title: Vitamin B12 levels in patients with tinnitus and effectiveness of vitamin B12 treatment on hearing threshold and tinnitus.
abstract: OBJECTIVE
  The aim of this study was to determine vitamin B12 levels in patients with non-pulsatile tinnitus and to assess the efficacy of replacement treatment in tinnitus and hearing in patients with vitamin B12 deficiency.
  
  
  METHODS
  We assessed 100 patients (mean age, 43.87, SD 10.12; 62 females, 38 males) and 20 healthy volunteers (9 females, 11 males). Patients whose blood serum vitamin B12 levels were below 180 pg/mL were deemed to be vitamin B12-deficient. The effect of vitamin B12 replacement treatment on hearing was examined using audiometric tests between 250 and 20000 Hz, and we compared results with a visual analogue scale (VAS) before and after treatment, which helped to produce an objective assessment of the therapeutic results in tinnitus.
  
  
  RESULTS
  Tinnitus was found to be unilateral in 57% of cases (the right ear in 56% and the left ear in 44% of these cases) and bilateral in 43% of cases. Of the patients with tinnitus, 63 had low B12 vitamin levels, and 37 had normal B12 vitamin levels. No statistically significant difference was found with the control group levels (p = 0.80, odds ratio = 1.13). No significant change was observed in tinnitus severity after vitamin B12 therapy. Eight of these patients reported some relief in tinnitus on the VAS, but the rate of improvement was not significant (p > 0.05). In the tinnitus patients with low B12 vitamin levels, audiometric tests conducted after B12 vitamin treatment revealed a significant improvement in hearing levels only at the 250 Hz frequency. No change was observed at other frequencies.
  
  
  CONCLUSIONS
  B12 replacement treatment was not effective in these patients with tinnitus. Some patients improved following vitamin B12 supplementation but the results were not significant. More studies are needed to find the reasons for, and effective treatment of, tinnitus since the aetiology of subjective tinnitus is highly variable.
authors.affiliation: ENT Department, Okmeydani Teaching Hospital, Sişli, Istanbul, Turkey. gulerberkiten@gmail.com
authors.forename: G
authors.initials: G
authors.lastname: Berkiten
authors.forename: G
authors.initials: G
authors.lastname: Yildirim
authors.forename: I
authors.initials: I
authors.lastname: Topaloglu
authors.forename: H
authors.initials: H
authors.lastname: Ugras
mesh_terms: D000328:Adult; D001299:Audiometry; D001309:Auditory Threshold; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012307:Risk Factors; D014012:Tinnitus / Q000097:blood* / Q000453:epidemiology*; D014806:Vitamin B 12 Deficiency / Q000188:drug therapy / Q000453:epidemiology*