Low-Level Laser Therapy (LLLT) for Tinnitus — Efficacy Debate

Say you decided to drive after drinking two six-packs, and I told you not to. You might not like that suggestion, but it would definitely be support. Same thing
Not quite the same (since drink driving might kill or maim several people). But otherwise, an amusing response. ;)
 
Not quite the same (since drink driving might kill or maim several people). But otherwise, an amusing response.

Analogies are never quite the same. That's why they're called analogies and not photocopies. But I was definitely not trying to amuse. I was trying to point out that support has many faces - and as long as it is offered respectfully it should be welcomed. This thread is about experience and support. I used lasers in my surgical practice for years - so I believe I have the necessary experience with the concept, if not the specific technology used in LLLT. I also have tremendous experience in critical analysis of scientific studies. And as far as support goes, I am sure that there are many folks on TT who offer as much support as I do. But nobody offers more.

Having made my point on LLLT (and the importance of vacations!), I'll leave this thread for now. But not on the grounds of failure to share experience or offer support.

stephen nsgler
 
I was trying to point out that support has many faces - and as long as it is offered respectfully it should be welcomed.
Sure, I got that point and although my response could be read as a little dark I was genuinely applauding your lightness of touch in your post. It made me smile.
 
Precisely. Why should Wilden sacrifice 25 Euro in the interest consumer protection and confidence when they do not enter into the equation at all!

stephen nagler

6%20salty%20foods.jpg
 
I have another idea, too. Go to Oslo for five days, enjoy all that the city has to offer, take loads of pictures, but don't bother with LLLT at all. You'll have a terrific vacation, the outcome will be the same, and you'll have saved yourself enough money to spend a few days in Bergen as well. I'm just sayin' ...

I have another better idea, go to Atlanta, there is clinic there that say "Fortunately, in almost all cases – even the most severe – tinnitus can be overcome. It can be overcome today. There is no need to wait for the cure of tomorrow to find meaningful lasting relief today." For sure you will have a great time. So take a 15 days vacation on Atlanta, and 14 days without T. Acording to this clinic.
 
I have another better idea, go to Atlanta, there is clinic there that say "Fortunately, in almost all cases – even the most severe – tinnitus can be overcome. It can be overcome today. There is no need to wait for the cure of tomorrow to find meaningful lasting relief today." For sure you will have a great time. So take a 15 days vacation on Atlanta, and 14 days without T. Acording to this clinic.

If you want to discuss my clinic in Atlanta, then start a thread and ask. But please do not try to do it in an LLLT thread. I do not offer that technology.

stephen nagler
 
I think the advice from @FERNANDO GIL is also very good. As long as you can get consultation sessions along with the device itself, it is worth spending the money.

I have a serious question.

If the device does what it is purported to do, why do you need consultation sessions? I presume it comes with an instruction sheet.

stephen nagler
 
This is a LLLT support thread, not efface debate. Please go to another thread. Cancer patients do Chemo treatment or other disease do machine treatments, they always come with the doctor follow up. Not answering the troll again.
 
I have a serious question.

If the device does what it is purported to do, why do you need consultation sessions? I presume it comes with an instruction sheet.

stephen nagler
Common sense says that if device helps with inner ear health then depending on the results and progress doctor helps with adjusting parameters to help achieve the best results compared to one doing it itself.
 
If you want to discuss my clinic in Atlanta, then start a thread and ask. But please do not try to do it in an LLLT thread.
That seems quite bossy. @FERNANDO GIL's post could be seen as a witty way of suggesting that there might be a conflict of interest worthy of declaring in your, erm, "critical analysis of scientific studies" relating to LLLT. It would therefore be very relevant to this thread.

Definition from Wikipedia:
A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests (financial, emotional, or otherwise), one of which could possibly corrupt the motivation of the individual or organization... The presence of a conflict of interest is independent of the occurrence of impropriety.
 
Common sense says that if device helps with inner ear health then depending on the results and progress doctor helps with adjusting parameters to help achieve the best results compared to one doing it itself.

Fair enough.

Then why in the world would anybody who could afford to see Dr. Wilden settle for "do it yourself" LLLT?

stephen nagler
 
Definition from Wikipedia:
A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests (financial, emotional, or otherwise), one of which could possibly corrupt the motivation of the individual or organization... The presence of a conflict of interest is independent of the occurrence of impropriety.

