found neurons die slow. So maybe there is a bigger time frame where maybe something stimulating
nervegrowth can take effect.
B12 or maybe Laserlight?

 

Seems to me like trying to fit a square peg into a round hole.

That's just the way I see it.

I try to keep things simple. If LLLT worked for tinnitus (after all, that's what we're talking about here), then by now there ought to be at least one reliable and independently verifiable double-blind randomized prospective placebo-controlled study attesting to its efficacy published in juried scientific journal. Such a study would be incredibly simple to design. And if legitimate, the major journals would be crawling over each other to publish it.

Stephen Nagler

 

I hope you are wrong ;-)

yes maybe it won't help against Tinnitus (ATEOS says the same)...
But I would be happy if it could remove pressure in the ear or enhance some hearing... this would probably
give the ear better feeling and less attention to T.
I d'like to ask you at this point some offtopic, what can I do against pressure in the ear? What is your experience?
How long can this anoying feeling of pressure after sudden hearing loss stay?
Could it be a warm red light for pressure reduction?

Greets Tom

 

I'd be thrilled to be wrong about LLLT.

Well if you don't mind, let's stop right there for a minute, OK? Just for a minute.

This is a tinnitus board. I don't care if LLLT will grow hair on my head. I don't care if LLLT will help my tennis elbow. I don't care if LLLT will give me a stronger erection. If I wanted stronger erection, I'd go to the penis support board. But the issue here on this board is tinnitus - and there is not one shred of legitimate evidence that LLLT does a thing for tinnitus. There are a bunch of weak studies with holes large enough to drive a truck through. But all the reliable and verifiable studies show that LLLT is no more effective for tinnitus than placebo.

Reminds me of another tinnitus scam on the Internet several years ago:

An Israeli M.D. was boasting of a tinnitus cure. There was a guy in Hawaii named Ray bragging that his tinnitus had been "reduced to a slight background noise" by the doctor. He even wrote an article about it in Tinnitus Today. And there was a fellow from Chicago named Mike who had moved to Israel and as a service to mankind (or some such garbage) was all over the support boards encouraging tinnitus sufferers to come to Israel to be cured. Moreover, as a "kindness" he arranged for international patients (primarily from the US and Europe) to stay in Israeli hotels for the required six week course of treatment. As a result of this campaign, hundreds upon hundreds of tinnitus sufferers from all corners of the globe came to the Holy Land to be cured by the M.D.

How wonderful, right? How hopeful! How uplifting! The Holy Grail of tinnitus - a cure. Yours for the asking and, of course, a few dollars.

So the guy from Hawaii was never heard from again. And years later the Chicago shill, who had made a spitload of money from hotel kickbacks (not to mention kickbacks from the good doctor), finally admitted that he could not produce even one patient who experienced any appreciable lasting tinnitus relief. What about the patients themselves? They continued to be fiercely loyal to the doctor, posting about his "sincerity" and the very positive moving experience they had while in Israel. They were all glad they went ... but nobody got any better!​

That would depend on what is causing the pressure in your ear. I respectfully suggest you discuss it with your own ENT. I am not an ENT, and it is not my area of expertise. Sorry.

Stephen Nagler

 

Dear Mr. Nagler,

thank you for your opinion on LLLT and other "cures" for Tinnitus, I really respect your point of view
and I am also thankful for you support here on the board, this must be said.
I really don't want confrontation with you personally, just discussing the therapies.
With effect of LLLT I just meant, if there is going something on, it might do something in the inner ear too.
(but I guess I know your answer) I haven't asked about if LLLT works for something specific, just if
it works for something different or if it's for everything "scam"....

Ok, ENT's here have no answers to my pressure question or a drug.

And yes, I am aware of many scam treatments.
Where people are distressed, there are masses of therapies.
As a new sufferer of T in the age of internet, it's hardly to figure out what's best and the fear
to miss or being to late for a therpy doesn't help from being hoodwinked by someone.
Especially if you just get the advice from the ENT to accept the situation...

