Tinnitus Retraining Therapy

[Frédéric]

Efficacy of tinnitus retraining therapy in the treatment of tinnitus: A meta-analysis and systematic review

 

[TinaRuns]

Some people have reported on this thread that the TRT White Noise Generators (sound) made their tinnitus worse.

My doctor just prescribed TRT for me (referral to another hospital).

What is your experience with whether the TRT White Noise Generators might possibly make tinnitus worse?

That already doesn't sound like a risk worth taking but I am so desperate, I'm not sure.

 

[AfroSnowman]

Some people have reported on this thread that the TRT White Noise Generators (sound) made their tinnitus worse.

My doctor just prescribed TRT for me (referral to another hospital).

What is your experience with whether the TRT White Noise Generators might possibly make tinnitus worse?

That already doesn't sound like a risk worth taking but I am so desperate, I'm not sure.

I'd give it a try. That being said, it didn't work for me, partially because occasionally it would make things worse, but any worsening is temporary, just reactive tinnitus.

Worst case, you ride out a couple of spikes for a few days and decide it isn't for you. Best case, in a few months you are feeling pretty habituated. You really don't have much to lose.

 

[Damocles]

Efficacy of tinnitus retraining therapy in the treatment of tinnitus: A meta-analysis and systematic review

Conclusions
Analysis of limited studies low-quality evidence with a high risk of bias showed that the TRT was an effective treatment for tinnitus, which could improve the response rate of tinnitus and reduce the THI scale. However, more multicenter RCTs with a large sample number and high quality should verify the conclusion mentioned above.

Hey guys, you can shut the forum down now; tinnitus isn't a thing anymore.

 

[Michael Leigh]

Some people have reported on this thread that the TRT White Noise Generators (sound) made their tinnitus worse.

My doctor just prescribed TRT for me (referral to another hospital).

What is your experience with whether the TRT White Noise Generators might possibly make tinnitus worse?

That already doesn't sound like a risk worth taking but I am so desperate, I'm not sure.

Hi @TinaRuns.

TRT will not make your tinnitus worse. I have had the treatment twice with good results. Providing white noise generators are used correctly there shouldn't be a problem.

Listening to the wrong advice from people that are ill-informed about TRT will prevent you from having any success with it. Some people that claim to have had TRT have not. Proper TRT requires regular counselling with an audiologist or hearing therapist for up to 2 years. The patient should also be wearing white noise generators for up to 10 hours a day and using a sound machine by the bedside, for sound enrichment throughout the night.

TRT cannot do all the work. You have to incorporate positive thinking into your life, by doing the things you like to do. If you start TRT, my advice is to keep away from social media platforms and not to discuss the treatment with anyone. Some people believe TRT is not helpful. By reading their posts or corresponding with them, can hinder or completely stop any progress that you are likely to make.

Please go to my started threads and read my posts on TRT.

All the best,
Michael

 

[IntotheBlue03]

I live in the EU and I saw the noiser costing here €150 EUR for one ear, so €300 EUR for both ears, so it doesn't look that bad. The health care is mostly free here in Europe. Not sure but I think insurance companies can cover it fully under certain circumstances. If it will be a question of few hundred bucks, then I will pay and go for it. But if it will costs thousands of dollars, then not (but if there was a cure with 100% efficacy, then surely I would get indebted for life to get it, sadly TRT isn't worth it).

However, I am so sad for you Americans that you have pay so much for everything... For example, here in the EU doctors send patients to CT, MRI etc very often and I can't imagine they would want patients to pay €1000 EUR for one MRI scan lol. It's completely free here. Everything, even the doctor visits. For example, I have been visiting a physiotherapist and didn't pay a single cent. And it didn't help me a single bit. So I know it must be super frustrating for you to pay for things that may not even help.

I don't know about TRT though. The opinion that it is expensive is mainly because it is US-based therapy and there aren't many doctors who provide TRT in Europe. So I am not sure how much it costs here. It really depends whether the insurance companies consider it a valid therapy. They don't pay for snake oil.

