Tinnitus: three months of Serc and ginkgo with no effect on the ringing

Tinnitus: three months of Serc, ginkgo and a ringing that won't go away

Why does the ENT specialist reply "just ignore it" to a ringing that has been installed in your head for months? It's the standard recommendation when the ear examination comes back clean: ignore the noise to lower anxiety and not feed it. The case that opens the subject is that of an older man for whom three months of Serc and ginkgo biloba have done absolutely nothing. He's not a complainer, they say of him; the ringing has him hysterical. And there the underlying problem emerges: the injury is ruled out, a remedy that doesn't address the cause is prescribed, and the patient is left alone with the noise.

What causes tinnitus: from noise trauma to cervical vertebrae

The catalogue of triggers that appears in the accounts is broad and not very reassuring. Acoustic trauma takes the prize: rehearsal rooms without protection, motorcycles, cinemas, breath-hold spearfishing. One case reports that the ringing started after a blow with a pressurized equipment part at work. Others point to circulation problems, the Eustachian tube or a cervical rectification. There are even those who link it to sustained stress: a low, constant sound, like a badly installed air conditioning unit, that disappeared within weeks of slowing down.

The list continues with infections —one case places it after an H1N1 flu— and with drug ototoxicity: antibiotics, with fluoroquinolones and beta-lactams singled out, especially in older people with already compromised kidney function. There is also talk of attributing it to cobi19 vaccines, which is dismissed with sarcasm and without any evidence to support it.

Why don't Serc and ginkgo biloba work?

Because in most cases there is no single cause to attack. Serc appears again and again prescribed and again and again described as useless: more than a remedy, it seems to simply try to mask it, summarises one sufferer. Ginkgo would only make sense if the origin were circulatory, and even then the results are inconsistent. The three months of the initial case are not an exception: they are the norm.

To this is added the metabolic argument. It is argued that lowering fasting insulin and background inflammation —low-carb diet, vitamin D, exercise— improves several fronts at once. The data provided is a HOMA-IR of 1.7 compared to 1.1 in an 83-year-old man who eats bread and sugar for breakfast, without anyone demonstrating what exact relationship that has with the ringing.

Cervical physiotherapy: the case that resolved in two days

Here is the interesting exception. One account describes tinnitus accompanied by vertigo that disappeared two days after the first session of physiotherapy to relax and release tension in the neck muscles, after Serc did nothing for him. Another coincides in cervical relief, although with relapse: fifteen days after the last session, back to square one. Prudence is mandatory in patients with spinal issues: no aggressive osteopathic manipulations. The detail of which muscles and which manoeuvres were worked on is not developed in the original text.

Does white noise help mask tinnitus?

It is the most repeated tool for the hours of silence, which are the worst. White noise generators, mobile applications, long videos of natural sounds —waves, rain, thunder— and specific videos for the exact frequency of the ringing, which one of the sufferers places between 8,000 and 11,000 Hz, very high-pitched. Hearing aids that would emit the same frequency in phase opposition are also mentioned; there is no confirmation whatsoever of their effectiveness.

Getting used to it, resigning oneself or applying for disability

The dominant message is that of forced coexistence. Those who have had it longest summarise it like this: at first a few terrible months, then you get used to it, and there's no other way. There is a case with the ringing in the left ear since 2002, to the point that sleeping on that side is almost impossible, and another that has dragged on for fifteen years after spearfishing, with hearing loss in one ear and gain in the other. In the assessment of disability, a doctor, psychologist and social worker intervene, and the percentage goes up or down depending on whether one lives alone or how affected the psychological terrain is. Below 33% it is practically useless; that case was around 20%.

---

If ignoring the ringing worked, no one would pay a physiotherapist. The only documented improvement in two days came from massaging a neck, not from a leaflet. Maybe the problem is that almost no one looks at it.