Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing.
It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears.
Roughly 10 percent of the adult population of the United States has experienced tinnitus lasting at least five minutes in the past year. This amounts to nearly 25 million Americans.
Causes of Tinnitus
Tinnitus (pronounced tin-NY-tus or TIN-u-tus) is not a disease. It is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve that connects the inner ear to the brain, and the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. But it can also be the result of a number of health conditions, such as:
Noise-induced hearing loss
Ear and sinus infections
Diseases of the heart or blood vessels
Hormonal changes in women
Tinnitus is sometimes the first sign of hearing loss in older people. It also can be a side effect of medications. More than 200 drugs are known to cause tinnitus when you start or stop taking them.
People who work in noisy environments—such as factory or construction workers, road crews, or even musicians—can develop tinnitus over time when ongoing exposure to noise damages tiny sensory hair cells in the inner ear that help transmit sound to the brain. This is called noise-induced hearing loss.
Service members exposed to bomb blasts can develop tinnitus if the shock wave of the explosion squeezes the skull and damages brain tissue in areas that help process sound. In fact, tinnitus is one of the most common service-related disabilities among veterans returning from Iraq and Afghanistan.
Pulsatile tinnitus is a rare type of tinnitus that sounds like a rhythmic pulsing in the ear, usually in time with your heartbeat. A doctor may be able to hear it by pressing a stethoscope against your neck or by placing a tiny microphone inside the ear canal. This kind of tinnitus is most often caused by problems with blood flow in the head or neck. Pulsatile tinnitus also may be caused by brain tumors or abnormalities in brain structure.
Even with all of these associated conditions and causes, some people develop tinnitus for no obvious reason. Most of the time, tinnitus isn’t a sign of a serious health problem, although if it’s loud or doesn’t go away, it can cause fatigue, depression, anxiety, and problems with memory and concentration. For some, tinnitus can be a source of real mental and emotional anguish.
Where Does the “Noise” Come From?
Although we hear tinnitus in our ears, its source is really in the networks of brain cells (what scientists call neural circuits) that make sense of the sounds our ears hear. A way to think about tinnitus is that it often begins in the ear, but it continues in the brain.
Scientists still haven’t agreed upon what happens in the brain to create the illusion of sound when there is none. Some think that tinnitus is similar to chronic pain syndrome, in which the pain persists even after a wound or broken bone has healed.
Tinnitus could be the result of the brain’s neural circuits trying to adapt to the loss of sensory hair cells by turning up the sensitivity to sound. This would explain why some people with tinnitus are oversensitive to loud noise.
Tinnitus also could be the result of neural circuits thrown out of balance when damage in the inner ear changes signaling activity in the auditory cortex, the part of the brain that processes sound. Or it could be the result of abnormal interactions between neural circuits. The neural circuits involved in hearing aren’t solely dedicated to processing sound. They also communicate with other parts of the brain, such as the limbic region, which regulates mood and emotion.
See Your Doctor
The first thing is to see your primary care doctor, who will check if anything, such as ear wax, is blocking the ear canal. Your doctor will ask you about your current health, medical conditions, and medications to find out if an underlying condition is causing your tinnitus.
If your doctor cannot find any medical condition responsible for your tinnitus, you may be referred to an otolaryngologist (commonly called an ear, nose, and throat doctor, or an ENT). The ENT will physically examine your head, neck, and ears and test your hearing to determine whether you have any hearing loss along with the tinnitus. You might also be referred to an audiologist who can also measure your hearing and evaluate your tinnitus.
Treatments that help many people cope better with the condition are available. Most doctors will offer a combination of the treatments below, depending on the severity of your tinnitus and the areas of your life it affects the most.
Hearing aids often are helpful for people who have hearing loss along with tinnitus. Using a hearing aid adjusted to carefully control outside sound levels may make it easier for you to hear. The better you hear, the less you may notice your tinnitus.
Counseling helps you learn how to live with your tinnitus. Most counseling programs have an educational component to help you understand what goes on in the brain to cause tinnitus. Some counseling programs also will help you change the way you think about and react to your tinnitus. You might learn some things to do on your own to make the noise less noticeable, to help you relax during the day, or to fall asleep at night.
