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

Please, I do not want to see any comment from Dr. Nagler. Many people told me LLLT helps. I do have positive result for now. Clinical trials cost millions and Dr. Wilden does not have that money to do so.

I will only believe what Dr. Nagler says "IF he goes through the therapy (both clinical and home device) himself for a least one year and has absolutely has Zero result. ", the he is qualified to speak here. Otherwise, it is blank criticism. No wonder @HelmutK does not come to forum anymore. It is a shame.

 

Don't read 'em!

How did this turn from a discussion about LLLT into a discussion about me?

A proper LLLT trial can be done for considerably less than $100K, and the funds are available for the asking. All Wilden has to do is submit a grant proposal and insure that the study will be run independently.

My ears ring 24/7 - it's like a cross between a jet turbine and a screaming teakettle. I am more than qualified to speak here. I wish I weren't. I wish I'd never heard of the word tinnitus.

Dr. Stephen Nagler

 

The fact you have tinnitus does not make you more qualified to make the judgement. Saying it as a scam without seeing the fact that a lot of people are benefitting from it is purely wrong. I just spoke to one friend who is physiatrist about this. He told me the statement is just wrong. Do not want to argue with you. Will ignore your comments from now on.

 

I didn't say I was more qualified to have an opinion. I said I was just as qualified as the next guy.

Lots of people benefit from placebo. See, for instance, the article I am attaching below.

The article was written by a psychiatrist. Perhaps your friend should read it!

Good idea. I'll do the same!

All the best -

Dr. Stephen Nagler

 

A suggestion (@Markku or other staff). Is it perhaps worth creating two threads - one for a resumption of hostilities in the LLLT wars (perhaps call it something like 'LLLT efficacy debate') and another for support and information for those who are using the therapy? That way folks can choose which sort of discussion they want to view or take part in.

We all have the right to express our opinions, but as @CarrieLee indicates the strident statement of views in opposition to LLLT can create an atmosphere where those using it feel that they do not wish to post their experiences and their questions. There is just so much past antagonism around LLLT (on other forums as well as this one) that anyone who has done their research could easily feel intimidated about posting. On the Yuku board, for example, that antagonism includes a prominent member of this forum accusing a poster who defends LLLT of taking kickbacks. Against this background the repetitious argument about efficacy becomes repressive.

 

I don't share many thoughts with @Dr. Nagler but I have to agree with him with this one. There isn't much proof that LLLT works on T.

Although I believe that it might bring some subjective relief if hearing gets better around T frequency (T gets masked easier in normal sound environment etc. -> easier habituation). So if I had hearing loss around T frequency, I could give it a shot.

One of the main arguments here seems to be that why Dr. Wilden doesn't prove that LLLT works. Well, let's see, he keeps getting doubts from everywhere but still gets enough patients to live nicely and gets ppl cured/relieved? I think I would too take the money and treat the people who come to me and let the rest of the world rot. Can't really blame him for what he is doing. Not every man seek fame, glory and acceptance in form of nobel prizes or proving something to the rest of the world.

 

I don't believe you, Zech. From your postings it seems to me that you are precisely the kind of guy who'd want to make a real difference for as many people as possible. Not for fame and fortune - but simply because it's the right thing to do, the moral thing to do, the ethical thing to do

He's running a scam. He's using shadows and mirrors to play the misery and desperation of his fellow man (and woman). You'd never do that!

Dr. Stephen Nagler

 

Thanks. Dr. Nagler is your word "good" so-to-speak? Can I take that piece of information to eg. Dr. Wilden if I wanted to? I was his patient during the Summer of 2013, as you know, but I have not seen him since. I briefly corresponded with him during Spring of 2014 regarding his current clinic location, but other than that, I have had no contact with him since. I therefore do not know where he "stands" in relation to a clinical trial, but I am not going to bother him with information regarding funding if it afterwards turns out to be just a false lead.

