HEARING LOSS RECOVERY

Hearing declines as we age:
https://ufhealth.org/conditions-and-treatments/aging-changes-in-the-senses

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My hearing has degraded over time and like Bryan Johnson I now have severe HF roll off, meaning I often confuse spoken words due to my inability to discern high frequencies. I also suffer from tinnitus. LLLT has been described as beneficial both to hearing loss and treatment of tinnitus. Below is a small sample of papers summarising clinical trials:

 

LLLT FOR TINNITUS

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[H10] Efficacy of Low-Level Laser Therapy for Tinnitus: A Systematic Review...

      1 trial (650nm, 830nm): NONE,

[H11] Combined Central and Peripheral Stimulation for Treatment of Chronic Tinnitus...

      1 trial (808nm): POTENTIALLY, when combined with LF rTMS [magnetic field];
 

December 2023, eBay China is flooded with white Apple-like wired earphones purportedly containing bog-standard 650nm red LDs which conflict with the above. The ear canal (transmeatal) is not the best route as the target inner ear is obstructed by bones and tissue and does not follow a straight line. Unless a dangerously high intensity is employed, the typical 5mW source is unlikely to do anything.

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A more effective route may be 830nm (based on LLLT for hearing loss, below) through the skull space cavity for, but outside the ear, or possibly below the jaw pointing up toward the inner canal or even orally within it however these would still have to go through bone. No paper mentions a jaw based route.
https://courses.lumenlearning.com/suny-ap1/chapter/the-skull/

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I would consider experimenting with low level 830nm below the jaw. How brain-safe is experimental rTMS?

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02/25, Deepseek:

Q++ Which wavelength(s) have been reported in scientific papers as beneficial for reducing tinnitus? What is the maximum power in milliwatts at the skin surface, that these wavelengths can be safely applied?
 

'Current Evidence for Tinnitus treatment by low-level laser therapy (LLLT)

 

Lack of Large-Scale Studies:As of now, there are no large, randomized controlled trials (RCTs) that definitively prove red light therapy is effective for tinnitus. While some individuals report significant improvement in their tinnitus symptoms after using red light therapy, others notice no effect. This variability may be due to differences in the underlying causes of tinnitus. Even if red light therapy provides some relief, it’s unlikely to completely eliminate tinnitus, especially if the condition is chronic or severe.

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Small Studies and Anecdotal Reports:

Some small studies and case reports have suggested that red light therapy may help reduce tinnitus symptoms, particularly when the tinnitus is associated with conditions like noise-induced hearing loss or cochlear damage. For example, a 2012 study published in the International Tinnitus Journal found that LLLT improved tinnitus symptoms in some participants, but the study was small and lacked a control group.

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Mechanism of Action:
Red light therapy is thought to improve mitochondrial function and increase blood flow to the inner ear, which could theoretically help repair damaged cells or reduce inflammation in the cochlea.

It may also have a calming effect on the nervous system, which could help reduce the perception of tinnitus.

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Application:

The light source is typically applied to the ear or mastoid bone (behind the ear).

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Wavelengths Reported in Scientific Papers:
650nm (Red Light) is commonly used in LLLT and has been studied for its potential to improve cellular repair and reduce inflammation. Example:
A 2012 study in the International Tinnitus Journal used 650 nm laser therapy for tinnitus treatment.

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808nm (Near-Infrared Light) penetrates deeper into tissues and is often used for conditions involving the inner ear or cochlea. Example:
A 2017 study in Lasers in Medical Science used 808nm laser therapy to treat tinnitus associated with cochlear damage.

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830nm (Near-Infrared Light) is also commonly used in LLLT and has been reported in some studies for tinnitus management. Example:
A 2019 study in Frontiers in Neurology explored the use of 830 nm laser therapy for tinnitus.

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Power Levels and Dosage is critical. Most studies use lasers or LED devices with power outputs ranging from 5mW to 500mW. For tinnitus specifically, lower power levels (e.g., 5-50mW) are often used to avoid overstimulation or damage to sensitive tissues.

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Energy Density (Fluence) is typically measured in Joules per square centimeter (J/cm²).
Studies often use energy densities ranging from 1J/cm² to 10J/cm² per session.

