DEAR DR. DONOHUE: Would you kindly write an article about tinnitus? I am interested in knowing its causes, treatments and prognosis. -- R.W.
ANSWER: More than 50 million Canadians and Americans put up with the annoying and distracting phenomenon of tinnitus -- constant noise in one or both ears. Some hear a ringing sound; others, a roar, a hissing or a persistent whistle. A few are bothered by a pulsating beat. Invariably, tinnitus worsens at night.
Anyone, if put in a soundproof room, will hear ear noises. In the real world, the sounds of everyday life drown out noises normally generated within the ear. People who lose their hearing, even a fraction of it, have ears that no longer suppress those self-generated ear sounds, and they are then plagued with tinnitus.
If hearing loss is the source of tinnitus, a hearing aid can frequently quell tinnitus by amplifying ambient noise.
High blood pressure, allergies, head trauma, tumors of the brain and hearing nerve, and hardened arteries in the vicinity of the ear can produce tinnitus. These causes, therefore, have to be investigated.
That still leaves a sizable number of people for whom no cause can be found. Tinnitus maskers can help them. Some of those devices are made like hearing aids and can be worn just like a hearing aid in the ear canal. They emit a sound that blocks tinnitus. A tinnitus masker at the bedside can relieve nighttime tinnitus.
There are specialized centers that offer tinnitus retraining therapy. It's a method that habituates the brain to tinnitus, and it also employs devices like tinnitus maskers to achieve that goal. Local ear, nose and throat doctors can provide patients with the locations of such centers.
DEAR DR. DONOHUE: I am a 56-year-old female who exercises four days a week. I was told I should be taking glucosamine and chondroitin. Someone else said I also need to take MSM with those. Is all this necessary? What do you suggests? -- L.K.
ANSWER: All joints are lined with cartilage. Osteoarthritis, the most common kind of arthritis, is the result of fragmentation and defective repair of joint cartilage. When cartilage frays, bone rubs against bone, and that hurts and limits joint motion.
Glucosamine is a component of cartilage. It keeps cartilage hydrated and plump. Chondroitin is another component of cartilage, and it is a constituent of joint fluid.
Either or both of these substances might slow joint deterioration due to osteoarthritis. There is no overpowering evidence, however, to show that either or both can prevent osteoarthritis.
MSM stands for methylsulfonylmethane, a sulfur-containing compound. It's said that the sulfur in MSM complements the action of chondroitin and glucosamine on joint cartilage. Not all joint experts are convinced of that.
I'll give you my opinion. First, your sources infer that exercise causes osteoarthritis. That's not necessarily true. Only if there is some intrinsic problem with a joint, like it's out of line, does exercise harm joint cartilage. Second, supplements, including the ones suggested by your sources, have not been shown to prevent osteoarthritis. I don't believe any of this is necessary for you.
People who would like a more complete rundown on all forms of arthritis can order the pamphlet on that topic by writing: Dr. Donohue -- No. 301, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient's printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Is there any proof that senior citizens no longer are bothered by allergies, cat allergies in particular? -- F.B.
ANSWER: Some people develop a tolerance to things they were once allergic to, and that includes cats. If people had severe reactions -- wheezing, a drop in blood pressure or a major hive outbreak -- they shouldn't expose themselves to the allergen unless they have medical help on hand to abort a possible reaction.
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