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Tinnitus: Ringing or humming in your ears? Sound therapy is one option

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That recurring sound that you hear but nobody else does? It’s not all in your head. Well, not exactly.

You may be one of the estimated 50 million-plus people who suffer from tinnitus. The mysterious condition causes a sound in the head with no external source. For many it’s a high-pitched ringing, while for others it’s whistling, whooshing, buzzing, chirping, hissing, humming, roaring, or even shrieking.

The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating. One approach to managing this condition is different forms of sound therapy intended to help people tune out the internal soundtrack of tinnitus.

What causes tinnitus?

There are many possible causes of tinnitus. Long-term exposure to loud noises is often blamed. But other sources include middle ear problems like an infection, a tumor or cyst pinching nerves in the ear, or something as simple as earwax buildup. Tinnitus also can be a symptom of Meniere’s disease, a disorder of the balance mechanism in the inner ear.

Even old-fashioned aging can lead to tinnitus, which is common in people older than age 55. As people get older, the auditory nerve connecting the ear to the brain starts to fray, diminishing normal sounds.

“Neurons (nerve cells) in areas of the brain that process sound make up for this loss of input by increasing their sensitivity,” says Daniel Polley, director of the Lauer Tinnitus Research Center at Harvard-affiliated Massachusetts Eye and Ear. “The sensitivity knobs are turned up so high that neurons begin to respond to the activity of other nearby neurons. This creates the perception of a sound that does not exist in the physical environment. It’s a classic example of a feedback loop, similar to the squeal of a microphone when it is too close to a speaker.”

At times, everyone experiences the perception of a phantom sound. If it only lasts for a few seconds or minutes, it’s nothing to worry about. However, if it pulsates in sync with your heart rate, it’s definitely something to get checked out by a physician, says Polley. If it’s a relatively continuous sound, you should see an audiologist or otolaryngologist (ears, nose, throat specialist).

Can sound therapy help tune out tinnitus?

There is no cure for tinnitus, but it can become less noticeable over time. Still, there are ways to ease symptoms and help tune out the noise and minimize its impact. Treatments are a trial-and-error approach, as they work for some people but not others.

One often-suggested strategy is sound therapy. It uses external noise to alter your perception of or reaction to tinnitus. Research suggests sound therapy can effectively suppress tinnitus in some people. Two common types of sound therapy are masking and habituation.

  • Masking. This exposes a person to background noise, like white noise, nature sounds, or ambient sounds, to mask tinnitus noise or distract attention away from it. Listening to sound machines or music through headphones or other devices can offer temporary breaks from the perception of tinnitus. Household items like electric fans, radios, and TVs also can help. Many people with tinnitus also have some degree of hearing loss. Hearing aids can be used to mask tinnitus by turning up the volume on outside noises. This works especially well when hearing loss and tinnitus occur within the same frequency range, according to the American Tinnitus Association.
  • Habituation. Also known as tinnitus retraining therapy, this process trains your brain to become more accustomed to tinnitus. Here, you listen to noise similar to your tinnitus sound for long periods. Eventually your brain ignores the tone, along with the tinnitus sound. It’s similar to how you eventually don’t think about how glasses feel on your nose. The therapy is done with guidance from a specialist and the time frame varies per person, usually anywhere from 12 to 24 months.

Additional approaches may help with tinnitus

Depending on your diagnosis, your doctor also may recommend addressing issues that could contribute to your tinnitus.

  • Musculoskeletal factors. Jaw clenching, tooth grinding, prior injury, or muscle tension in the neck can sometimes make tinnitus more noticeable. If tight muscles are part of the problem, massage therapy may help relieve it.
  • Underlying health conditions. You may be able to reduce the impact of tinnitus by treating conditions like depression, anxiety, and insomnia.
  • Negative thinking. Adopting cognitive behavioral therapy and hypnosis to redirect negative thoughts and emotions linked to tinnitus may also help ease symptoms.
  • Medication. Tinnitus can be a side effect of many medications, especially when taken at higher doses, like aspirin and other nonsteroidal anti-inflammatory drugs and certain antidepressants. The problem often goes away when the drug is reduced or discontinued.

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Skin in the game: Two common skin problems and solutions for men

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When I was on the junior varsity basketball team in high school, I wasn't surprised when I developed a case of itchy, flaky athlete's foot. After all, I was an "athlete," so I assumed it was a sign of dedication and hard work.

I was shocked when my mother told me the truth: it was due to poor foot hygiene, not my dribbling skills.

