What is tinnitus?
Tinnitus is a ringing sound in your ear or ears that only you hear. It is the perception of a sound in your ear when there is no corresponding external source of the noise. Some people describe it as ringing, while others may sense a clicking, buzzing, hissing, whistling, or roaring noise. Ten to fifteen percent of all adults report symptoms of tinnitus with 1-2% of those reporting that it negatively impacts their quality of life.
What are the signs and symptoms of tinnitus?
The first signs and symptoms of tinnitus are ringing, buzzing, hissing, clicking or roaring noises that originate from inside your ear, not from an external source. These sounds may affect one or both ears.
What causes tinnitus?
To better answer this question, you need an understanding of how your ears work. First, sound waves travel from the air and through your outer ear. Your outer ear conducts the sound waves to your middle ear. From there, the sound is conducted to your inner ear. Your inner ear then transmits an electrical impulse to your brain. Your brain then translates this impulse into a sound that you hear.
Causes of tinnitus:
- Damage to your inner ear
- Damage to your eardrum or ear bones (the hammer, anvil, and stirrup) of your middle ear
- Tumours in your ear or on your auditory nerve
- Regular exposure to very loud noises such as workers who use jackhammers, chainsaws, or other heavy equipment or musicians who are exposed to very loud music frequently
- Age-related hearing loss
- Muscle spasms in your middle ear
- Meniere’s disease, which is an inner ear condition that affects hearing and balance
- High blood pressure
- High cholesterol
- Head and neck injuries
- Temporomandibular joint disorders, which also causes chronic pain in your jaw and head
- An overabundance of earwax, which alters the way your eardrum works
- Certain medications also cause tinnitus and hearing damage. This is known as ototoxicity. Drugs that contribute to tinnitus include:
- very large doses of aspirin over a prolonged period
- antimalarial drugs, such as chloroquine
- certain antibiotics, such as erythromycin and gentamicin
- loop diuretic medications such as bumetanide
- certain anti-cancer drugs, such as vincristine
Tests for Tinnitus
Your family doctor may perform a hearing assessment and provide a referral to an ear, nose and throat specialist or audiologist for more extensive testing.
Does tinnitus cause hearing loss?
People with tinnitus often report hearing difficulties because the noises in their ears are interfering with hearing incoming external noises. Resolving the cause of tinnitus, helps to restore normal hearing in some cases.
How is tinnitus treated?
The treatment for tinnitus depends on determining which of the above is the underlying cause and addressing that.
Damage to your inner ear
Your inner ear can be damaged by loud noises, viral or less frequently bacterial infections, aging, head trauma, a hereditary disease known as otosclerosis and Meniere’s disease. Addressing the source of the damage may revert symptoms like tinnitus.
Damage to your eardrum or ear bones of your middle ear
Eardrums can be damaged by unresolved ear infections, extreme changes in air or water pressure, and trauma. A damaged eardrum can repair itself if the cause of the damage is removed.
Tumors in your ear or on your auditory nerve
These are called acoustic neuromas. They are rare. The best test for an acoustic neuroma is an MRI. Treatment of an acoustic neuroma is outside my scope of practice and best discussed with your MD.
Exposure to very loud noises
For those who are exposed to loud noises, wearing hearing protection helps prevent further damage to your ears. Damage to your ears from short term exposure to loud noises usually resolves on its own after the exposure stops.
Age-related hearing loss
Obviously, you can’t change your chronological age. However, many of the effects that we attribute to age can be moderated or improved through healthy lifestyle measures like a healthy diet, good sleep, regular exercise, and certain vitamins and minerals.
In some people with age-related hearing loss, the changes to the central auditory system resemble the changes seen in Alzheimer’s disease. In this case, our naturopaths would treat tinnitus similarly to how we address Alzheimer’s dementia.
Muscle spasms in your middle ear
Muscle spasms in your ear may be influenced by stress, caffeine intake, and certain vitamin and mineral deficiencies, particularly calcium and magnesium. Aside from hearing the spasm, you would also feel a twitching movement inside your ear.
Meniere’s is an inner ear condition that affects your hearing and balance. Sufferers experience varying degrees of vertigo, falls, hearing loss, and nausea or vomiting. Usually, only one ear is affected. Conventional treatment involves salt restriction, medication to control dizziness and diuretics.