The reason I ask is because, I believe you are no longer part of the ATA, and secondly based on Markku's post in the ATA petition thread...

...it did not exactly sound like the ATA cash register was overflowing with money. Therefore, I would be slightly surprised if I could simply write, say, Dr. Wilden an e-mail asking him to submit a proposal, and then it would all flow nicely from then on.


Regarding the LLLT study that I did a comparison of yesterday (but did not have the background details of), I have now managed to track down the group of "researchers" behind it:

http://www.hindawi.com/journals/isrn/2013/916370/

Below, a screenshot of the article (click on image to enlarge). You will notice that one of the study members is from GN Resound and given that they used laser therapy dosage rated at far less than 2,5% of Dr. Wilden's therapy, I have no choice but to restate what I did yesterday: there is ill intent behind their study. Yesterday, I was not so sure, as I didn't have the details. But now I am. It is a study designed-to-fail.



Although, I would be disappointed on behalf of tinnitus sufferers seeking relief, I have no problem as such seeing LLLT or Trobalt failing in demonstrating efficacy. But if a therapy is going to end up being "failed", at least it should be failed for the right reasons. The above study is no better than the trash being sold by T-gone.

Since I have now have access to the study, I will calculate the dosage differences (between Dr. Wilden's therapy and "the study").

The study

Total dosage RIGHT + LEFT left ear = 15+30+15+30+60+15+60 seconds = 225 seconds (per treatment).
Power output = 2 x 7,5 mW

Energy (J) = Power (W) x Time (s)
E = (15 mW) x (225 s)
E = (0,015 W) x (225 s)
E = 3.375 joules

With a total of three treatments it means that the patients received 3 x 3.375 = 10.1 joules in total.

Dr. Wilden's therapy

Treatment dosage, E = 4,000 joules x 10 = 40,000 joules

Analysis

The study: dosage received by patient = 10 joules
Dr. Wilden: dosage received by patient = 40,000 joules

Ratio comparison = 10 / 40,000 = 0.03%

Yesterday (due to lack of background details), I estimated the dosage ratio to be of the order of 1 to 2.5%. Turns out it was far worse: 0.03%...! And that is not even factoring in the detail that the study used two probes one of which is a green diode laser. Now green laser light does not penetrate body tissue - so essentially that laser was worthless.

The study is so useless that if it involved tax-payer money, I would suggest the "researchers" hand that back to where they got it from.

attheedgeofscience
07/JAN/2015.

 

Let me explain to you what the phrase "barriers to market entry" means. Regardless of whether LLLT works or not, audiologists and hearing aid manufacturers have no interest in selling it - LLLT, that is. The reason is money. I thought my post from yesterday highlighted it very clearly given the two articles I mentioned, but apparently not:

If you were running a business that ensured you got a certain markup each time you sold a pair of hearing aids, would you switch to some alternative (and receive less)?



The above is a comparison of the cost the consumer pays as a result of the market mechanism at play due to the scheme in place between audiologists and hearing aids producers (as highlighted in the quote).

@Dr. Nagler calls Dr. Wilden's therapy a scam. That may or may not be true. But, one thing is for sure, and that is that in the case of hearing aids - you - the consumer pays a hefty non-transparent price:

Now, if you are so pleased with your hearing aids, that's totally fine with me. But just know that you probably paid somewhat more than you had to, and that you could have gotten the same benefit from LLLT. I have generously provided information on my experience with LLLT along with my audiograms (as have several others on this board). I realize you are (still) skeptical even after seeing concrete evidence, but that is of course your very own decision. Personally, however, I will take my improved hearing over hearing aids any day.

attheedgeofscience
07/JAN/2015.

 

If you want to tell Dr. Wilden what every tinnitus clinician and researcher already knows, go right ahead.

