What is Tinnitus?
Tinnitus is the perception of noise or ringing in the ears. A common problem, tinnitus affects about 15 to 20 percent of people. Tinnitus isn’t a condition itself — it’s a symptom of an underlying condition, such as age-related hearing loss, ear injury, or a circulatory system disorder.
Although bothersome, tinnitus usually isn’t a sign of something serious. Although it can worsen with age, for many people, tinnitus can improve with treatment. Treating an identified underlying cause sometimes helps. Other treatments reduce or mask the noise, making tinnitus less noticeable.
Tinnitus involves the sensation of hearing sound when no external sound is present. Tinnitus symptoms may include these types of phantom noises in your ears:
The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it can interfere with your ability to concentrate or hear an external sound. Tinnitus may be present all the time, or it may come and go.
There are two kinds of tinnitus.
- Subjective tinnitus is tinnitus only you can hear. This is the most common type of tinnitus. It can be caused by ear problems in your outer, middle, or inner ear. It can also be caused by problems with the hearing (auditory) nerves or the part of your brain that interprets nerve signals as sound (auditory pathways).
- Objective tinnitus is tinnitus your doctor can hear when he or she does an examination. This rare type of tinnitus may be caused by a blood vessel problem, a middle ear bone condition, or muscle contractions.
See your doctor as soon as possible if:
- You have tinnitus that occurs suddenly or without an apparent cause
- You have hearing loss or dizziness with the tinnitus
A number of health conditions can cause or worsen tinnitus. In many cases, an exact cause is never found.
A common cause of tinnitus is inner ear hair cell damage. Tiny, delicate hairs in your inner ear move in relation to the pressure of sound waves. This triggers cells to release an electrical signal through a nerve from your ear (auditory nerve) to your brain. Your brain interprets these signals as sound. If the hairs inside your inner ear are bent or broken, they can “leak” random electrical impulses to your brain, causing tinnitus.
Other causes of tinnitus include other ear problems, chronic health conditions, and injuries or conditions that affect the nerves in your ear or the hearing center in your brain.
Common causes of tinnitus
In many people, tinnitus is caused by one of these conditions:
- Age-related hearing loss. For many people, hearing worsens with age, usually starting around age 60. Hearing loss can cause tinnitus. The medical term for this type of hearing loss is presbycusis.
- Exposure to loud noise. Loud noises, such as those from heavy equipment, chain saws, and firearms, are common sources of noise-related hearing loss. Portable music devices, such as MP3 players or iPods, also can cause noise-related hearing loss if played loudly for long periods. Tinnitus caused by short-term exposure, such as attending a loud concert, usually goes away; both short- and long-term exposure to loud sound can cause permanent damage.
- Earwax blockage. Earwax protects your ear canal by trapping dirt and slowing the growth of bacteria. When too much earwax accumulates, it becomes too hard to wash away naturally, causing hearing loss or irritation of the eardrum, which can lead to tinnitus.
- Ear bone changes. Stiffening of the bones in your middle ear (otosclerosis) may affect your hearing and cause tinnitus. This condition, caused by abnormal bone growth, tends to run in families.
Other causes of tinnitus
Some causes of tinnitus are less common, including:
- Meniere’s disease. Tinnitus can be an early indicator of Meniere’s disease, an inner ear disorder that may be caused by abnormal inner ear fluid pressure.
- TMJ disorders. Problems with the temporomandibular joint, the joint on each side of your head in front of your ears, where your lower jawbone meets your skull, can cause tinnitus.
- Head injuries or neck injuries. Head or neck trauma can affect the inner ear, hearing nerves, or brain function linked to hearing. Such injuries generally cause tinnitus in only one ear.
- Acoustic neuroma. This noncancerous (benign) tumor develops on the cranial nerve that runs from your brain to your inner ear and controls balance and hearing. Also called vestibular schwannoma, this condition generally causes tinnitus in only one ear.
