Is TRT (Tinnitus Retraining Therapy) Useful for Desensitizing Reactive Tinnitus?

Michael Leigh sounds like a real name Why name yourself that?

I like to keep my anonymity. For this reason I do not use my real name or upload my picture anywhere on the Internet.

I thought Michael Leigh sounded nice rolling off the tongue. You would be quite surprised to know my real name which you'd never guess in a hundred years as it's very formal. Not even my family call me by it.

All the best
Michael
 
He probably uses that fake name for increased credibility. If his name was "tinnitus helper" it wouldn't sound so credible.

Anyone who shills for TRT I'm not going to take very seriously...

Other than that it seems like a weird thing to make a very real sounding name but it's fake. Maybe it's a nickname or something his friends maybe call him in real life. He said his name was very formal so I assume gen wouldn't use that here online anyways.

For what it's worth my real name sounds really eastern, and I wouldn't use that online either.
 
Ok I'll tell you two truths @Onsdag I drive a new Lexus GS300H disability didn't pay for that. I'm not bragging just letting you know a few facts. And I have my own house bought and fully paid for :)

Oh, and I have an expensive Audio system in a dedicated acoustically treated listening room.
A brand new Toyota, you have done well for yourself! Kidding, it's a very nice ride.
 
A brand new Toyota, you have done well for yourself! Kidding, it's a very nice ride.

My Lexus is beautiful to drive Tellis and thank you. I don't like to talk about material things but just wanted to make a point that I'm not on disability benefits. I'm here to help people because I know how debilitating tinnitus and hyperacusis can be. It seems though, even when you're trying to help people there are some which try their best to derail that which I find hard to understand.

Take care
Michael
 
Michael you seem to get a lot of stick about TRT, I've been reading a lot of posts about it.

I guess it wouldn't be so bad if it was 1980 but it's 2017 and still no treatment even if its the 'accepted treatment'. (Not that it even is a treatment)

What do you do work Michael or use to do?
 
What do you do work Michael or use to do?

TRT is recognised as one of the best treatments for tinnitus and hyperacusis and I thoroughly support it. However, for someone new to tinnitus I don't think that they should try this treatment or CBT for that matter, not until at least 6 months to a year has passed. I have already mentioned the reasons in my posts, which are on my "started threads".

Briefly, many people naturally habituate to tinnitus within the first 6 months sometimes a little longer. I would recommend counselling with a Hearing Therapist if someone is having problems coping with tinnitus in the early stages in additions to prescription medications like anti-depressants that are sometimes needed.

I am a carpenter and joiner but no longer work in this field for a living. With respect that's all I'm willing to say about my personal life and only want to talk about tinnitus.

Michael
 
Why should it matter to you @Marlino if I work in the TRT field as long as I'm helping people? I see nothing wrong in it. I have tinnitus like many others at this forum and have an understanding of the condition.

Michael
 
@Michael Leigh
I appreciate that you are honest about your financial benefit from TRT.
IMHO it was not really clear before. Taking in account the difficult situation of many people here, such interest should be clear out of fairness.

I don't envy anybody to make money with a good thing.
If TRT is a good thing I cannot decide. I can understand the critics here though.
 
If TRT is a good thing I cannot decide.

You are entitled to your opinion @Marlino and have expressed it well. However, and with respect, you stepped over the boundary with your innuendo. I try to be honest and will defend my veracity vigorously, should anyone attempt to bring it into question.

I wish you well
Michael
 
I want people to understand that I make no financial benefit from TRT or anything to do with Tinnitus.
Michael
Did I misunderstand you before?
If I did so, please excuse me. I'm not a native speaker.

Concerning pros and cons of TRT: I don't want to argue about that. It's all said so many times before and everybody can decide by himself.

I know we fight the same war!

All the bests and calm days Michael.
 
. It seems though, even when you're trying to help people there are some which try their best to derail that which I find hard to understand.

@Michael Leigh - You are sincere, have the best of intentions always and I am sure your knowledge, wisdom, sensitivity and advice are very much appreciated. Unfortunately, there are several malcontents, immature and malicious members amongst us.
 
Hello @G61 - I've had tinnitus for nearly 5 years and H for almost 2 years. My H was the kind that whistled and whined along to many sounds.

I have worn NHS UK pink noise generators for a year and the H has mostly gone. I received a very basic form of TRT from my hearing therapist, with virtually no counselling. My hearing is not the same in each ear and so it took a while to get the pink noise sound balance right. You worry that you may not be able to tolerate the pink noise sound, but it is very low - quieter than the tinnitus. My H took quite a while to lessen.

