DEAR DR. DONOHUE: I am 55 and have been diagnosed with tinnitus. The doctor said I would have to live with it. The ringing is always there and has gotten louder. Since my insurance does not cover nonmedical hearing problems, I am hesitant to go to a specialty medical center for exotic tests. Do you have any suggestions for tinnitus? – J.E.

ANSWER: Tinnitus (TIN-uh-tuss or tuh-NITE-us) is a buzzing, ringing, whooshing or pulsating ear noise that affects up to 50 million North Americans and drives them to distraction. It’s not a disease. It’s a symptom that something has gone wrong with the inner ear or with the nerve that transmits sound sensations to the brain. The first order of business is locating the problem.

For many, it results from hearing loss. If a person with normal hearing is put in a soundproof room, in a short time, that person will complain of hearing ear noises. The inner ear constantly generates those noises, but with an intact hearing apparatus, those sounds are suppressed and we don’t pay attention to them. For the hearing-impaired, a hearing aid is often the answer to tinnitus.

Tumors of the hearing nerve can also bring on tinnitus. They have to be removed.

Medicines are a major cause, and you should bring a list of all the ones you take to your doctor.

Caffeine and nicotine increase tinnitus’s loudness, so they should be avoided.

If the underlying problem can’t be fixed, a tinnitus masker can make the noise less intrusive. It’s a little device that fits in the ear like a hearing aid. It emits a noise that blocks the tinnitus racket from reaching the brain. At night, by tuning a bedside radio’s dial to soft static, the same effect can be obtained.

Tinnitus is a medical condition. Check with your insurer about whether treatment for it is covered. Also check with the American Tinnitus Association, which can provide information on this common condition. You can reach the Association at 1-800-634-8978. Canadians might have to dial 1-503-248-9985. The Web site is www.ata.org.

DEAR DR. DONOHUE: My mother came down with Alzheimer’s disease when she was 80. Am I likely to get it too? Her sisters lived into their 90s without any signs of it. – R.R.

ANSWER: It’s impossible to make such predictions, because the genetics of Alzheimer’s disease haven’t been clearly worked out.

Many years ago, I read about identical-twin studies. Identical twins have the same genes. If Alzheimer’s were purely genetic, then both identical twins should come down with the illness, but they often do not. So, more than genes are implicated.

Scientists are tracking down the genetic implications of this common condition and should have an answer in the near future.

The booklet on Alzheimer’s disease explains the illness in great detail. Readers can obtain a copy by writing: Dr. Donohue – No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have trouble swallowing meat. It gets caught somewhere in my esophagus, and I can feel it there. My doctor says it’s due to a ring, whatever that is. He says he can enlarge the ring with a weight on a tube that is passed through my mouth. I don’t fancy this. Is there some other way? – B.F.

ANSWER: The “ring” is a web of tissue in the lowermost part of the esophagus. It’s called a Schatzki ring. The procedure your doctor proposes is not a fun way to spend a morning or afternoon, but it is not as bad as you might imagine. Dilating the ring in the way your doctor described almost always solves the food-sticking problem. It’s the only way to do the job without having to submit to an operation.

The dilation goes by the name of bougienage (BOO-zhee-NAZ).

DEAR DR. DONOHUE: I take a multivitamin specifically for macular degeneration. It contains 268 mg of vitamin E – among other things.

I have read where you and many others say that too much vitamin E is dangerous. I don’t know what to do.

Should I continue to take this vitamin? – D.H.

ANSWER: The recommended daily allowance for vitamin E for adults between 19 and 51 is 15 mg and for those over 51, 12 mg.

High doses of vitamin E were once touted as a way to prevent heart disease and cancer. They do neither. In fact, they can increase the risk for heart failure.

It’s been found that a formulation that includes 268 mg of vitamin E can slow the progression of dry macular degeneration from moderate stages to more advanced stages. Dry macular degeneration is the more common form of this prevalent eye disease. So long as a doctor has prescribed it for you and is monitoring your progress, you can feel safe in taking that dose. Self-medication with high doses of vitamin E is something to be discouraged.

The formulation also includes vitamin C, vitamin A, zinc and copper. It is not a cure for the condition.

Readers who would like more information on macular degeneration can obtain the booklet on that topic by writing: Dr. Donohue – No. 701, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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