Question: Hi-I believe I am experiencing an autoimmune response specific to my left ear; symptoms of an inner ear infection (aural fullness, tinnitus). It began to occur ca.1 week after I first started taking Vyvanse (70-140mg). All perception in the lower frequencies (bass) is severly compromised (can`t hear bass, or weird distoritions occur). Last week or so, the fullness can disappear, increasing the dB of the "dial tone" (and vice versa). When I chew, or knock on my head-the "swooshyness" intensifies accordingly. Switched to Adderall since 5 weeks back. Thing is, I dropped my 60mg of Adderall for 1 cap. Vyvanse 70mg last Saturday-so 1 week since last use. Not taking it anymore. Suspecting a connection to my ear after reading the product`s monograph on side-effects -I asked others using the same medication. Nearly all reported back having the same problem (fullness in the ear, tinnitus)-specifically by Vyvanse-but never having made the connection themselves. I consulted my doctor to give me some Prednisone to try out-10mg morning/5 evening for 10 days. On Day 2 now, it maybe feels like its not so intense (?) I am a musician also, so I`d really like your views on this and if I am unto something trying out the corticostereoid treatment. Cheers, XXXXXXX

Hi-I believe I am experiencing an autoimmune response specific to my left ear; symptoms of an inner ear infection (aural fullness, tinnitus). It began to occur ca.1 week after I first started taking Vyvanse (70-140mg). All perception in the lower frequencies (bass) is severly compromised (can`t hear bass, or weird distoritions occur). Last week or so, the fullness can disappear, increasing the dB of the "dial tone" (and vice versa). When I chew, or knock on my head-the "swooshyness" intensifies accordingly. Switched to Adderall since 5 weeks back. Thing is, I dropped my 60mg of Adderall for 1 cap. Vyvanse 70mg last Saturday-so 1 week since last use. Not taking it anymore. Suspecting a connection to my ear after reading the product`s monograph on side-effects -I asked others using the same medication. Nearly all reported back having the same problem (fullness in the ear, tinnitus)-specifically by Vyvanse-but never having made the connection themselves. I consulted my doctor to give me some Prednisone to try out-10mg morning/5 evening for 10 days. On Day 2 now, it maybe feels like its not so intense (?) I am a musician also, so I`d really like your views on this and if I am unto something trying out the corticostereoid treatment. Cheers, XXXXXXX

Hi,

Results of exam uploaded. The ENT performing the exam, suggested hearing aid. I said no because it will only be a symptomatic treatment. If I can become convinced that my symptoms are that of a conductive nature--I am ok with it taking some time to treat. For then I will not be risking my hearing by not treating it quickly enough, correct?

I am NOT having any of the following symptoms: dizziness, vertigo and nausea.

Only what I have described (clogginess-low dB tone vs. no clogginess and high dB tone.)

And I have stopped taking the corticostereoid. If it was an adverse reaction to Vyvanse (now 8 days since last dose), can I expect a reduction in symptoms this week, and if so-at what rate?

This morning, I coughed a bit-sensed that typical "freeze" feeling in my chest that comes when you pace while having a cold. It could be I have some of bacterial/viral infection-but I am not showing any other signs of having a cold, flu etc. And There have been no risk of STDs. I do, however, work in a hospital-also around children.

I am using Adderall XR, prescribed for ADHD-at 60mg/dag. Last BP test was on Friday, 4.5t after dosing; result 136/86. I did not use my meds this weekend, and the problem was still there.


Cheers, V.

Hi,

Results of exam uploaded. The ENT performing the exam, suggested hearing aid. I said no because it will only be a symptomatic treatment. If I can become convinced that my symptoms are that of a conductive nature--I am ok with it taking some time to treat. For then I will not be risking my hearing by not treating it quickly enough, correct?

I am NOT having any of the following symptoms: dizziness, vertigo and nausea.

Only what I have described (clogginess-low dB tone vs. no clogginess and high dB tone.)

And I have stopped taking the corticostereoid. If it was an adverse reaction to Vyvanse (now 8 days since last dose), can I expect a reduction in symptoms this week, and if so-at what rate?

This morning, I coughed a bit-sensed that typical "freeze" feeling in my chest that comes when you pace while having a cold. It could be I have some of bacterial/viral infection-but I am not showing any other signs of having a cold, flu etc. And There have been no risk of STDs. I do, however, work in a hospital-also around children.

I am using Adderall XR, prescribed for ADHD-at 60mg/dag. Last BP test was on Friday, 4.5t after dosing; result 136/86. I did not use my meds this weekend, and the problem was still there.


Cheers, V.