Well, I read your comments again and I understood that it cannot cause tinnitus but it can permanently exacerbate already existing tinnitus. However, I think that majority of people, if they were in soundproof room, would hear some tinnitus. So basically my paraphrase is not much different.

THIS! I've spent thousands of dollars now while in a crisis state on absolutely worthless treatments as an American in a fucked up disjointed system. We sure do pay the most for the lousiest healthcare. I liken my situation to someone in the middle of a heart attack having to call around to find the best ambulance and life saving treatment before they die. I've spent an endless amount of time, money and energy chasing cold hearted doctors via phone calls and researching different treatments and tests that take weeks and months to complete just to end up nearly hospitalized from all the stress and lack of treatment. Best of all thanks to lack of Labor protections I've had to do all this while maintaining my full time job so I don't lose my shitty healthcare!

Being an American is an uphill suicide run once you get sick.

 

[ZFire]

THIS! I've spent thousands of dollars now while in a crisis state on absolutely worthless treatments as an American in a fucked up disjointed system. We sure do pay the most for the lousiest healthcare. I liken my situation to someone in the middle of a heart attack having to call around to find the best ambulance and life saving treatment before they die. I've spent an endless amount of time, money and energy chasing cold hearted doctors via phone calls and researching different treatments and tests that take weeks and months to complete just to end up nearly hospitalized from all the stress and lack of treatment. Best of all thanks to lack of Labor protections I've had to do all this while maintaining my full time job so I don't lose my shitty healthcare!

Being an American is an uphill suicide run once you get sick.

It's so difficult to find an in-network provider with my health insurance. I end up paying out of pocket most of the time. As for labor, most unions have been demolished which is one factor that explains our trash labor protections. That's why I didn't even bother with TRT.

@Juan, this is another reason why I keep saying I wish I was born in Norway. Love me some Nordic model where there is a commitment by the state to ensure the well-being of its citizens.

 

[mbsq]

TRT cannot do all the work. You have to incorporate positive thinking into your life, by doing the things you like to do. If you start TRT, my advice is to keep away from social media platforms and not to discuss the treatment with anyone. Some people believe TRT is not helpful. By reading their posts or corresponding with them, can hinder or completely stop any progress that you are likely to make.

It is disappointing that the effectiveness of a treatment depends on believing it will work. This suggests that the placebo effect plays a strong role.

 

[Michael Leigh]

It is disappointing that the effectiveness of a treatment depends on believing it will work. This suggests that the placebo effect plays a strong role.

If one is to achieve anything in life they have to believe in it and adopt a positive attitude, otherwise they will not succeed in their chosen venture. This starts the moment we learn to walk, talk, go to school, university and eventually to work and throughout the rest of our lives.

Getting to grips with tinnitus and treatments for it and moving on with our lives is very similar, because it's an integral part of our mental and emotional well-being and cannot be separated from it. Therefore, if one chooses to feel sorry for themselves and see nothing but doom and gloom for their future, that is what they will get.

I am not saying it is easy to have a positive attitude with tinnitus, for I have been there and faced many difficulties but I refused to sit back and do nothing and beat the drum of negativity.

Michael

 

[mbsq]

If one is to achieve anything in life they have to believe in it and adopt a positive attitude, otherwise they will not succeed in their chosen venture.

I'm sorry, but no. Positive attitude has nothing to do with whether the measles vaccine is effective. It just works, and it doesn't matter how you feel about it.

 

[Watasha]

It is disappointing that the effectiveness of a treatment depends on believing it will work. This suggests that the placebo effect plays a strong role.

I think it's important to call something out here. TRT is not a classical "treatment" like a pill or other medicine. It is a protocol to help facilitate habituation, a natural psychological process. Other treatments don't require positive thoughts because they do not involve psychological processes. This is why to Michael's point, a positive (or at least neutral) attitude is most helpful. If one harps on negative thoughts constantly, it's going to likely be more difficult for this natural process to take place.

I was fairly habituated for about 2.5 years. It took me about one year and I've recently had a setback. So this isn't coming from someone who goes about their day like everything is wonderful.