After a few months I would get the odd day, and then a week, and currently 4 weeks H-free. It is a huge relief and I feel much better. The T is still there but I have mostly habituated to that. I cannot be sure that the maskers have helped my recovery but I still wear them most of the time. I run a small fan, which has a similar sound at night time for a while before I fall asleep. I was very lucky because my TRT was free of charge.

The pink noise is delivered by Siemens hearing aids with the hearing aid function disabled. It may be possible to get a free trial period of hearing aids with noise generators so that you can get a sense of what they will feel like.
Do you know the exact model of your siemens maskers? Did it irritated your Tinnitus at the beginning? I mean did it make your Tinnitus louder when you were using it let's say in first several days, weeks or not? Have you worn it for whole days from the start or did you start with 1-2 hours and built tolerance gradually?
 
Is TRT still considered the best treatment for "Reactive Tinnitus"?

I now have it, and it is a living hell. i would give anything to have my normal nonreactive T sound back that I used to fuss so much about. This is 10x worse.
 
Hi @G61

TRT can help lower your perception of the tinnitus and desensitize your sensitivity to sound. Trying to do this yourself isn't possible and therefore, you need the help of a Hearing Therapist or Audiologist trained in TRT and the management of tinnitus. This requires counselling (talk therapy) and wearing 2 white noise generators. Treatment can take up to two years. I suggest you do some research and find someone reputable. I first advise that tests are carried out on your auditory system by ENT then later referral to Hearing Therapist or Audiologist.

Click on my Avatar and choose "started threads" there are many posts that I have written on TRT that you might find helpful. Read my two articles that are also in the list: Tinnitus, A Personal View, and Hyperacusis, As I see it.
https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

Reactive tinnitus is actually: Hyperacusis. There are different intensity levels and pain is not always felt. The term "Reactive Tinnitus" is made up and used a lot in tinnitus forums.

Michael
Michael, I'm curious about you defining reactive tinnitus as hyperacusis. Are you saying that once hyperacusis is cured, that the tinnitus will no longer be reactive? But then, what exactly does that mean? Clearly some noises (eg. 90 dB for an hour) could cause tinnitus to react... but I think you would call this something else.

Maybe would you mind detailing out a bit "reactive tinnitus, as you see it"? I do see the parallels with hyperacusis and how they could often be related. But you're saying they are *the same thing*, and I'd like to hear more about that, if that's really what you mean.

Thanks,
Matt
 
Michael, I'm curious about you defining reactive tinnitus as hyperacusis. Are you saying that once hyperacusis is cured, that the tinnitus will no longer be reactive? But then, what exactly does that mean?

@MattS

I have just seen your post and you ask an interesting question. I am going out but will be back later, when I shall give an answer to your question in more detail.

All the best
Michael
 
Is TRT still considered the best treatment for "Reactive Tinnitus"?

I now have it, and it is a living hell. i would give anything to have my normal nonreactive T sound back that I used to fuss so much about. This is 10x worse.
I think reactive tinnitus must be one of the worst types of tinnitus out there.
Mine is also reactive to sound and there is virtually no masking it, as the louder sounds just make it sharper and more piercing.

For example if I stand by the busy road, the traffic will drive it up to the point, where it is so sharp and penetrating, it feels like it is actually drilling or cutting into the brain.
 
The advice that I give in this post is just my opinion and leave it to the reader to decide for themselves, what they choose to believe.

HI @MattS

I have had tinnitus for many years and read a lot of books on tinnitus. Not once did I see the word Reactive Tinnitus in any of them. Although of late this may have now changed.

About eight years ago I started to see this word appear in tinnitus forums. Written by people mostly affected with acoustic trauma, describing the way their tinnitus felt when hearing or exposed to certain sounds. Around the same time I read an article online, written by an ENT doctor who said, there was no such thing as Reactive tinnitus. According to him it was terminology made in tinnitus forums. These people were actually experiencing hyperacusis, which like tinnitus varies in intensity and pain is not always felt but one can still have an oversensitive auditory system to sounds due loud noise exposure.

Based on my experience with noise induced tinnitus, corresponding and counselling people with it, I believe there is no such thing as Reactive Tinnitus. People that have developed tinnitus due to an acoustic trauma often experience some oversensitivity or some reaction to sound but I believe it is Hyperacusis. It can be treated and often significantly reduced or cured as in my case, by wearing white noise generators as part of TRT which also includes counselling.

