What is Tinnitus?
Tinnitus is the medical term for the perception of buzzing or ringing sounds in the ear even when there is no source of the sound. It is also commonly called ringing in the ears. Tinnitus presents itself in several other ways like hissing, whooshing, roaring or whistling. The condition is persistent and continuous. It may affect one or both ears. Tinnitus affects as many as 50 million people in the United States (x).
Symptoms of Tinnitus
Not only does tinnitus cause subtle ringing sounds, but it may also cause the patient to hear whistling or buzzing in the ears. The sounds may occur in each ear independently or in both ears. Sometimes tinnitus is continuous and sometimes it only lasts for a short while. However, it is a condition of perception. The patient hears the sounds in the ear, but there is nothing in proximity that is actually causing them. That is why they are often called phantom sounds (x). The phantom noises may differ in terms of pitch, either high or low. They can even be loud enough to interfere with concentration (x).
Causes & Risk Factors of Tinnitus
High Blood Pressure
Pulsatile tinnitus is a type of tinnitus related to changes in blood flow. For example, when the arteries harden, it causes atherosclerosis and blood vessels close to the middle and inner ear canal can lose elasticity. It causes blood pressure changes in these blood vessels and the higher pressure can cause dreaded buzzing or popping sounds in the ear (x).
Thyroid Disease
The thyroid is a small gland that makes hormones to regulate energy. Thyroid disease is linked to hearing loss, changes in balance and tinnitus. Both hyperthyroidism and hypothyroidism can cause tinnitus. Hyperthyroidism is when the thyroid is overactive and produces too much of the hormone thyroxine, while hypothyroidism is when the thyroid is underactive and doesn’t produce enough (x).
Meniere’s Disease
Meniere’s disease is a disorder of the inner ear that affects balance and hearing and triggers severe dizziness (vertigo). The disease is a result of fluid buildup that causes pressure in the inner ear. The fluid in the ear helps send signals to the brain. When it builds up, it disrupts the signals from the brain and interrupts normal balance and hearing ability (x).
Meniere’s disease causes the patient to feel pressure in only one ear, but it can spread to the other ear over time (x). It is a chronic condition and there is no cure, but there are several treatments that can help mitigate the symptoms. Patients with Meniere’s disease may experience tinnitus continuously or they may experience it every once in a while. The symptoms may also differ depending on the person (x).
Head or Neck Injuries
Injuries to the head or the neck usually cause tinnitus in only one of the ears, mainly the inner ear. It affects the nerves in the brain responsible for hearing (x). For example, a concussion causes a slight collision between the brain and the skull. This affects the brain’s ability to control hearing. Head injuries cause structural damage to the brain or interfere with the nerves’ messaging system. Tinnitus associated with head and neck issues are called somatic tinnitus (x).
Excess Earwax
Earwax is a natural, vital secretion in the ear. It protects the ear from bacteria, dirt and dust by lubricating the ear canal. The ear cleans itself and usually wax disappears on its own. However, too much earwax can cause hearing problems. Wax can build up in the ear canal if it is very narrow or very dry, possibly leading to tinnitus. Headphones, hearing aids and manually cleaning the ears with cotton swabs can also cause buildup because these objects push earwax down into the ear canal. Earwax buildup in the ear canal puts more pressure on the inner ear, creating blockage and making the patient’s ears ring (x).
Smoking
If a patient already suffers from tinnitus, smoking can worsen the condition in as little as one or two days. This is because smoking interferes with blood flow to the vital nerve cells responsible for hearing. It can also stimulate the sounds, making the ears ring louder (x, x).
Exposure to Loud Noise
Loud noise is one of the major causes of tinnitus. It can also cause damage to a patient’s overall hearing ability. Sometimes tinnitus disappears after a few minutes or hours, but sometimes it can persist for weeks or months. Close range exposure to intense sound can even cause permanent hearing damage. Continuous exposure may also pose a greater risk to hearing ability (x).
Ototoxic Medications
The first sign of an ototoxic medication is usually tinnitus but the patient can eventually suffer hearing loss. These medications have toxic effects on the ear in general because they damage sensory cells in the inner ear and disrupt nerve communication. Ototoxic medications include certain antibiotics, quinine-based medications and cancer chemotherapy drugs. One of the side effects of these medications is tinnitus, which can either be permanent or temporary (x).
Other Health Conditions
Researching the particular causes of tinnitus can prove to be tricky. This is because there are numerous health conditions that can trigger it. Tumors, ear infections, anemia and otosclerosis may also cause the ears to ring (x).
Risk Factors for Tinnitus
Age
Tinnitus can develop at any age, but it is more common in older adults (x). Patients may experience symptoms like age-related hearing loss (x). Old age can cause a decline in the number of operational nerve fibers in the ears (x). It is also more common in men than women (x).
Younger patients may develop tinnitus from exposure to loud noise using headphones or attending music venues. Doctors advise that young people monitor signs of tinnitus and avoid excessively loud music to avoid future hearing damage.
Anxiety and Depression
Symptoms of anxiety or depression may trigger tinnitus. Brain imaging research shows that individuals who hear ringing in their ears have a remarkable depletion in tissue size in the medial prefrontal cortex, compared to those without tinnitus. This area is responsible for modulating sensory information (x). When tissue loses its volume, it reduces the neuron’s ability to suppress unwanted signals, which causes ear ringing. Anxiety, stress and depression originate from malfunctions in the same point of the brain. Cases of depression and anxiety in individuals with tinnitus are more than double the national average (x).
