I have achieved effectively permanent relief from tinnitus. And not just habituation, adaptation, or acceptance; I no longer hear the ringing (except very quietly if I really plug my ears and really listen for it, but this probably matches the same level of ringing that I heard before I considered myself to have tinnitus)

In the summer of 2016, I first noticed some ringing in one of my ears when I would insert ear plugs at night. I shared my concern with an ENT who then prescribed ciprofloxacin ear drops. I administered it that night to the one ear and awoke a few hours later to profoundly increased ringing. It was bad enough that it triggered pretty severe suicidal ideation. It also greatly exacerbated my difficulty sleeping, which in turn exacerbated the tinnitus, forming a feedback loop. By late 2017, I also started to develop migraines, intermittent brain fog, and malaise. Addressing these symptoms became a higher priority than the tinnitus, although I believed them to likely have a common cause.

After the first year or so, I very gradually began to habituate to the tinnitus. By early 2019, I had largely habituated to it. I could still hear the ringing regularly, but it no longer contributed to low mood or insomnia. My other neurological symptoms had also somewhat abated.

Throughout that time, I had visited many doctors: ENTs, audiologists, general neurologists, cardiologists, a migraine specialist, a sleep specialist, gastroenterologists. None of the doctors were helpful at all. I had a full battery of tests and none revealed anything abnormal.

Around mid 2019, I had mostly given up on doctors being able to help my condition and instead determined that I'd have to figure it out myself.

After years of trying to directly resolve the neurological symptoms, I eventually reasoned that I probably had some sort of more systemic issue of which the tinnitus was merely one symptom. This was initially difficult for me to accept as I was otherwise generally "looked" like I was in good health: I worked out regularly (both cardio and weightlifting), I mostly ate healthily, I didn't drink very much, I didn't do any other recreational drugs, I socialized regularly.

I then set out to try every possible intervention which was generally safe and which could potentially improve my health (not just the tinnitus, but my health holistically). I tried tons of supplements individually. I reduced my dairy intake. I tried low FODMAP. I tried various prescription drugs (CGRPi, beta blockers, blood pressure medication, etc.). I started to do red light therapy regularly. I started to sauna (both dry and infrared) regularly. I did extended water fasts (5-7 days), which provided surprisingly large (albeit temporary) symptomatic relief. I did some gut microbiome protocols. I tried some other protocols for eradicating latent infections. I tried protocols for improving mitochondrial health and protocols for addressing chronic fatigue syndrome. I tried stem cell therapy, both autologous and umbilical cord-derived.

Throughout late 2019 and through 2020, I increasingly started to notice times where I couldn't find my tinnitus, even when I was looking for it. Unfortunately, I couldn't very easily correlate this with any particular intervention. I also was executing multiple interventions simultaneously, so attribution would have probably been impossible anyway.

Since late 2020, my tinnitus has been more absent than it is present. I cannot hear it today, even if I listen for it and try to trigger it. The last time I recall hearing my tinnitus involuntarily was mid 2021.

I wish I could tell you definitively what caused my tinnitus and which intervention(s) worked for me.

My best guess is that I had some sort of gut dysbiosis which resulted in elevated ammonia and hydrogen sulfide levels in my blood. These toxins are known to harm both mitochondria and neurons, which could manifest as tinnitus (and eventually as my other symptoms). This gut dysbiosis likely originated from the time that I got very bad food poisoning twice within two weeks while visiting Southeast Asia; I also had terrible appendicitis in the months following that, ultimately culminating in the removal of my appendix.

Red light therapy improves mitochondrial health (which in turn improve anything which relies on ATP production, which is quite literally everything). It seemed to help me.

Sauna also improves mitochondrial health. Sweat contains more ammonia than does plasma, and so the sweating from sauna likely reduces ammonia levels (and possibly other toxins like hydrogen sulfide, too). This also seemed to help me.

When I fasted, I stopped fueling my gut microbiome, which meant that they stopped producing those toxins. This could explain why I noticed such sudden relief. This also clued me in to this being some sort of diet or digestive issue.

I think the gut microbiome protocols helped, but by the time I had started those, my symptoms were already abating. These also tend to be a bit hit-or-miss, and they can take months to impact symptoms.

But this theory as to the origin of my condition and what specifically resolved it is probably colored as much by my a priori beliefs about what would work as it is informed by my actual experience.

That being said, I do think the general approach of "aggressively try everything (safe) which could potentially improve your health" worked for me and could likely work for many others.