- Eustachian tube dysfunction. In this condition, the tube in your ear connecting the middle ear to your upper throat remains expanded all the time, which can make your ear feel full. Loss of a significant amount of weight, pregnancy, and radiation therapy can sometimes cause this type of dysfunction.
- Muscle spasms in the inner ear. Muscles in the inner ear can tense up (spasm), which can result in tinnitus, hearing loss, and a feeling of fullness in the ear. This sometimes happens for no explainable reason, but can also be caused by neurologic diseases, including multiple sclerosis.
In rare cases, tinnitus is caused by a blood vessel disorder. This type of tinnitus is called pulsatile tinnitus. Causes include:
- Atherosclerosis. With age and buildup of cholesterol and other deposits, major blood vessels close to your middle and inner ear lose some of their elasticity — the ability to flex or expand slightly with each heartbeat. That causes blood flow to become more forceful, making it easier for your ear to detect the beats. You can generally hear this type of tinnitus in both ears.
- Head and neck tumors. A tumor that presses on blood vessels in your head or neck (vascular neoplasm) can cause tinnitus and other symptoms.
- High blood pressure. Hypertension and factors that increase blood pressure, such as stress, alcohol, and caffeine, can make tinnitus more noticeable.
- Turbulent blood flow. Narrowing or kinking in a neck artery (carotid artery) or vein in your neck (jugular vein) can cause turbulent, irregular blood flow, leading to tinnitus.
- Malformation of capillaries. A condition called arteriovenous malformation (AVM), abnormal connections between arteries and veins, can result in tinnitus. This type of tinnitus generally occurs in only one ear.
Medications that can cause tinnitus
A number of medications may cause or worsen tinnitus. Generally, the higher the dose of these medications, the worse tinnitus becomes. Often the unwanted noise disappears when you stop using these drugs. Medications are known to cause or worsen tinnitus include:
- Antibiotics, including polymyxin B, erythromycin, vancomycin (Vancocin HCL, Firvanq) and neomycin
- Cancer medications, including methotrexate (Trexall) and cisplatin
- Water pills (diuretics), such as bumetanide (Bumex), ethacrynic acid (Edecrin) or furosemide (Lasix)
- Quinine medications used for malaria or other health conditions
- Certain antidepressants, which may worsen tinnitus
- Aspirin taken in uncommonly high doses (usually 12 or more a day)
In addition, some herbal supplements can cause tinnitus, as can nicotine and caffeine.
Anyone can experience tinnitus, but these factors may increase your risk:
- Loud noise exposure. Prolonged exposure to loud noise can damage the tiny sensory hair cells in your ear that transmit sound to your brain. People who work in noisy environments — such as factory and construction workers, musicians, and soldiers — are, particularly at risk.
- Age. As you age, the number of functioning nerve fibers in your ears declines, possibly causing hearing problems often associated with tinnitus.
- Sex. Men are more likely to experience tinnitus.
- Smoking. Smokers have a higher risk of developing tinnitus.
- Cardiovascular problems. Conditions that affect your blood flow, such as high blood pressure or narrowed arteries (atherosclerosis), can increase your risk of tinnitus.
Tinnitus can significantly affect the quality of life. Although it affects people differently, if you have tinnitus, you may also experience:
Treating these linked conditions may not affect tinnitus directly, but it can help you feel better.
In many cases, tinnitus is the result of something that can’t be prevented. However, some precautions can help prevent certain kinds of tinnitus.
- Use hearing protection. Over time, exposure to loud sounds can damage the nerves in the ears, causing hearing loss and tinnitus. If you use chain saws, are a musician, work in an industry that uses loud machinery or use firearms (especially pistols or shotguns), always wear over-the-ear hearing protection.
- Turn down the volume. Long-term exposure to amplified music with no ear protection or listening to music at a very high volume through headphones can cause hearing loss and tinnitus.