Pregnancy
Tinnitus is more common in pregnant women than in the general population. Pregnancy causes several natural physical changes, such as increased blood volume and blood pressure. It may change pressure in the blood vessels in the ear and change the electrical impulses and cause tinnitus. Circulating estrogen and progesterone may also alter nerve cell activity (x).
Treatment & Remedies for Tinnitus
Sometimes tinnitus might go away on its own. While there is no cure, there are several different remedies that can help patients cope with tinnitus. Some supplements like Vitamin B12 and melatonin can also help, but they are not a replacement for any underlying condition that may cause tinnitus (x).
Clean Excessive Earwax
Excessive earwax is a major cause of tinnitus. However, the best way to clean earwax out of the ears is to allow a doctor to do it. First they will soften the wax with hydrogen peroxide in the ear canal. Warm water may soften the wax and then the water drains from the ears. Dry the ear canal gently. To make sure the excess wax clears, doctors may repeat the process several times.
Hearing Aids
Patients wear hearing aids to hear sounds that are usually masked by ringing sounds in the ears. Hearing aids may help them mask the tinnitus symptoms. Doctors can program hearing aids to reduce tinnitus symptoms. They may also help improve communication if loud tinnitus makes it difficult to follow conversations or take part in social activities. Hearing aids can raise the volume of these activities to mask that of tinnitus (x, x).
Antioxidants
Antioxidants may be an effective treatment since they help reduce oxidative stress and inflammation. Studies suggest that they counteract reactive oxygen involved in stimulating the development of tinnitus. They may also help ease hearing disorders. Antioxidant-rich sources include blackberries, blueberries, pecans and cranberries (x).
Supplements for Ear Health
Vitamin B12
In one study, almost half of tinnitus patients had Vitamin B12 deficiency. Vitamin B12 levels decline with age, which may partially explain why older adults are more prone to tinnitus. Some Vitamin B12-rich sources include eggs, meat, cheese and fish. Deficiency in this vital vitamin causes a decrease in endocochlear function, which can result in tinnitus (x). Vitamin B12 deficiency also disrupts the auditory nerve function. The advised dosage for Vitamin B12 powder is 100 to 200 mg a day as a daily supplement. Taking it as a daily supplement may help in the long term, but consult a doctor before adding supplements to a daily regimen.
Melatonin
Produced by the pineal gland, melatonin is a hormone that helps regulate a healthy sleep cycle. Its nickname is the sleep hormone. Melatonin is one of the natural ways that may help treat tinnitus. It helps patients fall asleep faster and reduces the number of times the patient wakes up during the night. Studies suggest that melatonin helped patients reduce tinnitus symptoms and get better sleep quality (x). The recommended dosage for melatonin powder is 1 to 3 mg a day before bedtime.
Acai Berry
Antioxidants counteract and neutralize free radicals and protect the body from toxins. These chemicals may be an effective treatment against tinnitus. Acai berry is a powerful antioxidant that has been used for years to benefit health. The recommended dosage for acai berry extract is 1,200 mg once a day, unless a doctor recommends another dosage.
Amla (Indian Gooseberry)
Amla is also called Indian gooseberry and it comes from a small tree that grows in India, Pakistan and Bangladesh. For years, people in these regions used amla for medicinal purposes. It is an excellent antioxidant and anti-inflammatory substance. As a dietary supplement, the recommended dosage for amla extract powder is 800 mg once a day or following a physician’s orders.
Asparagus
The ancient Egyptians and ancient Greeks used asparagus for its medicinal benefits. It has vitamins, minerals and protein and it is low in fat. It contains folate, which studies suggest may help lower anxiety and depression. The recommended dosage for asparagus extract powder is 2,000 mg unless a physician advises another dosage.
Zinc
An important mineral to the nervous system, zinc is rich in anti-inflammatory and antioxidant properties. Its sources include beef, almonds, chicken, oysters and cashew nuts. Zinc gluconate powder is a great way to supplement a diet. The recommended dosage for zinc gluconate powder is 225 to 450 mg per day unless a physician suggests otherwise.
Magnesium
Vital to the body’s ability to function, magnesium is one of the most important minerals. It may help maintain normal nerve activity, including the nerves responsible for hearing. Magnesium also helps to keep blood vessels relaxed, which allows for proper blood flow to the inner ear. This will, in turn, allow for protective antioxidant distribution to the cochlea, making it one possible option for relieving tinnitus symptoms (x, x). The recommended dosage for magnesium gluconate is 1,300 mg per day, or as advised by a doctor.
The Bottom Line
Tinnitus is a condition that causes patients to perceive a ringing, buzzing or hissing sensation in the ears. Potential causes include blood pressure changes that disrupt the ear canal and thyroid disease, which is linked to hearing loss and head or neck injuries. Scientists have also discovered a link between tinnitus and anxiety and depression. Another risk factor is exposure to loud noise or age.
Sometimes tinnitus may disappear on its own after a few minutes or hours, but sometimes the conditions that cause it may cause long-term or permanent hearing damage or hearing loss. Avoid exposure to extremely loud noises and avoid cleaning the wax from the ears, as this can cause blockage in the ear canal. Hearing aids may also help patients hear better and block out ringing or buzzing in the ears. Supplements may be able to promote better ear health and hearing ability. However, supplements are not a wholly sufficient form of medical treatment for any underlying condition. Always consult with a physician and follow all medical advice before using supplements.