Tinnitus

What is tinnitus?

“Tinnitus” (pronounced “tin-NITE-us” or “TIN-ne-tus”) is the medical term for ringing in the ears. If you have tinnitus, sounds fill your head that no one else hears — like ringing, clicking, pulsing, humming or rushing. These sounds can be so soft you barely notice them or so loud that they seem to block out sounds in your environment. People with severe tinnitus might have trouble concentrating or sleeping. Over time, this can lead to frustration and depression.

Tinnitus isn’t a disease. It’s a symptom of several health conditions like ear injuries or age-related hearing loss. According to research, about 15% of the world’s population has it — including more than 50 million people in the United States. Anyone can get tinnitus, but it’s most common in people between the ages of 40 and 80.

What is the main cause of tinnitus?

Experts don’t know exactly why some people have ringing in their ears and others don’t. But tinnitus is a common symptom of certain medical conditions.

Common tinnitus causes include:

• Age-related hearing loss. Your brain is used to a certain level of sound stimulation. As a result, your hearing nerve is used to a certain level of activity. When hearing loss occurs, your brain receives less stimulation, but your hearing nerve may still fire at the rate it always has. This can cause you to hear sounds that aren’t really there. About 1 in 3 adults over age 65 develop ringing in their ears.
• Noise-induced hearing loss (NIHL). Exposure to loud noises can cause hearing loss and tinnitus. This can happen over time or from a single incident, like an explosion or close-range gunshot.
• Ear injuries and trauma. These injuries may affect nerves or areas of your brain that help you hear. People who get tinnitus after an injury usually only have ringing in one ear.
• Ear conditions. Earwax blockages or ear infections can cause temporary hearing loss, resulting in ear ringing.
• Medications. Certain drugs can cause tinnitus, including some antibiotics, antidepressants, cancer drugs and nonsteroidal anti-inflammatory drugs (NSAIDs).

Less common tinnitus risk factors include:

• Eustachian tube dysfunction.
• Ménière’s disease.
• Temporomandibular joint (TMJ) disorders.
• Vestibular schwannoma (a noncancerous tumor that forms on the vestibular nerve).
• Otosclerosis (abnormal bone growth inside your ears).
• Blood vessel disorders, which can cause pulsatile tinnitus — a rare form of ear ringing that happens in time with your heartbeat.
• Autoimmune diseases like lupus or rheumatoid arthritis.

People with tinnitus may experience flare-ups after exposure to certain triggers like stress or sleep deprivation. As you can imagine, this can result in a frustrating cycle.

How is tinnitus treated?

Tinnitus treatment depends on the cause. To learn more about the ringing in your ears, a healthcare provider (usually an audiologist) will do a physical examination and check your ears for any obvious issues. They’ll also ask about your medical history and whether you’ve had recent exposure to loud noises. Depending on your situation, they may refer you to an otolaryngologist. They can determine if you have any medical conditions affecting your ears.

Because tinnitus is a symptom of many conditions, providers may be able to treat it by addressing the underlying cause. But they may need to run tests to get an accurate diagnosis. These assessments might include:

• Hearing tests like pure-tone audiometry, speech understanding and tympanometry if needed.
• Blood tests to check for heart disease or other health conditions.
• Imaging tests like MRI (magnetic resonance imaging) or CT (computed tomography) scans.

You may also need an evaluation with a dentist to determine if tinnitus is a symptom of temporomandibular joint disorder (TMD).

What is the best way to deal with tinnitus?

For many people, tinnitus sound therapy can be very effective in decreasing how noticeable or bothersome your tinnitus is over time. An audiologist might recommend that you:

• Use a noise machine. Things like white noise, nature sounds or ambient soundscapes can help distract your brain and reduce your tinnitus symptoms. You can purchase noise machines for this very purpose, but many fans and humidifiers emit white noise that can help with ear ringing, too. You can also find white noise playlists online or download noise-generating apps to your smartphone.
• Wear in-ear noise generators. These are earbuds that give off a continuous white noise hum. You can wear them during the day whenever you need tinnitus relief. You shouldn’t sleep with these in, though. If you need a device for nighttime use, ask your audiologist about other options (like a headband with built-in headphones).

What are the possible complications of untreated tinnitus?

Left untreated, ringing in your ears could lead to:

• Anxiety.
• Depression.
• Irritability.
• Difficulty concentrating.
• Difficulty communicating.
• Cognitive decline.

Can tinnitus be prevented?

Because tinnitus is a symptom of other health conditions, you can’t always prevent it. But you can take steps to protect your hearing, which can help reduce your risk. Hearing protection may be warranted:

• When working in construction or factory settings.
• In certain performance arts or music careers.
• In some exercise classes. Many gyms play loud music for motivation.
• At concerts and movie theatres. Noise levels at these types of events can be too loud and may harm your hearing over time.
• When using power tools, mowing the lawn or utilizing other loud equipment.
• With the use of firearms like recreational shooting or hunting.

You should also be mindful any time you wear headphones or earbuds. Protect your ears by keeping the volume low.

Audiologists can fit custom hearing protection. Consider seeing an audiologist for this service if you participate in one or more of these activities frequently.

When should I see a healthcare provider about ringing in my ears?

You should schedule a visit with a healthcare provider if you have:

• Ringing in your ears that lasts for more than one week.
• Hearing loss.
• Dizziness.
• Vertigo.
• Tinnitus that sounds like your heartbeat.

If you develop sudden hearing loss in addition to tinnitus, schedule an appointment with a healthcare provider immediately. Treatment for sudden hearing loss is most effective within the first three days.

Can you live a long life with tinnitus?

Yes, you can. Tinnitus itself doesn’t shorten your life expectancy. But some underlying conditions, like heart disease, could affect your lifespan.

What is tinnitus a warning of?

It’s not always apparent what causes tinnitus. But there are common links in some people:

Having the above symptoms doesn’t necessarily mean that you have the corresponding conditions. If you notice something isn’t quite right, you should tell your healthcare provider so they can give you a proper diagnosis.

Will tinnitus go away?

It depends on the cause. If your ears are ringing after you leave a loud concert, it’s probably temporary. But if you still have tinnitus after a week or two, there’s probably something else going on.

There’s no standard tinnitus cure. But providers can often treat underlying conditions and help you manage your symptoms.

What should I avoid?

If you have ringing in your ears, try to avoid:

• Total silence (this can make symptoms worse because the ringing is more noticeable).
• Exposure to loud noises.
• Common tinnitus triggers like poor sleep quality and extreme stress.

Foods to avoid with tinnitus

Some experts believe that nutrition plays a role in whether people experience tinnitus. There’s limited research about this topic, but recent studies suggest that these foods and beverages may increase your risk for tinnitus:

• Caffeine.
• Salt.
• Saturated fats.