High blood pressure
People with high blood pressure may notice roaring or blood rushing sounds in their ears, although this is uncommon. Supporting your HPA axis, magnesium supplementation and strengthening your cardiovascular system are some of the means that we as naturopathic doctors help you manage your blood pressure.
Cholesterol levels are increased when blood sugar levels are not well managed and when there is damage to the vascular endothelium. Correcting your diet, increasing exercise, and supplementation for healthy veins and arteries helps lower cholesterol levels naturally.
Head and neck injuries
Temporomandibular joint disorders
Temporomandibular joint dysfunction, or TMJ, can be caused by misalignment of the bones of your jaw, neck, and skull. It also causes chronic pain in your jaw and head. Our chiropractors and osteopath help this. Anxiety or stress that causes tooth grinding at night also contributes. Our naturopaths reduce stress and anxiety so that you are more relaxed during the day and while you sleep. Therapy with Ichih Wang will relieve stress and anxiety. Acupuncturist Joy Walraven uses Traditional Chinese Medicine and acupuncture to relieve TMJ pain and tinnitus.
An overabundance of earwax
Impacted earwax can alter the way your eardrum works. Abundant earwax is a sign that something is irritating your ears. Earwax is like mucous for your nose, it is a way for your body to flush an irritant. Food sensitivities like dairy often provoke excessive earwax production. A trial dairy elimination diet is a good place to start if you notice a lot of earwax. You may need to see your medical doctor for ear irrigation to flush out impacted wax. Never stick things in your ears to do this as it may damage your eardrum.
Certain medications also cause tinnitus and hearing damage. This is known as ototoxicity. In the case of ototoxic drugs, the solution would be to discuss switching medications with your doctor.
Is tinnitus temporary or permanent?
Whether tinnitus is permanent or temporary really depends on the underlying cause. In some cases it will go away with appropriate treatment, in others, it will lessen and in some instances it is permanent.
How do you get rid of Tinnitus? What are natural treatment options?
Here are some natural remedies that are used for tinnitus relief:
Studies show that melatonin helps to relieve symptoms of tinnitus. Optimize your own production of melatonin by following these good sleep hygiene practices:
- Shut down electronics by 8 p.m. Backlit screens decrease your melatonin production.
- Dim the lighting in your home once it is dark outside. Your brain’s cue to make melatonin is darkness. If you are exposed to bright lights once it’s dark outside, you will produce less melatonin.
- Get blackout curtains for your bedroom. Keep the melatonin production optimal all night by keeping it dark in your bedroom.
A 2016 study reported a significant association between lower blood levels of magnesium and tinnitus. Magnesium acts to calm the nervous system and relax muscles. Both mechanisms could provide relief of tinnitus symptoms. Another study had participants take 532 mg of magnesium per day for 3 months and rated them on the Tinnitus Handicap Index before and after. After 3 months, the 19 participants who completed the study demonstrated a significant decrease in tinnitus afterward.
In addition, magnesium is a key component of melatonin production.
A water-soluble formulation of Coenzyme Q10 for 30 days after exposure to loud noise, helped participants recover their hearing. The reduction in the recovery time following treatment can be explained by CoQ10-mediated improvement of your ears’ response to oxidative stress.
Studies on using Gingko for tinnitus have demonstrated conflicting results, some showing an improvement, others not. Given Gingko’s ability to improve circulation, this remedy may be most useful in patients with other signs and symptoms of circulatory issues or vascular dementia.
The conflicting evidence for Gingko may also be due to a lack of standardization of Gingko products used and/or dosage given.
A study in North India subjected participants to Vitamin B12 assay and audiometry pre- and post- a therapy that involved 6 weeks of intramuscular B12 injections (2500 mcg). Patients with Vitamin B12 deficiency showed significant improvement in mean tinnitus severity index score and visual analog scale (VAS) after Vitamin B12 therapy. Dr. Rachel Vong can administer vitamin B12 injections.
Fish oil studies show that it reduces nerve inflammation by decreasing the release of various inflammatory chemicals in the brain. Neuroinflammation has been implicated as a cause of tinnitus.
A 2018 study suggested that salicylate-induced tinnitus may be improved by taking a water extract of Spirulina.
Is Tinnitus Serious?
Some of the causes of tinnitus mentioned above are serious. If you are experiencing symptoms of tinnitus, see your doctor then see one of our practitioners for help with the underlying cause.