Masking and Sound Generators – A soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music. Tabletop sound generators are used as an aid for relaxation or sleep. Placed near your bed, you can program a generator to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. If your tinnitus is mild, this might be all you need to help you fall asleep.
There are a lot of white noise machines around, but the the ‘LectroFan is my top pick due to its sleek design and high-quality white noise production. It may not have a vast range of features, but what it does do, it does very well. It has a simple, clean design which is streamlined to do its job rather than have lots of buttons to play with.
The aim of the LectroFan is to give you two main choices. You have the standard sound of white noise or the sound of a fan, which some people find more relaxing than static white noise.
Within both of those choices you have 10 different settings, so you can find a pitch and volume which suits your ear and mind.
Add to that the fact that the sound is dynamically generated to avoid any looping, you should be able to block external sound without replacing it with another annoying one.
Here are the key points to consider:
You have a range of 10 fan sounds and 10 white noise sounds, with some deeper white noise than other machines provide.
The volume can be turned up surprisingly high. So if you have a large bedroom space to fill, the sound won’t get lost in the corner.
There’s a timer feature, but if you don’t want to use that, it seems to run all night.
It’s light and compact, so it’s great for traveling.
You can plug it into the mains or a computer with a USB cable.
The downside is that it lacks additional soundscapes like some other machines do. So if you like birdsong and oceans, you might prefer the Adaptive Sound Technologies below.
But if you find white noise or fan sounds soothing and good sound blockers, and appreciate minimalist design, the ‘Lectrofan could be ideal for you.
This is a great video demonstrating the ‘LectroFan:
If you are looking for a great machine with additional soundscapes to mask your tinnitus, I like the Adaptive Sound Technologies Sound+Sleep Sleep Therapy System.
The Adaptive Sound Technologies Sleep Therapy Machine is my favorite when it comes to variety of sound and extra features. In particular, it has one excellent feature which sets it above many other white noise machines.
That feature is what the manufacturer calls adaptive sound technology. The machine actively detects the volume of external noise and changes its own volume to match it.
If the traffic noise increases while you sleep, it will automatically turn the volume up to prevent you being woken up. If all is quiet outside it reduces the volume. A genius idea in my opinion, and it works with surprising accuracy.
The designers have clearly put a lot of thought into what customers want and need from a white noise machine.
Some of the features I loved about it are:
It has 10 different soundscapes, all of which sounded realistic.
A series of different recordings are randomly generated to prevent looping.
It has the clever external sound monitoring and automatic volume control.
It has richness settings that add extra details like bird song to make the soundscapes more realistic and random.
It has a stylish design that won’t look out of place in the modern home.
It has a range of timers so you can fall asleep without having it on all night.
Most importantly, you can play with the settings until you find the right sound and volume to mask the noise you’re hearing. And the speakers and volume are definitely good enough to block out most external noise so you can sleep better at night.
The main downside is that it’s more expensive than most other makes. But if you don’t mind the cost, with the Sleep Therapy Machine you’ll find one of the best white noise machines I’ve seen and heard.
This video demonstrates both the Sleep Therapy Machine and the ‘LectroFan:
Acoustic neural stimulation is a relatively new technique for people whose tinnitus is very loud or won’t go away. It uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits in the brain, which eventually desensitizes you to the tinnitus. The device has been shown to be effective in reducing or eliminating tinnitus in a significant number of study volunteers.
Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits.
Antidepressants and anti-anxiety drugs might be prescribed by your doctor to improve your mood and help you sleep.
Eustacian Tube Drainage is a naturopathic technique used to relief congestion in the tube behind the eardrum by draining fluid away from the ear. Ideally you can find your local naturopath to show you this technique; if not, you can give it a whirl on your own.
This practice will help your tinnitus if it’s due to congestion of the ear, nose or throat. It’s also a good technique to expedite curing a simple ear infection, or unblocking your ears after diving or flying.