Hi, there is still the possibility that this is an ETB, correct? My use of Adderall XR does not fall under substance-abuse, nor have I ever experienced any hearing-related issues with either of the two enantiomers of amphetamine. Until now possibly and specifically-the (special) formulation of lisdexamphetamine. I have nearly 100% symptom-relief (and no major sideeffects) with Adderall-so I am not switching.
If this is a sensori-neural condition caused (only) by lisdexamphetamine, and started ca.6 weeks ago, with the last dose taken aprox.10 days ago, how can I expect the recovery to take form?

Hi, there is still the possibility that this is an ETB, correct? My use of Adderall XR does not fall under substance-abuse, nor have I ever experienced any hearing-related issues with either of the two enantiomers of amphetamine. Until now possibly and specifically-the (special) formulation of lisdexamphetamine. I have nearly 100% symptom-relief (and no major sideeffects) with Adderall-so I am not switching.
If this is a sensori-neural condition caused (only) by lisdexamphetamine, and started ca.6 weeks ago, with the last dose taken aprox.10 days ago, how can I expect the recovery to take form?

Hi-

Yes, I meant to write ETD.

So, it is inside normal-range to experience the symptoms I have described if this is an idiosyncratic (ototoxic) reaction to Vyvanse? Time since last dose:11 days.

It is definitely vascular in nature-like everytime when chewing, scratching head in the said region etc-the symptoms respond accordingly (intensity increase).

How will I recognize improvements-for example, by
A) a (slow) return of hearing in the lower frequencies (incl.no weird resonances, distortion etc.)?
B) and what is likely to disappear first-the tinnitus tone, the feeling of aural fullness, reduction in dB or even a change in the (musical) key of the tinnitus etc?

I am a great fan of essential oils (DOTERRA)-so reading that Peppermint Oil sometimes is used for ear-realted issues, I have carefully applied some to the outer regions of the ear for a couple of days now.

I have read studies using a particular soundwave stimulation at 40Hz that have been shown to improve neural networks in patients with disorders of consciousness.
This could be helpful in my case, also, or not? Via a headset, at low volume (even though-at this point-I cannot hear it.), streaming a Sine wave at 40Hz. Your views?
(ref. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/)

How else will you suggest I maximize the healing process-by playing the piano (I am a musician)? Staying away from noisy environmnts is given. Dietary ideas?

Lastly, given that this is very most likely an ototoxic reaction to Vyvanse-how to exclude the possibility of it being an autoimmune response? I took Prednisone (10mg/5mg eve) only for 3 out of the 10 days my GP prescribed me (10mg morning/5mg night). It was my suggestion to test it out, not his. If my immune system was the cause, and during my three days of taking it, should I have noticed any improvement? I don`t think I noticed anything.

Cheers,

Hi-

Yes, I meant to write ETD.

So, it is inside normal-range to experience the symptoms I have described if this is an idiosyncratic (ototoxic) reaction to Vyvanse? Time since last dose:11 days.

It is definitely vascular in nature-like everytime when chewing, scratching head in the said region etc-the symptoms respond accordingly (intensity increase).

How will I recognize improvements-for example, by
A) a (slow) return of hearing in the lower frequencies (incl.no weird resonances, distortion etc.)?
B) and what is likely to disappear first-the tinnitus tone, the feeling of aural fullness, reduction in dB or even a change in the (musical) key of the tinnitus etc?

I am a great fan of essential oils (DOTERRA)-so reading that Peppermint Oil sometimes is used for ear-realted issues, I have carefully applied some to the outer regions of the ear for a couple of days now.

I have read studies using a particular soundwave stimulation at 40Hz that have been shown to improve neural networks in patients with disorders of consciousness.
This could be helpful in my case, also, or not? Via a headset, at low volume (even though-at this point-I cannot hear it.), streaming a Sine wave at 40Hz. Your views?
(ref. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/)

How else will you suggest I maximize the healing process-by playing the piano (I am a musician)? Staying away from noisy environmnts is given. Dietary ideas?

Lastly, given that this is very most likely an ototoxic reaction to Vyvanse-how to exclude the possibility of it being an autoimmune response? I took Prednisone (10mg/5mg eve) only for 3 out of the 10 days my GP prescribed me (10mg morning/5mg night). It was my suggestion to test it out, not his. If my immune system was the cause, and during my three days of taking it, should I have noticed any improvement? I don`t think I noticed anything.

Cheers,

Hi,

I like your answers :) I have noticed lately that whilst in up-right position, walking around, at work etc., the sense of fullness seems be the most prominent feature of the condition. Approaching the hours of Zzz, as well as during sleep and in the morning-just before getting out of bed, the opposite is the case; the tinnitus happens and the "clog" fades into the background (or disappears altogether). My home environment is significantly less busy, less sound-inputs-quiet for the most part now that I am not making music.
Could this be a factor that also accounts for the rise of the tinnitus and inversely, the feeling of fullness?

