What are the effects of THC and CBD for Tinnitus?
By Barry Keate
Barry Keate, has lived with tinnitus over 40 years and has published 150+ research articles on numerous aspects of tinnitus. He is an expert on the condition and a well-known advocate for those with tinnitus.
Since the legalization of cannabis, in some form, in 33 US states, there has been an avalanche of interest into the medicinal uses of marijuana. Many claims have been made that it can alleviate or cure multiple medical conditions. Some of these claims are based on solid evidence while others are not. Although this is a hot topic, very few studies have investigated the effects of cannabis on hearing loss, hyperacusis, tinnitus and balance disorders. Now there are some early indications as to what effects cannabis may have on the hearing and balance system.
This article is largely based on the paper, “Cannabis and Hearing Care” by Dennis Colucci, AuD, and published, in two parts, in The Hearing Journal, July and August, 2019. (1) (2)
History and Use of Cannabis
Many ancient civilizations grew cannabis for fiber and seed production. They also used it for religious or medical use starting in Asia at around 2700 BC.
In the early 1800’s, it was found that cannabis extracts helped reduce the pain and vomiting of people who had cholera. By the late 1800’s, US doctors and pharmacists were prescribing cannabis extracts for nausea and stomach problems.
Recreational use of cannabis started after the Mexican Revolution in 1910 when marijuana, cultivated in Mexico, became available for smoking. Because of the psychoactive properties of the plant, cannabis was criminalized in the US in 1937.
In 1973, President Richard Nixon signed the Drug Enforcement Act as part of his “War on Drugs”. This made all cannabis products, including hemp and marijuana, illegal and stopped research into potential benefits. It was not until the 1990’s that the benefits of cannabis started to be explored.
Modern Day Uses of Cannabis
The two primary cannabis compounds in use today are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the compound that gives the traditional “high” of marijuana,
while CBD is non-psychoactive and does not give a high. Both are now being studied for their effects on human health and well-being.
Several systematic analyses, randomized trials, and observational studies include evaluations of THC and/or CBD on cases of multiple sclerosis, Alzheimer’s disease, autism, PTSD, inflammation, Parkinson’s disease, cancer and epilepsy. The US Food and Drug Administration (FDA) has approved the use of cannabis for chronic pain, nausea and vomiting related to chemotherapy, and appetite stimulation for patients with cancer or HIV. Furthermore, multiple studies have shown a reduction in opioid use following the introduction of cannabis.
CBD has been approved by the FDA for the treatment of refractory epilepsy. This is epilepsy that does not respond to typical pharmaceutical treatment. Over 50 million people worldwide have epilepsy and about a third of those have seizures that do not respond to treatment. In fact, the FDA has approved Epidiolex, a 99% pure oral CBD extract for use by children and adults with refractory epilepsy, because the addition of CBD has been proven to reduce seizure frequency.
In one of the largest clinical studies on cannabis usage and effects, over 3,000 people who used either THC or CBD reported on the severity of their symptoms before and 90 minutes after usage. Symptoms were organized in 27 categories, including back pain, sleep and depression. The participants reported and average improvement of 31.8%. According to study authors, THC products provided the greatest relief and smoking THC was the most widely used method.
The authors concluded that cannabis provides symptom relief and has both positive and negative side effects. There are short-terms risks to the use of THC, including functional safety issues, product toxicity and abuse, and various health concerns. However, unlike THC, CBD potency was not associated with side effects or immediate symptom changes. CBD is non-psychoactive, non-addictive, and well-tolerated with a good safety profile. No evidence shows that recreational use of CBD results in public health-related problems. However, in this study, CBD was less effective than THC in addressing participants symptoms.
Cannabis for Hearing Loss and Tinnitus
Only a few studies have looked into the use of cannabinoids for hearing loss, tinnitus and balance disorders and there is much more work to be done here.
One study examined the potential of cannabinoids to inhibit the action of a particular receptor (TRPV1) that responds to stimuli and causes pain and cellular injury. This receptor’s activation is responsible for the pathological development of cystitis (inflammation of the bladder), asthma, epilepsy, diabetes and hearing loss. The use of CBD as an inhibitor of this receptor may have clinically therapeutic potential.
Cisplatin is a powerful chemotherapy drug, which produces widespread hearing loss and associated tinnitus. Another study evaluated the use of cannabinoids in maintaining normal hearing in laboratory rats. They were given cannabinoids through transtympanic injections before being given cisplatin. These injections were given through the eardrum and the drug surrounded to cochlea, perfusing into it. The results showed hearing was protected from cisplatin damage.
Another study, with apparently opposite effects, was conducted on laboratory rats with prior hearing damage. This study showed cannabinoids may increase the occurrence of tinnitus in previously hearing-impaired rats.
There is obviously a great need for much more study in this area. Laboratory animals are used before trials on humans in order to determine safety, dosage and effectiveness. Results concluded in the laboratory frequently do not transfer to humans in the same way so large human studies are necessary.