 

[Michael Leigh]

I'm sorry, but no. Positive attitude has nothing to do with whether the measles vaccine is effective. It just works, and it doesn't matter how you feel about it.

You are entitled to your opinion and I have nothing more to say on this matter.
Goodbye.

Michael

 

[IntotheBlue03]

It's so difficult to find an in-network provider with my health insurance. I end up paying out of pocket most of the time. As for labor, most unions have been demolished which is one factor that explains our trash labor protections. That's why I didn't even bother with TRT.

@Juan, this is another reason why I keep saying I wish I was born in Norway. Love me some Nordic model where there is a commitment by the state to ensure the well-being of its citizens.

Exactly. I hate to be political but it's all political. Before this happened I was very politically active for the BBB legislation (human infrastructure side) and universal healthcare because I had been through this nightmare before with severe chronic pain from spinal injuries for a decade. I managed to stay working but I was destroyed by both the lack of protections at work and our nightmare healthcare system. I drive right back to work after a $4000 epidural in my neck because I'm a contractor. That's insanity! Spent tens of thousands of dollars on that ordeal as well getting nowhere but feeding our greedy corrupt system. It now feels like PTSD to go through this all over again on a new "mental" level. I'm sure this feeds into the panic fight or fight state I've been in for 2 months now.

Happy that our European Allies are doing better and I've also never wanted to be one of them more in my life.

 

[Watasha]

I'm sorry, but no. Positive attitude has nothing to do with whether the measles vaccine is effective. It just works, and it doesn't matter how you feel about it.

That's because the measles vaccine doesn't rely on a psychological process to be effective.

 

[slc]

Some people have reported on this thread that the TRT White Noise Generators (sound) made their tinnitus worse.

My doctor just prescribed TRT for me (referral to another hospital).

What is your experience with whether the TRT White Noise Generators might possibly make tinnitus worse?

That already doesn't sound like a risk worth taking but I am so desperate, I'm not sure.

I use the TRT white noise devices and they do help me. Keep in mind that you can request that they preset the sound to white noise which really annoys me, pink noise, brown noise etc. Some may be better than others.

If you want to give this a try and save some money, keep in mind that the therapy consists of some basic counselling about tinnitus that is supposed to diffuse the high anxiety. The counseling is worthwhile if one is new to tinnitus and totally freaked but otherwise it's pretty basic stuff.

Another option is to get Bose SleepBuds and cut triangular holes with a very sharp scissors in the silicone bud part that fits into the ear so you can still hear ambient sound (or perhaps try the Bose Sport earbuds).

Both options are way cheaper than TRT. I have used the Bose SleepBuds as a back up to my TRT devices and they don't let in quite as much of the ambient exterior sound as the TRT devices do but if you want to try something similar to TRT white noise devices, they are a hell of a lot cheaper than paying $3000 for TRT.

The Bose Sport earbuds are much more similar to a TRT device and might be worth checking out before making a decision. They are designed so you can really hear the exterior ambient sound. I think you could use them to play ocean or river sounds or anything of your choice. The Bose SleepBuds are limited to prepackaged sound such as the ocean and running water.

SLEEPBUDS — You'll need to cut holes in the silicone to hear ambient everyday life around you but these buds don't require that you carry your phone around. You must use the phone to set them up and then you're good to go:

https://www.bose.com/en_us/products/wellness/noise_masking_sleepbuds/noise-masking-sleepbuds-ii.html

SPORT EARBUDS — These leave the ear canal open to exterior sound by design, but they require a Bluetooth hook up so you have to keep your phone on hand:

https://www.bose.com/en_us/products/headphones/earbuds/sport-open-earbuds.html

 

[Michael Leigh]

That's because the measles vaccine doesn't rely on a psychological process to be effective.

Exactly, @Watasha. I have already explained tinnitus is an integral part of our mental and emotional well-being and cannot be separated from it. If a person wants to habituate to tinnitus and move on with their life, they have to learn to adopt a positive mental attitude, whether they have TRT or not. For each person this process will be different because life is problematic and many factors are involved. My threads: How to Habituate to Tinnitus, The Habituation Process and others explains how to do this. It takes time but a lot can be achieved.