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Treatment Duration:
Sessions usually last between 30 seconds to 10 minutes, depending on the device and protocol.
Treatments are often repeated multiple times per week over several weeks.

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Maximum Safe Power at the Skin Surface, general safety guidelines:

650nm safe power levels are typically 5-200mW at the skin surface.
Higher power levels (e.g., 200-500mW) may be used for short durations but require careful monitoring to avoid tissue damage.

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808nm and 830nm safe power levels are generally 5-500mW at the skin surface.
Near-infrared light penetrates deeper, so lower power levels (e.g., 5-100mW) are often sufficient for tinnitus treatment.

 

General Safety Threshold:
The maximum safe power density for skin exposure is typically considered to be 200mW/cm² for continuous wave lasers or LEDs. For pulsed lasers the safety threshold may be higher.

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Example Protocols from Studies
Wavelength 1:   650nm Laser:
Power:          5-50mW
Energy Density: 1-4J/cm²
Duration:       1-5 minutes per session
Frequency:      2-3 times per week for 4-6 weeks

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Wavelength 2:   808nm Laser:
Power:          10-100mW
Energy Density: 2-10J/cm²
Duration:       2-10 minutes per session
Frequency:      2-3 times per week for 4-8 weeks'

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Q++ A laser may provide a narrow focus but the tissue associated with tinnitus is not typically the width of a narrow laser beam. Therefore a broader beam LED light source should surely be better at treating tissue mass? 

 

A'While lasers offer precision and depth of penetration, the broader beam of an LED light source can indeed be advantageous for treating conditions like tinnitus, where the target tissue (e.g., the cochlea, auditory nerve, or surrounding structures) is not a single, narrow point but rather a broader area.

Why a Broader Beam (LED) Might Be Better for Tinnitus:
Tinnitus often involves multiple structures, such as the cochlea, auditory nerve, and surrounding blood vessels. A broader beam from an LED can cover more of these areas simultaneously, potentially enhancing therapeutic effects. Some studies have shown that LEDs can achieve similar therapeutic effects to lasers when the total energy delivered is equivalent.

Lasers: Lasers have been the focus of most tinnitus research, but their narrow beam may not be ideal for covering the diffuse or hard-to-reach structures involved in tinnitus.'

 

Q+++ An LED can be pulsed with a higher current to provide an intensified beam of light that can match laser power levels considered safe for LLLT treatment of tinnitus. Do you know of any papers that have done this, and if so, what were the LED wavelength, pulse duration and the power intensities?

 

A'while there are no specific studies using pulsed LEDs for tinnitus, research on the conditions described below suggests the following could be effective:

Wavelength:     650nm or 808nm to target the cochlea and auditory nerve.

Pulse Duration: 10-50ms to balance penetration and safety.

Peak Power:     100-500mW to achieve therapeutic effects without overheating tissues.

Energy Density: 2-10J/cm² per session.

Frequency:      10-50Hz to match biological rhythms and enhance cellular response

 

1. General Photobiomodulation Studies:

Pulsed LEDs have been shown to improve cellular repair, reduce inflammation, and enhance blood flow, which are mechanisms that could also benefit tinnitus treatment.
Wavelength:     630-660nm or 800-850nm.
Pulse Duration: 1-100ms.
Peak Power:     100mW to several watts (with average power kept low).
Energy Density: 1-10J/cm².
Frequency:      1-100Hz.

 

2. Neurological Applications:

Pulsed LEDs have been shown to improve neuronal function and reduce oxidative stress, which could be relevant for tinnitus associated with neural damage or inflammation.
Wavelength:     810nm.
Pulse Duration: 10ms.
Peak Power:     250mW.
Energy Density: 2-4J/cm².
Frequency:      10Hz.

 

3. Wound Healing and Tissue Repair:

Pulsed LEDs have been shown to accelerate tissue repair and reduce inflammation, which could support recovery in the cochlea or auditory nerve.
Wavelength:     660nm.
Pulse Duration: 50ms.
Peak Power:     500mW.
Energy Density: 5J/cm².
Frequency:      20Hz.'