Dear Readers,

Althea M, 72, writes LIFELINE from St Mary. She is suffering with "ringing in her ears". She says that she has experienced noise in her ears for some years now which just won't go away although she has visited several doctors with this problem. She is now giving LIFELINE a chance to see what we have to say about this condition which is an everlasting "bother" to her.

Ringing in the ears or "tinnitus" is the perception of hearing sound in the absence of any external hearing stimulus. Usually the sound heard originates in the person's head or even in the ear itself, and no one else can hear it although occasionally an external observer is able to also identify the noise, in which case the noise is usually generated from within the body and is usually from a vascular or neurological source.

running water

This is 'objective' tinnitus and is unusual. 'Subjective' tinnitus, noise heard only by the person with the complaint, is by far the more common occurrence. The noises can involve one ear but more commonly occur in both ears. It may or may not interfere with the ability to hear normally, but, in any case it is usually very, very annoying!

These noises are often described as "tinkling, ringing, buzzing, roaring, chirping, hissing, sawing, or like running water or an engine running".

Tinnitus can be characterised as 'pulsatile or non-pulsatile'. Pulsatile tinnitus is usually suggestive of a vascular cause as it beats like the blood moving through blood vessels. Non-pulsatile tinnitus would suggest a disorder in the hearing mechanism itself.

The presence of tinnitus in one ear only can be reason for greater caution as this can indicate more serious causes such as an underlying structural condition or even a tumour of some form.

Commonly, it is also linked to the 'aging' process, which also involves some gradual loss of hearing. Other people can experience 'tinnitus' as a toxic reaction after the ingestion of SALICYLATES or foods containing salicylates.

These would include:

Aspirin ( the primary salicylate)

Foods containing salicylates such as

apples, cucumbers, grapes, tomatoes and several other foods.

Atropine

Ergot derivatives (used to treat migraine headaches or in treatment to stop female bleeding after fetal loss (miscarriage) ).

Quinine and its derivatives

Caffeine

Nicotine

Cigarette smokers and coffee addicts beware. Tinnitus (ringing in the ear) can also be a symptom of almost any ear disorder such as a labyrinthitis, or even a simple middle-ear infection, which can readily be treated by a doctor's visit.

low blood sugar

Tinnitus can also result from over-exposure to loud noise or from a build-up of ear wax! High blood pressure with its pounding arterial pulse can also cause tinnitus, as can people with chronically low blood sugar! Another rare cause of tinnitus occurs after a head injury from a fall or car accident.

The first step in treatment, therefore, would be to visit one's physician for a check-up, which would include a blood-pressure check, examination of the ears and a discussion of all medications being taken (including over-the-counter drugs).

Sometimes, just a decrease in the dosage of a drug (as recommended by the physician) can make a big difference! All aspirin-containing products should be discontinued even temporarily (drugs and food kinds). Coffee, green tea, black tea, chocolates and carbonated drinks should be avoided.

Use of antidepressant therapy has been found to help in the management of this problem, although it is possible that these drugs can also at times cause tinnitus. Note also that alcohol WORSENS tinnitus! Drugs such as stemetil and stugeron are sometimes prescribed with variable success and the ENT (otolaryngologist) surgeon can sometimes add local treatments with some success.

Anecdotally, use of Vitamins A and C high-dose supplementation for a limited time (eg one month) will help some individuals with this problem, as also does taking Vitamin B-complex supplements twice daily for a while. Ginkgo biloba supplementation may also help.

Write to: LIFELINE

PO Box 1731

KGN 8