Tinnitus is the perception of noise or ringing in the ears without any external source.
It’s estimated that approximately 10-15% of the global population experiences some form of tinnitus.
The causes are varied but can generally be one of the following ;
- Exposure to loud noises (such as concerts, gunfire, or machinery)
- Age-related hearing loss (presbycusis)
- Earwax build up or blockage
- Certain medications (such as aspirin, antibiotics, or chemotherapy drugs)
- Ear infections (otitis media or otitis externa)
- Meniere’s disease
- Temporomandibular joint (TMJ) disorders
- Head or neck injuries
- Cardiovascular disorders (such as hypertension or atherosclerosis)
- Tumours (such as acoustic neuroma)
- Neurological conditions (such as multiple sclerosis or migraine-associated tinnitus)
- Ototoxicity (damage to the inner ear from exposure to certain chemicals or medications)
Exposure to loud noises and age related hearing loss are usually the most common causes of tinnitus. You can also group tinnitus into two distinct groups, ear related tinnitus and brain related tinnitus.
- Ear-related tinnitus:
- This type of tinnitus originates from the structures within the ear itself, primarily the cochlea or auditory nerve.
- Common causes include exposure to loud noises, age-related hearing loss (presbycusis), earwax build up or blockage, ear infections, Meniere’s disease, and ototoxic medications.
- In ear-related tinnitus, damage or dysfunction in the peripheral auditory system, such as hair cell damage in the cochlea or inflammation in the middle ear, can lead to the perception of sound when there is no external sound source present.
- Brain-related tinnitus:
- Brain-related tinnitus is associated with abnormalities or alterations in the central auditory pathways and neural networks within the brain.
- It can result from neurological conditions such as multiple sclerosis, migraine-associated tinnitus, or brain injuries affecting the auditory processing centres.
- This type of tinnitus can also be linked to changes in the brain’s neural activity and connectivity due to factors like emotional stress, anxiety, or depression.
- Brain-related tinnitus often involves complex interactions between auditory, emotional, and cognitive processes, where the brain amplifies or generates perceived sounds even in the absence of external stimuli.
Tinnitus noises can vary widely in their character and perception. Here are some common types:
- Ringing: A high-pitched ringing sound is one of the most prevalent types of tinnitus.
- Buzzing: Described as a low-frequency humming or buzzing noise.
- Whistling: Similar to the sound of a whistle, it can range from soft to piercing.
- Hissing: Often likened to the sound of steam or air escaping, characterized by a steady, continuous noise.
- Clicking: Repetitive clicking sounds that can resemble the ticking of a clock or the sound of a metronome.
- Roaring: A deep, low-frequency noise akin to the sound of waves crashing or a waterfall.
- Humming: A persistent, low-frequency hum often perceived as coming from within the head.
- Pulsatile: Tinnitus synchronized with the heartbeat, typically described as a rhythmic pulsing or throbbing sound.
There’s currently no cure for tinnitus, however some people do manage to reduce their tinnitus or manage it through various techniques and treatments. Research is ongoing for a cure, and there’s always promising news coming out about possible cures.
Describing your tinnitus and any other symptoms you’re experiencing is vital for helping a doctor work out the cause of your tinnitus. Some causes have much more effective treatments than others and it’s obviously helpful to be on the right track for treatment instead of chasing red herrings.
Whilst there is some progress in the research into a cure for tinnitus, the current situation with medical professionals can sometimes be quite frustrating. Since there is no cure, tinnitus is often something that doctors might dismiss in favour of what they can treat especially if tinnitus is part of a cluster of symptoms you’re experiencing. It’s also something people can’t easily emphasize with unless they’ve experienced it themselves.
Having tinnitus is similar to a car or burglar alarm constantly going off in the near distance. It can inflict a profound and relentless suffering, as individuals experience persistent phantom noises that disrupt their daily activities, sleep, and concentration, often leading to anxiety, depression, and a diminished quality of life. The relentless nature of the sound, coupled with the lack of effective treatment options for many sufferers, exacerbates the psychological distress and emotional toll associated with this condition.
The disruption of sleep is especially troublesome with tinnitus because sleep quality is a gateway to various health implications and the ability to overcome suffering. Being sleep deprived drops you further into a pit of suffering.
There are some techniques that work for some. such as clasping the back of your head and tapping with your fingers, however this is usually gives only a temporary relief to only a subset of patients.
People also rely on white noise to mask the sound of tinnitus. Since focusing on tinnitus when everything is quiet often amplifies the tinnitus ringing, white noise can help prevent this situation.
