by Katherine Brind’Amour, PhD
If you have ringing in the ears, you are not alone. Estimates suggest that more than 50 million Americans have experienced their ears ringing at one point in time or another. About 1 in every 5 people with ringing ears end up seeking care, usually because the ringing is constant and is impacting their quality of life. (1)
The condition is also known as tinnitus, and it can be temporary or permanent. The sound of ringing in the ears can range from mild to severe and from a low pitch to a high pitch, and it happens even though there really is no sound coming from outside of your ears. There is technically no cure for tinnitus, but many people can achieve less ringing in the ears or a total stop to the sound when they are treated for the cause of ear ringing.
What Is Ringing in the Ears?
Ringing in the ears means you hear a sound that is not actually coming from something outside of your ears. Often described as a ringing, whining or roar, it can be very annoying. It can range in volume and how long it lasts. Some people may have ear ringing that comes and goes, while others have a constant ringing in their ears that may last longer than six months. This long-term problem is called persistent tinnitus.
Because ear ringing can be caused by a wide range of problems — from a buildup of earwax to a brain tumor — it’s crucial to get evaluated by an ear, nose and throat (ENT) doctor and an audiologist. They can help find the source of the noise and develop a plan for treatment.
In many cases, tinnitus goes away after the cause is treated or even disappears on its own. However, in some people, tinnitus warns of oncoming hearing loss. In this case, the ear ringing may not go away, though you may have options for reducing the noise.
Tinnitus Signs & Symptoms
People with ringing in the ears can have widely varying experiences. Most types of tinnitus have a similar range of symptoms. However, some conditions that cause ear ringing result in specific symptoms.
- Head noises or hearing sounds that no one else can hear
- This does not include hearing voices or environmental sounds, but rather a similar, fairly steady noise.
- It is called subjective tinnitus.
- Hearing a noise inside your ear or head that others can hear with a special microphone
- This is called objective tinnitus, since another person can hear it.
- Ringing in both ears
- Ringing in one ear only
- This includes ringing in the left ear or ringing in the right ear only.
- High-pitched ringing in ears, sounding like a steady squeal or shrieking
- Low-pitched ringing in ears, sounding like a dull or low roar
- Ringing that sounds like buzzing, clicking, rushing, humming or hissing
- Ringing that comes and goes
- Constant ringing in ears
- Whooshing or pulsing sound, like a heartbeat or pulse in your ear
- This may signal cardiovascular disease or a tumor in the head, neck or ear.
- If you notice tinnitus that sounds like this, consult a physician as soon as you can.
- Difficulties sleeping, working, hearing, remembering or focusing due to the noise
- Having long-term ringing in the ears can also lead to fatigue, stress, anxiety, depression and irritability.
Causes & Risk Factors
Many health problems can get your ears ringing, but some are far more common than others.
- Hearing loss
- Damage to the tiny hairs in your inner ear
- This can be caused by noise, medications or age. Excessive noise exposure, prescription medications such as aspirin or acetaminophen in high doses, and prescription medications such as diuretics or antibiotics.
- Ear infections
- Sinus infections
- Labyrinthitis (inflammation in the inner ear, usually after an infection)
- Earwax buildup
- Muscle stress or physical fatigue
- Drinking too much alcohol or caffeine
- Eardrum rupture
- A foreign object lodged in the ear or skull
- Injury or trauma to the head or ears, including whiplash or concussion
- Bell’s palsy
- Temporomandibular joint arthralgia (TMJ)
- A rapid change in pressure in the environment
- Significant weight loss from malnutrition
- Long-term holding of the head in a hyperextended position
- Problems with the nerves, such as multiple sclerosis or with migraine headaches
- Thyroid problems
- Hormonal changes (in women)
- Heart or blood vessel disease, including high blood pressure and preeclampsia
- Depression or anxiety
- Otosclerosis (a hardening of the tiny bones in your ears)
- Post-radiation or surgical damage to the inner ear
- Muscle spasms of the ear muscles
- Meniere’s disease
- Brain tumors and neurofibromatosis 2
- Acoustic neuroma (a noncancerous tumor pressing on the ear)
Risk factors for ringing in the ears include: (6)
- Older age
- Exposure to loud noises, including from headphones
- Being male
- Having high blood pressure, narrow arteries or other cardiovascular health issues
- Having other health conditions that can cause tinnitus
In many cases, tinnitus can go away on its own. You may notice it fading or happening less often over time. Otherwise, how you get rid of tinnitus may depend on its cause. In most cases, the cause does not indicate a serious health condition — it is far more likely that the annoying sound is caused by loud noises or an ear infection.
