Be Well _ July 2011 Issue

Feature: Ringing in the Ears? Tinnitus Can Be Tamed

You hear constant ringing or a rhythmic whooshing sound. But your cell phone is turned off, and the ocean is nowhere in sight.

That’s tinnitus — the perception of noise in the ear, the head or both — without any external source. Tinnitus affects 42 million Americans.

No need to ‘put up with it’

There is no cure for tinnitus, but if you or a loved one suffers from its daily frustrations, audiologist Craig W. Newman, PhD, has this message: “You don’t have to just live with it. Many patients manage their tinnitus successfully after following a few simple suggestions.”

Dr. Newman, Head of Cleveland Clinic’s Section of Audiology, says the effects of chronic tinnitus are similar to those of chronic pain. They include:

  • Problems concentrating
  • Difficulty sleeping
  • Trouble at work
  • Stressful relationships

It’s no wonder that a large percentage of patients with tinnitus experience distress.

The cause of tinnitus is unknown, but evidence suggests that it is the result of changes in auditory neurons (the nerve cells that transmit sound to the brain). These neurons become hyperactive and tend to fire more frequently, causing the perception of constant noise.

If you are experiencing tinnitus, see your physician first for an evaluation. Underlying health problems may prompt your physician to refer you to an ear, nose and throat specialist (otolaryngologist), an audiologist, a dentist, a neurologist or even a physical therapist. “There isn’t a singular ‘cure’ for tinnitus,” explains Dr. Newman.

Fortunately, he notes, "Many patients manage their tinnitus successfully after following a few simple suggestions."

Sound therapy: A practical solution

If the tinnitus continues, sound therapy is one of the best ways to manage it, says Dr. Newman. The idea behind sound therapy is to decrease your perception of the sounds of tinnitus.

There are two ways to use sound to improve tinnitus:

Background sound (or “white noise”) can make tinnitus less noticeable. Examples include:

  • Fans
  • Television
  • CDs of rain, waterfalls or ocean waves
  • Adjusting hearing aids to amplify ambient sound
  • Sound generators, worn in the ear

Attention-getting sound can be used to distract you from your tinnitus. Examples include:

  • Books on tape
  • Talk shows
  • Music
  • Conversation

To choose the best method for you, think about specific times when your tinnitus is most troublesome. Decide if background or attention-getting sound would be better. Then pick the sound-producing device you like the most.

You may not need to leave home to find it — the CD player in your living room, your favorite music on an mp3 player, the bedroom fan or a chat with a family member (or pet) may do the trick.

Other tinnitus tips

Dr. Newman recommends these other ways to improve tinnitus as well:

  • Get enough sleep
  • Reduce your stress levels
  • Lower your intake of coffee, alcohol, cigarettes, aspirin and salt
  • Eat healthy
  • Exercise regularly
  • Improve your posture
  • Stay busy with activities you care about

You can also join the American Tinnitus Association at, he says.

Related Content


Tip: Hydrating the Right Way

Water keeps us nourished and flushes out toxins. To stay hydrated, drink before you get thirsty — if you’re thirsty, you're dehydrated. Drink 12 to 20 ounces of cold fluids two to three hours before strenuous activity. Tea, coffee and cola are OK — our bodies usually compensate for their caffeine, which draws out water. Plus the flavonoids in green and black tea promote heart health.

Be Well – July 2011 Issue

Feature: Gout — Getting a Grip on a Unique Form of Arthritis

Gout is often associated with wealth and privilege. King Henry VIII suffered with gout. So did Sir Isaac Newton.

But gout strikes commoners as well as kings, and can have serious repercussions on everyone’s health. Fortunately, doctors today can control gout so that no one needs to suffer.

Answering 7 questions about gout

Below, Ajay Buddaraju, MD, of Cleveland Clinic’s Department of Rheumatic and Immunologic Diseases, answers seven questions to clear up some misunderstandings about gout:

1.What causes gout?

Gout is caused by a combination of lifestyle factors and genetics that raises uric acid levels in the blood. Eventually, uric acid crystals form. The body deposits these crystals in the joints (typically the big toe, but in other joints as well), where they cause pain and inflammation. How much uric acid you make and how well your kidneys eliminate uric acid are largely determined by genetics. If you make a lot of uric acid or if your kidneys cannot expel it well, your uric acid levels will be elevated, and your risk of gout will rise.