I think LLLT as a tinnitus treatment is a scam. I have explained why I think so ad nauseum and will not give you the satisfaction of doing it again. I would think it is a scam if I were a garbage man. I would think it is a scam if I were a teacher. I would think it is a scam if I were a plumber. I would think it is a scam if I were a neurosurgeon. I would think it is a scam if I were unemployed. My rationale for thinking it is a scam is totally independent of what I do for a living. I happen to run a tinnitus clinic. And I think LLLT is a scam.

As far as conflict of interest goes, I have spelled out that conflict in detail so that anybody who wishes to can take it into consideration when assessing the validity of my position.

See:

https://www.tinnitustalk.com/threads/tinnitus-retraining-therapy-trt-financial-disclosure.6281/

Incidentally, I confess that I actually do happen to have a vested interest in this matter. My ears scream 24/7 and have done so for some 20 years. If I thought for one moment that there was a reasonable chance that LLLT would rid me of tinnitus, I would head to Dr. Wilden's clinic in a heartbeat. TRT or no TRT, given a legitimate shot for a true cure, I'd buy that plane ticket tomorrow. But hoping it is not a scam will not change the reality one bit.

stephen nagler
 
I think LLLT as a tinnitus treatment is a scam. I have explained why I think so ad nauseum and will not give you the satisfaction of doing it again.
Dr Nagler please believe me when I say that I get no satisfaction at all from seeing you repeat yourself.

I will confess to being intrigued about why you are so bothered about LLLT in particular when there are a great many treatments discussed on TT (and seemingly ignored by yourself) that also do not have independent peer reviewed double blinded placebo controlled trials to back them up. Many of these are not even in the 'Alternative Treatments and Research' section (which is of course prefaced by the following warning plain for all to see: "Treatments and research that does not fall within the realm of conventional medicine. Beware: what you see here is mostly unproven and scientifically questionable.")

Could I ask (as I genuinely do not know) whether 'gold standard' clinical trials have proved the effectiveness of all the treatments (TRT, Neuromonics, TAT, PTM) that are referred to on your site as ones that you can provide or supplement the counselling for? Thanks.
 
Could I ask (as I genuinely do not know) whether 'gold standard' clinical trials have proved the effectiveness of all the treatments (TRT, Neuromonics, TAT, PTM) that are referred to on your site as ones that you can provide or supplement the counselling for?
The topic of the success rate of TRT was perfectly covered by @Steve in this post:

https://www.tinnitustalk.com/threads/why-trt-fails-people.6389/page-3#post-69632

As for Neuromonics, there are plenty of anecdotal reviews by members of this board which highlights a poor success rate for a "treatment" that comes with a price tag of as much as $5,000,-

As a general reminder (to everyone), the purpose of this thread is to discuss the efficacy of LLLT.
 
Dr Nagler please believe me when I say that I get no satisfaction at all from seeing you repeat yourself.

Great. I'll try not to repeat myself then.

Could I ask (as I genuinely do not know) whether 'gold standard' clinical trials have proved the effectiveness of all the treatments (TRT, Neuromonics, TAT, PTM) that are referred to on your site as ones that you can provide or supplement the counselling for?

I have answered that question before on a number of occasions.

stephen nagler
 
I believe that TRT is not a solution can do only worsening in case of reactive T like me.
Is a total scam and my opinion can not be change for TRT.
But i believe for LLLT that is much worse scam than TRT.
My opinion for LLLT can change i have not tried yet so iam sceptical.
My doubt is about hearing damage in high frequencies ... have anyone tried LLLT/100mw
and do hearing test before and laser stimulation ? Is the hearing the same in high frequencies (>14khz)
Iam saying that because sometimes deafening in high frequencies with ototoxic drugs lowered preexisting T.
I worry if laser do the same thing.Exists a trial/paper with LLLT and hearing thresholds with high frequency audiograms monitoring before and after LLLT?
 
I have answered that question before on a number of occasions.
Unfortunately I do not have the heart to go through lengthy threads on those treatments. So until I discover otherwise it seems fair to assume that the answer is either "no" or perhaps "no but special extenuating circumstances should be allowed for treatments that I favour or offer for sale". Please feel free to correct me.

The point of my question was that I was curious about whether a double standard was applied in your rationale for rejecting LLLT for tinnitus. Based provisionally on the above my personal conclusion would have to be that it was.
 
Unfortunately I do not have the heart to go through lengthy threads on those treatments. So until I discover otherwise it seems fair to assume that the answer is either "no" or perhaps "no but special extenuating circumstances should be allowed for treatments that I favour or offer for sale". Please feel free to correct me.

You'd be totally wrong on that account, but you should be quite used to that by now.

The point of my question was that I was curious about whether a double standard was applied in your rationale for rejecting LLLT for tinnitus. Based provisionally on the above my personal conclusion would have to be that it was.

