Ear damage and exposure to loud noises are common causes of tinnitus. Lesser-known causes include medications and thyroid disease. It’s not always possible for a doctor to identify the cause, but various treatments are available.
Tinnitus is the medical term for “ringing in the ears.”
It’s not a condition in and of itself. Instead, it can be a symptom of a medical condition or another issue. For many people, though, tinnitus appears on its own and isn’t accompanied by other symptoms or issues.
If you have tinnitus, you may hear more than just ringing. You may also hear:
Although you hear these sounds in your ears, there’s no external source of the sounds. For this reason, the sounds of tinnitus are also known as phantom sounds.
Tinnitus can be frustrating. Sometimes, the sounds of tinnitus can interfere with other sounds around you. In addition, anxiety and stress can aggravate tinnitus, which can make you feel worse all around.
You may experience tinnitus in one ear or both ears. People of all ages can develop tinnitus, but it’s more common in older adults.
Tinnitus can be either objective or subjective.
If other people can also hear certain noises in your ears, then you have objective tinnitus. Objective tinnitus is rare.
Subjective tinnitus is much more common. You’re the only one who can hear the ringing, roaring, and other sounds of subjective tinnitus.
Pulsatile tinnitus is one form of subjective tinnitus. It may result from abnormal blood vessels in and around your ears. The sounds may have the same rhythm as your heartbeat.
Damage to the inner ear is a common cause of tinnitus.
Your middle ear picks up sound waves. The conduction of those sound waves prompts your inner ear to transmit electrical impulses to your brain.
You can only hear these sounds after your brain accepts the electrical signals and translates them into sound. Sometimes, your inner ear sustains damage, altering how your brain processes sound.
Damage to the tiny bones in your middle ear or your eardrums can also interfere with the proper conduction of sound. Tumors in the ear or on the auditory nerve may cause tinnitus as well.
Regular exposure to very loud sounds can cause tinnitus in some people. People who use jackhammers, chainsaws, or other heavy equipment are more likely to have it.
Listening to loud music through headphones or earbuds or at a concert may lead to temporary tinnitus.
Medical conditions that can cause tinnitus include:
- ear infections
- an overabundance of earwax, which alters the way you hear
- age-related hearing loss
- muscle spasms in your middle ear
- Meniere’s disease, which is an inner ear condition that affects hearing and balance
- thyroid disease
- high blood pressure
- high cholesterol
- head and neck injuries
- temporomandibular joint (TMJ) disorders, which also cause chronic pain in your head and jaw
Rare causes include aneurysms and palatal myoclonus (muscle spasms in the roof of the mouth).
Medications that cause tinnitus
Medication use can also cause tinnitus and hearing damage. This is known as ototoxicity (ear poisoning).
These medications include:
- very large doses of aspirin
- loop diuretic medications, such as bumetanide (Bumex)
- antimalarial drugs, such as chloroquine
- certain antibiotics, such as erythromycin (Eryc, Ery-Tab) and gentamicin
- certain anticancer drugs, such as vincristine
Diagnosing tinnitus can be tricky. This is because you’re typically the only person who can hear the sounds it creates.
A primary care physician or a specialist called an audiologist will attempt to diagnose tinnitus by examining your ears and conducting a hearing test.
The doctor will transmit sounds — to one ear at a time — through a set of headphones. You’ll respond by raising your hand or making a similar gesture when you hear each sound.
The doctor may be able to diagnose any hearing loss by comparing what you can hear to what people of your age and sex should be able to hear.
The doctor may also use imaging tests, such as CT scans or MRIs, to see if you have irregularities or damage. Standard plain film X-rays don’t always show tumors, blood vessel disorders, or other abnormalities that can affect your hearing.
In some cases, a doctor may not be able to identify what’s causing your tinnitus.
The doctor will treat any underlying medical conditions causing your tinnitus. If medications are contributing to your tinnitus, the doctor may have you switch to different ones to restore your hearing.
They’ll also remove any excess earwax and address any blood vessel issues.
There are various other tinnitus treatments and remedies. Some are described below.
Noise-canceling machines can help dull the ringing, buzzing, or roaring by providing relaxing noises to mask your ear sounds. You can also try a masking device that is inserted into your ear and works similarly to a hearing aid.
Reducing your stress can also help you manage tinnitus. Stress doesn’t cause ringing in the ears but can make it worse. Engaging in a hobby or talking with a trusted friend or family member are just a few ways to reduce stress.
Also, avoid exposure to loud noises. This will help lessen the severity of your tinnitus.
Drug therapy can help reduce those pesky sounds in your ears, too.
In some cases, anti-anxiety medications or tricyclic antidepressants can reduce the sounds.
This is because these medications alter your nervous system and brain signals, which can affect your hearing. They can also help you manage other effects of tinnitus, such as insomnia and emotional problems.
Examples of these medications include:
- alprazolam (Xanax)
- nortriptyline (Pamelor)
Medications are typically reserved for people with more severe symptoms that are affecting their quality of life.
Not everyone responds to drug therapy, and the side effects can be bothersome.
Side effects of medications used to treat tinnitus may include:
- blurry vision
- heart problems, in rare cases
When people take these medications to treat tinnitus, it’s known as off-label drug use.
Off-label drug use
Off-label drug use means a drug that’s approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that hasn’t yet been approved.
However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs but not how doctors use drugs to treat their patients. So your doctor can prescribe a drug however they think is best for your care.
People who have hearing loss in addition to tinnitus may use hearing aids. The sound amplification can help you if you’re having trouble hearing normal noises.
There are a few steps you can take to help prevent tinnitus.
To start, try to protect your ears from loud noises.
Keep a close eye on the volume levels of your television, radio, and personal music player. Wear ear protection around noises louder than
Cover your ears if you’re surrounded by loud music or construction noise and you don’t have proper ear protection (such as earplugs).
In addition, avoid medications that may cause your tinnitus symptoms to recur.
Also, schedule regular hearing tests with a doctor so they can promptly detect and diagnose any structural problems in your inner or middle ear.