Greets
Tom

 

I will give lllt a try soon...
But hbot first...
Basically to me if something works or not does not matter. . Would u regret not trying it or not in the future. .
What I think of lllt..
we all know ultra violet rays can cause caner and mutation. .
In yoga early morning sun rays are supposed to be good for eyes and body..
So could a low level laser or red light might work ?.. Probably yes..
Human body does have the ability to cleanse itself and repair itself..some say it rebuild itself every few years..
Power of mind is no lesser than any medications.. with enough nutrition and time it can regenerate itself.. .. if sticking in couple of red lights in my ears daily and deeply belive that my hearing or T is gonna get better and if do it long enough it might work..

I am for one is a fighter.. giving up means I tried everything I can within my power...
If you got the means and resources why not give it a try..

Few hundred years ago Earth was flat and center of universe. .
A decades ago pluto was a planet.. so things will change sooner or later..

I am for one surely not want to regret not trying what I can..by that I mean afford hbot sessions or buy a laser or buy vitamins tablets.. may be I will lose couple of months of salary.. or years worth of savings in the process. . But going down fighting is better than giving up. .

Bottom line it comes to ur common sense, beliefs, your resources, your choices, chance and fate.. and last your regret of doing and not doing something. .
( I edited to add some points and clear some typos)

 

I appreciate the idea of KISS (Keep It Simple Stupid). As an engineer, I try to practice that in anything I design.

Unfortunately, the idea that if LLLT worked, then by now there ought to be at least one reliable and independently verifiable study to support it is not a KISS propopsition. It makes a huge assumption. That is, that someone has taken the time and effort to design a GOOD and RELIABLE study, found the money to execute it, and has EXECUTED it WELL. The key assumptions are highlighted by the words GOOD, RELIABLE, EXECUTED WELL.

If there is one thing that is abundantly clear its that many, many (if not most) medical studies are simply not done very well, and you simply do not know which one are good and which one are bad. The best you can do is gain as much intimate knowledge of the study as you can and make that assessment yourself. The drive behind many studies has nothing to do with altruistically illuminating science and growing knowledge for the sake of science and knowledge, and least of all for the benefit of suffering patients. Most of them are conducted to support an ulterior agenda which often involves a benefit for the study producer (money, prestige, fulfillment of a research paper quota, whatever - just usually not to really help people) . Sometimes those two interests properly intersect and you get a good result, but that is the exception rather than the rule by my observations.

I read a study reported on in Science News about a year ago that basically said the brand of statistics employed in medical studies is extremely flawed. It basically called into question nearly every medical study ever done. Should I believe it. Heck if I know.

I can remember all the studies when I was a teenager telling me that eating eggs was bad for me. Despite loving eggs, I reduced my egg consumption tremendously. Now we have studies that tell us that eggs are not bad for us at all, and that we should eat more of them. Ditto for butter. When I was young we were told that margarine is better for you than butter. Now its just the opposite - so much so that the city of New York has banned the use of magarine in restaurant food - margarine is a trans fat). I haven't a clue which is true. I might as well flip a coin. These turnarounds simply could not occur if studies were well developed and well executed. One simply cannot trust the medical community to develop and execute a good study. Frankly, I'm not sure what community I can trust to carry out a good study where health issues are concerned.

I'm sure that occasionally there are good studies, but the fact is, you just never know which is a good study and which is not. Peer review means little these days because most people publishing and reviewing such articles are not doing it for the benefit of science or patients. They are doing it for prestige, ego, money, and a host of other reasons.