Bioflavonoids are a group of plant-derived compounds with antioxidant properties, and they are often suggested as a potential treatment for tinnitus. While the exact mechanisms by which bioflavonoids may alleviate tinnitus symptoms are not fully understood, some theories suggest that their antioxidant properties could help protect the delicate structures of the inner ear from damage caused by oxidative stress. Additionally, bioflavonoids may improve blood flow and circulation in the inner ear, which could benefit individuals with tinnitus, particularly those with underlying vascular issues.
Several supplements are suggested as potential treatments for tinnitus, although scientific evidence supporting their effectiveness varies. It’s important to consult with a healthcare professional before starting any supplement regimen for tinnitus. Here are some supplements that have been studied or suggested for their potential benefits:
- Magnesium: Some research suggests that magnesium deficiency may contribute to tinnitus, so supplementation with magnesium may be beneficial for some individuals.
- Zinc: Zinc deficiency has been linked to hearing loss and tinnitus, so supplementation with zinc may help in cases where deficiency is present.
- Vitamin B12: Deficiency in vitamin B12 has been associated with tinnitus, particularly in individuals with noise-induced hearing loss. Supplementing with vitamin B12 may be beneficial for those with low levels.
- Ginkgo biloba: Ginkgo biloba is an herb often used for its potential benefits in improving blood circulation. Some studies have suggested that it may help alleviate tinnitus symptoms, although results are mixed.
- Coenzyme Q10 (CoQ10): CoQ10 is an antioxidant that plays a role in cellular energy production. Some research suggests that it may have protective effects on the inner ear and could potentially benefit individuals with tinnitus.
- Melatonin: Melatonin is a hormone that regulates sleep-wake cycles. Since tinnitus can often disrupt sleep, melatonin supplementation may help improve sleep quality in some individuals with tinnitus.
- Omega-3 fatty acids: Omega-3 fatty acids found in fish oil have anti-inflammatory properties and may help reduce inflammation in the inner ear, potentially benefiting individuals with tinnitus.
- Vitamin C: As an antioxidant, vitamin C may help protect against oxidative stress in the inner ear, although evidence specifically for tinnitus is limited.
- Lipo-flavonoid: Lipo-flavonoid is a proprietary supplement that contains a combination of vitamins and flavonoids. While some people report relief from tinnitus symptoms with lipo-flavonoid, scientific evidence supporting its effectiveness is limited.
Several medications may be prescribed to help alleviate tinnitus symptoms, although their effectiveness can vary depending on the individual and the underlying cause of the tinnitus. It’s important to note that no medication has been specifically approved by regulatory agencies for the treatment of tinnitus. However, some medications may be prescribed off-label to manage certain aspects of tinnitus, such as associated anxiety or depression, or to address underlying conditions contributing to tinnitus. Here are some examples:
(An important note is that antidepressants are also connected with causing tinnitus for many individuals who seem to get an ototoxic reaction to the medicine.)
- Antidepressants: Certain antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs), may be prescribed to help manage tinnitus-related anxiety or depression.
- Benzodiazepines: Benzodiazepines, such as clonazepam or diazepam, may be prescribed to help reduce tinnitus-related anxiety or to promote relaxation and improve sleep quality in individuals with tinnitus.
- Anticonvulsants: Some anticonvulsant medications, such as gabapentin or carbamazepine, may be prescribed off-label to help manage certain types of tinnitus, particularly those associated with neuropathic pain or hyperactivity in the central nervous system.
- Muscle relaxants: Muscle relaxant medications, such as cyclobenzaprine, may be prescribed to help alleviate tinnitus symptoms associated with tension or muscle spasms in the jaw or neck (e.g., temporomandibular joint disorders).
- Vasodilators: Vasodilator medications, such as betahistine, may be prescribed to improve blood flow and circulation in the inner ear, particularly in cases of tinnitus associated with conditions like Meniere’s disease.
- Steroids: Corticosteroid medications, such as prednisone, may be prescribed in certain cases of tinnitus associated with sudden hearing loss or inflammation in the inner ear.
- Medications for underlying conditions: If tinnitus is caused or exacerbated by an underlying medical condition (e.g., hypertension, thyroid disorders), medications to manage or treat the underlying condition may help alleviate tinnitus symptoms.
In conclusion, tinnitus is a complex and often distressing condition characterized by the perception of sound in the absence of external stimuli. While there is no universal cure, management strategies tailored to individual needs can help alleviate symptoms and improve quality of life for those affected by tinnitus.
