By Megan Redshaw, J.D.
Tinnitus, or ringing in the ears, is an often debilitating condition with no approved treatment or cure. Some sufferers, however, may find relief from low-level infrared light therapy, according to a new peer-reviewed, first-of-its-kind study published in the Journal of Personalized Medicine.
Over four weeks, researchers evaluated treatment for tinnitus in more than 100 men and women aged 18 to 65 whose condition either had an unknown cause or had been unresponsive to treatment and divided them randomly into 10 groups. Researchers investigated personalized treatment options involving low-level laser therapy (LLLT) using red and infrared light in the inner ear or cochlea, where tinnitus often occurs, and LLLT combined with other treatments, such as vacuum therapy and drug therapy.
LLLT uses a narrow spectral width of light close to infrared to promote tissue regeneration, reduce inflammation, and relieve pain. Whereas a high-powered laser is used to cut and destroy tissue, low-level near-infrared light penetrates more deeply than ultraviolet or visible light and does not harm living tissue, according to a study published in Medical Lasers.
The study assessed both red light and infrared light laser therapy. Red light is visible and uses wavelengths of 630 to 700 nanometers (nm). Infrared light, at wavelengths from 800 to 1,000 nm, is invisible and penetrates farther into the body.
Treatments evaluated included the following:
- LLLT modalities using only light.
- LLLT combined with vacuum therapy, ultrasound, Ginkgo biloba tablets—an herb commonly used for vertigo and tinnitus caused by circulatory disorders and lack of blood flow to the brain—or a drug used to treat dizziness, vertigo, and migraines called flunarizine dihydrochloride.
- Laser acupuncture (LP)—a specific type of LLLT that uses nonthermal, low-intensity laser irradiation to stimulate traditional acupuncture points.
- Treatment with only flunarizine dihydrochloride.
- Treatment with only ginkgo biloba.
LLLT using infrared wavelengths was superior to the placebo, and lasting therapeutic effectiveness was also observed 15 days post-treatment with LLLT, LP, and light therapy combined with other treatments. Researchers also observed that the most effective treatment was when light therapy sessions focused on the cochlea and middle ear were increased from six to 15 minutes.
Since there are currently no recommended treatments or approved drugs to treat tinnitus, medicines such as sedatives, antihistamines, antidepressants, local anesthetics, and antipsychotics are commonly prescribed for treatment. These drugs can cause short- and long-term systemic side effects.
This is the first study that shows that treatment with LLLT to the middle ear and cochlear area is superior to placebos and the first to investigate the effects of LLLT combined with other therapies, to monitor short-term effects of nine treatment modalities during and 15 days after treatment, and to suggest protocols for tinnitus patients.
What Causes Tinnitus?
The National Institute on Deafness and Other Communication Disorders estimates that 10 to 25 percent of U.S. adults experience some form of tinnitus—making it one of the country’s most common health conditions.
People experiencing tinnitus often hear ringing, roaring, whooshing, hissing, humming, or buzzing in one ear or both, and the noise can be soft or loud, low- or high-pitched, and sporadic or constantly present. Symptoms can resolve spontaneously or become chronic, resulting in sleep deprivation, loss of concentration, psychological distress, and depression.
Scientists theorize that tinnitus results from damage to the inner ear that changes the signals carried by the nerves to the parts of the brain that process sound. Other evidence suggests that abnormal interactions between the auditory cortex and neural circuits could contribute to the condition.
Tinnitus can also be caused by underlying conditions, such as circulatory problems, hearing loss, infection, tumors, diabetes, autoimmune conditions, Ménière’s disease, heavy metal toxicity, and medications. More than 25,000 people have reported developing tinnitus after receiving a COVID-19 vaccine—an adverse event U.S. regulatory agencies have seemingly ignored but is commonly associated with other vaccines.
Because it’s hard to determine the underlying cause of tinnitus, it’s challenging to treat and determine whether or when it might resolve.
Using Infrared Light Therapy to Treat Tinnitus
Scientists discovered in the 1960s that LLLT could enhance tissue repair, but it has only been used during the past two decades to reduce tinnitus severity. Previous studies have yielded inconsistent results, but the authors of the recently published study say this could be attributed to not using the appropriate power for wavelengths, not having the proper sessions over a long enough duration of treatment, or not focusing the light on the correct part of the ear.