And can this observation aid you in determining further the extent and possibly the nature of the problem?

When the dial-tone comes on at night, I figure it is only due to having trained my ears in Analytical Listening, that I can -departmentalize- it and fall asleep. Which is a good thing.

Might you think it also helpful on the order of re-generating the inner ear cells tasked with the perception of frequencies the lower-spectrum (sub, mid-and high bass), that I try to focus in on those (even though I cannot hear them), no matter what I am listening to (except white, brown & pink noise)?

A product called "Diatomaceous Earth" has a reputation for promoting hair growth, in that it contains sillica. Say this is the case, Is it then reasonable to assume that this property also can apply itself towards helping the hair cells in the Scala Media? That region is supposed to be high in concentrations of potassium. Maybe also eat more bananas? :)

ADDERALL XR is not listed with ototoxic properties according to the FDA reports I have on hand. My schedule of taking it, involves a properly enterprised dose of 60mg administered regularly every day in the am`s at hour 10(-ish).

Should I re-start the treatment with the Prednisone and complete the seven days left out of a schedule of ten (days) as described by my GP? In case there could be improvements to be noticed?

As for diuretics, are there some OTC drugs available, or teas perhaps? I live in Scandinavia. Your meditation and Yoga ideas, I shall definitely look into. Also, there is the idea of using acupressure points in the region, or even acupuncture. What are your thoughts on this?


Happy Days,
V.

Hi,

I like your answers :) I have noticed lately that whilst in up-right position, walking around, at work etc., the sense of fullness seems be the most prominent feature of the condition. Approaching the hours of Zzz, as well as during sleep and in the morning-just before getting out of bed, the opposite is the case; the tinnitus happens and the "clog" fades into the background (or disappears altogether). My home environment is significantly less busy, less sound-inputs-quiet for the most part now that I am not making music.
Could this be a factor that also accounts for the rise of the tinnitus and inversely, the feeling of fullness?

And can this observation aid you in determining further the extent and possibly the nature of the problem?

When the dial-tone comes on at night, I figure it is only due to having trained my ears in Analytical Listening, that I can -departmentalize- it and fall asleep. Which is a good thing.

Might you think it also helpful on the order of re-generating the inner ear cells tasked with the perception of frequencies the lower-spectrum (sub, mid-and high bass), that I try to focus in on those (even though I cannot hear them), no matter what I am listening to (except white, brown & pink noise)?

A product called "Diatomaceous Earth" has a reputation for promoting hair growth, in that it contains sillica. Say this is the case, Is it then reasonable to assume that this property also can apply itself towards helping the hair cells in the Scala Media? That region is supposed to be high in concentrations of potassium. Maybe also eat more bananas? :)

ADDERALL XR is not listed with ototoxic properties according to the FDA reports I have on hand. My schedule of taking it, involves a properly enterprised dose of 60mg administered regularly every day in the am`s at hour 10(-ish).

Should I re-start the treatment with the Prednisone and complete the seven days left out of a schedule of ten (days) as described by my GP? In case there could be improvements to be noticed?

As for diuretics, are there some OTC drugs available, or teas perhaps? I live in Scandinavia. Your meditation and Yoga ideas, I shall definitely look into. Also, there is the idea of using acupressure points in the region, or even acupuncture. What are your thoughts on this?


Happy Days,
V.

Dr. Vaishalee,

Of all the five specialists I have talked to regarding this, you are the one that have had the most interesting answers, so thumbs up :)

As an experiment last night, I put on a headset to listen to my fav music while only the tinnitus was present. Amazingly, I was able to hear the music as I usually do! I adjusted the volume to overpower the background noise of the tinnitus (besides, I figure it sits on a semi-note rarely used for composing melodies in this genre).

This leads me to believe that my `bass-hairs`(to name them such), are still in working order-but it seems that something venous is in misalignment, helping to cause the problem?

It also occurred to me as an idea to pick out things to listen to that are more saturated in the bass-areas and not so much upwards in the spectrum.
⦁     Reason: to avoid having the groups of hair-cells responsible for interpreting sound in those frequencies, ---over-trained--- to do so.

Or music that is perfectly harmonized and with full spectral coverage, may be more advantageous (i.e some of Bach`s work).

Which idea (if any) do you believe can have some merit?