- Take care of your cardiovascular health. Regular exercise, eating right, and taking other steps to keep your blood vessels healthy can help prevent tinnitus linked to blood vessel disorders.
Your doctor will examine your ears, head, and neck to look for possible causes of tinnitus. Tests include:
- Hearing (audiological) exam. As part of the test, you’ll sit in a soundproof room wearing earphones through which will be played specific sounds into one ear at a time. You’ll indicate when you can hear the sound, and your results are compared with results considered normal for your age. This can help rule out or identify possible causes of tinnitus.
- Movement. Your doctor may ask you to move your eyes, clench your jaw, or move your neck, arms, and legs. If your tinnitus changes or worsens, it may help identify an underlying disorder that needs treatment.
- Imaging tests. Depending on the suspected cause of your tinnitus, you may need imaging tests such as CT or MRI scans.
The sounds you hear can help your doctor identify a possible underlying cause.
- Clicking. Muscle contractions in and around your ear can cause sharp clicking sounds that you hear in bursts. They may last from several seconds to a few minutes.
- Rushing or humming. These sound fluctuations are usually vascular in origin, and you may notice them when you exercise or change positions, such as when you lie down or stand up.
- Heartbeat. Blood vessel problems, such as high blood pressure, an aneurysm or a tumor, and blockage of the ear canal or eustachian tube can amplify the sound of your heartbeat in your ears (pulsatile tinnitus).
- Low-pitched ringing. Conditions that can cause low-pitched ringing in one ear include Meniere’s disease. Tinnitus may become very loud before an attack of vertigo — a sense that you or your surroundings are spinning or moving.
- High-pitched ringing. Exposure to very loud noise or a blow to the ear can cause a high-pitched ringing or buzzing that usually goes away after a few hours. However, if there’s hearing loss as well, tinnitus may be permanent. Long-term noise exposure, age-related hearing loss or medications can cause a continuous, high-pitched ringing in both ears. Acoustic neuroma can cause continuous, high-pitched ringing in one ear.
- Other sounds. Stiff inner ear bones (otosclerosis) can cause low-pitched tinnitus that may be continuous or may come and go. Earwax, foreign bodies, or hairs in the ear canal can rub against the eardrum, causing a variety of sounds.
In many cases, the cause of tinnitus is never found. Your doctor can discuss with you steps you can take to reduce the severity of your tinnitus or to help you cope better with the noise.
Treating an underlying health condition
To treat your tinnitus, your doctor will first try to identify any underlying, treatable condition that may be associated with your symptoms. If tinnitus is due to a health condition, your doctor may be able to take steps that could reduce the noise. Examples include:
- Earwax removal. Removing impacted earwax can decrease tinnitus symptoms.
- Treating a blood vessel condition. Underlying vascular conditions may require medication, surgery, or another treatment to address the problem.
- Changing your medication. If a medication you’re taking appears to be the cause of tinnitus, your doctor may recommend stopping or reducing the drug, or switching to a different medication.
In some cases, white noise may help suppress the sound so that it’s less bothersome. Your doctor may suggest using an electronic device to suppress the noise. Devices include:
- White noise machines. These devices, which produce simulated environmental sounds such as falling rain or ocean waves, are often an effective treatment for tinnitus. You may want to try a white noise machine with pillow speakers to help you sleep. Fans, humidifiers, dehumidifiers, and air conditioners in the bedroom also may help cover the internal noise at night.
- Hearing aids. These can be especially helpful if you have hearing problems as well as tinnitus.
- Masking devices. Worn in the ear and similar to hearing aids, these devices produce a continuous, low-level white noise that suppresses tinnitus symptoms.
- Tinnitus retraining. A wearable device delivers individually programmed tonal music to mask the specific frequencies of the tinnitus you experience. Over time, this technique may accustom you to the tinnitus, thereby helping you not to focus on it. Counseling is often a component of tinnitus retraining.
