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

[Dr. Nagler]

So simple logic applied to his statements suggests that either Dr Nagler is not genuinely frightened or he is not genuinely convinced that LLLT is ineffective.

Oh please.

I feel very strongly that LLLT is ineffective for tinnitus and moreover that it is a scam. I have thoroughly explained the basis for my arriving at that position. I cannot know for a fact that LLLT is ineffective; nobody can - because you cannot prove a negative. With your doctoral level training in humanistic psychology, psychotherapy, critical theory, and philosophy, you know that as well as anybody.

And on the remote chance that it LLLT is, indeed, effective for tinnitus, then the stuff in that thread is dangerous.

And that frightens me. What frightens me even more is that I am actually dignifying your post with a response.

stephen nagler

 

[attheedgeofscience]

But if you are right, then surely its efficacy - as well as its potential permanent damage - are dose-related. It is LLLT's dose-related potential permanent damage that make all the authoritatively written pronouncements from tinnitus sufferers about various doses they recommend on the LLLT "Experience" thread highly irresponsible and moreover frightening.

...Anymore "frightening" or "highly irresponsible" than a doctor who makes an incorrect statement based on assumption rather than fact (re: penetration depth of laser light)? As you yourself pointed out earlier on...

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.

...people on this board are more likely to listen to you because you have an M.D. title.

Something to think about.

 

[Dr. Nagler]

...people on this board are more likely to listen to you because you have an M.D. title.

Good point. I hope they do. So they will think twice about wasting their hard-earned dollars on parlor tricks.

stephen nagler

 

[dboy]

I feel very strongly that LLLT is ineffective for tinnitus and moreover that it is a scam.

OK, so you are frightened about something that you feel very strongly is not true. I see.

I cannot know for a fact that LLLT is ineffective; nobody can - because you cannot prove a negative.

But you have frequently made absolute statements such as the following:

LLLT doesn't work for tinnitus.

Indeed, in a lengthy and very well considered post the basis for making this sort of absolute statement was challenged. Here is the short version; click the link for the longer:

I think it is perfectly fine and correct to say, "There is not sufficient evidence to convince me to spend money on LLLT for tinnitus." Or to say, "I think the people who are selling LLLT treaments are frauds". I think it is wrong and insensitive to others values to say, "LLLT absolutely does not do anything for T" unless you have verifiable proof.

To this very post you responded:

I made the statement that LLLT is ineffective in the treatment of tinnitus, and in considerable detail I explained the basis for my coming to that conclusion. I'll stand by that statement..."

Hmmm. OK. I guess you are changing your mind now that it suits to do so.

What frightens me even more is that I am actually dignifying your post with a response.

I know the feeling. Please do not feel that you have to 'dignify' this post. I just wish to point out the contradictory nature of your statements for the benefit of other readers of the thread.

 

[Dr. Nagler]

Tinnitus is difficult. Support is difficult. You guys are treating this like some kind of contest. Well it's no contest to me. It's no game to me. I've said what I want to say. The fact that some folks might consider my posts to have a bit more credibility than the next person's apparently really galls you, but it is nothing I feel I need to apologize for. The fact that when I am wrong I have no problem standing up and acknowledging it is something else I feel I have no need to apologize for.

And as far as your need to "debate" goes, I feel no such compulsion. You win. I give up. Congratulations! You get the trophies. And if you like, I'll be happy to tell you where to put them.

stephen nagler

 

[dboy]

Dr Nagler it is not about trophies.

You clearly get a big psychological kick out of your status as a doctor. I don't begrudge you that as you must have worked very hard for it. But with status comes responsibility - in this case for what you say and how you say it.

And like I say to my son, "You play nice and the other kids will like you." Not always true, but it has value.

 

[Dr. Nagler]

And like I say to my son, "You play nice and the other kids will like you."

Do you have a question about tinnitus?

stephen nagler

 

[dboy]

Why would you think I am here to ask you a question?

