Tinnitus (tinnitus auris) is a widespread condition affecting millions worldwide, characterized by the perception of sound without an external or internal source. This condition can occur occasionally or develop into a chronic problem that significantly impacts quality of life. The underlying causes can be diverse, ranging from psychological to physiological factors. Successfully eliminating tinnitus typically requires proper diagnosis of the root cause followed by targeted treatment strategies.
What Is Tinnitus?
Tinnitus is the perception of sound when no actual external sound is present. The term “tinnitus” is broadly used to describe various auditory sensations, including:
- Ringing
- Buzzing
- Hissing
- Whistling
- Pulsating sounds
- Clicking
- Humming
The intensity of these phantom sounds can vary considerably, from barely noticeable to severely disruptive. They may appear suddenly or develop gradually, persist briefly or continue for extended periods. Tinnitus can affect one ear (unilateral) or both ears (bilateral).
Many patients report that their tinnitus is more noticeable during evening hours. This isn’t necessarily because the condition worsens at night, but rather because daytime environmental sounds mask the tinnitus. In the quiet of evening, when ambient noise decreases, the subjective ear sounds become more prominent and noticeable.
Common Causes of Tinnitus
The development of unusual sound perceptions in the ear can be attributed to numerous causes. While some underlying factors may be relatively benign, such as earwax buildup or stress exposure, it’s crucial to recognize that ringing or buzzing in the ears might indicate more serious conditions, either isolated to the ear itself or reflecting systemic health problems.
Systemic Health Conditions
Tinnitus often accompanies various systemic disorders, particularly those involving blood circulation disturbances. Some examples include:
- Blood pressure abnormalities: Both hypertension and hypotension can contribute to tinnitus development.
- Anemia: Deficiencies in iron, vitamin B12, or folic acid can all lead to anemia, which may manifest with tinnitus symptoms.
- Diabetes: Elevated blood glucose levels can damage the small blood vessels in the ear, resulting in both hearing impairment and tinnitus.
- Thyroid dysfunction: Particularly hyperthyroidism can trigger tinnitus symptoms.
- Atherosclerosis: Narrowing of the carotid or vertebral arteries can reduce oxygen supply to ear structures, causing tinnitus.
- Chronic stress: Prolonged stress response can manifest as tinnitus through various physiological mechanisms.
Certain medications can also induce tinnitus as a side effect. These include:
- Antidepressants
- Some antibiotics (particularly aminoglycosides)
- Diuretics
- Non-steroidal anti-inflammatory drugs (NSAIDs)
When all other potential causes have been excluded, a psychosomatic origin may be suspected. Conditions like anxiety disorders or depression can manifest with various somatic symptoms, including tinnitus.
Otolaryngological Causes
Several ear-specific conditions can result in tinnitus:
- Earwax impaction in the external auditory canal
- Exposure to loud noise (both acute and chronic)
- Middle ear inflammation
- Acoustic neuroma (a benign tumor on the auditory nerve)
- Ménière’s disease (characterized by hearing loss, tinnitus, and vertigo)
Neurological Factors
Tinnitus can also stem from neurological disorders, including:
- Multiple sclerosis
- Brain or auditory nerve trauma
- Vestibular concussion
- Degenerative changes in the cervical spine causing nerve compression
- Meningitis
- Neurological infections like Lyme disease or syphilis affecting the central nervous system
Diagnostic Approach to Tinnitus
A thorough diagnostic process for tinnitus should begin with an otolaryngologist consultation. This specialist can perform comprehensive otolaryngological and audiological examinations. If ear-specific causes are ruled out, the following blood tests should be conducted:
- Complete blood count with differential
- Iron and ferritin levels
- Vitamin B12 and folic acid levels
- Lipid profile
- Blood glucose
- TSH and thyroid hormone panel
- Electrolyte levels
If the cause remains unidentified after these initial tests, further diagnostic procedures may be recommended, including:
- X-ray of the cervical spine
- Ultrasound of the carotid arteries
- Magnetic resonance imaging (MRI)
- Computed tomography (CT)
Treatment Options for Tinnitus
Management of tinnitus is highly dependent on identifying and addressing the underlying cause. Treatment approaches aim to resolve the primary disorder:
Conventional Medical Approaches
- Anemia treatment: Normalization of iron or vitamin B12 levels, along with blood count parameters, through supplementation and dietary modifications.