So far, it seems that cannabinoids may be valuable in preventing hearing loss due to ototoxic medicines. This would be a tremendous advantage to millions of people who have to use medications that may damage their hearing. However, if hearing loss has already occurred, cannabinoids may worsen the condition and actually cause tinnitus
Mike Tyson’s Doctor Examines If CBD Can Relieve Tinnitus Or Hyperacusis Extreme Sound Sensitivity
Tinnitus is a common condition, as over 50 million Americans suffer from this problem, as they seem to hear constant noise or ringing in their ears. While much of this problem can be blamed on aging, the problem can arise as a result of head and neck injuries, a virus, acoustic shock, vascular diseases, and more. Over time, many people are able to become accustomed to this noise, but others find the discomfort to be overwhelming. As researchers learn more about what CBD can do for the body, is tinnitus one of the conditions it can improve?
Laguna Hills audiologist Dr. Dennis Colucci believes that it can help with relief from the stress and anxiety of tinnitus, but maybe not the actual problem. Dr. Colucci states that the anxiety is often the bigger issue, adding that the most debilitating tinnitus patients often become “so anxious it can actually turn into a psychopathology.” The idea of working to stop the ringing becomes an obsession, ultimately making the condition harder to handle.
Dr. Colucci is an executive with Mike Tyson’s cannabis brand called Tyson Ranch. One subject of interest for Tyson’s businesses is the potential treatment of chronic traumatic encephalopathy (CTE) with cannabis. Dr. Colucci fields that the CTE research could potentially lead to treatment of brain injuries and even tinnitus.
Many of the treatment for tinnitus rely on the use of cognitive behavioral therapy, sound and music therapy, and meditation for relaxation. Many medications that treat the same anxiety have been tied to adverse side effects. CBD, considering the few side effects (if any) is poised to be an attractive alternative. At this point, Dr. Colucci is the first scientist that sees potential for CBD with treatment of tinnitus.
With additional research, perhaps CBD could ultimately be used in more ways than what is presently imaginable.
I've been living with Acoustic Shock and Hyperacusis with pain, with a serving of intense Tinnitus on the side. Hyperacusis means everything that sounds normal to most is extremely loud for me, yet the type I have also comes with pain. Noise is pain. Once the pain starts it continues on, as though something within my ears were burning. The ears also get a sensation of pressure and fullness.
Acoustic Shock is how I got stuck with Hyperacusis and if a noise is sudden, loud and catches me off guard I get another episode of shock which means I'll get disoriented, light headed, a sense of detachment, adrenaline, aural fullness (where it feels like something is physically wedged in my ears) and sometimes sound becomes a bit muffled in one ear. When I come down from that I will be greeted by intense stabbing ear pain, extremely heightened super hearing and a great deal of anxiety. If the stabbing subsides there is still a heavy sense of pressure and pain. On a 'regular' day noise can gradually or immediately trigger a fight or flight instinct (I'll feel increasingly aggressive or freaked out) but Acoustic Shocks drive that all the way up to an intense sense of endangerment. I've worked to try and delay or avoid anxiety and aggression towards sounds with mindfulness and acceptance techniques, but when they are that intense and instinctual I can only seem to ride it out.
I've worked at methods to tolerate pain and I've made progress, I also am trying the TRT method (playing controlled levels of white noise via hearing aids) to retrain my brain to filter in sound at normal levels, but the Acoustic Shocks cause me to backtrack severely on any progress. The anxiety that comes with it and the depression living this way, as well losing my plans and lifestyle, has got me feeling increasingly distanced from whoever I used to be. Days of intense pain are starting to make me feel strange and less of a person, more of a twisted experience. It is a very isolating injury, I can't tolerate being outdoors for long. I've tried various forms of assistance in the instances they've been available for me (learning facial massage to calm nervous system feeding into the pain, therapy, pain management) but nothing helps with the extreme ongoing pain once its triggered and I think finding a way to relieve it would give me a better chance at steady progress.
Recent research is showing that the pain appears to be nerve damage within the cochlea. There isn't a great deal of research as it's such a difficult part of the body to examine. Interest in finding solutions is growing and I'm glad for that but I really need some help with the pain now.
Where I live it is legal to purchase medically. I've been researching different dispensaries and menus via sites with a positive reputation, as well as via Leafly, and I notice prices tend to jump a bit. I'll see CBD heavy pheonix tears that claim to be from the same provider going between 40-70. I was initially looking into whatever was almost strictly CBD but I've been hearing that a balance of THC can have better results, depending on the problem and the person. I'm not sure what sort of balance of CBD and THC would offer the most benefit. I tried a piece of a friend's pot cookie last year and within half an hour my hearing was augmented intensely. Unbearably. My brain had locked on to clanging sounds in a kitchen from across a restaurant I foolishly agreed to go to and wouldn't leave. I could hear everything in that room like it was next to me and the noise in between was a dizzying blur. The people next to me were too loud to really focus on. I had to leave. Such projected hearing made me feel so disoriented and lasted for a few hours. :p On another occasion I had tried smoking a friend's joint to see if it would help but it only augmented my anxiety and unease.
I hope to at least try what I can and see if it offers any relief. I really appreciate any help, experience or insight. If anyone has experienced similar pain and found a solution that would also be awesome to learn about. My priority is the pain, followed closely by the fight or flight anxiety and depression. Tinnitus would be a bonus as it's a bit intense but since so many noises already distract me it's just like a sort of background orchestra hanging out. It only becomes impossible to ignore whenever I resort to earplugs.
tldr: Looking for recommendations to manage nerve related ear pain and noise triggered fight or flight anxiety. Thanks!