Pulsatile Tinnitus and TRT

[Cathrine]

Dear Dr. Nagler,

my name ist Catherine. I am from Germany an a tinnitus sufferer.

I have a very special kind of tinnitus – it is the pulsating one.

It started April this year after a whiplash injury and and since then it has driven me up the wall.

This loud hissing sound began on the right side. After a month it changed to the center of my head, later to he left. (I know, it sounds strange –but I cannot explain it otherwise.)


Of course I had all exames you can imagine: MRA/MRI, CT, Doppler and so on. All came back clear.


In this hopeless state I went to hospital, spezialized on TRT. After spending 7 weeks there nothing had changed. So I started to read each and every paper on tinnitus I could download. Finally – after having read the statements and works by Robert Aaron Levine and Tanit Ganz Sanchez I am convinced that my tinnitus results from a hearing loss (I have hearing aids now) and from somatic causes. In the upright-MRT they could see a atlanto-axial instability. And I have also learned that this kind of tinnitus will stay.


One night, when I was exremely desperated I found your "letter to a tinnitus sufferer". Thank you for having written this! It ist not exaggerated, but that night it saved my life! Thank you again.


I understood that you were suffering from a tonal loud sound. And you could cope after some time. My question now: Can you imagine or have you learned that also pulsatile tinnitus sufferers were able to habituate that terrible noise, or even overheard it? I have never met anyone with a pulsatile tinnitus who really managed it.

It is a basic question I have, because my "going on" depends on it. I need some hope.


So far I have tried lots of different medicaments. Xanax, gingko, magnesium and some more. And I see the physiotherapist on regular terms.

But nothing has helped up to now. So I fear I must accept this terrible condition, Do you see a chance that i could make it? To accept it an live with it one day?


Sorry for my poor English. I would be very happy if you could send me a short answer.


I wish you a wonderful quiet day,


Catherine

 

[Dr. Nagler]

Sorry for my poor English.

Your English is excellent!

I would be very happy if you could send me a short answer.

OK. Here's a short answer.

You wrote [in part]:

"In this hopeless state I went to hospital, spezialized on TRT. After spending 7 weeks there nothing had changed."

TRT is done on an outpatient basis. I have never heard of anybody being in a hospital that specializes in TRT for seven weeks. Moreover, if you improved after seven weeks of TRT, I would be very happy for you that you had improved ... but it would not be due to TRT. TRT takes six months or more before appreciable benefit is achieved.

So my sense is that whatever they were doing in that hospital that purportedly specializes in TRT, it wasn't TRT at all. They were just calling it TRT.

TRT success rates for individuals with pulsatile tinnitus are no different than TRT success rates for individuals with non-pulsatile tinnitus. Given that you have shown an interest in TRT, my suggestion would be to find a place where they do TRT the way it's supposed to be done ... and go do TRT.

All the best -

Dr. Stephen Nagler