However, if a person convinces themselves they are unable to make any improvement, or unwilling to try then they won't.

Michael

 

[DaveFromChicago]

When I visited my ENT Doctor he mentioned that having had a lifetime of Migraines may have exhausted my brain
such that the potential for successful habituation would be far less than what it would be for others with no similar deleteriously influential conditions (another example is severe PTSD).

Coincidentally, our Chicago Tribune in their Health and Wellness Section had a report about Migraines that said very much the same thing; neural pathways may be worn out so that they cannot "carry" the full import of whatever one wishes to be disseminated.

I envy those who do not have such conditions that impair their chances for maximizing the potential for habituation.
The proponents of habituation should take such factors into consideration before they so blithely chastise anyone for "not having the right attitude", not trying hard enough to believe in improvement, etc.

A refusal to take such factors into considering a person's potential for habituation is the worst sort of victim-blaming.

After 8 years, in spite of many conscientious efforts and a yearning for successful habituation, I still daily lean over and peer into the Abyss of Suicidal Ideation.

I am reminded of that great opening sentence in Fitzgerald's "The Great Gatsby":

"In my younger and more vulnerable years my father gave me some advice that I've been turning over in my mind ever since.
"Whenever you feel like criticising any one", he told me, "just remember that all the people in this world haven't had the advantages that you've had."

 

[kingsfan]

When I visited my ENT Doctor he mentioned that having had a lifetime of Migraines may have exhausted my brain
such that the potential for successful habituation would be far less than what it would be for others with no similar deleteriously influential conditions (another example is severe PTSD).

Coincidentally, our Chicago Tribune in their Health and Wellness Section had a report about Migraines that said very much the same thing; neural pathways may be worn out so that they cannot "carry" the full import of whatever one wishes to be disseminated.

My doctor, a professor at the University of California Irvine, believes migraines and tinnitus are linked and wanted me to do all kinds of migraine stuff (mind can't think of the right words, sorry) as well as sleep testing. I kind of shrugged it all off, but now I'm thinking maybe I should go back and try it all.

 

[Watasha]

My doctor, a professor at the University of California Irvine, believes migraines and tinnitus are linked and wanted me to do all kinds of migraine stuff (mind can't think of the right words, sorry) as well as sleep testing. I kind of shrugged it all off, but now I'm thinking maybe I should go back and try it all.

I'd say it's worth a shot. Professor Rauschecker believes there is a relationship between sleep and tinnitus and that coincides with my own experiences, especially early on. I'd wake up in the morning to near silence, and as the day went on it would get louder. Unfortunately those days are gone, even days where I'd feel waked up more refreshed, but there was definitely something "restorative" going on while I slept.

 

[Damocles]

 

[Uklawyer]

Sorry to ask about something that I think is on here: Tinnitus can often become worse when you start TRT, right? I tried listening to white noise last night; that messed up my sleep; and some today. I felt my ears were worse after it.

I think there is some sound covered by the spectrum that my ears do not like. Is hissing high-pitched?

 

[Michael Leigh]

Tinnitus can often become worse when you start TRT, right?

TRT does not often make tinnitus worse when it is started. Proper TRT is wearing white nose generators and having regular counselling under the guidance of an audiologist/hearing therapist that specialises in the treatment.

Listening to white noise through headphones, earbuds or headsets is likely to irritate the tinnitus and hyperacusis. The sound is often crude, abrasive and unregulated which is completely different from white noise generators that are designed to treat tinnitus and hyperacusis. Wearing white noise generators without being under the guidance and care of an audiologist/hearing therapist is still not TRT.

Please click on on the link below and read my post: What Is TRT and When Should It Be Started? It explains the treatment in full.

Michael

What Is TRT and When Should It Be Started? | Tinnitus Talk Support Forum

 

[buttercake]

Love me some Nordic model where there is a commitment by the state to ensure the well-being of its citizens.

