Top Treatments to Consider in the Early Days After Onset

What are the top time-sensitive treatments to consider for tinnitus?

When I first arrived here the information was hard to dig out. It requires looking through many, many threads, and evaluating each one. This took a lot of time, which slowed me down and made my treatment worse, since I needed to drive my doctors to treat me properly.

Let's make a list of the top things to consider, in order, so that newcomers have an easy checklist of things to start from.

NOTE: This list isn't stating what everyone needs to do. People should evaluate each treatment based on their own circumstances. But, it would be incredibly useful to have a decently-ordered list of things to at least consider.

NOTE: This list is also focused on time-sensitive treatments. Long-term treatments can be explored at further length elsewhere, but this is really more of a "things not to miss in your first X days" list.

My list of so far:

1. Oral steriods, predinosne or prednisolone. Essential first-line defense. Ideally take within 2 days of onset, possibly effective up to 30 days after onset. Dosage: 1mg/kg of bodyweight, up to 60mg/day for at least a week, tapering off. Dosage matters! Get a high dose. (my doc badly underdosed me)
2. Magnesium supplements. No real risk here and some serious scientific reasons to think it works.
3. Vitamin B12. No real risk here and some serious scientific reasons to think it works.
4. Vitamin D. No real risk here and some serious scientific reasons to think it works.
5. Steroid injections into the ear. Possibly effective up to 90 days after onset, but best before 30. Some sources say these are ineffective, some state they work.

What other time-sensitive treatments would be worth at least considering?

(I'm currently 35 days from onset.)

 

@Canadaman

We are still in the Stone Age of tinnitus treatments, and even for acute cases there is basically nothing. Some people will try HBOT (Hyperbaric Oxygen Therapy), but the evidence is inconclusive to say the least. Other people might try LLLT, but again no real evidence that it does anything.

The description of your case from your other posts sounds like mild tinnitus, and it might improve over time without doing anything particular (just avoid any further acoustic trauma/stress). It is also very possible that you will habituate easily.

 

Prednisone had remarkable effect for me even 60 days after onset.

 

Thanks for the info. How much did you take for how long? What's your body weight (just to compare dosage)?

I took 2 weeks of 60mg/day. I'm ~90kg. It didn't seem to do much for me.

 

I haven't been able to get ahold of a doctor who would let me take the full (I think 30 mg per day for two weeks, followed by a taper pack?) course. Instead I was only given a taper pack, twice. Both times when taking the starting dose (the highest one, typically 20+ mg) I noticed a remarkable effect. I would wake up and it would be very dormant. I'm currently taking both amitriptyline and Gabapentin and those have not helped.

 

Add stem cells and HBOT.

 

@Richard Bladykas careful with amitriptyline. It spiked my tinnitus bad and made my anxiety worse. I read up on it and apparently tinnitus is a side effect of the medicine I went to a neurologist yesterday with hope he could help but all he did was offer the same drug my primary did. I told him it spiked my tinnitus, he suggested a lower dose, I won’t be taking it. I hear my tinnitus in my head (loud high pitched constant sound). He believes anxiety causes tinnitus perceived in the head... But I feel so much pressure in my sinus’s so I don’t know anymore.

 

Funny you should say this, 3rd day on Gabapentin and Amitriptyline and I'm doing at least a little bit better.

 

Amitryptiline isn't candy. My GP warned for serious suicidal effects in the first weeks of taking it. It should subsidise afterwards. But it differs from patient to patient and of course the dose.

And I have read on the T as side effect too. My Gnathologist recommended it but it is still under consideration.

 

Funny you should mention that as well. I have a different tone in each ear. The tone in my right was gone until about 4pm. The one on the left has been a fair bit softer. But I am having some dark thoughts. Not unusual though, its been that way quite a bit all the while I've been dealing with tinnitus.

 

You can try NAC

 

Which dose are you taking, 10mg?

 

50 mg per day as recommended and I am doubling the dose as of Tuesday.

 

50mg amitryptiline and going to double it to 100 if I read correctly.. Does it do anything?

 

I'm still searching for an answer to that. My sleep has gotten a bit easier, but the results have not been as excellent as Prednisone (even though I took that almost two months after my acoustic trauma). I'm getting frequency shifts and sound changes just about every day so far. Not entirely sure it's helping just yet...

 

Which one of these are the best. I'm less than two weeks from my hearing loss onset and I'm still waiting on my referral to an ENT, which my doctor did say he might give me an injection, but since it's time sensitive. Which one of these should I order supplement wise?!

 

You didn't do prednisolone? That's the first line of defence. The sooner the better. For the rest, HBOT is a chance you have (low succesrate) but can be done in the first 2 months. After the first 2 months it's pretty much only deanxit / rivotril what my tinnitus doc suggested or brain stimulation. Other options don't exist yet.