Fast-forward almost four decades, and I’m much more diligent about skin care. Still, some skin issues plague me at times, like they do many men. Here is a look at two common problems and solutions.

Dry skin

Symptoms of dry skin include scaly patches (with or without redness), itching, and overall dryness. You can get dry skin year-round — from the heavy heat of summer to the bitter cold of winter. Sun exposure damages skin, leaving it thinner and less likely to hold in moisture over time. Also, aging skin produces less of the natural oils that keep skin lubricated.

Treatment. The first line of defense is a moisturizer that softens and smooths skin with water and lipids (fats). Some moisturizers attract water to the skin and seal it in. Others prevent moisture loss by coating skin with a thick, impermeable layer.

  • Petroleum jelly. This waxy, greasy substance stops water loss without clogging pores. It can be used by itself but is also an ingredient in many moisturizers and ointments. Because petroleum jelly doesn’t contain water, it’s best used while the skin is still damp after bathing to seal in moisture.
  • Mineral oil. Mineral oil has the same effect but without a greasy feeling. It also should be used while skin is damp.
  • Moisturizing lotions and creams. These products contain both water and oils. They’re less greasy and more cosmetically appealing than petroleum jelly or oils. Look for moisturizers with at least one of the following ingredients: glycerin, urea, pyroglutamic acid, sorbitol, lactic acid, lactate salts, or alpha hydroxy acids.

Prevention. Try a few changes to help prevent dry skin:

  • Add moisture to the air with a humidifier or a pan of water set atop the radiator.
  • In the shower or bath, use lukewarm water (hot water can dry the skin by stripping it of natural oils).
  • Choose nondrying soaps with no abrasives or irritants. Super-fatted soaps or cleansing bars are less drying than regular, liquid, or antibacterial soaps.
  • To retain the water your skin absorbs while showering or bathing, apply jelly, oil, or moisturizer immediately afterward.

Athlete’s foot

Athlete’s foot is caused by dermatophytes, a group of fungi on the surface of the skin. Tell-tale signs include intense itching; cracked, blistered, or peeling areas of skin, especially between the toes; and redness and scaling on the soles. Dermatophytes thrive in warm, moist environments like pools, showers, and locker rooms where people walk with bare feet. The warm, moist environment of sweaty socks and shoes encourages them to grow.

Treatment. First, try an over-the-counter antifungal ointment, cream, or powder, such as clotrimazole (Lotrimin AF, Mycelex, generic), terbinafine (Lamisil AT, Silka,), or miconazole (Lotrimin AF spray, Micatin). It can take weeks for an infection to improve, and recurrences are common. If symptoms don't improve after several weeks, consult a doctor, who may prescribe antifungal pills.

Prevention. Keeping feet clean and dry is the best way to ward off athlete’s foot. Also, do the following:

  • Wash your feet well every day, and wear a clean pair of socks after your bath or shower.
  • Take time to dry your feet thoroughly (including each toe and especially the web space between the toes) after you bathe, shower, or swim.
  • Wear flip-flops or sandals around public pools and in gym locker rooms and showers.
  • Wear moisture-wicking socks that absorb sweat.
  • Don’t wear the same shoes two days in a row. Give shoes a 24-hour break between wearings to air out and dry.

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Yoga for weight loss: Benefits beyond burning calories

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If you have trouble losing weight despite your best efforts, this is because obesity is a complex disease with many causes. A family history of weight issues can make it more likely that you’ll have the same issues managing your weight. A diet high in ultra-processed foods, sugar, and fat and being sedentary also contribute to weight gain. Stress and struggles with mental health, including medications to treat certain mental health conditions, poor sleep, and hormonal changes, are all factors that further contribute to weight gain.

There are many ways to combat excess weight, but there is no single solution. If you are trying to lose or maintain your weight, you may want to try yoga. There is good research that yoga may help you manage stress, improve your mood, curb emotional eating, and create a community of support, all of which can help with weight loss and maintenance.

Yoga can also help you burn calories, as well as increase your muscle mass and tone. Yoga may reduce joint pain, which in turn allows you to exercise more and increase your daily activities. These are only some of the many benefits of yoga.

Yoga can help you manage stress that can impact weight gain

Yoga is derived from the Sanskrit word yuj, which means to unite the body, mind, and emotions. It is a holistic mind-body practice that improves many of the causes of weight gain.

Some people may experience stress as physical pain or sleep deprivation, or it may be psychological and cause feelings of anxiety and agitation. Stress leads to an increase in the hormone cortisol. Cortisol increases abdominal fat, decreases muscle mass, causes cravings for fat and sugar-rich food, and thus can lead to obesity.