To perform LLLT, a device is used to apply red or infrared laser wavelengths at a particular setting to various parts of the ear for a set duration. The therapy is not painful or associated with adverse events. A Norwegian study published in the British Medical Journal describes LLLT as “harmless.”
According to the Medical Lasers paper, the exact mechanisms of LLLT are not fully understood. Still, it is believed that once the light is absorbed, it can “modulate cell biochemical reactions and stimulate mitochondrial respiration, enhancing the production of molecular oxygen, ATP synthesis, and collagen deposition.”
Natural Treatments for Tinnitus
With no approved medical treatments in the United States or Europe, many turn to alternative and complementary medicine to address tinnitus’s underlying causes and alleviate their symptoms. In addition to infrared light therapy, the following natural remedies have been shown to be effective for some people.
In a randomized controlled trial published in Cell Biochemistry and Biophysics, Gushen Pian, a traditional Chinese herbal remedy, showed significant therapeutic results for tinnitus compared with a placebo after four weeks of treatment, with an overall effective rate of 89.2 percent versus 30.8 percent for the placebo and a symptom relief rate of 59.5 percent versus 5.1 percent for the placebo.
Ginkgo biloba, a tree native to China, has been used as a medicinal herb for more than 2,000 years. Ginkgo biloba extract, EGb 761, is the most widely tested drug in nonclinical tinnitus models and clinical trials, according to a review published in Frontiers in Pharmacology. Bioflavonoids and flavonoids in Ginkgo biloba, terpene trilactones, such as ginkgolides and bilobalide, polyprenols, and organic acids are thought to have a vasodilatory effect and help alleviate tinnitus symptoms.
Although the treatment may not work for everyone, preclinical and clinical studies have shown that apart from its antioxidant and vasodilatory effects, Ginkgo biloba extract may improve cochlear microcirculation, protect against ototoxicity—damage to the ear caused by medicine, resulting in hearing loss, ringing in the ear, or balance disorders—and alleviate aging-associated degeneration.
The study in the Journal of Personalized Medicine didn’t show significant results when Ginkgo biloba was used on its own.
Korean Red Ginseng
Studies mentioned in the Frontiers in Pharmacology review show that Korean red ginseng can protect against ototoxic medications, attenuate noise-induced hearing loss, and improve cochlear damage.
In a study published in the Journal of Audiology & Otology, patients with chronic tinnitus received 1,500 milligrams per day (mg/day) or 3,000 mg/day of Korean red ginseng or 160 mg/day of Ginkgo biloba extract over four weeks. The authors found that the patients receiving 3,000 mg/day of Korean ginseng showed significant improvement in their scores and improved emotional and mental health.
Research suggests that as many as 31 percent of patients with tinnitus are deficient in zinc.
In a study published in the Journal of Otology and Neurotology, 46.4 percent of patients given zinc reported clinically favorable progress, and 82 percent of patients experiencing subjective tinnitus experienced an improvement in symptoms; patients who received a placebo experienced no significant decrease.
Supplementing with melatonin—a hormone that the brain produces in response to darkness and that helps regulate your circadian rhythm—at 3 milligrams per day for 30 days was associated with a “statistically significant decrease in tinnitus intensity and improved sleep quality in patients with chronic tinnitus,” according to a study published in the Annals of Otology, Rhinology, and Laryngology. Melatonin therapy is most effective in men without a history of depression, those with severe and bilateral tinnitus, and those with a history of noise exposure.
Diet may play a role in the susceptibility of the inner ear to noise- and age-related tinnitus and hearing loss.
A 2020 study found associations between single nutrients and dietary patterns in those with tinnitus and hearing difficulties. A higher intake of vitamin B12 was associated with a reduced chance of developing tinnitus, while calcium and iron increased the chances of developing tinnitus. Vitamin D intake was associated with a reduced risk of hearing difficulties, as was a diet higher in protein, vegetables, and fruit and lower in fat.
Other natural therapies that may prove helpful for people experiencing tinnitus include biofeedback, heavy metal chelation, acupuncture, stress management, and, if tinnitus is related to dental grinding or temporomandibular joint dysfunction, wearing a mouth guard.