- Atherosclerosis management: Maintaining appropriate cholesterol and homocysteine levels, potentially supplementing with Ginkgo biloba, which improves microcirculation.
- Hypertension control: Implementing lifestyle modifications to reduce blood pressure.
- Psychological interventions: When tinnitus has a psychogenic origin, appropriate psychotherapy is essential.
Advanced Therapeutic Methods
When the cause remains unknown or conventional treatments prove ineffective, alternative approaches can be considered:
Tinnitus Retraining Therapy (TRT)
This method involves providing continuous background sound to facilitate neural habituation. Habituation is a cognitive process where the brain stops responding to repetitive stimuli.
A good example of acoustic habituation is our response to a ticking clock. Initially, the constant ticking may be irritating, but with continued exposure, we eventually stop noticing it. TRT applies this principle by using a special behind-the-ear noise generator for several hours daily.
Key components of TRT include:
- Avoiding both complete silence and highly irritating sounds
- Participating in cognitive-behavioral therapy
- Committing to a treatment duration of 12-18 months
Transcutaneous Stimulation of the Auricular Branch of the Vagus Nerve
This technique involves placing electrodes in the ear that emit impulses transmitted through the auricular branch of the vagus nerve to the brainstem. This stimulation inhibits abnormal neuronal plasticity in the brain, reducing tinnitus perception.
Complementary Approaches
Several adjunctive methods may support tinnitus treatment:
- Hyperbaric oxygen therapy
- Relaxation techniques
- Laser biostimulation
Hirudotherapy: An Alternative Approach to Tinnitus Management
Hirudotherapy—the therapeutic application of medicinal leeches—has shown promising results in treating tinnitus. This method has been extensively studied, particularly in Russia and Far Eastern countries, where it remains a popular and sometimes the only available treatment option.
Medicinal leeches produce numerous compounds in their salivary glands, including enzymes and various proteins—not all of which have been fully documented yet. When a leech makes an incision in the host’s skin, it injects salivary secretions that prepare the blood for consumption. These compounds have several beneficial properties:
- Anticoagulant and blood-thinning effects: Facilitating blood flow
- Analgesic properties: Often making the leech bite imperceptible
- Calming effects: Particularly noticeable in animals treated with leeches … more information
Scientists have identified up to 300 different compounds in leech saliva. While the exact mechanism of tinnitus relief through hirudotherapy isn’t fully understood, patient feedback and professional literature suggest it is one of the most effective alternative methods currently available for addressing tinnitus, migraines, and chronic headaches.
According to research published in Academia.edu: “It was reported that leeches and their salivary secretion were successfully used for the treatment of tinnitus, acute and chronic otitis… Leeching has been applied in sudden hearing loss. In such cases, the therapist used just two leeches; one behind the ear and the other one over the jaw in front of the ear, and the treatment was repeated 2-4 times at intervals of 3-4 days. Despite the unexplained reasons of tinnitus, leeches were proven to be of great benefits in the treatment of this disorder.”
At Rehealth.me, we have helped many individuals overcome tinnitus using hirudotherapy. This painless method typically requires only two to four sessions, is non-toxic unlike many pharmacological interventions, and is very safe when properly administered. It’s important to note that amateur attempts at leech application often result in infection and unnecessary complications requiring antibiotic treatment.
Our protocol ensures safety through:
- Single-use leeches that are properly disposed of after treatment
- Disinfection procedures that minimize the presence of Aeromonas bacteria (which live symbiotically with leeches)
- Careful monitoring for adverse reactions, which are extremely rare and typically only occur in immunocompromised individuals
Conclusion
Tinnitus represents a complex condition with diverse causes and manifestations. A methodical diagnostic approach is essential to identify the underlying factors before appropriate treatment can be initiated. While conventional medical treatments address specific causes, alternative approaches like TRT and hirudotherapy offer promising options for those who haven’t found relief through traditional methods.
If you’re struggling with tinnitus, consider consulting with specialists who can provide a comprehensive evaluation and personalized treatment plan. Remember that effective management is possible, even for chronic cases.
We welcome your questions about leech therapy and encourage you to share information about this remarkable method with others who might benefit. For appointments and inquiries, please visit Rehealth.me.
Titsian Zavatzki