You seem to believe that your being called 'doctor' means that the only possible way we can relate to each other is with you as the expert and me (or everyone else here) as the uninformed idiot coming to request your boundless wisdom. Do not try to position me as such. I reject that wholeheartedly. I need to respect somebody that I consult in that capacity, and I only respect people who show respect to me and to others.

 

[Dr. Nagler]

You clearly get a big psychological kick out of your status as a doctor.

I've been a doctor for forty years. The "psychological kick" wore off long ago. I do, however, derive a great deal of satisfaction out of making a real difference in people's lives. I suspect that feeling will never wear off. At least I hope it won't. It is why I became a doctor in the first place.

Why would you think I am here to ask you a question?

I don't. But before I put you on "Ignore," I just wanted to be sure.

stephen nagler

 

[dboy]

But before I put you on "Ignore," I just wanted to be sure.

Good night Dr Nagler.

 

[bwspot]

@Dr. Nagler
I see only one solution to this.
Would you ever consider to try lllt yourself? Test your hearing, do some lllt, test your hearing again. Check results. If hearing is better give the lllt a second though.
I know you will say why waste money on something you call a scam but what if. What if this scam can do something beneficial? Would not you feel better then about lllt? Of course this is just my crazy idea.

I do like the debate as it brings many important points so why end it.
Stay with us and fight.

 

[Dr. Nagler]

@Dr. Nagler
I see only one solution to this.
Would you ever consider to try lllt yourself? Test your hearing, do some lllt, test your hearing again. Check results. If hearing is better give the lllt a second though.

In post #414 I explained to you what anecdotal evidence is and how it has no predictive value. In post #415 you said you understood. And now you say that the only solution is to come up with one more piece of anecdotal evidence?

No, Kimosabe, that is not the only solution. In fact it is no solution at all. The solution is very simple. All that is necessary is for Dr. Wilden or whomever to submit a grant proposal for a double-blind randomized prospective LLLT tinnitus study that would be both reliable and verifiable and of a quality that would be publishable in a juried scientific journal, do the friggin' study, and publish the results. But after more than two decades they still won't do it. Such studies are done every day in various disciplines all over the world to demonstrate efficacy. But the LLLT crowd wants no part of it. Why? Because the outcome of such a study would almost certainly put a halt to their boondoggle. After all, they couldn't really object to the doses and schedule used in the treatment arm of the study if they themselves got to dictate those parameters, now could they? Of course they couldn't. And they know it. That's why. They'll give you all sorts of excuses, but the truth is that they do not have enough confidence in their own treatment protocol to put it to the test.

I do like the debate as it brings many important points so why end it. Stay with us and fight.

No. I like to fight for you, not against you. And besides, everything I have to say on this subject, I've already said.

stephen nagler

 

[attheedgeofscience]

And besides, everything I have to say on this subject, I've already said.

I'd agree with that Dr. Nagler (x 10). Here is the tally of all the top posters within this thread (click on image to enlarge)...

...as you can see, you have posted more than 3 times more posts than the next highest ranking poster below yourself (@dboy). And of the total 431 posts in this 15-page thread, 137 of them are yours. That means 32% of the total number of posts within this thread are one of your own. That corresponds to every third post in this entire thread having been written by yourself. I mean... I thought I was "busy" in this thread - and still, I can only manage a total 35 posts - that's one hundred less than yourself.

A bit of an eye opener. To myself, at least...

 

[bwspot]

In post #414 I explained to you what anecdotal evidence is and how it has no predictive value. In post #415 you said you understood. And now you say that the only solution is to come up with one more piece of anecdotal evidence?

Yes I do get it, but because your point of view differs from others which I respect I though what if you would try it yourself. Maybe with your laser experience and being md it would be much easier for you to get access to laser devices? Just a though. Did you ever though about trying something like that at the beginning of your tinnitus?
My reaction to T seemed to be pretty good and I live with it, i sleep and I do stuff I used to do, but I like the research part hoping someday something will show up that will change everything. I see light in lllt as according to anecdotal evidence I have seen improvements in audiograms. I might be foolish, but for me there is some value in these posts and I dont think that people post hear to scam.