My hyperacusis was so severe I had to ask people to please lower their voice when in conversation as my ears hurt so much. I have been hyperacusis free for 20 years. I never get spikes (touch wood) The only time it did occur, was in 2008 after a second noise trauma, resulting in my tinnitus increasing which took four years for me to habituate for the second time. Two of those years was having TRT. What surprised me and something I'm thankful for, the hyperacusis did not return.

I have explained in some of my posts that tinnitus can improve over time without any treatment. However, if a person also has hyperacusis or some oversensitivity to sound and this is not treated or improves by itself sensitivity to sound will usually become a long term problem. Unfortunately, if left untreated oversensitivity to sound can increase and additional medical and psychological problems can occur that I have touched on in my post: The complexities of tinnitus and hyperacusis, in the link below.

Some people try to treat or address their oversensitivity to sound by wearing earplugs to the point of overuse. This too will often make the condition worse, as a lowering of the loudness threshold of the auditory system occurs, making the ears more sensitive to sound and increasing stress and anxiety. This can become a very complex problem requiring a person to seek help with a Hearing Therapist or Audiologist that is trained in Tinnitus and hyperacusis treatment and management. Counselling is often required.

Some people believe tinnitus and hyperacusis are primarily physical problems but this is not the case. They are forgetting that tinnitus is intrinsically linked to our mental and emotional wellbeing and cannot be separated from it. Stress makes tinnitus worse and tinnitus makes stress worse. It can become a vicious cycle and this needs to be managed, otherwise a person could find themselves spiralling down into a vortex of misery and discontent. Although hyperacusis or oversensitivity to sound is physical occurrence and something which is felt, one mustn't forget the psychological impact this can have.

I often read posts where people have got themselves worked up into a frenzied state of alertness, at the mere notion of being subjected to a sudden burst of loud sound, or sense they are going to be in ear-shot of a police siren coming towards them at speed and the subsequent damage it will do to their auditory system. With great alacrity they reach for earplugs or earmuffs to protect themselves from the approaching noise. All this does more harm than good because it often instils negative thinking that I have mentioned in my post: Hyperacusis, As I see it. Making matters worse is going around armed with a decibel meter App on a mobile phone, instilling more negativity that one has a problem with intolerance to sound. If a person isn't careful this can cause long term psychological problems and will need to seek professional help with a Hearing Therapist or Audiologist to treat and cure the problem.

It is my belief, once hyperacusis is cured either by natural means which can include self help or professional treatment wearing white noise generators and having counselling, with a Hearing Therapist or Audiologist, trained in Tinnitus and hyperacusis management. Oversensitivity to sound will no longer be a problem as in my case. I do not get spikes in tinnitus and do not carry earplugs on my person. I do use hearing protection when using my petrol lawn mower and petrol grass strimmer.

I recently corresponded with a member in this forum that is having treatment for tinnitus and hyperacusis with an Audiologist. The treatment entails wearing one white noise generator and having counselling. This person told me their Audiologist informed them, that all the patients she has treated with hyperacusis it has been completely cured within 18 months.

All the best
Michael

https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/
https://www.tinnitustalk.com/threads/the-complexities-of-tinnitus-and-hyperacusis.25733/
 
The advice that I give in this post is just my opinion and leave it to the reader to decide for themselves, what they choose to believe.

HI @MattS

I have had tinnitus for many years and read a lot of books on tinnitus. Not once did I see the word Reactive Tinnitus in any of them. Although of late this may have now changed.

About eight years ago I started to see this word appear in tinnitus forums. Written by people mostly affected with acoustic trauma, describing the way their tinnitus felt when hearing or exposed to certain sounds. Around the same time I read an article online, written by an ENT doctor who said, there was no such thing as Reactive tinnitus. According to him it was terminology made in tinnitus forums. These people were actually experiencing hyperacusis, which like tinnitus varies in intensity and pain is not always felt but one can still have an oversensitive auditory system to sounds due loud noise exposure.

Based on my experience with noise induced tinnitus, corresponding and counselling people with it, I believe there is no such thing as Reactive Tinnitus. People that have developed tinnitus due to an acoustic trauma often experience some oversensitivity or some reaction to sound but I believe it is Hyperacusis. It can be treated and often significantly reduced or cured as in my case, by wearing white noise generators as part of TRT which also includes counselling.

My hyperacusis was so severe I had to ask people to please lower their voice when in conversation as my ears hurt so much. I have been hyperacusis free for 20 years. I never get spikes (touch wood) The only time it did occur, was in 2008 after a second noise trauma, resulting in my tinnitus increasing which took four years for me to habituate for the second time. Two of those years was having TRT. What surprised me and something I'm thankful for, the hyperacusis did not return.

