Originally published in the Summer 2026 issue of Tinnitus Today Magazine

In his presentation at the online Madison, Wisconsin, Tinnitus Support Group, run by Deb Holmen, esteemed audiologist and tinnitus care expert Richard Tyler, PhD, opened with a warning and a fact check. Because tinnitus has different causes and different underlying mechanisms, effective treatment requires different treatments, depending on the cause. This clinical fact, he argued, is what much of the internet tinnitus marketing landscape ignores—and exploits.

Tyler walked through how the Food and Drug Administration handles deceptive product claims. When the agency identifies a violation, based on a report, it contacts the company and issues a warning letter describing the problem. The company then can respond with its own reasoning and supporting evidence. In practice, this creates a familiar pattern on product websites and packaging. Companies add disclaimers stating the material is not an advertisement, that the FDA has not evaluated the claims, and that the product is not intended to diagnose, treat, cure, or prevent any disease. The disclaimer coexists, often awkwardly, with marketing language that implies such things.

Tyler distinguished between two related but different problems. Misinformation is false information that is spread without intent to harm, which can be an honest mistake or because of outdated information repeated in good faith. Disinformation is false information created and spread to mislead. Identifying and countering both, he noted, is a challenge on the internet, where claims travel faster than corrections.

Tyler gave examples from product searches. Several sites used framing around the notion of “the old explanation was wrong.” For instance: “For years, ringing in your ears was linked to hearing loss and loud sound exposure, but new research points to a different, previously overlooked cause.” That “cause” is usually presented as something the company’s product addresses.

Common versions of this marketing language included claims such as insufficient nutrient intake creates neural activity that causes tinnitus or poor blood flow to the auditory system makes tinnitus worse by increasing nerve activity. Products purport to provide nutrients or manage blood flow, thus improving tinnitus. Other listings promoted “relief” medications that claim to be the “best” available or “natural.” These include eardrops that promise success and comfort.

A search for “tinnitus therapy” turned up magnet therapy self-help guides described as “clinically proven,” along with customer testimonials claiming their tinnitus had been cured. Other therapies pitched the ability to “rewire” tinnitus. An herbal patch for tinnitus relief, for instance, was marketed as drug-free. A recurring theme across such products is the suggestion that conventional healthcare providers aren’t addressing the “real” problem.

One example Tyler highlighted was the claim that the source of tinnitus is a structure in the brain that requires a specific nutrient which, when insufficient, causes tinnitus. The product contains it. The framing sounds clinical, follows the logic of the inadequate nutrient and blood flow claims, identifies a plausible-sounding target in the brain, and sells a product that addresses the so-called problem.

He noted that nearly all the products carried some version of the same legal disclaimer: that statements about dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease or health condition.

Against that backdrop, Tyler laid out what decades of research, including his own, support. Tinnitus falls into broad categories. Middle ear tinnitus originates in the middle ear, often from twitching middle ear muscles or pulsing blood vessels. Sensorineural tinnitus originates in the sensorineural system and is generally diagnosed and treated using the same framework used for sensorineural hearing loss, spanning cochlear, vascular, mechanical, sensory, neural, retrocochlear, and central components.

Where people perceive tinnitus varies. In Tyler’s research with Stouffer (1990), 37 percent of patients described their tinnitus as unilateral, 52 percent as bilateral, 10 percent as located in the head, and less than 1 percent as located outside the head.

Spontaneous neural activity plays a role. Activity at the junctions between cochlear hair cells and nerve fibers, and between nerve fibers on the way to the brain, is regulated by chemical transmitter release. Tinnitus may involve an increase in excitatory chemicals, a decrease in inhibitory chemicals, or both.

Tinnitus is not purely a cochlear or peripheral phenomenon. Tyler pointed to several lines of evidence from his research. He noted that cutting the auditory nerve, which should eliminate a purely peripheral signal, succeeds in resolving tinnitus only about 30 percent of the time. Tinnitus perceived unilaterally can sometimes be masked by sound presented to the opposite ear, and low-level sound in the ear opposite the perceived tinnitus can suppress it. As Tyler noted in his own published work, these results are more consistent with a source more central than the cochlea and suggest that even tinnitus reported in one ear can have a central component.

Several physiological models are under consideration. Tyler suggested that more than one cause may be operating at once:

• Increased spontaneous neural activity, potentially driven by an increase, a decrease, or an edge effect in the underlying signal.
• Cross-fiber correlation, in which normal or increased spontaneous activity becomes synchronized across nerve fibers.
• An overrepresentation of fibers tuned to a similar frequency following hearing loss. Perception itself is understood to involve the auditory cortex and, likely, the temporal lobe. When emotional reactions to tinnitus are part of the picture, the amygdala and autonomic nervous system become involved as well, along with other neural systems that can influence the overall experience.

Tyler connected this complexity directly to how tinnitus should be treated. His Tinnitus Activities Treatment approach is built on managing patient expectations and needs, using visual counseling tools, and centering the individual patient’s experience rather than applying a single protocol to every patient.

Identifying each patient’s specific challenges is central to the approach and is supported by tools such as the Tinnitus Open Ended Questionnaire, developed with Baker, and the Tinnitus Primary Functions Questionnaire, published in 2014.

The contrast Tyler drew between internet cures and patient-centered treatment was deliberate. Real tinnitus science describes a condition with multiple types, multiple physiological mechanisms, and treatment built around individual assessment. Much of the product marketing aimed at people with tinnitus describes a single cause and a single fix. That gap between documented complexity and marketed simplicity is where misinformation and disinformation both take hold.