Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
There’s no cure for tinnitus yet, but been found, effective and noninvasive management strategies are available. We covered more conventional approaches like hearing aids, behavioral therapies, and medications in the previous video. Might any alternative therapies help?
Some physical interventions, like acupuncture, may reduce the burden of tinnitus. But given the low quality of the evidence and inconsistency among the trials, results should be interpreted with caution. Of over 30 trials included in this meta-analysis, only two had no major red flags. Let’s take a closer look at one of them. In a prospective, randomized controlled study of acupuncture treatment, people were given either 10 acupuncture sessions or 10 sham acupuncture sessions over five weeks, and after these treatments, were monitored for three months. Over the five weeks of treatment, the acupuncture group had a 30-point decrease in THI Index score, while the sham group had none. Three months after the last treatment, THI scores crept up about 10 points, suggesting you might have to keep doing acupuncture therapy to continue seeing effects.
Yoga and meditation may also help, reducing THI scores, stress, and tinnitus severity. The authors of this systematic review go on to praise the effects of yoga on tinnitus. But wait. None of these were actually randomized, controlled trials, except the study without any yoga. The non-yoga study, comprised of five sessions of mindfulness meditation, successfully reduced tinnitus symptoms and severity over and above the group who had five relaxation-only sessions. Given mind-body therapies like meditation are relatively low cost and come with minimal risks, might be worth giving it a try.
Yoga didn’t make the cut, but what about good old physical activity? In a U.S. survey of about 3,800 people, those who met U.S. physical activity guidelines of at least 150 minutes per week were less likely to have tinnitus. But since this was cross-sectional, just a snapshot in time, we can’t get at cause and effect. For that, we need to put it to the test. In a randomized clinical trial of diet and physical activity, people with obesity were instructed to take 10,000 steps a day. Although they ended up averaging only 7,500 steps at the end of the 12-week trial, they had significantly lower tinnitus distress, including measures of severity and annoyance, along with higher quality of life scores. For every increase in 1,000 steps, quality of life scores increased by 1.5 points, and THI scores decreased by 0.75 points.
The trial also included two diet groups aiming to achieve 5 to 10% weight loss, one instructed to follow a diet and the other instructed to follow a diet, plus physical activity plan. While the diet alone and physical activity alone groups had similar improvements, the group who followed the diet plus did physical activity saw a greater boost in quality of life and reduced tinnitus severity measures. All three groups: diet plus physical activity, diet alone, and physical activity alone all lost weight, with those losing more than 5% of their body weight experiencing greater improvements in tinnitus frequency and severity.
Observational studies suggest that fruit and fiber may help prevent tinnitus, and caffeine is unlikely to increase risk. But what if you already have tinnitus? Does caffeine make it worse? In a randomized triple-blind placebo-controlled clinical trial, a 300mg dose of caffeine was put to the test and did not alter any of the acoustic measures or tinnitus-related discomfort. On the plus side, it did result in a mood boost about an hour after caffeine consumption, along with a reduction in feelings of tension, anxiety, depression, and hostility. A longer trial found something similar. The title says it all: “Caffeine abstinence: An ineffective and potentially distressing tinnitus therapy.” Roughly 85% of adults consume caffeine on a daily basis. Therefore, roughly 85% of people with tinnitus could benefit by freedom from useless, perhaps distressing advice to abstain from their usual tea, coffee, and other caffeinated products.
Are there some things tinnitus sufferers should abstain from – like dietary supplements? We’ll find out, next.
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