Drugs can’t cure tinnitus, but in some cases, they may help reduce the severity of symptoms or complications. Possible medications include the following:
- Tricyclic antidepressants, such as amitriptyline and nortriptyline, have been used with some success. However, these medications are generally used for only severe tinnitus, as they can cause troublesome side effects, including dry mouth, blurred vision, constipation, and heart problems.
- Alprazolam (Xanax) may help reduce tinnitus symptoms, but side effects can include drowsiness and nausea. It can also become habit-forming.
Lifestyle and home remedies
Often, tinnitus can’t be treated. Some people, however, get used to it and notice it less than they did at first. For many people, certain adjustments make the symptoms less bothersome. These tips may help:
- Avoid possible irritants. Reduce your exposure to things that may make your tinnitus worse. Common examples include loud noises, caffeine, and nicotine.
- Cover up the noise. In a quiet setting, a fan, soft music, or low-volume radio static may help mask the noise from tinnitus.
- Manage stress. Stress can make tinnitus worse. Stress management, whether through relaxation therapy, biofeedback, or exercise, may provide some relief.
- Reduce your alcohol consumption. Alcohol increases the force of your blood by dilating your blood vessels, causing greater blood flow, especially in the inner ear area.
There’s little evidence that alternative medicine treatments work for tinnitus. However, some alternative therapies that have been tried for tinnitus include:
- Ginkgo biloba
- Zinc supplements
- B vitamins
Neuromodulation using transcranial magnetic stimulation (TMS) is a painless, non-invasive therapy that has been successful in reducing tinnitus symptoms for some people. Currently, TMS is used more commonly in Europe and in some trials in the U.S. It is still to be determined which patients might benefit from such treatments.
Coping and support
Tinnitus doesn’t always improve or completely go away with treatment. Here are some suggestions to help you cope:
- Counseling. A licensed therapist or psychologist can help you learn coping techniques to make tinnitus symptoms less bothersome. Counseling can also help with other problems often linked to tinnitus, including anxiety and depression.
- Support groups. Sharing your experience with others who have tinnitus may be helpful. There are tinnitus groups that meet in person, as well as internet forums. To ensure that the information you get in the group is accurate, it’s best to choose a group facilitated by a physician, audiologist, or other qualified health professional.
- Education. Learning as much as you can about tinnitus and ways to alleviate symptoms can help. And just understanding tinnitus better makes it less bothersome for some people.
Herbal Remedies For Tinnitus
1. Ginkgo Biloba
Ginkgo biloba is considered the best herbal remedy for tinnitus. It plays a key role in improving blood circulation, which in turn improves the ear functioning and reduces ringing sensations.
Plus, this herb has antibacterial and antifungal properties that can treat any underlying infection that may be contributing to the condition.
To treat tinnitus, you can take ginkgo Biloba extract that you can buy from herbal drug stores. Take 120 to 240 mg of standardized extract containing 24 to 32 percent flavonoids and 6 to 12 percent terpenoids.
Take it daily, ideally in three or four divided doses, for six weeks to get positive results. Consult your doctor before starting the treatment as this herb may interact with certain medications.
Note: Ginkgo biloba should not be given to children.
2. Apple Cider Vinegar
Being an antifungal and anti-inflammatory agent, apple cider vinegar can also be used to treat any underlying infection that may be contributing to tinnitus. Apple cider vinegar also balances the alkaline level in the body.
- Mix two teaspoons of apple cider vinegar and a little honey in a glass of water.
- Drink this solution two or three times daily until the ringing sensation in the ears stops.
3. Holy Basil
Holy basil is another good natural remedy for treating tinnitus. Its antibacterial properties can kill the bacteria that may be causing the problem. Plus, this herb can give you relief from ear pain.
- Put a handful of basil leaves in a blender to make a paste.
- Put the paste on a strainer and press with a spoon to extract the juice.
- Warm the basil juice slightly.