Talking about Sweden, this was true maybe 20 years ago. Now you have to beg them even for seeing a GP. I don't know how and when they reached such a miserable state.

 

[Watasha]

Sorry to ask about something that I think is on here: Tinnitus can often become worse when you start TRT, right? I tried listening to white noise last night; that messed up my sleep; and some today. I felt my ears were worse after it.

I think there is some sound covered by the spectrum that my ears do not like. Is hissing high-pitched?

I also think sometimes it can be so soothing, that when you turn it off and you're just left with your tinnitus, it's really shocking and intrusive. Same effect as getting out of the shower for me. Hits you like a ton of bricks.

 

[Uklawyer]

@Michael Leigh, thanks.

I also think sometimes it can be so soothing, that when you turn it off and you're just left with your tinnitus, it's really shocking and intrusive. Same effect as getting out of the shower for me. Hits you like a ton of bricks.

That's precisely what I am concerned about. What if you have come a certain distance but still suffer and want to move on as quickly as possible? It feels a bit like starting all over again.

Maybe a compromise is to try a sound machine first.

 

[Michael Leigh]

Leigh, thanks

You are welcome @Uklawyer.

The most important part of TRT is the counseling and can't emphasize this enough. The reason being tinnitus and to some extent hyperacusis, are an integral part of a person's mental and emotional well-being. Therefore, learning to be more positive is very important and takes time to acquire.

Michael

 

[AnthonyMcDonald]

You are welcome @Uklawyer.

The most important part of TRT is the counseling and can't emphasize this enough. The reason being tinnitus and to some extent hyperacusis, are an integral part of a person's mental and emotional well-being. Therefore, learning to be more positive is very important and takes time to acquire.

Michael

Kind of hard to be positive and use white noise generators when tinnitus gets worse on a daily basis from sounds that are less than 40 decibels. I fail to see how positive thinking has anything to do with that. Advice like "not overprotecting" has caused me to get catastrophically worse. Have you not read the research paper that shows TRT to be no more effective than any general CBT or literally just doing nothing?

EDIT: I know my case is special. Some people do get help from TRT, but I do think that it's mostly placebo and people give it too much credit instead of just time making them better.

 

[AfroSnowman]

I do think that it's mostly placebo

Effectively placebo is all we've got with tinnitus treatment, right? Everything is about convincing ourselves that we feel better even though the symptoms are exactly the same. That being said if we can convince ourselves that we don't feel bad, well I guess then we don't feel bad.

I would way rather just stop having phantom noise in my head, but that isn't an option now so got to make the best of it any way we can: TRT, CBT, lucky rabbit's feet (do people do that anymore?), any port in a storm.

 

[Watasha]

Kind of hard to be positive and use white noise generators when tinnitus gets worse on a daily basis from sounds that are less than 40 decibels. I fail to see how positive thinking has anything to do with that. Advice like "not overprotecting" has caused me to get catastrophically worse. Have you not read the research paper that shows TRT to be no more effective than any general CBT or literally just doing nothing?

EDIT: I know my case is special. Some people do get help from TRT, but I do think that it's mostly placebo and people give it too much credit instead of just time making them better.

I am very sorry you're suffering, I suffer too. I have heard accounts of people who suffered for decades, then tried TRT and improved quite well. It may not be for everyone, but I think it has some utility for some.

 

[Watasha]

@Michael Leigh, thanks.

That's precisely what I am concerned about. What if you have come a certain distance but still suffer and want to move on as quickly as possible? It feels a bit like starting all over again.

Maybe a compromise is to try a sound machine first.

I'm not sure that I understand what you're saying, but sound machines are crucial. TRT acolytes will probably disagree, but my first year I ran a fan at my desk set at the mixing point pretty much and sat there for mostly 8 hours a day. I considered it a pseudo-form of TRT sound therapy and I was getting the counseling as well (long story). Amazingly after a year or so, I'd come in and wouldn't turn the fan on right away, and little by little I made it longer and longer. Hoping to get back to that.