I have explained in some of my posts that tinnitus can improve over time without any treatment. However, if a person also has hyperacusis or some oversensitivity to sound and this is not treated or improves by itself sensitivity to sound will usually become a long term problem. Unfortunately, if left untreated oversensitivity to sound can increase and additional medical and psychological problems can occur that I have touched on in my post: The complexities of tinnitus and hyperacusis, in the link below.

Some people try to treat or address their oversensitivity to sound by wearing earplugs to the point of overuse. This too will often make the condition worse, as a lowering of the loudness threshold of the auditory system occurs, making the ears more sensitive to sound and increasing stress and anxiety. This can become a very complex problem requiring a person to seek help with a Hearing Therapist or Audiologist that is trained in Tinnitus and hyperacusis treatment and management. Counselling is often required.

Some people believe tinnitus and hyperacusis are primarily physical problems but this is not the case. They are forgetting that tinnitus is intrinsically linked to our mental and emotional wellbeing and cannot be separated from it. Stress makes tinnitus worse and tinnitus makes stress worse. It can become a vicious cycle and this needs to be managed, otherwise a person could find themselves spiralling down into a vortex of misery and discontent. Although hyperacusis or oversensitivity to sound is physical occurrence and something which is felt, one mustn't forget the psychological impact this can have.

I often read posts where people have got themselves worked up into a frenzied state of alertness, at the mere notion of being subjected to a sudden burst of loud sound, or sense they are going to be in ear-shot of a police siren coming towards them at speed and the subsequent damage it will do to their auditory system. With great alacrity they reach for earplugs or earmuffs to protect themselves from the approaching noise. All this does more harm than good because it often instils negative thinking that I have mentioned in my post: Hyperacusis, As I see it. Making matters worse is going around armed with a decibel meter App on a mobile phone, instilling more negativity that one has a problem with intolerance to sound. If a person isn't careful this can cause long term psychological problems and will need to seek professional help with a Hearing Therapist or Audiologist to treat and cure the problem.

It is my belief, once hyperacusis is cured either by natural means which can include self help or professional treatment wearing white noise generators and having counselling, with a Hearing Therapist or Audiologist, trained in Tinnitus and hyperacusis management. Oversensitivity to sound will no longer be a problem as in my case. I do not get spikes in tinnitus and do not carry earplugs on my person. I do use hearing protection when using my petrol lawn mower and petrol grass strimmer.

I recently corresponded with a member in this forum that is having treatment for tinnitus and hyperacusis with an Audiologist. The treatment entails wearing one white noise generator and having counselling. This person told me their Audiologist informed them, that all the patients she has treated with hyperacusis it has been completely cured within 18 months.

All the best
Michael

https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/
https://www.tinnitustalk.com/threads/the-complexities-of-tinnitus-and-hyperacusis.25733/
Thanks for all your opinions on this Michael. I appreciate you taking the time. While I am not sure that I agree with some of what you've said, there are definitely several important points to think about, and it's helpful to hear your perspective.

That said, I still have some questions - including, actually, my first question. You provided a very useful background, but may not have entirely handled my more specific question. That's okay - not criticizing - but I'll try asking again, because I really am interested in your perspective, and would like to dig down into it a bit more if possible.

Some of it is probably that I didn't ask my initial question very clearly. I'll try again:

* I understand you and others don't believe that "reactive tinnitus" actually exists. I'm willing to accept this.

* You suggested that what it actually is is hyperacusis. This is very interesting to me.

* So if I'm interpreting you correctly, what you're suggesting is that the spikes we experience are actually because our auditory system remains overly sensitive, and that if we reduce the sensitivity, we will not only reduce the in-the-moment pain, but also the subsequent spike. Is that right? Without the hyperacusis, we would not experience any environmentally-mediated spikes? Up to what noise level, do you think?

* An alternative perspective could be that the reason we experience spikes is because our auditory system remains *injured*, and that the spikes aren't because of sensitivity, but rather continued injury. I'd be interested in hearing your thoughts on that, because injury versus sensitivity would need to be handled very differently. Are you saying you don't believe there is a physical injury at all? It's *all* just psychological sensitivity mumbo jumbo?

* On a separate note: Can I ask what your second node trauma was that worsened your tinnitus?

Thanks again for your time.

Also Michael, what are your thoughts on "winding-up" and "kindling"?
 
