What to think about when visiting your GP

Supporters often ask us what they should think about before attending their GP for the first time with tinnitus and what to expect.

GPs are generalists and therefore their knowledge of tinnitus may be limited or may be very advanced. You may find it helpful to take this article when you talk to your GP about your tinnitus.

Your GP will want to know about the following. It is worth thinking about these beforehand and even writing down your responses:

Describe the tinnitus:

1. High or low pitched
2. One sided or external or in your head
3. Pulsatile or constant

Risk factors:

1. Have you been exposed to loud noises (either socially at pop concerts or night clubs etc, or through employment)?
2. Have you been exposed to medication which may cause tinnitus (aspirin, quinine, NSAIDS (ibuprofen, naproxen etc), loop diuretics (water tablets), some antibiotics, and some anti-cancer drugs)?
3. Have you recently had benzodiazepines (diazepam, nitrazepam, or temazepam etc) suddenly stopped?
4. Have you had a head injury?
5. Have you increased risk factors for furring up of the arteries - close family members with stroke or heart disease, high cholesterol, high blood pressure?
6. Have you a dietary or inherited risk of low vitamin B12?
7. Any recent change in hearing?
8. Have you noticed any weakness, clumsiness, pins and needles, or other change in sensation in any other part of your body?
9. Do you have a history of heart disease, stroke (or TIA/mini-stroke), or furring up of your arteries in your legs?

Following your discussion and any examination, your GP may arrange the following:

1. To examine your ear for infection or other problems
2. To examine your nervous system
3. A blood test for your vitamin B12 level, and cholesterol levels.
4. A CT or MRI scan of the brain (these are not always available to GPs)
5. Referral to an Ear Nose and Throat (ENT) department
6. Referral for 'tinnitus retraining' or 'counselling'
7. Trial of medication
8. Referral for a hearing aid for one or both ears (this can reduce tinnitus in many sufferers)

Remember that tinnitus is a symptom rather than a diagnosis, and it is very rare to be associated with a significant or worrying problem. There are many things you can do to help yourself:

1. Remember the noise is harmless
2. Consider noise 'masking' - keeping a radio, TV or sound generator on low volume at night etc
3. Try and practice relaxation techniques
4. Wear hearing aids as advised (and ensure proper fitting with your audiologist)
5. Avoid caffeine (in coffee, tea and Coke, etc.)
6. Avoid alcohol (although a small amount may help relaxation)
7. Remember that tinnitus is very common (affects one in ten people at some time)
8. Talk to other people with tinnitus, and what they find helpful

We hope you find this useful, but we are always looking for anecdotal stories or evidence that advance our knowledge of tinnitus, or what might help it.