In some cases, no cause can be found. And in others, even when the cause is known (such as hearing loss), tinnitus may remain even after treatment. Treatments for ringing ears include: (3, 7)
- Removing earwax buildup
- Antibiotics to treat ear infections
- Changing medications if the problem is caused by a prescription medication, over-the-counter drug or a drug-drug interaction
- Treating underlying cardiovascular conditions with appropriate medications, surgery or lifestyle changes
- Starting use of a hearing aid
- Using masking devices that fit like a hearing aid and make a constant background noise of neutral sounds to help mask the ringing
- Treating stress, anxiety, depression and other underlying mental health issues with prescription medications or talk therapy
- In cases of severe tinnitus, symptoms may be treated with tricyclic antidepressants or alprazolam to reduce symptoms
- Emotional support, including counseling, support groups and education sessions
- Lifestyle changes, such as using white noise machines to help fall asleep and avoiding alcohol and caffeine
- Surgery to remove tumors causing tinnitus
7 Natural Treatments for Ringing in the Ears
There are many ways you can try to naturally stop the ringing in your ears. Depending on the cause of your tinnitus, some of these strategies may be more effective than others. In addition, some of these strategies may not be appropriate. Always work with a doctor to try to uncover the cause of your ears ringing before starting treatments. Discuss any changes to your diet, exercise and medication or supplement regimen with a medical professional.
Natural strategies for treating ringing in the ears include:
Protect your ears
Many people experience tinnitus because of damage to the tiny hair cells in their ears. This can be caused by loud noises and hearing loss, as well as certain medications. You can avoid further damage to these hair cells and potentially stave off some hearing loss by protecting your ears. Ways to protect your ears include: (8)
- Wear ear plugs or ear muffs in loud environments, such as sporting events, airplanes, shooting ranges, concerts, bars or clubs and other noisy locations.
- Keep the windows up when driving and avoid motorbikes and speedboats.
- Turn down the volume on headphones, music stereos and television.
- Do not exceed 60 percent of the maximum volume.
- Use noise-cancelling headphones.
- Take frequent breaks from noisy places or music for at least five minutes per hour.
- When you have spent time in a noisy place and have ringing in your ears, give your ears at least one day to recover by keeping things quiet.
- Speak with your employer if your work environment is noisy. You may be able to get employer-purchased hearing protection or be relocated to working at a quieter piece of equipment or part of the office.
- Get a hearing test. Visiting an audiologist can help you understand if you’re facing hearing loss or just temporary damage to your hair cells.
- Visit an ear, nose and throat doctor. They can check for earwax buildup, show you how to protect and clean your ears and tell you whether any of your medications could be causing ear ringing.
Please note that age-related hearing loss is usually due to changes in ear structure, blood flow, nerves, brain processing and more. It may not be possible to prevent these changes. However, other health issues can contribute to age-related hearing loss, such as diabetes, heart disease, smoking, certain medications and exposure to loud noises. By limiting these more preventable causes of hearing loss, you may be able to protect your hearing (and avoid long-term tinnitus) as long as possible. (9)
Mask the sound
One of the most common and effective ways to treat ringing in the ears is to cover or mask the sound. (3)
- “Masking” devices are effective in stopping the ear ringing in about half of all people with hearing loss who use them. The treatment is non-medical and involves simply placing a special device in your ear. The device makes a low-level sound like white noise that covers or cancels out tinnitus for many people without causing further hearing damage.
- White noise machines can help you sleep by providing another gentle noise that may distract you from your ringing ears. Popular sound options include ocean waves, falling rain, crickets, static or other soundtracks. Some models come with pillow speakers. Fans, air conditioners and humidifiers or dehumidifiers are other options that can have a similar effect.
- Try a hearing aid. By improving your ability to pick up on true environmental sounds, some people find that ringing in the ears becomes less noticeable or goes away entirely.
- Tinnitus retraining helps accustom your brain to the tinnitus noise by emitting another noise. The sound comes through a small device you wear on your ear. It is programmed to mask the specific noise that you personally hear so that over time it has a noise-cancelling effect. You may be encouraged to do talk therapy at the same time.
Avoid dietary irritants
What you put into your body can impact your tinnitus symptoms. Beyond medication side effects, dietary habits also influence ear ringing. Avoid these common culprits:
- Tobacco: Nicotine in any form (chew, cigarettes, patches) can make tinnitus worse. In addition, smoking, especially in combination with high cholesterol or other cardiovascular conditions, can put you at greater risk for tinnitus in the first place. (10)
- Alcohol: Dilated blood vessels caused by drinking alcohol causes greater blood flow in the vessels of your inner ear. This can make tinnitus worse or cause ear ringing to start when you previously had no problem with this sort of noise. Reduce your consumption or avoid it altogether, especially if you have continuous ear ringing already.
- Caffeine: Some people notice that tinnitus gets worse when they have caffeine. Try eliminating it to see if your symptoms improve. If the tinnitus goes away, you can try gradually reintroducing small amounts of caffeine to see what you can tolerate without ringing in the ears.