First, make sure your hands are clean. With your mouth not too wide open, gently find your back molars on one side with your index finger. Beyond the molars is the curve of flesh-covered bone that creates the hinge between the upper and lower jaw. Gently go beyond the hinge, towards the back of the throat until you find a stringy vertical tendon. This is called the “tonsillar pillar”. Touch here will make most people gag, so go softly and carefully. Just behind the tonsillar pillar, down low near the root of the tongue, is the Eustachian tube, which feels like a small “mole tunnel” under the flesh. It may be impossible to feel, but if you got the tonsillar pillar you’re in the right area. Gently stroke the Eustachian tube from the ear side of the back of the throat towards the middle (towards the tongue) several times until you can’t stand it. Same thing on the other side if the tinnitus is bilateral. Do this daily and consistently for up to a week. Repeat as needed.
Acupuncture – Several controlled studies have shown acupuncture to improve tinnitus; just as many claim no benefit from acupuncture. Choose a licensed acupuncturist who has studied in China or Japan as part of their clinical training. Generally an MD acupuncturist has much less training. Traditional Chinese Medicine (TCM) distinguishes chronic or intermittent tinnitus from an acute, or sudden onset. The chronic form usually presents with a low, buzzing sound and is associated with general weakness, and thought to be a “deficiency” condition. Thus, “tonifying” is indicated. The sudden onset tinnitus is thought to be due to “excess” and the ringing is low, like screaming or thunder, and is not relieved by pressure on the ear. This presentation is treated by removing the “obstruction” in the channels (meridians) around the ears.
A basic acupuncture prescription for tinnitus, which may take 10 to 15 sessions for improvement, is San Jao 3 and 17, Gallbladder 2 and 43, with Kidney 3 and 6 for the chronic type. Scalp or ear points are also useful. TCM has been around for many centuries; acupuncture often works, and it doesn’t hurt.
Gingko biloba is one of the most studied herbal medicines. It is well established that Gingko enhances blood flow to the periphery (edges of the body), in particular to the head and brain. If your tinnitus is due to circulatory problems, Gingko is likely to help, otherwise it will merely improve your memory.
Take 240 mg of a standardized Gingko (in capsule form) daily, ideally in divided doses. The product should claim to contain 24% gingkolisides or gingko heterosides. You will notice your thinking is sharper within 3 to 10 days.
Relief from tinnitus will take longer; give it 6 weeks. Once relief is achieved, you can lower the dose maintenance levels of 40-60 mg daily.
Zinc, ideally in the picolinate form, 90-150 mg daily for 3-6 months may help, especially if zinc is low. If zinc lozenges taste really yucky, you probably don’t need zinc. If zinc seems to have little or no taste, you are deficient.
Studies on zinc and tinnitus generally indicate that zinc is helpful in age-related tinnitus and hearing loss. Zinc can also help with age-related loss of taste.
Ring Zen is one of the top rated safe and natural tinnitus treatments, and has helped provide many tinnitus sufferers with relief – there are over 115 reviews.
This formula contains citrus bioflavonoids, ginkgo biloba extract, deodorized garlic and magnesium. It is manufactured in the USA and every batch is tested by a third party lab for quality and potency assurance.
I recommend taking a vitamin B12 supplement along with the Ring Zen formula because Vitamin B12 deficiency has been reported to be common in people exposed to loud noises, and who have developed occupational tinnitus and hearing loss.
The evidence of the connection between Tinnitus and Vitamin B12 has been around for a while, but very few people made the connection, including those in the medical industry.
In 1993, there was a clinical study carried out that tested people with a vitamin B12 deficiency in order to discover which medical issues they had in common. Three groups were tracked over a number of months, and it turned out that each of the groups of people suffering from a vitamin B12 deficiency had some form of Tinnitus. Some of the most common forms of this aggravating condition the test subjects suffered from were chronic tinnitus, noise-induced hearing loss, and others suffered from pulsatile tinnitus.
Most Tinnitus studies show that individuals with vitamin B12 deficiencies were 45% more likely to have Tinnitus than those who did not.
Nearly half of the Tinnitus sufferers out there are deficient in B12, so if you’re hearing strange things, getting ear aches or suffering any sort of issues with your ears it might be tied to a vitamin B deficiency. I recommend ZenWise Timed Release Formula. It has more than 495 great reviews, is made in the USA, and is a great value for the 100 mcg/160 count bottle.
