Top Treatments to Consider in the Early Days After Onset

[Steph1710]

@Juan - actually I had prednisolone not prednisone. My mistake!

Still no taper and completely different packaging. I know it will differ country-to-country.

The difference is interesting: The main difference between prednisone and prednisolone is that prednisone must be converted by liver enzymes to prednisolone before it can work. In people with severe liver disease, prednisolone is usually preferred.

Steph

 

[porcelainblue]

Do the treatments listed apply only to acoustic trauma induced T or do they equally apply to T arising from an unknown cause?

 

[mknature]

Maybe Lenire would be a good treatment if you use it early on. There are signs pointing towards that.

Unfortunately, Lenire is only accepting "chronic" cases (I think it was a year after onset at the earliest). Their little intake questionnaire told me I had to use my hearing aids for a year before I was a candidate. Womp womp.

 

[CAgirl]

Can Prednisone still help 5 weeks out of an acoustic trauma?

I tried it in the beginning (just one 10 mg pill) and the side effects were tough on me (burning skin, nausea, restlessness) so I gave up. I thought how can I handle 40 mg of this when I can barely tolerate 10 mg? However, my tinnitus has worsened in the last week, likely with continued swelling in my ear.

I am wondering if I should give it another go as one last ditch attempt and to prevent this from worsening.

 

[Dennis LeRoy]

I am currently in my first week of Prednisone use. 60mg/day the first four days! I know how you feel CAgirl. Pretty wired right now, typing is more difficult than normal. Onset of tinnitus was September 1st, and thankfully I recognized what was going on and went to the ENT right away. Sleeping is difficult - not sure if it's the medication or the constant hiss.

Did you go in for more Prednisone? What were the results?

 

[Matthew Piecora]

I'm currently taking both amitriptyline and Gabapentin and those have not helped.

Same, neither have done anything. I did have one day that I felt a little better but it was just for part of the day - I wonder what it was that helped so much, probably not those meds, haha. I wonder what CBD oils work best

 

[Matchbox]

I'm in a very similar situation to everyone here. I had a very bad experience with earbuds and not noticing how bad it was, and then being told by a family member to try some high does aspirin (wow right?).

Unfortunately, everyone in my life would rather of coddled me than helped me including doctors.
I managed to get steroids but I think it was too little avail, only 4 days worth, I'm back on them for the last 2 weeks and to be honest, have only noticed it getting louder with some moments where it quiets at night briefly.

I'm also doing HBOT... but 2 weeks in. I've done a few sessions so far and have to say I've had no effect, it's possibly even gotten worse. There could be some delayed reaction but I'll keep you all in the loop. I also have been taking tons of supplements antioxidants but who knows right? I didn't get the good one, NAC in time... and asking doctors for help is pulling teeth.

The ENT was not helpful in regards to recommending anything but HBOT (I asked for steroid injections and he wasn't into it).

Trying to live with this, is really terrifying at my age, I'm still trying to get a family together. Even in a noisy environment is absolutely brutal, sleep doesn't exist. I don't see how I can work in an office like this.

I don't know what effect the steroids have had really, but I'm now tapering 3 weeks in. I might try one more large dose at the end to see if there's any reduction that day or not.
Pretty much out of options.

Benzos work for volume reduction, but yeah... they have their own big problems.

Any advice?

 

[GBB]

I had a horrible mix of tinnitus, and the horrible sound was very high pitched, loud, electrical.
The benzo made it go from a horrible sound to a sshsshssh and then it disappeared. It came back two or three times but then completely disappeared.

I was also advised by a shrink to take benzodiazepines for any new tinnitus sounds because of the impact on stress and memory. And I have read a lot of articles on tinnitus and they all said the memory and emotion parts of the brain are involved and as I said, benzodiazepines work on both.

When you use benzodiazepines only temporarily, there shouldn't be adverse effects.

If I may say so, HBOT is useless if the tinnitus is not from a pressure problem.

Magnesium and vitamin B are really good picks. Even as long term treatment. With no side effects.

I also read a lot about Ginkgo Biloba. And science is backing it up. It can work in certain cases (inflammatory and blood flow).

What benzo were you on and at what dose?

 

[GBB]

I'm in a very similar situation to everyone here. I had a very bad experience with earbuds and not noticing how bad it was, and then being told by a family member to try some high does aspirin (wow right?).

Unfortunately, everyone in my life would rather of coddled me than helped me including doctors.
I managed to get steroids but I think it was too little avail, only 4 days worth, I'm back on them for the last 2 weeks and to be honest, have only noticed it getting louder with some moments where it quiets at night briefly.

I'm also doing HBOT... but 2 weeks in. I've done a few sessions so far and have to say I've had no effect, it's possibly even gotten worse. There could be some delayed reaction but I'll keep you all in the loop. I also have been taking tons of supplements antioxidants but who knows right? I didn't get the good one, NAC in time... and asking doctors for help is pulling teeth.