They'll give you all sorts of excuses, but the truth is that they do not have enough confidence in their own treatment protocol to put it to the test.

What is the value of these studies? Are these even a studies?
http://www.healinglightseminars.com...y/ear-hearing-loss-tinnitus-menieres-disease/

No. I like to fight for you, not against you.

Good to have somebody who does that.

 

[Dr. Nagler]

A bit of an eye opener. To myself, at least...

It's good to have open eyes. You should try it more often instead of continually forging ahead in total blindness. Where LLLT for tinnitus and especially Wilden are concerned, you are no longer at the edge of science; you have totally fallen off the cliff.

stephen nagler

 

[Dr. Nagler]

Did you ever [think] about trying something like [LLLT] at the beginning of your tinnitus?

Absolutely. I didn't know about LLLT back then - but if I did, I'm sure I'd have tried it. Misery and desperation make you do things like that. And the tinnitus charlatans of the world depend on it!

Stringplayer's Second Law:

"The degree to which a person will apply common sense and logic in search of relief from a malady is inversely proportional to the square of that person's misery and desperation."

stephen nagler

 

[dboy]

the next highest ranking poster below yourself (@dboy).

I gotta get another hobby besides pointing out Dr Nagler's own 'smoke and mirrors'.

 

[tomytl]

Absolutely. I didn't know about LLLT back then - but if I did, I'm sure I'd have tried it. Misery and desperation make you do things like that. And the tinnitus charlatans of the world depend on it!

Stringplayer's Second Law:

"The degree to which a person will apply common sense and logic in search of relief from a malady is inversely proportional to the square of that person's misery and desperation."

stephen nagler

LLLT is still an unprofen treatment for tinnitus & hearing loss.
I also tried it and I'm also openminded and hopeful to discover something which helps.

But resellers and promoters of LLLT can't show a relevant clinical study it says it's working.
Instead, they keep their work in a most diffuse light instead doing an industry standard double blind study.
The overpriced equipment looks more "get the most out of it" to me....
So it's like with many alternative treatments, it's para-scientific stuff, and not likely to be a
causal treatment.

And their stories about all the "evil pharma" is very ridiculouse..
I wish, that the promoters of LLLT would get seriouse and do a clinical trial.
But if it fails, they will lose their business, and that's the real problem behind.

Once I had a phone call with one of these LLLT Guru's .... It was a monologue and just firing against the
whole school medicine... so all others are wrong, and I'm the only one in the world, who is right!
Even some other people offering a similar LLLT are not good, just the Guru is the only one!
That's strange, isn't it?

Seriouse clinical trials are trials from Auris or Autifony or Genvec, they must fit some industry standards.

That's my opionion
Greets Tom

 

[attheedgeofscience]

For those interested in LLLT (and Dr. Wilden, specifically) here is a slightly dated video (it is from Dr. Wilden's original practice in Bad Füssing):



(It's all in German, unfortunately - and it would be rather lenghty to translate it all, but the video essentially starts off with an introduction stating that we humans are living in an ever increasing loud society where our ears never get a rest; the video then proceeds with an interview of Dr. Wilden and one of his patients; the patient is 72 years old; she developed hearing loss; Dr. Wilden goes on to explain that the inner ear is often in a "challenged" state because we misuse our ears in a modern noisy society).

The presenter also mentions a quote from Robert Koch, biologist and Nobel Prize winner:

"The day will come when man will have to fight noise as inexorably as cholera and the plague."

 

[mcgregor]

For those interested in LLLT (and Dr. Wilden, specifically) here is a slightly dated video (it is from Dr. Wilden's original practice in Bad Füssing):



(It's all in German, unfortunately - and it would be rather lenghty to translate it all, but the video essentially starts off with an introduction stating that we humans are living in an ever increasing loud society where our ears never get a rest; the video then proceeds with an interview of Dr. Wilden and one of his patients; the patient is 72 years old; she developed hearing loss; Dr. Wilden goes on to explain that the inner ear is often in a "challenged" state because we misuse our ears in a modern noisy society).