I am repulsed by double standards.

And I am sick and tired of taking flak on this board for having the unmitigated gall to have an opinion that differs from that of the Holy Lords of LLLT. So go ahead and believe what you want to believe.

stephen nagler
 
I am sick and tired of taking flak on this board for having the unmitigated gall to have an opinion that differs from that of the Holy Lords of LLLT. So go ahead and believe what you want to believe.
I don't think anybody has a problem with your opinion. You're getting flak because nobody will let you have the last word and many aren't taking your opinion as "the truth" and stopping their LLLT path.

Honestly I think your time on this board would be more valuable if it was spent teaching people more about treatments or behaviors that _do_ work rather than wasting so much of it here on the ones most agree don't. You're an expert on TRT and yet you spend more time talking about LLLT!

-Mike
 
I don't think anybody has a problem with your opinion. You're getting flak because nobody will let you have the last word and many aren't taking your opinion as "the truth" and stopping their LLLT path.

There are so many posts here about LLLT with which I disagree but do not comment. Talk about having the last word; most of the time I don't care to have any word at all! And I am not stopping anybody in their LLLT path. All I want to do is give folks something to think about "on the other side of the coin" as they make important decisions about their healthcare. The decisions themselves are personal ones.

Honestly I think your time on this board would be more valuable if it was spent teaching people more about treatments or behaviors that _do_ work rather than wasting so much of it here on the ones most agree don't. You're an expert on TRT and yet you spend more time talking about LLLT!

I just checked, and it turns out that 94% of my posts on this board to date are not even remotely related to LLLT. So it turns out that I don't spend much time talking about LLLT at all. Why would I? It doesn't work. I much prefer to talk about stuff that does!

stephen nagler
 
And I am sick and tired of taking flak on this board for having the unmitigated gall to have an opinion that differs from that of the Holy Lords of LLLT. So go ahead and believe what you want to believe.
My apologies, I was under the mistaken impression that this thread was called "LLLT - Efficacy Debate". It seems I wandered into the "Incontestable Opinions of Dr Nagler" thread by mistake.

I am repulsed by double standards
Look, this thread titled "LLLT for Tinnitus - Efficacy Debate." Last time I looked, debates have two sides... [W]hat you should not do is read through the posts in a debate thread and expect to feel warm and fuzzy about everything you see there.
 
My apologies, I was under the mistaken impression that this thread was called "LLLT - Efficacy Debate".

It is a debate, and I have said all I want to say on this particular subject for now. I have had enough. Surely that's OK, isn't it? If you would like to consider yourself the winner in this debate, then by all means do so.

It seems I wandered into the "Incontestable Opinions of Dr Nagler" thread by mistake.

My opinions are my opinions. You can take them or leave them. You can contest them until the cows come home. Knock yourself out over it, if you like.

I find it curious that my opinions are of such great importance to you, when your opinions are of such little importance to me to me. Why this fascination with what I have to say?

stephen nagler
 
I find it curious that my opinions are of such great importance to you, when your opinions are of such little importance to me to me. Why this fascination with what I have to say?
I think this is due to the fact that you have experience in medicine and people usually put more trust into people like you compared to just other individuals with so called "anecdotal evidence". But as you can see some of us still want to try things. It could be a good or a bad thing.
 
I think this [the weight given to my opinions] is due to the fact that you have experience in medicine and people usually put more trust into people like you compared to just other individuals with so called "anecdotal evidence".

If I read you correctly, what I think you are saying is (1) the fact that I have been a physician for more than forty years, (2) the fact that I have first-hand knowledge of what it is like to truly suffer from severe intrusive tinnitus, (3) the fact that I myself have overcome severe intrusive tinnitus, (4) the fact that I am familiar with a wide variety of tinnitus treatment modalities, (5) the fact that I am a tinnitus clinician and have helped hundreds upon hundreds overcome their severe intrusive tinnitus, (6) the fact that I am a teacher of and resource person for other tinnitus clinicians throughout the world, (7) the fact that I know how to read grant proposals and scientific research with a critical eye towards what is there (and just as importantly what is not), and (8) the fact that I have been an invited guest speaker at tinnitus conferences through out the world ... suggest to some on this board that perhaps my opinions on various tinnitus-related issues might be worthy of serious consideration. If that's what you are saying, well it makes perfect sense to me that they would feel that way.

But as you can see some of us still want to try things.

I certainly understand that. I didn't realize that by pointing out that the LLLT coin has two sides that I was stopping anybody here from trying anything they like.

stephen nagler
 
I find it curious that my opinions are of such great importance to you, when your opinions are of such little importance to me to me. Why this fascination with what I have to say?