This is a quiet, non-force, hands-on therapy designed to improve the flow of fluid (cerebral spinal fluid) around the brain and along the spinal column. In the hands of a skilled therapist, symptoms may resolve in a single treatment.
Neural Therapy is an injection technique pioneered in Germany about 30 years ago, mostly for pain control. A very safe analgesic, usually 1 or 2% Procaine, is placed in specific “trigger points”. In the case of tinnitus, the trigger points will be similar to the acupuncture points, mostly around the ears. The idea is to “reset” and correct the nerve impulses which convey information from the outside world to the brain. Most doctors in the U.S. skilled in this technique were trained by Dr. Dietrich Klinghardt, MD.
Tinnitus Retraining Therapy (TRT)
TRT aims to teach the tinnitus patient to reduce or eliminate negative emotional reactions and to learn to live with the tinnitus. The intensive time commitment (18 months to 2 years) and financial investment required by TRT may make it unfeasible for most, but check it out on the Internet.
Biofeedback is a therapy that employs mild electrical stimulation to help you become more aware of physical changes resulting from stressors, and provides guidance for reducing those physical stress responses.
In a nutshell, you learn to put mind over matter; this is why using background music or mechanical noise like that of a fan is helpful especially at night and during quiet periods, since silence can intensify the perception of tinnitus, which creates stress, which makes everything worse.
Homeopathy is a 250-year-old medical science with German origins which uses plant, mineral and even animal material in minute doses to help the patient’s innate “healing force” to overcome the disease or symptom obstructing health.
While better results are to be expected when working with a trained homeopath, the following remedies have been useful in tinnitus:
Salicylicum acidum: loud roaring, may present with vertigo or deafness. Especially helpful if tinnitus is due to excessive aspirin use.
Preventing Further Damage
Noise-induced hearing loss, the result of damage to the sensory hair cells of the inner ear, is one of the most common causes of tinnitus. Anything you can do to limit your exposure to loud noise—by moving away from the sound, turning down the volume, or wearing earplugs or earmuffs—will help prevent tinnitus or keep it from getting worse.
Researching Promising Treatments
Along the path a hearing signal travels to get from the inner ear to the brain, there are many places where things can go wrong to cause tinnitus. If scientists can understand what goes on in the brain to start tinnitus and cause it to persist, they can look for those places in the system where a therapeutic intervention could stop tinnitus in its tracks.
In 2009, the National Institute on Deafness and Other Communication Disorders (NIDCD) sponsored a workshop that brought together tinnitus researchers to talk about the condition and develop fresh ideas for potential cures.
During the course of the workshop, participants discussed a number of promising research directions, including:
Electrical or magnetic stimulation of brain areas involved in hearing. Implantable devices already exist to reduce the trembling of Parkinson’s disease and the anxieties of obsessive-compulsive disorder. Similar devices could be developed to normalize the neural circuits involved in tinnitus.
Repetitive transcranial magnetic stimulation (rTMS). This technique, which uses a small device placed on the scalp to generate short magnetic pulses, is already being used to normalize electrical activity in the brains of people with epilepsy. Preliminary trials of rTMS in humans, funded by the NIDCD, are helping researchers pinpoint the best places in the brain to stimulate in order to suppress tinnitus. Researchers are also looking for ways to identify which people are most likely to respond well to stimulation devices.
Hyperactivity and deep brain stimulation. Researchers have observed hyperactivity in neural networks after exposing the ear to intense noise. Understanding specifically where in the brain this hyperactivity begins and how it spreads to other areas could lead to treatments that use deep brain stimulation to calm the neural networks and reduce tinnitus.
Resetting the tonotopic map. Researchers are exploring how to take advantage of the tonotopic map, which organizes neurons in the auditory cortex according to the frequency of the sound to which they respond. Previous research has shown a change in the organization of the tonotopic map after exposing the ear to intense noise. By understanding how these changes happen, researchers could develop techniques to bring the map back to normal and relieve tinnitus.
Please share your thoughts and tips on tinnitus in the comment section below.