2. How serious a problem is it?

We know there is a significant relationship between gout and cardiovascular disease, high blood pressure and diabetes. New data indicate that elevated uric acid levels, which can signify pre-gout, may increase the risk of cardiovascular disease and kidney disease.

3. Are meat and alcohol mostly to blame?

People who eat a diet that is low in dairy and high in red meat and certain kinds of fish (like shellfish), and those who drink alcohol to excess, are likely to have high uric acid levels. However, evidence is growing that uric acid levels may be even higher among people who eat a diet high in fructose (the sugar found naturally in fruit and honey and a key ingredient in the much maligned high-fructose corn syrup).

4. Can changing your diet control gout?

Losing weight and watching what you eat and drink may lower uric acid levels, but probably not enough to completely prevent attacks. Lessening the pain of a gout attack requires an anti-inflammatory drug. Any kind, including aspirin or naproxen (Aleve®), will work, but such a high dose is necessary that side effects become problematic. It’s best to ask your primary care doctor for a prescription. Some patients find applying ice to the painful joint somewhat effective.

5. Can gout be cured?

Unfortunately, there is no cure for gout. But gout can be controlled with medications. We know that lowering uric acid levels to about 6 mg/dL causes the crystalline deposits in the joints to resorb after a period of months to years, stopping attacks. But if therapy is stopped, the gout likely will return.

6. How long do you have to take medication?

Gout requires consistent, lifelong therapy. Fluctuations in uric acid cause attacks. Medication such as allopurinol (Lopurin®, Zyloprim®) and febuxostat (Uloric®) can be prescribed to slowly lower uric acid levels and prevent attacks. Colchicine, a plant extract, can be prescribed to prevent uric acid crystals from being deposited in the joints. However, starting and stopping medications will alter uric acid levels and can trigger an attack.

7. How do you avoid gout when uric acid levels are high?

Elevated uric acid levels don’t always lead to gout, so we generally don’t try to prevent gout until someone has an attack. However, it’s important to take steps now if you have elevated uric acid levels, to lower your risks of cardiovascular disease and kidney disease: Lose weight, lower your blood pressure and reduce your cholesterol and triglyceride levels.

Related Content


Be Well – July 2011 Issue

Free Guide: Osteoporosis

Osteoporosis is an elusive disease — most people won’t have any symptoms until they break a bone. But fractures from falling are not a normal part of aging. Learn how osteoporosis is both preventable and treatable.

Recipe: Pumpkin Pancakes

Add nutrition and fiber to your next batch of pancakes with this recipe, which uses canned pumpkin, applesauce and whole wheat flour.


1 cup flour
1 cup whole wheat flour
1 tablespoon baking powder
2 tablespoons sugar
1 teaspoon pumpkin pie spice
½ cup egg substitute
1-¾ cup skim milk
3 tablespoons applesauce
½ cup canned pumpkin

  1. Sift flours, baking powder, sugar and pumpkin pie spice into a large bowl.
  2. Whisk egg substitute and milk in separate bowl. Stir in applesauce and canned pumpkin.
  3. Pour wet mixture over dry ingredients. Stir, but do not beat. Batter may be lumpy.
  4. Heat a frying pan or griddle coated with cooking spray to prevent sticking.
  5. Pour batter out in 4-inch circles on a hot pan.
  6. Once batter starts to bubble, flip to cook the other side.
  7. Consider topping with sautéed apple slices instead of syrup.

Makes 16 pancakes (4 inches each)

Per serving (1 pancake):
Calories: 102 (26% calories from fat)
Fat: 3 g
Saturated fat: 0.3 g
Protein: 4 g
Carbohydrates: 15 g
Dietary fiber: 1.4 g
Cholesterol: 0.6 mg
Sodium: 71 mg
Potassium: 123 mg

Related Content

Be Well – July 2011 Issue

Let's Move It! Mondays at Progressive Field

Move it with Cleveland Clinic and enjoy free, exclusive access to Progressive Field in downtown Cleveland on select Mondays this summer. Invite your friends to walk the warning track with you over the lunch hour on Let's Move It! Mondays - and stop by our booth for free giveaways and health information.