I was recently diagnosed with tinnitus. I am a bit unclear as to what causes it and if there are any alternative remedies to treat it. Can you provide some information?

Ringing in the ears, or tinnitus, is a common and annoying problem. Some studies have suggested that almost one in three Americans report this problem at some time and about 2% of the population haves evere ringing. Although people of any age can be troubled by this condition, it becomes more common the older we get. People describe the sounds in their ears in a number of different ways – ringing, roaring, whistling, humming and buzzing are some of the most common descriptions.

The most common cause for tinnitus is a problem with the hearing nerve. It is usually associated with some decrease in the ability to hear higher pitched sounds, known as a high-frequency sensorineural hearing loss. The best explanation is that as there is degeneration in the hearing apparatus, a kind of self-generated noise arises that we perceive as ringing or humming.

The first step in approaching this process is to have a complete hearing evaluation. This will usually include an examination of the hearing structures along with an audiogram to test if there is associated hearing loss. A good evaluation will rule out the very rare causes for tinnitus such as toxins and tumors that can affect the auditory system. You should also be assessed for Meniere's disease which can cause hearing loss, tinnitus and vertigo.

Assuming that no specific causes are determined, there are a number of approaches that are usually attempted to relieve the symptoms of vertigo. Medically a number of drugs have been used with inconsistent benefit. These include sedatives, antidepressants and vasodilators. A new medicine, misoprostol is a synthetic cousin of a natural prostaglandin and has been suggested to help with tinnitus.

Other medical producers have included masking devices that generate a white noise to override the ringing and cochlear implants that are used to help with hearing loss but also improve tinnitus.

From the natural world, ginkgo biloba has been reported to reduce tinnitus in rats and has been promoted for a similar use in humans. If you are going to try gingko, do not take it with anything that might thin your blood for there have been some reports of bleeding in people on gingko. The usual dose of gingko extract is 60 milligrams twice daily. A study from Japan found that many people with tinnitus had low serum zinc levels. Some people benefited from zinc supplementation. An herb used by Native American tribes for menstrual and menopausal symptoms, Black Cohosh, also has a history of treating tinnitus. The usual dosage of the ground root is 500 milligrams twice daily.

Biofeedback specialists report that reducing muscle tension around the temporal-mandibular joint can reduce the intensity of tinnitus. Many studies show that no matter what treatments are used, people tend to be less concerned about the symptom over time, even though the ringing may persist.