On the contrary, your opinions are not of great importance to me and I have no problem whatsoever with you having them. But I think what you are really asking me (neglecting the tone of the offended party) is why I have felt compelled to argue with you in this thread. That is a complicated question, but I'll take a shot at it since you asked.

First, I'm going to state my formal qualifications to offer an opinion since you apparently make much of such things. I started my university education in science subjects, so I know a little about how that works. But I then moved into humanistic psychology and psychotherapy, critical theory and philosophy. I am a doctor too in those worlds. I have taught on university courses and have been published in the field of ethics. In those areas of inquiry, intellectual rigour tends to be evidenced by how you argue. So while your field might involve looking at scientific studies, mine involves looking at how texts and arguments work and understanding what goes on behind them (assumptions, psychology, etc.).

So let me say that there are ways of conducting a discussion that respect the intelligence and the decency of the person or persons that you are discussing with. And, of course, there are other ways – ways that I have seen used repeatedly by yourself (and occasionally others) in debating against LLLT both on this forum and to an even greater extent on the Yuku forum. They involve bluff, bluster and belligerence. They involve subtly twisting the things that people say to turn those things against them and score points – without a care for how this makes them feel. They are ugly and callous: the arts of the political spin doctor rather than the seeker after truth. Having spent many hours reading through these threads when researching LLLT I began to become personally offended on behalf of the people who did not share your opinion, and who were treated as idiots. Just one relatively minor example: the ridiculous Nobel Prize argument that you now claim was 'tongue-in-cheek' but which was used repeatedly to obstruct meaningful discussion.

For a short while this lapsed. Some new contributors came along who had tried the treatment and experienced benefits. They shared their experiences and points of view in a generous fashion. They were not sycophantic to Dr Wilden since some doubts and some criticism of him was offered alongside the reports of benefits. The thread became more interesting and interest in the thread picked up… which inevitably meant that the battles had to begin again.

I suggested splitting this debate thread off from the support thread because of the fear that your voice would intimidate or drown out those who were reporting their experiences and that they would drift away. Ask yourself why a newish member to the forum (someone who came here to share and to help people) would write things like this:

Please, I do not want to see any comment from Dr. Nagler.
Not answering the troll again.

I never intended to get involved in the 'debate' at all. But I saw holes in what you were saying and I asked you a simple question. And it must have touched a nerve because you proceeded to throw your toys out of the pram in much the same fashion as you did yesterday.

So by then I was involved – and like you I find it hard to walk away. I tried my best to argue rationally and respectfully. Indeed, I made very real efforts to be friendly about it so as not to upset your ego again. I really don't want to spoil anyone's day. But you made no such efforts, so of course my frustration grew. Look at the effort and thought that ATEOS must have put into this post:

Dr. Nagler…
Now look at how you responded. You effectively told him that his time was worthless to you. How do you think that makes him feel? Imagine it again and again.

After a while all this gets too much. It gets under a person's skin. Yesterday I was weak and I was tempted to the dark side. I settled for scoring cheap points the way that you do instead of aiming for rational discussion. By then I saw that rational discussion was futile. I am not proud of what I did (slightly ashamed if I am honest) since I reduced myself in the process. But you know what? I showed you how it feels.

Here is the punchline: I don't even have a strong opinion about how well LLLT works. My best guess is that it helps a few folks quite a lot and most folks a bit or not at all. Much like TRT probably does. Only a guess. But there's one thing that I know for sure doesn't work – and that is how you argue. It proves nothing and it makes people feel like s***.

You do some great work in the doctor's corner and are an asset to the forum in many ways. This post took me some time to write. Please do not lose any sleep over it, but please do think about it rather than just giving me a trite come back and feeling pleased with yourself. I took this trouble because I've been an a**hole many times in my own life, and because I trust and I hope that (like I try to be) you are a man who has the capacity to care about others and to grow.

Dr. dboy.
 
You effectively told him that his time was worthless to you.
Thank you for your concern. But no, I actually do not feel offended at all by the limited response from @Dr. Nagler.

The lack of content...
We disagree.
...simply means I won the debate.

If ever there was one. A debate, that is...

attheedgeofscience
20/JAN/2015.
 
I won the debate.

I'm fine with that. My congratulations. Hat's off to you!

But that doesn't change the fact that LLLT for tinnitus is a scam. It's all shadows and mirrors. One dose of parlor magic and one dose of placebo.

Enjoy your debate trophy.

stephen nagler
 

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