The ENT was not helpful in regards to recommending anything but HBOT (I asked for steroid injections and he wasn't into it).

Trying to live with this, is really terrifying at my age, I'm still trying to get a family together. Even in a noisy environment is absolutely brutal, sleep doesn't exist. I don't see how I can work in an office like this.

I don't know what effect the steroids have had really, but I'm now tapering 3 weeks in. I might try one more large dose at the end to see if there's any reduction that day or not.
Pretty much out of options.

Benzos work for volume reduction, but yeah... they have their own big problems.

Any advice?

Start taking NAC and magnesium and bide your time. Protect your ears, and you could consider seeing another ENT and pushing for steroids if you want.

 

[weab00]

Start taking NAC and magnesium and bide your time. Protect your ears, and you could consider seeing another ENT and pushing for steroids if you want.

What's the timeframe for Dexamethasone? I got pain hyperacusis 5 weeks ago and am seeing an ENT. I want to try to push for a round window injection.

 

[GBB]

What's the timeframe for Dexamethasone? I got pain hyperacusis 5 weeks ago and am seeing an ENT. I want to try to push for a round window injection.

I'm not sure if there is clear efficacy but I've heard up to three months according to some sources. No idea if it would help for hyperacusis as it is usually studied with regard to hearing loss, and people append it to tinnitus as such.

 

[Juan]

I'm not sure if there is clear efficacy but I've heard up to three months according to some sources. No idea if it would help for hyperacusis as it is usually studied with regard to hearing loss, and people append it to tinnitus as such.

I don't think Dexamethasone works 3 months after.

After being exposed to loud noise, ears develop a series of symptoms, pressure, muffled hearing, tinnitus, hyperacusis, etc etc... this rarely subsides (the acute phase of symptoms) after 2 months. It would be very rare. There is usually a horrible period of 10 days after noise exposure, then the other time mark is like 3 weeks. To have an acute phase of symptoms for 2 months means major hearing damage, with permanent hearing loss. And more than 2 months, I think it is very rare.

When symptoms go away (acute phase) usually whatever is left is your baseline hearing, or the real situation of your ears...

So having corticoids, including Dexamethasone, like 2 month after... I don't see it. I think even 3 weeks after is really really late...

 

[Kriszti]

Do you think that it's a good sign if tinnitus changes / increases in frequency and loudness while on Methylprednisolone?

Doctors here say that it's good, because it shows that the steroid does something.

This is not my personal issue, I'm just wondering.

 

[Chris Goodman]

Prednisone had remarkable effect for me even 60 days after onset.

Did yours spike while you were taking Prednisone? I just tried it and mine is through the roof.

 

[Matchbox]

Mine was ALWAYS better on Prednisone, but ALWAYS made me twice as bad coming off.

Permanently.

I'd do one course tops and live with what you get on the other side... and taper super duper slowly even if the course is just "2 weeks", like taper over another 2 weeks at least.

Ginkgo biloba and Magnesium are probably the best things to use early on... or any vasodilators.

 

[Chris Goodman]

Mine was ALWAYS better on Prednisone, but ALWAYS made me twice as bad coming off.

Permanently.

I'd do one course tops and live with what you get on the other side... and taper super duper slowly even if the course is just "2 weeks", like taper over another 2 weeks at least.

Ginkgo biloba and Magnesium are probably the best things to use early on... or any vasodilators.

Thanks so much for getting back. I think I might call it quits tomorrow. I'm not showing any good signs and don't want to see where I'll be in 8 days.

 

[GeorgeLG]

There are studies that suggest that getting your Glutathione status up before and/or quickly after an exposure can help prevent some of the oxidative stress damage. One study used NAC plus Glycine and other discussions recommend some of the cofactors in the synthesis process such as Magnesium, Selenium, B2, vitamin C, Lipoic Acid. In another study, correcting a B12 deficiency lowered tinnitus loudness scores in deficient subjects.

George

 

[Matchbox]

There are studies that suggest that getting your Glutathione status up before and/or quickly after an exposure can help prevent some of the oxidative stress damage. One study used NAC plus Glycine and other discussions recommend some of the cofactors in the synthesis process such as Magnesium, Selenium, B2, vitamin C, Lipoic Acid. In another study, correcting a B12 deficiency lowered tinnitus loudness scores in deficient subjects.

George

Noise conditioning, so listening to low levels of noise a lot actually helps hair cells resist oxidative stress, as those reduction enzymes get upregulated in mRNA expression. So that the next time it happens, they can deal with the higher levels of free radicals.

Of course, supplementing helps so long as it isn't toxic and can get into the nerve and hair cells via lipid solubility and mechanotransduction channels, respectively.

 

[GeorgeLG]

Noise conditioning, so listening to low levels of noise a lot actually helps hair cells resist oxidative stress, as those reduction enzymes get upregulated in mRNA expression. So that the next time it happens, they can deal with the higher levels of free radicals.