The presenter also mentions a quote from Robert Koch, biologist and Nobel Prize winner:

"The day will come when man will have to fight noise as inexorably as cholera and the plague."

Pity I can't understand German

 

[Dr. Nagler]

Your cells will be weaker when you start the LLLT, so for a wille you should avoid as much noise as possible. Remember that now they are a regenerating, so are weaker.

I do not wish to take this thread off course, but I would greatly appreciate just one clarification. Are you saying that LLLT causes human hair cells to regenerate?

stephen nagler

 

[Nick J.]

@FERNANDO GIL
Remember....DONT FEED THE TROLL!!!!!

Thx and have a good day all

 

[Dr. Nagler]

Remember....DONT FEED THE TROLL!!!!!

I am not a troll. I am an active member of the Tinnitus Talk community and had a question about something Fernando said in a post in this thread, a question that I asked simply and respectfully. If Fernando does not wish to answer, that is certainly his prerogative. But let's not engage in name-calling.

stephen nagler

 

[FERNANDO GIL]

I do not wish to take this thread off course, but I would greatly appreciate just one clarification. Are you saying that LLLT causes human hair cells to regenerate?

stephen nagler

YES. how do you explain that I gained hearing loss?

Dr Nagler do you what is funny about ENT´s ? Is when people gain some hearing, they say is very good, I heard this direct from several ENT´s, cause I gain 20 db in my 8 Mhz before doing LLLT . But if you say that exist a treatment that make the same, they say is not possible. So is possible to gain hearing natural, but is not possible to gain hearing if you use LLLT , that is a proved concept for cell regenaration in human and animals.

They see a audiogram where you gain 20 db or even more and they just can not explain how it did happen.It´s a miracle.

LLLT is not the cure for T, but it can reduce it and it can cure it, But LLLt as treatment is a more then proved concept any where in the world.

I did post all my audiograms, if for example in a couple of months time I have an audiogram where my hearing improved 30/35 db in the high frequencies and stop having T , as it did happen to me two days ago during a few hours, Would you accept that LLLT can in fact make humam gain hearing?

Why ENT´s do accept that a human can gain hearing naturaly, and can not gain using a treatment that promotes the regeneration of human cells ? We born with 25 000cels in our ear,and we will dye with the same 25 000. But there is no biological explanation why ear cells do not regenerate when the other 5 billion can. That does not make sense. They are cells as any other in our body, they are specific cells and but they are cells. And if T is a symptom why during in all evolution process , the human body "promotes" a symptom if then you can´t cure the cause of that same symptom.

Note that i say REGENERATE not GENERATE.

Any way, just to say last Saturday I had NO T for a few hours. My T is decreasing and the only way to reduce T is by gaining hearing loss, and that is happening cause my ear cells are REGENERATING. Maybe is hard for you to ear that, but yes it does happen.

I did post an audigram of a Portuguese lady that did start making LLLT here in Portugal with my old laser. After 5 year with T she never gained hearing, one month doing LLLT and she gained 25 / 30 db in some frequencies. How can you explain that? And her T decreased.

Fernando

 

[dboy]

To the best of my meagre knowledge Dr Wilden does not claim that inner ear hair cells that have died can be regenerated. Indeed, I believe he says that they cannot. He does claim that hair cells can become damaged or 'exhausted' and that LLLT can restore these to better functioning. I cannot personally comment on the plausibility of this claim as I do not have the necessary knowledge.

There is information freely available on his website in case anybody who does have the necessary knowledge wishes to give an educated/scientific critique for our benefit. Perhaps the efficacy thread would be a more appropriate place to do it though. It would be a refreshing change from the silly talk about red flashlights, etc.

http://www.dr-wilden.de/en_info/31.html#funct

I think I have read elsewhere that there is good evidence that LLLT is effective in regenerating nerve cells, but again I cannot endorse or comment on the relevance of such claims.