ATA, NIDCD, and similar research funding entities all have well-established mechanisms for identifying worthy projects. If you want to do a study and get funding for it, you submit a grant proposal. This is not rocket science, nor is it some sort of secretive clandestine process. It is how science is done and how progress is made. Several times a year committees comprised of internationally regarded clinicians and researchers meet to review the grant proposals with one of three outcomes: (1) a project is approved for funding, (2) a project is rejected for funding, or (3) concrete suggestions are offered for improving the quality of a promising proposal (e.g., methodology) so that it can hopefully be approved in the near future.

On the other hand, if you are asking whether or not I personally would be willing to go to bat for Wilden in this process, the answer is a resounding HELL NO.

Dr. Stephen Nagler

 

Just to be clear here. I have called Dr. Wilden's tinnitus therapy a scam. And I have outlined the reasons I feel that way. I have not offered an opinion one way or the other about the purported effect of LLLT on hearing thresholds.

Please let's not cloud the issue. This has nothing to do with how audiologists make money selling hearing aids.

Dr. Stephen Nagler

 

So people know who is GN Resound
http://www.gnresound.com
It´s a hearing aids company no less.....

 

Hi @Dr. Nagler
I would like you to have a comment on the the just above study from a hearing aid company, concerning LLLT.

Do you consider it a SCAM? Or a valid study.
I would appreciate a simple answer.

More or less like: yes or no.

Apreciated

 

@dboy
I echo your opinion. I don't need to see another person crashing the forum like this when people try to seek support here. The staff of this forum may want to think of that. Thank you!

 

I cannot give a "yes or no" response because it's a loaded question.

"SCAM" is not the opposite of "valid study."

A scam is a purposeful misrepresentation of the facts for the purpose of taking advantage of the public.

Dr. Stephen Nagler

 

Excellent.

Thank you.

stephen nagler

 

But surely in arguing (as I think you have) that the light cannot reach the cochlea you have implicitly argued that it cannot affect hearing thresholds?

 

I'd like to share an email that I sent and response that I received from Dr. Wilden back in August of 2014. I didn't know about the grant proposal option that Dr. Nagler mentioned...otherwise I would have included it in my email. I truly hope that (attheedgeofscience) does contact Dr. Wilden with the proposal option and posts his response.
-Brian

Dear Dr. Wilden,
Your name came up on a forum that is discussing LLLLT, and I was wondering if you have ever considered running a double-blind, placebo-controlled, peer-reviewed trial? It would be really easy to run such a trial, and definitely not cost prohibitive. Additionally, something like that would definitively prove that your laser therapy works. I look forward to hearing back from you.
-Brian


Brian,
Thank you for your email. For this I recommend that you read on www.dasgesundeohr.de my new texts. The responsible institutions are not willing to work with LLLT. I am only a normal member of the medical community, telling what experiences I have. I was asking all German speaking ENT universities to make such a study like you mentioned. I did not receive any answers.
You are very welcome to make your own studies by using our home therapy by Dr. Wilden. Go for this at www.lux-spa-ibiza.com
Dr. Lutz Wilden

 

I believe that @attheedgeofscience has offered some rather compelling photographic evidence to the effect that LLLT light can, indeed, reach the cochlea. So it seems that my initial impression based upon some studies in the literature may have been wrong.

Dr. Stephen Nagler

 

Fair enough.

 

Is a valid study in your opinion?
Can you compare it with the a treatment done from dr Wilden?

If Dr Wilden would make a TRT double-blinded study, Would you consider it a valid study? Even if made according to the TRT standars studies ?

Fernando
TRT,LLLT and SC patient.

 

Bravo

 

RE: ATA's finances in general:

Not sure how many in this discussion are from the USA (seems like not many) but we have a service here for 501(c)(3) (nonprofit public charities) organizations where the Form 990, the financial disclosure form filed with the Internal Revenue Service on an annual basis for nonprofit organizations, is open for public inspection. I have uploaded ATA's most recent Form 990 here. Considering the total net assets at the end of the year is only $415,414, including a loss of $175,790 in the most recent fiscal year, it is totally fair to say that ATA's financial reach is somewhat limited.