The overall most important thing in this, is that my brain needs to continue to be able to interpret & remember what bass is, what it sounds like and how it fits in with the rest of the group. Just looking for the most effective way back to this and a way that is not putting at risk this ability.


I believe these conclude my questions, so thank you again & Merry Christmas :)

Vittorio.

Dr. Vaishalee,

Of all the five specialists I have talked to regarding this, you are the one that have had the most interesting answers, so thumbs up :)

As an experiment last night, I put on a headset to listen to my fav music while only the tinnitus was present. Amazingly, I was able to hear the music as I usually do! I adjusted the volume to overpower the background noise of the tinnitus (besides, I figure it sits on a semi-note rarely used for composing melodies in this genre).

This leads me to believe that my `bass-hairs`(to name them such), are still in working order-but it seems that something venous is in misalignment, helping to cause the problem?

It also occurred to me as an idea to pick out things to listen to that are more saturated in the bass-areas and not so much upwards in the spectrum.
⦁     Reason: to avoid having the groups of hair-cells responsible for interpreting sound in those frequencies, ---over-trained--- to do so.

Or music that is perfectly harmonized and with full spectral coverage, may be more advantageous (i.e some of Bach`s work).

Which idea (if any) do you believe can have some merit?

The overall most important thing in this, is that my brain needs to continue to be able to interpret & remember what bass is, what it sounds like and how it fits in with the rest of the group. Just looking for the most effective way back to this and a way that is not putting at risk this ability.


I believe these conclude my questions, so thank you again & Merry Christmas :)

Vittorio.

Hi

This morning (Monday) the tinnitus was unusaully loud, making hearing difficult, and it lasted for like an hour-and-a-half after getting up (usually only lasts for 20-25mins), gradually changing into a really strong aural fullness, making things equally difficult to hear, if not more.
This lasted the whole afternoon, till about 4.30PM

Also, have been plagued with a slight nausea today, plus the medication has barely worked. (which has never happened before).

Now, in the afternoon, some 7 hours later, the tinnitus/clog level is back to "normal". And the nausea is gone.

On Sunday, I was watching a show on my cellphone, with the speaker angled towards and ca. 45-50 away from my left ear (the afflicted one), with the volume up for 2-3 hours in a row. Also, the language spoken was Polish-which contains alot of "sh-" /"esse-" sounds (rel.high frequency). After some hours, I noticed a slight painful sensation in my ear, so I stopped watching and listening at this close range.

-could this maybe explain the worsening of my symptoms today?


In addition, I took for the first time L-5-Hydroxy Troptophan Complex 45mins before going to sleep, which contains 5-HTP 100mg, Magnesium 50 mg, Vit.B6 10mg & Valerian 100mg. After waking up, I recall I remarked on a feeling of having had a particularly sound sleep. I sleep well naturally, but thought I`d check it out.

Maybe taking this supplement-with the 5-HTP component- while on Adderall, is not a good idea (?);
evidence formed via a study on conscious male rats (undergoing in vivo microdialysis in nucleus accumbens), suggests that increases in synaptic serotonin can reduce the stimulant properties of amphetamine-like drugs. This precursor for 5-HT reduces the Locomotor Activation produced by (+)-Amphetamine in the rat, the study concluded.

I did actually experience reduced coordination-ability today while working on a piece of equipment.

--do you think there could be a connection between this supplement and my experience of the medication not working properly?


Thanks again,
Cheers.

Hi

This morning (Monday) the tinnitus was unusaully loud, making hearing difficult, and it lasted for like an hour-and-a-half after getting up (usually only lasts for 20-25mins), gradually changing into a really strong aural fullness, making things equally difficult to hear, if not more.
This lasted the whole afternoon, till about 4.30PM

Also, have been plagued with a slight nausea today, plus the medication has barely worked. (which has never happened before).

Now, in the afternoon, some 7 hours later, the tinnitus/clog level is back to "normal". And the nausea is gone.

On Sunday, I was watching a show on my cellphone, with the speaker angled towards and ca. 45-50 away from my left ear (the afflicted one), with the volume up for 2-3 hours in a row. Also, the language spoken was Polish-which contains alot of "sh-" /"esse-" sounds (rel.high frequency). After some hours, I noticed a slight painful sensation in my ear, so I stopped watching and listening at this close range.

-could this maybe explain the worsening of my symptoms today?


In addition, I took for the first time L-5-Hydroxy Troptophan Complex 45mins before going to sleep, which contains 5-HTP 100mg, Magnesium 50 mg, Vit.B6 10mg & Valerian 100mg. After waking up, I recall I remarked on a feeling of having had a particularly sound sleep. I sleep well naturally, but thought I`d check it out.