- Using a dropper, put two or three drops of it in the affected ear.
- Repeat twice daily for three or four days.
The medicinal and antibacterial properties of onions help treat ear infections causing tinnitus.
- Chop one small onion into small pieces.
- Microwave the onions for one to two minutes.
- Allow it to cool, and then strain out the juice.
- Put two or three drops of the juice in the infected ear.
- Leave it in the ear for five minutes, then turn your head to let the juice drain out.
- Do this a few times a week to get rid of tinnitus.
Garlic can be used to treat tinnitus caused by high altitudes or cold weather. Garlic helps reduce inflammation as well as improve blood circulation. Plus, it has antibacterial properties that can get rid of any infection that may be contributing to the problem.
- Fry two crushed garlic cloves in one tablespoon of sesame oil.
- After straining and letting it cool, and put two or three drops of the oil into the ear canal.
- Do this daily at night before going to bed. Continue for about one week.
You can also take garlic capsules or use this herb in your cooking.
6. Saline Solution
Saline solution can help treat tinnitus caused by blocked nasal passages or excessive fluid in the sinuses.
- Mix one teaspoon each of salt and glycerin in two cups of warm water to make a homemade saline solution.
- Use a nasal spray bottle to inject the solution into each nostril until it starts to drain into the back of your throat.
- Spray the solution into your throat also.
- Follow this remedy three times a day until your nasal passages are clear.
Ginger is also used as a cure for tinnitus. The medicinal and healing properties in ginger help improve blood circulation, get rid of pathogens, and fight free radicals. Plus, it has aspirin-like properties that can help reduce pain accompanying tinnitus.
- Add one-half teaspoon of freshly grated ginger to a cup of hot water. Allow it to steep for 10 minutes, strain it, and add a little honey. Drink this herbal tea two or three times a day for several days to ease tinnitus symptoms.
- Also, chew a few slices of raw ginger. The process of chewing helps relieve pressure in the ear that may be causing tinnitus.
8. Mustard Oil
Mustard oil is another popular home remedy for tinnitus. Being a natural rubefacient, mustard oil helps increase circulation. Also, its antifungal and antibacterial properties help treat ear infections. Mustard oil also boosts the immune system to protect against further infections and helps remove the buildup of earwax.
- Slightly warm a little mustard oil in a microwave.
- Put a few drops of warm mustard oil directly into the affected ear.
- Allow the oil to sit for five to 10 minutes.
- Then tilt your head to the other side so that the oil drains out of the ear.
- Remove the softened earwax with the help of an earbud.
- Repeat once daily for a few days.
Eating foods like pumpkin that are rich in vitamin A can help get rid of tinnitus. It has been found that vitamin A deficiency is one of the leading causes of many ear problems, including tinnitus.
Vitamin A is essential for the proper functioning of the cochlea, or inner ear, which is responsible for the reception and transmission of sounds.
Simply include pumpkin in your salad or soup, or have it steamed, grilled, stuffed, stir-fried, or in baked dishes.
Adding pineapple to your diet can help reduce tinnitus. Pineapple helps lessen inflammation throughout the body due to the presence of an enzyme known as bromelain. Plus, pineapple has various vitamins including vitamin A.
Eat fresh pineapple at regular intervals throughout the day to reduce inflammation. You can also drink fresh pineapple juice.
Some additional tips:
- Use a warm compress or heating pad (wrapped in a cloth) to relieve pressure and pain
- Cut back or stop drinking alcohol
- Stop smoking
- Limit your use of aspirin
- Exercise regularly
- Limit or avoid exposure to loud noises
- Practice relaxation techniques like meditation or yoga.
- Play music or white noise when you are trying to fall asleep.
Follow these remedies and tips to treat tinnitus. However, visit your doctor immediately if you have numbness on one side of the face or body, vertigo, loss of balance, nausea, or vomiting.
Always consult with your doctor before taking any herbal remedies.
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