Yoga can decrease stress and cortisol levels, enhance mood, decrease anxiety and depression, improve sleep, and improve chronic conditions such as hypertension and diabetes, reducing the need for medications that can cause weight gain.

Yoga is not a band-aid for excess weight, but it may work on the underlying causes. Its benefits extend beyond the calories-in-versus-calories-out equation.

Yoga can improve mindfulness related to eating behaviors

Most of us who crave ice cream after 9 pm or can’t stop eating potato chips know that these behaviors hurt our chances of losing weight. We all know that eating vegetables, whole grains, lean protein, etc. is good for our health and weight. While this knowledge is necessary, it seems insufficient to help us stick to our healthy eating plans.

One of yoga’s benefits is that it improves mindfulness of the body and awareness of body sensations. This is why yoga is called “moving meditation.” Research shows that you don’t have to do any formal sitting meditation to get the mindfulness benefits of yoga.

By improving mindfulness, yoga decreases emotional eating, stress eating, and binge eating. These habits sabotage our weight loss efforts and can cause a negative spiral of guilt and shame, which often leads to giving up.

A study published in 2015 showed that practicing yoga led to healthier eating, including lower fat intake and an increase in vegetables and whole grains.

The bottom line: the best diet plan is the one that you can stick with over the long term, and by improving mindfulness, yoga can help you make healthier food choices.

A yoga community can provide acceptance and support

Going to a gym can be intimidating, and may provoke feelings of not belonging for some people with larger bodies. By contrast, yoga culture embodies kindness, support, and self-acceptance.

Yoga teachers and advanced practitioners can serve as role models and inspire newer students to live a healthier lifestyle. Research shows that social networks influence behaviors that affect weight. The yoga network encourages positive health behaviors, and being a part of such a community can make a meaningful difference for weight loss. This type of community can be hard to find with other types of exercise.

Practitioners should look for a safe, comfortable environment. A welcoming yoga group may help you improve your self-esteem and confidence. Find a local studio that feels nurturing and not overwhelming, with other practitioners at your level. Teachers can help beginners or those with physical limitations by modifying poses. You might have to try a few different classes before you find an instructor or a class that you like. Don’t give up after the first one!

If you can’t find a local studio, there are always online options on YouTube and Instagram, with classes at all levels. There are instructors who understand what it is like to be a larger size, and having an inclusive, body-affirming attitude shows that yoga is not just for “skinny people.” Some share inspirational stories of how yoga helped them overcome their own weight struggles, depression, and binge eating. If you are a beginner, consider signing up for a short challenge to get committed to the practice.

The benefits of yoga are universal — no matter what your shape or size. It can take weeks or months to establish a yoga practice, and frequent practice is key for long-lasting benefits.

Follow Dr. Anekwe on Twitter @Chikagirl

Follow Dr. Reddy on Twitter @NiyotiReddy

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Tics and TikTok: Can social media trigger illness?

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A student suddenly develops leg pain and paralysis; soon hundreds of schoolmates have similar symptoms. Nuns begin biting each other, and soon the same thing is happening at other nearby convents. Three schoolgirls begin laughing uncontrollably, sometimes going on for days. When nearly 100 classmates develop the same problem, the school is forced to close down.

Yet in each case, no medical explanation was ever found. Eventually, these came to be considered examples of mass sociogenic illness, which many of us know by different names: mass hysteria, epidemic hysteria, or mass psychogenic illness. Over the years, many possible sources for these illnesses have emerged — and today TikTok and other social media sites may be providing fertile ground.

What is sociogenic illness?

The hallmark of these conditions is that multiple people within a social group develop similar, medically inexplicable, and often bizarre symptoms. In some cases, those affected believe they have been exposed to something dangerous, such as a toxin or contagion, although thorough investigation finds none.

The suffering caused by these illnesses is quite real and profound —even in the absence of a clear cause and presence of normal test results. And no, a person with sociogenic illness is not “just looking for attention” or “doing it on purpose.”

Labeling people as hypochondriacs or “crazy,” or illness as “hysteria,” isn’t helpful. Hysteria and hysterical — drawn from hystera, the Greek word for womb — are loaded terms, often used to diminish women as psychologically unstable or prone through biology to uncontrollable outbursts of emotion or fear. And while some researchers suggest these illnesses more commonly affect women, most of the published literature on this condition is decades old and based on a limited number of cases.