I'll give you one more example of how bad the medical professionals are with this sort of thing. I have a problem where my heart pauses whenever I dream. Pauses as long as 8 seconds have been recorded. I can not get a consistent answer on whether this is a dangerous situation or not. I have 5 different opinions ranging from "you need to get a pacemaker right now" to "it could cause cardiac arrest in theory, but it has never been known to happen; if you want to eliminate the unknown risk of cardiac arrest get a pacemaker (but recognize that pacemakers are not without dangers)", to "this is perfectly normal and there is no length of nocturnal pause that is dangerous". These are the opinions of experts from major medical research institutions in the US including Washington University and the Mayo Clinic. How is it possible that they can vary so much? I might as well flip a coin. At the beginning when I figured out that these pauses were occurring, I was told by more than one heart specialist and sleep specialist that it was not possible for me to have such pauses. That such a condition was only known to occur in a specific genetic subset of people of oriental descent, and they all died in their twenties. Yet, here I am, well beyond my twenties without any known oriental ancestors, and the tests confirm that my heart pauses only occur when I'm in REM sleep. (Actually, I was first told that these pauses were in my imagination and that I was suffering from anxiety - that turned out to not be reliable information either. Just another example of the professionals being way off base).

The bottom line in my mind is that what you trash today just might be identified as the holy grail tomorrow - you just never know. Medical science is just plain too disorganized, too flaky, and too plagued with conflicting motivations. All you can do is gain as much understanding of the situation on your own and make your own deductions, your own decisions. One way to do that is with open and frank discussions with people of various viewpoints who have the same vested interest as you. That's what I see as the benefit of forums like this. It provides an opportunity to hear the pro and cons from people with differing views, and different experiences. That is the kind of info I want to help me decide for myself what reality is and what is best for me. I appreciate hearing from the people who think LLLT is quackery as much as I do hearing from people who have had first hand positive experiences. Don't stop discussions because you're afraid of offending someone, or afraid of being offended. I think the only rule should be that politeness and respectfullness are mandatory. All opinons expressed that way are welcome in my mind.

 

@mick, I understand what you are saying. Perhaps I did not properly convey my point, which really has nothing to do with the current state of medical research. My point was one of logic.

Either LLLT works for tinnitus or it doesn't. That fact is obvious. What the phrase "LLLT works for tinnitus" means is that LLLT is more effective than placebo in decreasing the tinnitus loudness match and/or the tinnitus loudness rating in a statistically significant proportion of the tinnitus population. Preferably the effect should be long-lasting, but all that is required is that the effect should exist. Now none of the above is debatable.

Here is something else that is not debatable. Tinnitus significantly impacts the lives of approximately 4% of the population of the industrialized world. If a treatment - any treatment - did for tinnitus what Dr. Wilden claims LLLT does for tinnitus, the economic and social consequences to society would be enormous, not to mention all the relief that would be realized by those who truly suffer. And likely Dr. Wilden, as the greatest proponent of this therapy, would be a shoe-in for a Nobel prize ... and would become wealthy beyond his wildest dreams.

How does one establish that the effect of any given treatment is greater than placebo? Well, since there are good quality studies and bad quality studies, the simplest way would be to do a study the quality of which would meet the exacting standards of The Lancet or The New England Journal of Medicine. Then there would be no doubt. And interestingly, with LLLT it would be incredibly easy to design such a study and incredibly inexpensive to carry it out. You take 40 individuals who have had tinnitus for more than a year, who are not on any medication, and who agree not to undergo any other treatment during the time of the study. You randomize them into two groups of 20. One group is treated using Dr. Wilden's precise laser protocol. The other group is treated using Dr. Wilden's precise laser protocol with one exception: the red light emitted from the apparatus is not a laser. The clinicians administering the treatment are blinded as to who is receiving the treatment and who is receiving the placebo, and the participants are similarly blinded. Prior to and again at the conclusion of treatment, each participant undergoes a tinnitus loudness match and tinnitus loudness rating performed by an audiologist who is also blinded. And the data are analyzed by an independent statistician.

If such a study were completed with an outcome favorable to LLLT and if the methodology were felt to be reliable and verifiable by the editorial boards of those two journals, they would be literally falling over each other to be the one to publish it. And Wilden could purchase his ticket to Stockholm.

The fact that to date no such study has appeared in either journal - or for that matter in any major journal - tells me all I need to know.

Stephen Nagler