Maybe taking this supplement-with the 5-HTP component- while on Adderall, is not a good idea (?);
evidence formed via a study on conscious male rats (undergoing in vivo microdialysis in nucleus accumbens), suggests that increases in synaptic serotonin can reduce the stimulant properties of amphetamine-like drugs. This precursor for 5-HT reduces the Locomotor Activation produced by (+)-Amphetamine in the rat, the study concluded.

I did actually experience reduced coordination-ability today while working on a piece of equipment.

--do you think there could be a connection between this supplement and my experience of the medication not working properly?


Thanks again,
Cheers.

Hi,

Interesting. I agree, I do not need it for sleep. Nausea is also listed as being one of the side-effects of taking that supplement.

A headache came on later that night, and I `ve learned to differentiate between a couple of types. I`ve inherited migraines from my mother`s side, but this one last night was not it (I think). I took one 100mg of this supplement early evening to see if it helped remove it, and it felt like it did. So I will watchfully reserve it for this purpose.

However, there is one type supplement I am greatly appreciative of, and that is L-tyrosine, and a properly enterprised multi-vit.tablet; I take 1g of the tyrosine & 1 multivit. every day 1 hour before breakfast and I notice it helps to support the effects of the medicine*.

-can you agree that this is a good idea? I experience none of the usual side-effects of *Adderall, except for a slight reduction in appetite. Thus, I feel privileged for it does such a good job with symptom-relief (averaging 90-100%).

Today, the hum is back to much lower volume and I can hear voices (both from speakers and people) ok well (i.e not significant amount of clogginess).

-can I treat this a good news? :)

Do you think that the 5-HTP supplement could have interfered with the work of the amphetamine?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/


Cheers,
V.

Hi,

Interesting. I agree, I do not need it for sleep. Nausea is also listed as being one of the side-effects of taking that supplement.

A headache came on later that night, and I `ve learned to differentiate between a couple of types. I`ve inherited migraines from my mother`s side, but this one last night was not it (I think). I took one 100mg of this supplement early evening to see if it helped remove it, and it felt like it did. So I will watchfully reserve it for this purpose.

However, there is one type supplement I am greatly appreciative of, and that is L-tyrosine, and a properly enterprised multi-vit.tablet; I take 1g of the tyrosine & 1 multivit. every day 1 hour before breakfast and I notice it helps to support the effects of the medicine*.

-can you agree that this is a good idea? I experience none of the usual side-effects of *Adderall, except for a slight reduction in appetite. Thus, I feel privileged for it does such a good job with symptom-relief (averaging 90-100%).

Today, the hum is back to much lower volume and I can hear voices (both from speakers and people) ok well (i.e not significant amount of clogginess).

-can I treat this a good news? :)

Do you think that the 5-HTP supplement could have interfered with the work of the amphetamine?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/


Cheers,
V.

Hi-what I meant to say is that even without the L-tyrosine, I am not having any of the usual side-effects associated with this medication (except for some reduction in appetite).
So indeed, considering that I am using Adderall XR pretty much every day for its excellent symptom-relief properties; the L-tyrosine helps to keep it very effective (whilst minimizing the crashes) at 100-150mg/Kg (1.25grams).

But --without this precursor--my DA levels will be depleted quite fast, and when ADHD is the case there is not much dopamine readily available to play with in the first case.

"Another problem is contamination of these supplements"; this is because these (also) can have the ability to form unexpected metabolites, which may turn out to have both unforseen and unpredictable as well as undesireable interactions with both the host body and the medication one is using, correct?

-it is possible that having an even slightly elevated BP when going to bed (causing the type of headache that tends to go away when you put a cold cloth on the back of your neck), can worsen the condition overnight- making the hum louder/more impairing in the morning and following hours?


/Cheers

Hi-what I meant to say is that even without the L-tyrosine, I am not having any of the usual side-effects associated with this medication (except for some reduction in appetite).
So indeed, considering that I am using Adderall XR pretty much every day for its excellent symptom-relief properties; the L-tyrosine helps to keep it very effective (whilst minimizing the crashes) at 100-150mg/Kg (1.25grams).

But --without this precursor--my DA levels will be depleted quite fast, and when ADHD is the case there is not much dopamine readily available to play with in the first case.

"Another problem is contamination of these supplements"; this is because these (also) can have the ability to form unexpected metabolites, which may turn out to have both unforseen and unpredictable as well as undesireable interactions with both the host body and the medication one is using, correct?

-it is possible that having an even slightly elevated BP when going to bed (causing the type of headache that tends to go away when you put a cold cloth on the back of your neck), can worsen the condition overnight- making the hum louder/more impairing in the morning and following hours?


/Cheers