Common features of mass sociogenic illness

Past outbreaks include illnesses in which people suddenly fainted; developed nausea, headaches, or shortness of breath; or had convulsive movements, involuntary vocalizations, or paralysis. Usually, these outbreaks occurred among people in close proximity, such as at a school or workplace. Rarely, cases appear to have been spread by shows on television. Now, social media is a possible new source.

Certain features are typical:

  • experiencing symptoms that have no clear medical explanation despite extensive investigation
  • symptoms that are temporary, benign, and unusual for those affected
  • rapid onset of symptoms and rapid recovery
  • those affected are connected by membership and interaction within a social group or by physical proximity.

Generally, treatment includes:

  • ruling out medical explanations for symptoms
  • shutting down a facility where it occurred
  • removing people from the site of supposed exposure (online or not)
  • separating affected individuals from one another.

Reassurance regarding the lack of danger, and demonstrating that the outbreak stops once individuals are no longer in close contact with each other, generally reduces anxiety and fosters recovery.

Tics and TikTok: a new driver of sociogenic illness?

The first known examples of social media-induced sociogenic illness were recognized in the last year or two, a time coinciding with the pandemic. Neurologists began seeing increasing numbers of patients, especially teenage girls, with unusual, involuntary movements and vocalizations reminiscent of Tourette syndrome. After ruling out other explanations, the tics in these teenagers seemed related to many hours spent watching TikTok videos of people who report having Tourette syndrome and other movement disorders. Posted by social media influencers, these videos have billions of page views on TikTok; similar videos are available on YouTube and other sites.

What helped? Medications, counselling, and stress management, according to some reports. Avoiding social media posts about movement disorders and reassurance regarding the nature of the illness also are key.

Geographic boundaries may have become less relevant; now, the influences driving these illnesses may include social media, not just physical proximity.

Dancing plagues, mad gassers, and June bugs

Sociogenic illnesses are nothing new. If you had lived in the Middle Ages, you might recall the “dancing plague.” Across Europe, scores of afflicted individuals reportedly began to involuntarily and deliriously dance until exhaustion. And let’s not forget the writing tremor epidemic of 1892, the Mad Gasser of Mattoon during the mid-1940s, and the June bug epidemic of 1962.

The anxieties and concerns of the times play a role. Before the 1900s, spiritual or religious overtones were common. When concerns were raised about tainted foods and environmental toxins in the early 1900s, unusual odors or foods sparked a rash of palpitations, hyperventilation, dizziness, or other anxiety symptoms. More recently, some residents of the West Bank who thought nearby bombings released chemical weapons reported dizziness and fainting, although no evidence of chemical weapons was found.

Closer to home, reports are swirling that Havana syndrome may represent another example of mass sociogenic illness, although no firm conclusions can yet be made. Initially described among members of the US State Department in 2016 in Havana, Cuba, individuals who experienced this suddenly developed headache, fatigue, nausea, anxiety, and memory loss.

These symptoms have been reported by hundreds of people in different parts of the world. Many are foreign service workers attached to US diplomatic missions. Soon after the first case reports, suspicion arose that a new weaponized energy source was causing the illness, such as microwaves fired from some distance. Cuba, Russia, or other adversaries have been blamed for this. Thus far, the true nature and cause of this condition is uncertain.

Nocebo, not placebo

One theory suggests that sociogenic illness is a form of the nocebo effect. A placebo — like a sugar pill or another inactive treatment — may help people feel better due to expectation of benefit. The nocebo effect describes the potential that people could have a negative experience based purely on the expectation that it would occur.

Think of it this way: you may be more likely to experience a headache from a medication if you’ve been warned of this possible side effect, compared with another person warned about a different side effect. Similarly, let’s say you see people fainting. If you believe this is caused by a substance they — and you! — were exposed to, you may faint, too, even if there’s no actual exposure to a substance that could cause fainting.

The bottom line

We don’t know why some develop sociogenic illness while others don’t. Plenty of people have lots of stress. Millions of people were stuck inside during the pandemic and turned to social media for more hours each day than they’d like to admit. Many people are prone to the power of suggestion. Yet, sociogenic illness remains relatively rare. Despite existing for hundreds of years, much about this condition remains mysterious. An open mind is important. Some cases of sociogenic illness may be due to an environmental toxin or contagion that wasn’t detected at the time.

If you or a loved one spends a lot of time on social media and has developed an illness that defies explanation, talk to your healthcare providers about the possibility of social media-induced sociogenic illness. We may soon learn that it’s not so rare after all.