Researchers need to step up their game instead of offering no options.

 

My physician won't give me them, and my referral for an ENT is taking forever. Tomorrow marks my second week.

 

Sorry to read test about your Dr. My doctor was on it right away after my onset 3 weeks ago. Sadly it hasn't done anything. Can you contact another physician?

 

Just a warning, I got ETD only a couple weeks after doing HBOT, not sure if it caused it but yeah.

 

Insulin-like growth factor 1: A novel treatment for the protection or regeneration of cochlear hair cells.

"Insulin-like growth factor 1 (IGF1) is considered a novel and potent treatment for SNHL based on the findings of various in vivo and in vitro experiments and clinical trials. The application of IGF1 maintains hair cell number of postnatal mammalian cochleae after various kinds of ototoxicity including aminoglycoside treatment, noise exposure, and ischemia."

https://www.ncbi.nlm.nih.gov/pubmed/25937136

The ATA and BTA are basically useless, even dangerous, for not drawing attention to this. If we could have gotten this in the acute stage many of us wouldn't even be here.

 

Interesting, indeed. I know bodybuilders use IGF-1, I did not realise it would be a good acute treatment for this absolute crap. Would it do anything after the acute stage? Hmm.

 

Maybe, the people that conducted that study seem to be unsure as to exactly how it works.
Notice it says "for the protection or regeneration of cochlear hair cells".

I'd think that it would have some effects on chronic tinnitus if it is regenerating the hair cells. The real question is; why isn't this being tested? Because you can't patent IGF-1? Can anybody actually follow through with anything?

 

A number of people have reported success with CBD oil. There's a number of other supplements that I've read that helped: 1) Magnesium; 2) Zinc; 3) Vit. A; 4) CoQ10; 5) Apple Cider Vinegar (internally and as ear drops--diluted); 6) Gingko Biloba; 7) Garlic-Mullein ear drops; and a few others, including Traditional Chinese Medicine (TCM).

One therapy I'm considering, and wish I would have been more famililar with in the beginning (a year ago), is Low-Level-Laser-Therapy (LLLT). There's a fairly long thread on it here on the forum, and the major takeaways I took is that it is time sensitive (the sooner the better), and that professional sessions are far more effective than trying to find a home unit that might do the trick. Apparently, quite a few practitioners offer LLLT therapy these days. -- Good luck to all!

 

Okay the best option would be NT-3 for cochlear synaptic ribbon regeneration but that's behind FDA red tape unfortunately.

The first four you listed are obtainable, but the steroid via intratympanic injection is extremely unlikely unless one has a dedicated otologist to do it.

 

Just to add to the info here I was given prednisone about 2 months after onset (ENT refused this at first, granted it on a second request) and it spiked my tinnitus for a week. Before taking it I gathered accounts on Facebook groups and saw some people said their tinnitus improved when they took this early on, some who'd had tinnitus long term said the tinnitus reduced or went when on prednisone but came back when they stopped, and some found it increased their tinnitus, as I did.

However as in my case all the increases I saw reported were temporary.

 

Screw the referral. Call an ENT and declare an emergency and make an appointment. It’s your body and you need to take charge. I didn’t bother w a referral. For me it was sudden hearing loss w Tinnitus and the first thing I read about it was at onset it should be considered a medical emergency.

 

They didn't care.

 

Tinnitus should be treated the same as sudden deafness, it's an emergency. I hope you will get prednisolone fast.

 

40 MG of pred is amazing stuff; but the docs are not kidding around about the side effects.

Over the last year and a half (since Dec 17 really) I've been taking varying doses per my ability to "find" courses, taper packs, you name it. I've taken at least six full courses (2 x days of 40 mg, 2x days of 30, 2x days 20, etc) over 12 months and while I do get some serious relief it doesn't last very long and the downsides are obvious.

You're going to put on weight, start having panic attacks even if you've never had them in your life, start having vivid nightmares, be unable to sleep without an aid, there's a nasty after taste, and that's just the stuff that you can see. The stuff puts unbelievable stress on your adrenals and can compromise bone density with long term use. There are credible reports of long term users (as in people who did not stop using it and continued to take, say, 10 mg per day for three weeks straight) of actually developing tinnitus in those who didn't have it or worsened tinnitus in those who did.

This is an emergency drug. Period. It absolutely can help you at first onset and during a major spike (EG you can easily tell your tinnitus has gotten worse during a loud event) but it should NOT be used when you're feeling "bad" or when someone drove a lawnmower past you. This stuff will mess you up. I may be relatively lucky because I'm young, not taking other medicines and in decent shape, but I can't speak for everyone.