DEAR DR. DONOHUE: I am writing in regard to my sister-in-law’s problem. She is diagnosed as having tinnitus. I have told her we would get a sensible reply from you. She has gone through numerous tests, but the problem remains. — H.J.

ANSWER: Tinnitus (TIN-uh-tiss or tuh-NITE-iss, whichever way you wish) is a constant ringing, thundering, whooshing or whistling ear noise that won’t go away. For many older people — and it’s older people who are the ones most often stricken with tinnitus — a loss of hearing prompts the onset of tinnitus. Background noise assaults our ears everywhere. That noise dampens noises generated by the brain and heard as tinnitus.Without that auditory input, the inner noise becomes noticeable, and a person has tinnitus. A hearing aid can correct both hearing loss and the tinnitus generated by it.

Hearing loss isn’t the only cause; ear wax can produce it. Ear trauma and ear infections are other reasons for it. Meniere’s (men-YAIRS) disease features spells of dizziness, hearing loss and tinnitus. As time goes by, the interval between spells becomes shorter, and these three features become chronic. Medicines can bring on tinnitus or make it worse. Calcium channel blockers, ACE inhibitors, aspirin, nonsteroidal anti-inflammatory drugs (Aleve, Advil, etc.), some water pills and proton pump inhibitors (used for heartburn control) are among those drugs.

As often as not, a cause for tinnitus isn’t found. In those situations, a tinnitus masker can be helpful. It’s a device much like a hearing aid that emits a sound similar to the tinnitus sound, and that quiets tinnitus. At nighttime, turning on a bedside radio also can drown out tinnitus. If the sound of soothing music doesn’t do it, turn the dial so that the radio produces static. That might turn the tide in your favor.

Your sister-in-law will find a loyal friend in the American Tinnitus Association for information and updates. The phone number is 800-634-8978 and its Web site is www.ata.org.

DEAR DR. DONOHUE: I read that we should eat two meals a week of salmon and a handful of walnuts a day for their omega-3 fatty acids. Are fish oil supplements (1,000 mg a day) as good as, better than or not as good as eating fish? Where does flaxseed oil fit in? — K.S.

ANSWER: Omega-3 fatty acids in fish and fish oil protect against heart attacks and strokes. There are two such fatty acids: EPA, eicosapentaenoic acid, and DHA, docosahexaenoic acid. Two fish meals a week (a total of 8-12 ounces per week) provide the necessary amounts of omega-3s. People who do not like fish or cannot take it for other reasons can meet their omega-3 goal by taking fish oil capsules.There is no difference in the EPA and DHA found in fish or found in capsules.

Eating fish provides other benefits. Fish is a good protein source. Replacing red meat with fish is a healthy dietary move. Fish also have little saturated fat, the kind of fat that promotes liver production of cholesterol. Two fish meals a week, therefore, have their advantages.

Flaxseeds, walnuts and canola oils have alpha linolenic acid, a fatty acid related to EPA and DPA. It too prevents heart attacks, but in a manner different from the fish oil fatty acids. It should be taken in addition to EPA and DHA, not in place of it.

DEAR DR. DONOHUE: In a recent article, you recommended taking 1,200 mg of calcium a day. You also stated not to take more than 500 mg at one time. I am an 82-year-old woman, 4 feet 9 inches tall and weighing 95 pounds. I have osteoporosis. How do I not take more than 500 mg at one time and still get 1,200 mg a day? I find only 500 and 600 mg tablets. — I.H.

ANSWER: You get the daily total by taking one tablet in the morning and another at noon or in the evening. You are a very petite woman. A total daily intake of 1,000 mg is more than sufficient for you. Use whichever tablet you want, the 500 or the 600 mg. The body isn’t that sensitive in its ability to distinguish between the two. Even those who truly need 1,200 mg can get it by taking two 600 mg tablets at two different times. The 500 mg limit to one-time calcium intake is not set in stone.

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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