I'm not posting this at all to contribute to the "are they good or bad" type of debate--just factually, it is unrealistic that they would be overly helpful given the limited amount of cash they have on-hand. They donated $150,000 in grants in the year--hardly enough to be funding multiple types of studies, good or bad. This is not to say that if some funder or some big movement to improve the standing of this organization could not change things--but realistically, the $$$ in pharmaceuticals, etc., dwarfs the amount an org like ATA could donate.

Again, this is not intended to stoke any debate--ATA is in the same position as thousands of other advocacy / support type nonprofits in the USA -- limited in funds and dwarfed financially by gigantic corporations. Like @attheedgeofscience I work in the finance industry, in particular with nonprofit orgs in the USA. So it's a passion of mine!

 

I don't need the patronization, I understand what it means just fine. I just happen to disagree with you. Again, there are 25+million people, or approximately 75% of people with hearing loss that do not wear hearing aids! The audiologists and hearing aid manufacturers do NOT have this stronghold on the market of people with hearing loss. If LLLT worked, the amount of sales and people it reached would jump exponentially compared to that measly $4.3MM global market size of hearing aid sales (is that number even right? It honestly seems too low and hardly "big business" on a global scale). There is so much more money to be made in this market where there is currently little to no competition. If an audiologist or ENT could offer a cure and allow them to tap into a small part of the 75% of people without hearing aids, no amount of kickbacks or the like by aid manufacturers would stop them.

Any startup company that can guarantee restored cochlea hair cells or improved hearing would have no problem overcoming any barriers created by hearing aid manufacturers. They would have no problem getting all the investment money they needed once they shared the results. It appears universally agreed that LLLT is useless for tinnitus, yet Dr. Wilden still treats people for it? If he is willing to scam those people out of their money, how can you trust anything by him?

Bottom line, the overarching problem is NOT hearing aid manufacturers creating market barriers, it is that when LLLT comes up, it is associated with the word "scam" by many people who have tried it.

I don't recall you having much hearing loss to being with, and I thought your improvement was only around 15dbs in some frequencies. Taking into consideration natural fluctuations, that wasn't much change. Did your LLLT treatment come before or after your stem cell treatments? How about someone who lost their hearing completely? Are there any people out there who used LLLT and saw a meaningful improvement in their speech recognition scores? If this actually did what you claim, it would go viral!

I know I paid an inflated price because so few people buy hearing aids. Demand is low, so device costs are high. Thankfully (I guess?) my hearing in one ear is so bad that hearing aids are useless for it so I only had to buy one.

-Mike

 

For a study to be valid, in my opinion, it needs to be both reliable and verifiable. I cannot just glance at a summary or abstract and make that sort of determination.

No, I can't.

I once read an article Wilden wrote about TRT - and he is obviously so totally clueless about the entire process that I wouldn't trust a TRT study of his as far as I could spit.

More importantly, this is an LLLT for tinnitus thread. It's not a hearing aid thread or a TRT thread. Perhaps we could stick to the subject at hand?

Dr. Stephen Nagler

 

And GN Resound are expertise in LLLT of corse.

 

I suspect not.

But what does any of that have to do with LLLT and tinnitus, which yet again I would like to remind you is the subject of this thread.

Dr. Stephen Nagler

 

Just to clarify possible implications of this, would it be fair to infer that you believe that improving the hearing of people with tinnitus will (or would) have no effect on their tinnitus?

This is a point which has huge implications for the future of tinnitus so would it be possible for you to give a little detail about why you believe this - if in fact it is fair to infer it logically from your separation of treating tinnitus and treating hearing thresholds?

 

The only "implication" I care about is whether or not LLLT does what its advocates claim it does for tinnitus. How it gets there is of no concern to me.

Dr. Stephen Nagler