Turning Down the Volume on Tinnitus: Causes, Tips, and Treatments for the Ringing in Your Ears
Dr. Jessica Lee is an ear, nose and throat (ENT) doctor, also known as an otolaryngologist, practicing in Charleston, SC. Dr. Lee specializes in diseases and disorders of the ear, nose and throat as well as other parts of the head and neck, but approaches her patients with a holistic view. Such awareness allows her to treat... more
Tinnitus is the perception of sound without any external noise source, often described as ringing, buzzing, or humming. It’s a common yet often misunderstood condition that affects an estimated 10-25% of the population. Tinnitus can vary in severity, with some individuals experiencing it occasionally and others facing daily disruptions to their sleep and overall quality of life.
What Causes Tinnitus?
Tinnitus usually arises in response to an issue with the ears or hearing system, such as hearing loss, an ear infection, or even wax buildup. The brain’s auditory centers, located in the temporal lobe, may become hyperactive, producing the sensation of sound. This hyperactivity occurs when there is a disruption in the balance between excitatory ("go") and inhibitory ("stop") signals in the brain due to hearing loss. Essentially, the brain compensates for the lack of sound input by “creating” its own. This is why tinnitus is more noticeable the more quiet a room is, because there is less "input" noise for the brain.
A good way to think about it is as "two side of the same coin". You may only see one at a time, but they are both present and linked together. Some people notice tinnitus first, others notice hearing loss first.
Certain medications, known as ototoxic drugs, can cause tinnitus as a side effect. These include nonsteroidal anti-inflammatory drugs (NSAIDs), certain antibiotics (like aminoglycosides), and chemotherapy drugs, which can damage the auditory system. In some cases, tinnitus caused by medications can be reversible once the drug is discontinued, but the severity and reversibility vary depending on the specific drug and duration of use.
Since tinnitus is a neurologic symptom, several factors can exacerbate it, including caffeine or alcohol intake, stress, anxiety, and certain medications (like NSAIDs and specific antibiotics).
How Hearing Protection Can Help
One effective way to prevent tinnitus is through regular hearing protection, which can safeguard against premature sensorineural hearing loss — a common precursor to tinnitus. While some individuals are genetically predisposed to hearing loss, using earplugs or earmuffs in noisy environments can reduce the risk of long-term hearing damage and, consequently, help prevent the onset of tinnitus. This may include concerts, power tool use, lawn equipment use and other noise exposures.
Interestingly, not everyone with tinnitus finds it distressing. For some, the condition might not interfere with daily life, but for others, the persistent sound can severely impact sleep, work, and overall well-being.
Traditional Methods for Managing Tinnitus
Unfortunately, there is no cure for tinnitus, especially when it’s related to irreversible hearing loss. However, several management strategies aim to alleviate the distress associated with the condition. One well-researched approach is Cognitive Behavioral Therapy (CBT). CBT has been shown to reduce the emotional impact of tinnitus, helping individuals develop coping mechanisms to manage the condition.
Another emerging area of treatment is neuromodulation, which involves using electrical or electromagnetic stimulation to reduce the hyperactivity in the brain that causes tinnitus. Although this approach is still under investigation, it offers promising new hope for those suffering from more severe symptoms.
Can Supplements Help with Tinnitus?
Over the years, various supplements have been suggested as potential remedies for tinnitus. However, the evidence supporting these treatments is inconsistent. One theory behind tinnitus involves oxidative stress in the inner ear, which results from damage caused by noise exposure, aging, ototoxic drugs, or even autoimmune conditions. This oxidative stress produces reactive oxygen species (ROS), which can harm inner ear tissue.
Many tinnitus supplements are antioxidants, which are believed to help combat oxidative damage. These may be beneficial as a preventive measure, but their effectiveness after damage has already occurred is still uncertain. Instead of relying on supplements as a primary treatment, it’s better to focus on a balanced diet rich in natural antioxidants and essential vitamins, such as those found in fruits, vegetables, and foods rich in vitamin B12.
The Role of Cognitive and Emotional Health
Tinnitus is not just a physical condition; it also impacts cognition and emotional well-being. Studies have shown that mindfulness-based therapies and interventions can significantly reduce tinnitus distress and improve overall health-related quality of life. By addressing both the mental and physical aspects of the condition, these therapies help individuals adjust and cope with the daily challenges of tinnitus.
In addition to CBT, other therapies like sound therapy and combination treatments, such as the FDA-approved device Lenire, are showing promise in managing tinnitus symptoms. Sound therapy works by introducing neutral or soothing sounds to distract from the perception of tinnitus, while neuromodulation devices aim to recalibrate the brain’s abnormal activity.
The Future of Tinnitus Treatment
Research into tinnitus treatments is ongoing, and while some therapies show potential, it’s important to remember that there is no one-size-fits-all solution. Studies have explored numerous agents, including N-acetylcysteine (NAC), sodium thiosulfate, ginseng, gingko biloba, and coenzyme Q10, among others. While animal studies have been promising, translating these results to humans is more complicated.
Additionally, some human studies have found positive effects when antioxidants are used as pre- or co-treatment before exposure to known tinnitus triggers, such as ototoxic medications. However, antioxidants used after tissue damage has occurred have shown less benefit. It’s a good idea to plan ahead with your healthcare provider to discuss potential protective measures if you’re undergoing treatment with drugs that could potentially damage your hearing.
What You Can Do
If you’re concerned about tinnitus or hearing loss, it's a good idea to schedule a hearing test to establish a baseline hearing threshold. This can help track any changes over time. Additionally, protecting your ears with hearing protection in loud environments and notifying your doctor of any sudden changes in your hearing or tinnitus can help prevent further damage and ensure early intervention.
Final Thoughts
While there is no quick fix for tinnitus, a combination of preventive strategies, cognitive therapies, and emerging treatments can help individuals manage the condition. If you or someone you know is experiencing tinnitus, speak with a healthcare professional to explore the best approach for your specific situation. Regular hearing protection, stress management, and a healthy lifestyle can go a long way in both preventing and alleviating the symptoms of this challenging condition.