Of course, supplementing helps so long as it isn't toxic and can get into the nerve and hair cells via lipid solubility and mechanotransduction channels, respectively.

I noticed in your profile that you list Prednisone as a cause of tinnitus. I finished my first 5-day Prednisone course for hip pain and developed severe light sensitivity. Got my eyes checked, nothing found. That has faded by about 80%. A couple of weeks later a brief leaf blower exposure seemed to cause my tinnitus and hyperacusis or so I thought. Could this have been brought on by the steroids themselves?

George

 

[Matchbox]

Could this have been brought on by the steroids themselves?

No, I doubt it. It was probably the noise exposure.

Upon finishing the steroids I knew immediately something was very wrong. I had new noises in the morning on awakening (bilateral drones) and nothing sounded "crisp". The sounds got a bit better but now there's distortions, the drones have turned into... best description is just pure nonsense in both ears when I wake up in a silent room.

Could the steroids have "primed" you to get worse? I wouldn't doubt THAT given my experience with them. While on them if I got exposed to noise, that noise "stuck around" in my bad ear.

 

[rogerlee]

I am 6 weeks after my acoustic trauma event. Is it too late to ask for steroid treatment? I asked several ENTs but they all refused based on my "normal" hearing test, which I think is irrelevant at 8 kHz top range.

Can more people share their experiences with steroid treatment while they were still in (mid) acute stage of tinnitus?

Clearly, I wish I tried steroids much sooner regardless of what the doctor said. I just didn't find any consensus on this and I wasted a lot of time just waiting doing nothing.

 

[Lane]

I wish I tried steroids much sooner

Hi @rogerlee -- Check out THIS POST. And this...

Prednisone for Hyperacusis: Any Experiences? Natural Alternatives?

At the above link, I discuss hydrocortisone as a possible substitute for prednisone. I actually think hydrocortisone is a better option than Prednisone, as a person can experience some pretty severe side effects from Prednisone, including anxiety, sleeplessness, etc. I believe that even relatively low doses of hydrocortisone for a few days has the potential to have a significant impact on inflammation in the inner ears.

 

[rogerlee]

I haven't been able to get ahold of a doctor who would let me take the full (I think 30 mg per day for two weeks, followed by a taper pack?) course. Instead I was only given a taper pack, twice. Both times when taking the starting dose (the highest one, typically 20+ mg) I noticed a remarkable effect. I would wake up and it would be very dormant. I'm currently taking both amitriptyline and Gabapentin and those have not helped.

So the effect of steroids for 2 weeks was not permanent on your tinnitus?

I really wished I tried it but my doctors kept telling I had normal hearing tests despite the fact that I knew something was wrong after an acoustic trauma.

 

[rogerlee]

Mine was ALWAYS better on Prednisone, but ALWAYS made me twice as bad coming off.

Permanently.

I'd do one course tops and live with what you get on the other side... and taper super duper slowly even if the course is just "2 weeks", like taper over another 2 weeks at least.

Ginkgo biloba and Magnesium are probably the best things to use early on... or any vasodilators.

How long after noise exposure did you try the Prednisone pack?

 

[rogerlee]

FWIW, I've always heard prednisone is tapered, even if the full dose is as short as one day, as is the case when using a standard pack (descending rows represent day 1, day 2, day 3, etc.)

View attachment 37819

Did the steroid treatment resolve your tinnitus permanently?

 

[RichardGuy]

So the effect of steroids for 2 weeks was not permanent on your tinnitus?

I really wished I tried it but my doctors kept telling I had normal hearing tests despite the fact that I knew something was wrong after an acoustic trauma.

Always ignore the doctors when they say you have "normal" hearing. Normal hearing in the US is up to 25 dB lost, which is very noticeable. I personally have 15 dB across most frequencies and quite noisy tinnitus.

Yes, the Prednisone is rarely, if ever, permanently effective if taken after the first two weeks from noise exposure event.

 

[rogerlee]

Yes, the Prednisone is rarely, if ever, permanently effective if taken after the first two weeks from noise exposure event.

Were you able to take Prednisone within 2 weeks after onset?

 

[FlatDarkEarth]

I'm surprised to see multiple people here recommend benzodiazepines for treatment.

From what little I understood, benzos seem easy to develop tolerance/dependence for, and coming off them seems to have developed tinnitus for a lot of people.

What's the 'safe' way to use these during a tinnitus spike?

 

[RichardGuy]

Were you able to take Prednisone within 2 weeks after onset?

No, I was not. An ENT saw me shortly after developing tinnitus and when I asked her if there was anything she could do, she only shook her head. A year later I asked her why she didn't give me prednisone and she said it was because emotionally, I was a wreck, and she didn't want to make things "worse".

 

[Ola]

This is all so frustrating. It seems like all the treatments in this thread are as likely to make tinnitus worse as they are to make tinnitus better.