Tips for Managing Tinnitus

Is there a constant ringing in your ears? If so, you may be suffering from a medical condition called tinnitus. Schedule a hearing test with your audiologist, as tinnitus is often the first sign of hearing loss.

Approximately 50 million Americans have experienced the phantom sounds of tinnitus, including professional musicians such as Barbra Streisand, Paul Simon, and Bob Dylan. It is estimated that less than 16 million people seek medical help for this condition, the number one disability among veterans returning from conflict. Tinnitus can be a maddening and debilitating condition in which someone hears high-pitched ringing, buzzing, or clicking.

It can affect one or both ears, 24 hours a day, seven days a week. For some it can be a sound as loud as a chainsaw that happens sporadically and without reason. For others it can be a pulsing in the ear timed to the beat of the heart.

Possible Causes 

Though experts are not always certain of the causes of these phantom sounds, they agree that tinnitus is a signifier that something in the auditory system has gone wrong. It has been linked to several conditions that may trigger or exacerbate the problem. The two most common of them is longtime exposure to excessive noise and the myriad drugs that do harm to the ear. Compelling new research exists that implies that when hearing is damaged, changes occur in the brain that cause neurons to fire erratically and create “noise,” which can be likened to a phantom limb causing pain.

Experts believe other possible causes of tinnitus include ear or sinus infections, punctured eardrum, ear wax, high blood pressure, and Lyme disease. It is also connected to rare medical conditions, like acoustic neuroma (a slow-growing, benign tumor that presses on the auditory nerve) and Ménière’s disease, which causes fluid buildup in the inner ear. In some cases, when the underlying condition is properly treated, the effects of tinnitus may be lessened or reversed.

Unfortunately, there is no cure for tinnitus and treatments work differently for different people. Michael D. Seidman, an otolaryngologist (an ear, nose, and throat surgeon or ENT) at Florida Hospital Celebration Health in Celebration, FL, says, “It’s a process of trial and error. We can help people manage their tinnitus by treating the underlying causes, altering their reaction to it — or both.”

Looking Ahead

Scientists are working with several therapies to stimulate and revive the brain by generating weak electrical currents to offset the abnormal activity that causes tinnitus, including transcranial magnetic stimulation. In 2016 at the Karolinska Institutet in Sweden, researchers identified a gene in mice that can lead to new therapies for various kinds of hearing disorders, such as tinnitus and age-related hearing loss.

“We now know that there are three different routes into the central auditory system, instead of just one,” says François Lallemend, research group leader at the Department of Neuroscience, Karolinska Institutet, who led the study. “This makes us better placed to understand the part played by the different neurons in hearing.” The study is published in Nature Communications. 

Action Steps to Treating Tinnitus

• Check Medications You’re Currently Taking

Did you know that there are over 590 drugs, herbs, and chemicals that can trigger and are associated with tinnitus? Many are over-the-counter painkillers and antibiotics, as well as prescription drugs for depression, heart disease, and cancer. Sometimes interactions between two or more medications can spark tinnitus. This is why it is always important to consult with your doctor before starting new medication, switching medication, or adding supplements so that you can be informed of possible side effects. The Center for Hearing Loss Help has a list of medications linked to tinnitus available for review.

• Cover It Up

Tinnitus sound therapy can be a very effective treatment that utilizes CDs, sound generators that look like hearing aids, air conditioners, or white noise machines. “We perceive sound in relative terms,” explains Seidman. “If you’re in a noisy room, tinnitus bothers you less than when you’re trying to fall asleep at night. These devices work the same way. Your ear becomes so habituated to the other sounds that you don’t notice the tinnitus.”

• Manage Stress

Lack of sleep, anxiety, and anger can make tinnitus insufferable. Approaches like cognitive behavior therapy, biofeedback, or mindfulness-based therapy can be quite effective when coupled with sound therapy.

• Perhaps Hearing Aids Can Help

When hearing aids amplify environmental sound, tinnitus is less noticeable. It also lessens the stress of trying to listen over the ringing. Some hearing aids, like the Phonak Bolero B, feature a noise generator to cover up your tinnitus. Specialists experienced in treating tinnitus can be found through the American Tinnitus Association (ATA), the American Academy of Audiology or the Hearing Loss Association of America.

• Consider a Mediterranean Diet

This diet is high in fish, green vegetables, olive oil, nuts, seeds and fruits, and low in red meat, processed foods, saturated and trans fats, salt and simple sugars.

“Anything that improves health improves tinnitus,” Seidman says. There are some foods that can set off the constant ringing in the ears, for example red wine, cheese, chocolate, and caffeine. However, a study in the American Journal of Medicine from 2014 found that women between the ages of 20 and 50 who drink three or four cups of coffee a day have a lower risk of developing tinnitus. When addressing the question of supplements, the ATA notes that magnesium, B vitamins, and zinc may offer relief, but further study is necessary to test their effectiveness.

Consult a Hearing Health Professional

As tinnitus is often the first sign of hearing loss, scheduling an appointment with your doctor or a hearing health professional is an important step in your hearing health. They can treat an infection with antibiotics, they can remove a buildup of ear wax, or they can refer you to specialists for further diagnosis. You can be referred to an otologist (a physician who specializes in ears), an otolaryngologist (an ear, nose and throat doctor, or ENT) or an audiologist (a healthcare professional who diagnoses and treats hearing-related disorders) for a full hearing exam and information about various treatments available.