 

[Dr. Nagler]

I asked @FERNANDO GIL:

Are you saying that LLLT causes human hair cells to regenerate?

................

@FERNANDO GIL responded [in part]:

YES. how do you explain that I gained hearing loss?

................

Fernando, I do not know what you gained, how you gained it, or even if you gained it. All I wanted to know is whether or not I correctly understood you to claim that LLLT regenerates human hair cells. Thank you for your response.

stephen nagler

 

[FERNANDO GIL]

To the best of my meagre knowledge Dr Wilden does not claim that inner ear hair cells that have died can be regenerated. Indeed, I believe he says that they cannot. He does claim that hair cells can become damaged or 'exhausted' and that LLLT can restore these to better functioning.

Exactly. And if you talk to him, he even say " to a certain degree" . The point is if that degree is enouph to stop T or not.

or even if you gained i

The usual .... Dr Nagler. I wonder why I even respond it to you.

In the future i would appreciate you ignore me. You or @kilokalori .

 

[Dr. Nagler]

The usual .... Dr Nagler. I wonder why I even respond it to you.

@FERNANDO GIL, I meant no offense. There are so many unknowns here. We are all just trying to find our way through muddy waters.

I just find it incredibly hard to believe that LLLT can somehow do CPR on a hair cell and resurrect it from the dead. You feel otherwise.

As I said earlier, I do not wish to take this thread off course. Again, thank you for your response.

stephen nagler

 

[dboy]

Just to avoid any confusion, Dr Nagler asked whether @FERNANDO GIL believed that hair cells were regenerated. He did not specify dead hair cells. Fernando did not say that he believes dead hair cells can be regenerated (or 'resurrected'). As so often, Dr Nagler is twisting things to his own ends.

As I understand it, Dr Wilden claims that hearing loss is not all caused by hair cells dying. Some is hair cells being damaged in a way that can be repaired, and I think some is also claimed to be nerve damage that might also be reversible (cannot remember exactly where I read that particular point though so apologies). So the claim is that LLLT can repair some damage but not all if the hairs have actually died. This can be checked by looking at the webpage I linked earlier.

I am not personally claiming that LLLT works as I have had no noticeable benefit so far from home treatment. I just find myself compelled to point out what Dr Nagler is playing at as I find it disrespectful not just to those who have posted about experiencing a benefit, but also to readers of the thread more generally (it is trickery).

 

[Nick J.]

Just to avoid any confusion, Dr Nagler asked whether @FERNANDO GIL believed that hair cells were regenerated. He did not specify dead hair cells. Fernando did not say that he believes dead hair cells can be regenerated (or 'resurrected'). As so often, Dr Nagler is twisting things to his own ends.

As I understand it, Dr Wilden claims that hearing loss is not all caused by hair cells dying. Some is hair cells being damaged in a way that can be repaired, and I think some is also claimed to be nerve damage that might also be reversible (cannot remember exactly where I read that particular point though so apologies). So the claim is that LLLT can repair some damage but not all if the hairs have actually died. This can be checked by looking at the webpage I linked earlier.

I am not personally claiming that LLLT works as I have had no noticeable benefit so far from home treatment. I just find myself compelled to point out what Dr Nagler is playing at as I find it disrespectful not just to those who have posted about experiencing a benefit, but also to readers of the thread more generally (it is trickery).

I couldent agree with u more!
That is why it's to me totally pointless to discuss this issue with the guy, since he in my mind clearly has an agenda by his silly questions and therefore is a troll that should be ignored by all means!
Im not in here to waste my time on his twisting and turning of things.
If i wanted to waste my time in the same manner, i could just go see any local ENT and then bring up LLLT.
That would pretty much get me just as fare = (no where) or more like two steps back + even more confused + probably brainwashed into buying a hearingaid.