This post is in two parts, the second focused on the tinnitus issue, which several seem interested in.
I have come across two interesting papers, the first by Bozkurt A, “Safety assessment of near infrared light emitting diodes for diffuse optical measurements.” This makes the point that though there is no or very little danger of heating from the radiated light, the diodes themselves can emit considerable heat, and skin burns can result from direct contact.
The second is Khan I, “Molecular pathway of near-infrared laser phototoxicity involves ATF-4 orchestrated ER stress.” This one deserves a close reading. The lead researcher, Praveen Arany, is a dentist working within NIH who recently succeeded in using lasers to stimulate stem cell repair of damage within a tooth–unfortunately a rat tooth; maybe this is a treatment coming to a dentist near you one day, some day, maybe?? While reassuring us that there is no danger of DNA damage, surface heating is a possibility, as is damage from Reactive Oxygen Species. The latter, interestingly, can be moderated by NAC and Catalase, the former of which is widely recommended for us as a precursor of Glutathione. Such ROS can trigger cellular stress responses, and one partial answer is to take NAC–recall that Glutathione is a key intracell antioxidant which is low or damaged in us. Another answer is once again to remember the basic principle of “hormesis,” the adjustment of dose–not too little, but definitly not too much. But of course they do not suggest specific dose levels for specific conditions. Up to us.
Here are key parts of his conclusion: “The primary photochemical event mediating PBM appears to involve generation of Reactive Oxygen Species (ROS) following absorption by various cellular chromophores, especially cytochrome C oxidase in mitochondria [we all knew that]. The ROs thus generated has the ability to activate several extracellular and intracellular biological pathways. A significant barrier in enabling more widespread use of PBM therapy is our lack of understanding of target tissue parameters and biological responses that has prevented our ability to outline precise device (source, wavelength, dose and delivery) parameters for effective clinical treatment protocols.”
“Previous studies have postulated that the levels of ROS generation could determine the transition from the therapeutic to detrimental biological responses. A similar phenomenon has been observed by toxicologists using various doses of environmental agents termed Hormesis. Indeed, our previous study noted one of the beneficial effects of low amounts of laser-generated excessive ROS involves activation of latent TGF-31 and promotes wound-healing and regneration. Laser generated ROS and concomitant rise in temperature appear to act together to generate phototoxicity. Neutralization of heat or ROS rescues phototoxicity both in vitro and in vivo. The increase in laser-induced tissue temperature appears to reduce activity of crucial cellular ROS neutralizing enzymes Catalase and Glutathione Reductase, which lead to detrimental oxidative damage as shown previously.” . He is clear that there is no “evidence for genotoxicity or mutagenicity” involved, but there is the potential for damage nevertheless. Since we with ME have well evidenced difficulty in clearing ROS, we should take this warning seriously–once more, go low and slow, and take breaks; this is powerful stuff.
So on to my tinnitus update. I was without it for two days, then it came back at moderate level, and has now again diminished . Its reappearance was synchronous with a low barometric storm, which reminded me that I have always been very sensitive to pressure changes. Its resolution or partial resolution comes with a return of high pressure and clear sky. But it is also quite clear that the Vielights have been playing a major role in this–it was my first trial of the 810 that to my surprise gave me an evening of clear ears. Which leaves open the question of just how this effect is being produced–systemic, or local? Is tinnitus produced locally in the ear apparatus, which seems pretty well enclosed in bone, or also in the brain’s processing? Somehow the 810 shone into my nasal cavity but aimed further towards my brain managed to have some effect, and clearly shining the lights directly into my ear canal is having a stronger effect. But they do not adapt to this use gracefully–the nose clip prevents a clean presentation of the tip of the diode housing into the ear canal, producing mild discomfort.
I have also begun checking my ears’ frequency response with a test CD; rather crude, but it gives single frequency checks in the high range (where I have suffered significant though not crippling loss), and using exactly the same setting on the volume control and using high quality headphones I can roughly measure my current range, and see if there is any improvement with time. If this stuff can improve tinnitus, as it clearly can in my case, it may also be able to improve my hearing.
I have two thoughts, both costing money. The first is that Lew Lim makes additional “adaptors” (diode housings with cable) available at $100 for the 633 and $175 for the 810. I could cut off the clip portion and, I am fairly sure, apply the diode housing directly to my ear canal, though would have to hold it there for the duration of the treatment.
Or I could spend more money and buy a Konflec emLas system for rather more, depending on whether I chose 808 or 660 lasers–though I am told I could choose one of each. These units are laser, not LED, and considerably more powerful than the Vielights, though not extravagantly–around 90 or 50 mW–the V 633 is rated at 10mW, the 810 at 7.5mW (the effect of pulsing). Or of course I could continue as I am without further expense and see how it goes, putting up with mild discomfort while I await further results.
But in the meantime I am dealing with a crash, primarily a noticeable loss of energy from an already low level. I think it may have been provoked by overuse of the Vielights, prompted by the excitement of realizing that they, or maybe better the Konftec units, might actually improve my hearing. I think I made the risky and almost certainly mistaken assumption that light directed into my ears would remain there, and not have to be counted in my daily dosing. I was using both Vielights daily–50 mins together–and also both simultaneously for 20 mins, so for 40 mins together, for a grand total of 90 mins. I think that was clearly too much, and I am paying the price. That at least is my current hypthesis. So I end with a warning, strengthening things I have written before (go low, slow, take breaks), aimed particularly at those using a Vielight. Don’t underestimate these little devices. They are very small and low powered and basically very safe, but over time they deliver a functional dose. Treat them with respect and do not overdose. The same applies of course to larger units used on the body or head. This is powerful stuff capable of much good, but also capable of some forms of damage if overused. I think I am experiencing that right now–they have proved capable of lessening or even abolishing my tinnitus, and maybe will even improve my hearing, but I think I will have to focus on one issue at a time–ME or my ears. Trying to treat both simultaneously may be asking for trouble.
student