* So if I'm interpreting you correctly, what you're suggesting is that the spikes we experience are actually because our auditory system remains overly sensitive, and that if we reduce the sensitivity, we will not only reduce the in-the-moment pain, but also the subsequent spike. Is that right? Without the hyperacusis, we would not experience any environmentally-mediated spikes? Up to what noise level, do you think?

@MattS

Tinnitus and hyperacusis can be very complexed. No two people will experience them the same, although they will share similar characteristics of these conditions. A lot of people overlook or do not realize how these conditions affect a person's mental and emotional wellbeing. I have touched on this more than once in my post to you and mentioned it many times in this forum. I also explain it at length in numerous posts on my "Started Threads" and I advise you to read them. It for this reason tinnitus can be difficult to treat and if hyperacusis is present more so.

Most people that complain of Reactive Tinnitus (hyperacusis) have been exposed to an acoustic trauma. The auditory system or gateways within the hearing part of the brain have become hypersensitive to sound which can often cause pain but not always. Some people think irreparable damage has occurred and this over sensitivity to sound cannot be treated or be cured but often this is not the case. This is documented on various websites if you care to peruse them. As I mentioned, a member of this forum told me their Audiologist has said, every patient she has treated for hyperacusis has been cured within 18 months. Hyperacusis can improve by itself as I have mentioned in my post: Hyperacusis, As I see it. However, specialist treatment may be required wearing white noise generators and having counselling. This is not a quick fix and can take up to 2 years.

The spikes that people experience in my opinion, is caused by an overly active auditory system. Often such a person will have tinnitus and may have habituated over time. However, because the hyperacusis or oversensitivity to sound hasn't improved or been professionally treated under the care of a Hearing Therapist or Audiologist, this over sensitivity to sound remains and as time goes on, it can become worse and incorporate other psychological and medical problems that I have mentioned in my post: Complexities of Tinnitus and Hyperacusis.

The overuse of earplugs, earmuffs, using decibel meter apps to constantly monitor sound levels can instil negative thinking and stress. keeping away from normal everyday sounds. Reading negative posts about intolerance to sound on tinnitus forums and websites exacerbates the problem. It can become a very toxic situation and if one isn't careful this can lead to depression and the impending feeling of doom and gloom with the belief there is no hope of improvement. I have received private messages from people afraid to leave their home because of fear of sound. Those that do venture out are armed with earplugs and earmuffs just in case they get a sense of being exposed to a loud sound. All this negativity does no good at all.

* An alternative perspective could be that the reason we experience spikes is because our auditory system remains *injured*, and that the spikes aren't because of sensitivity, but rather continued injury. I'd be interested in hearing your thoughts on that, because injury versus sensitivity would need to be handled very differently. Are you saying you don't believe there is a physical injury at all? It's *all* just psychological sensitivity mumbo jumbo?

I believe the auditory system has been affected or if you like injured but it can be repaired sometimes specialist treatment is required as I have mentioned in my post. If the hyperacusis or oversensitivity to sound isn't treated spikes can become a frequent occurrence and the condition can become worse as I have indicated in my post: The complexities of tinnitus and hyperacusis.

So if I'm interpreting you correctly, what you're suggesting is that the spikes we experience are actually because our auditory system remains overly sensitive, and that if we reduce the sensitivity, we will not only reduce the in-the-moment pain, but also the subsequent spike. Is that right? Without the hyperacusis, we would not experience any environmentally-mediated spikes? Up to what noise level, do you think?

If the oversensitivity to sound is treated or improves by itself then it is my belief, a person will not experience spikes. However, if this oversensitivity lingers on over a year etc it can become worse causing stress, anxiety and affect a person's mental and emotional wellbeing. I cannot emphasis that enough. It for this reason specialist treatment may need to be sought and not allow oversensitivity to sound hyperacusis to linger.

* On a separate note: Can I ask what your second node trauma was that worsened your tinnitus?

Please click on the link below and read my post: My Experience with tinnitus. It explains what caused by second noise trauma. My treatment and habituation that took 4 years.

Also Michael, what are your thoughts on "winding-up" and "kindling"?

Unfortuantely I do not know what: "winding -up" and "kindling" refers to.

All the best
Michael

https://www.tinnitustalk.com/threads/my-experience-with-tinnitus.12076/
 
Thanks @Michael Leigh. It's sometime difficult to sift through the unrequested mantras re TRT and the need for professional help, but I do appreciate you taking the time to respond to my questions. I think I now have a better understanding of your thoughts re "reactive tinnitus".
 

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