Injection impact on tinnitus

[will49]

The Tinnitus I had was debilitating, and I am glad it went away, and so I'm too scared to return to PDE5i's, incase the Tinnitus returns and doesn't go away.

How long did you have it before it went away?

It's been 4+ years for me. I have good days and bad days but never a silent day. Stress, lack of sleep, lack of exercise, MSG, spicy food, viagra, and listening to music at even a moderate level make it worse. Nothing makes it better.

[bldoink]

I had it before the pills. Firearms and sirens I guess and other loud noises. It's worse on the pills but seems to return to it's normal level after a few days. It's permanent and there's no cure. I don't usually think about it but reading this discussion I hear it loudly. Complete silence does not exist in my world.

The first time I heard it I was way up high on the mountain in an a'a lava field in mist. Think sound deadening insulation. No other sound other than the crunch of my steps. All I could hear was the loud whine of a big transformer. I kept trying to locate the transformer but eventually figured out it was in my ears.

I now need to go occupy my mind elsewhere so I can quit thinking about the noise.

[JohnSmith]

Yeah the trick with tinnitus is to just forget about it, easier said then done but even though mine is pretty intense I can already not notice it (until I look for it then it is loud!)

Had a trial injection yesterday of monomix, no impact on T of course, but a bit of an ache for a while afterward. Needle was way smaller than I thought thankfully. Not sure of the dose but it was very conservative, even so it seemed to be pretty close to what was needed (considering there was no stimulation or anything involved), erection felt a little strange but certainly enough to get things started, and thankfully didn't stay around too long (my greatest worry) I have a follow up in a week to dial in the dose a bit more and get training on how to do it.

I kinda want to try L-citrulline, but it is fairly similar to what PDE-5 inhibitors do ultimately (vasodilation through increased NO). The questions is what aspect of the inhibitors impacts T, is is just the vasodilation? Increased NO? Or is it specifically the way the inhibitors prevent the NO regulation? If it is the last one then L-citrulline would be fine, and if it is a sensitivity threshold for vasodilation/NO then citrulline may be ok, I am not sure the empirical differences between low dose Cialis and citrulline in terms of NO/vasodialation.

That being said I may trial L-citrulline for a few weeks. If I feel it is making the T worse that answers a lot of questions as to what about the inhibitors impact T.

[frwmw1]

How long did you have it before it went away? It's been 4+ years for me. I have good days and bad days but never a silent day. Stress, lack of sleep, lack of exercise, MSG, spicy food, viagra, and listening to music at even a moderate level make it worse. Nothing makes it better.

The acute tinnitus took 3 months to go away, usually they say that if it's not gone in 4 weeks it's likely permanent.

I had it before the pills. Firearms and sirens I guess and other loud noises. It's worse on the pills but seems to return to it's normal level after a few days.

I had background tinnitus that did occasionally flair up, but nothing like this.

The situation was like as you describe after pills, except it took months to recede, not days.

Yeah the trick with tinnitus is to just forget about it, easier said then done but even though mine is pretty intense I can already not notice it (until I look for it then it is loud!)

That's what they say, but it is strange that certain medications seem to aggravate it, and it's the same medications known to increase the risk of SSHL.

Nevertheless I found that focusing on it "improving" helps the brain start to mask it out.

The problem with Viagra is it was only found to linked to SSHL after it was released, and not during the trials, so there's no further research on it. Doctors prescribe it so much, they dismiss the idea of it being ototoxic. Yet a lot of people report getting acute tinnitus from it in forums. I wish they would do more research on it.

[JohnSmith]

https://www.tinnitusjournal.com/article ... nnitus.pdf

Interesting research in regards to how the PDE-5 inhibitors could spike tinnitus, and it would appear to be through NO increase, if this is the case L-citrulline would probably spike it too.

[frwmw1]

https://www.tinnitusjournal.com/articles/the-noonoo--cycle-as-the-etiological-mechanism-of-tinnitus.pdf

Interesting research in regards to how the PDE-5 inhibitors could spike tinnitus, and it would appear to be through NO increase, if this is the case L-citrulline would probably spike it too.

Yes, that's the same paper I read that indicates a pathway, my question is, doesn't this indicate PDE5i's are ototoxic and could contribute to increased tinnitus?

[JohnSmith]

I believe that PDE5 inhibitors are recognized as ototoxic (not just possibly ototoxic like the million meds that have tinnitus as a possible side effect, but up there with some of the other main classes of drugs that have hearing problems)

What isn't known is why exactly. Is it the NO/vasodilation, or something else? The drugs are not perfect in their selectivity, and do inhibit other PDEs to varying extents, which can cause some of the other well known side effects (the vision issue from Viagra is linked to it's inhibition of PDE6 for example).

There are other PDE in the ear: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677782/ (this article actually mentions the PDE5i class)

Also inhibition of PDE3,4, 5 can induce hydrops: https://pubmed.ncbi.nlm.nih.gov/27685753/
And another paper with a recoded case of hydrops in a human after tadalafil: https://pubmed.ncbi.nlm.nih.gov/30208203/

The timing is interesting too, when I last took tadalafil my T didn't spike until 8 hours later, so I don't think it is just the vasodilation but the NO cycle downsteam effects or some strange PDE inhibition

I'm going to try L-citrulline when I feel my T and everything is stable, as there is a chance it doesn't spike it and that would tell a lot about what is going on, but it hasn't been consistent enough lately to let me evaluate correctly.

[JohnSmith]

I would clarify that the scientific/research community appears to acknowledge they are ototoxic somehow, but most GP/Urologists do not.