Treat underlying health conditions
Some people have tinnitus because of other health conditions. Common health problems that can cause tinnitus include infections, high blood pressure, thyroid problems, anemia and more. In some cases, tinnitus disappears once the underlying health issue is addressed.
These tips may help you identify and treat your underlying condition:
- Get an ear exam. A quick exam will tell you whether an ear infection or sinus infection may be causing your symptoms. You can get a treatment plan or, if the infection is not too serious, wait it out.
- Get a physical. General checkups on a regular basis (annually for fairly healthy people but more often if you have a chronic condition like diabetes) can help identify possible tinnitus triggers. The physician will check your blood pressure. If you suspect something like anemia or thyroid dysregulation is causing your symptoms, you can request that the doctor run blood tests. Identifying hypothyroidism, anemia or another problem via blood tests opens up a wide range of dietary and lifestyle changes (as well as medication options) to treat a condition that may result in reduced tinnitus.
- Know your risks. Talk to your parents or older relatives, if possible, to find out about family health history. This can help you understand if you are at an increased risk for conditions related to tinnitus, such as hearing loss, heart disease, vascular disease and other problems.
- Maintain a healthy lifestyle. This includes a balanced diet and regular physical activity. Depending on particular health issues you may have, such as hypothyroidism or high cholesterol, your diet may need to be adjusted to avoid or include specific food groups.
- In general, a healthy diet limits saturated fats, simple sugars and processed foods. It should typically include lots of whole grains, lean protein and fresh fruits and vegetables.
- Most people should get a bit of moderate physical activity — even a brisk walk — every day. However, speak to a health care professional before starting a new exercise routine. This can reduce your chance of injury.
Tackle stress, anxiety and depression
In addition to being potential causes of tinnitus, depression, stress and anxiety can all result from ringing in the ears. The noise can keep people from getting good quality rest at night and from performing well during the day, which increases stress and anxiety. The irritating, constant drone of ringing ears — especially long-term tinnitus — is enough to make even previously calm and happy people stressed and irritable.
- Cognitive-behavioral therapy is an evidence-based treatment for tinnitus. CBT can help many people cope with the sound and even reduce symptoms in many people. A combination of education, counseling, psychological therapy and coaching give you a host of strategies to manage the noise and its related stressors. (11)
- Relaxation training and biofeedback are other natural psychological approaches to reducing stress. They may help you identify stressors, train you to calm anxiety when it arises, and help minimize tinnitus. (12)
- Hypnosis may offer some patients relief from tinnitus. A small clinical study examining Eriksonian hypnosis for its impact on quality of life in patients with severe tinnitus found that even six months after hypnosis, patients had significant improvements in physical and emotional symptoms related to tinnitus. (13) Other studies show similar promise for this technique as well, and as health risks are minimal, it may be worth a try to relieve some anxiety or stress related to the condition.
- Follow natural depression relief strategies, including a healthy diet and exercise routine.
- Yoga and tai-chi offer therapeutic exercise options, and diets high in omega-3 fatty acids offer benefits to the brain and blood vessels.
- Talk therapy is considered one of the most effective ways to relieve tinnitus symptoms. It may be able to do a double whammy by also focusing on the source and treatment of your depression.
- Try Dr. Axe’s other tips for natural stress relief, including journaling, aromatherapy and spending time in nature.
Consider transcranial magnetic stimulation (TMS)
In most medical circles, TMS is still considered a wild card for treating ringing in the ears. Clinical studies in Europe and now in the United States are examining whether the approach may be effective for tinnitus symptoms. TMS activates or deactivates the brain’s focal areas. The method is still under investigation. Some clinical trials are active, so speak with your physician to find out if you may be eligible or if it may be appropriate for you to seek TMS care for your symptoms.
- A study in Istanbul found that patients with low-frequency repeating TMS experienced a significant improvement in chronic tinnitus even one month after therapy. (14)
- Another study found that 600 pulses per session, once a day for five days, gave significant improvements in quality of life and severity of tinnitus symptoms, lasting for at least one month after treatment. (15)
Ask about acupuncture
If you are interested in alternative therapies such as acupuncture, the jury is still out. Some clinical research has found that acupuncture may be effective for tinnitus, while other studies have found it may have little or no benefit. (16) If you are interested in the therapy, consider the following:
- Select a practitioner familiar with the treatment of tinnitus.
- Expect the application of acupuncture needles to the scalp. This is done to target the areas believed to be most responsible for tinnitus symptoms.
- Consider acupuncture to target other symptoms as well, such as depression and stress.
- Do not ignore ringing in the ears. Although most causes of tinnitus are minor, some serious health problems could be the culprit. Always get tinnitus checked out by a physician and audiologist.
- If you recently had a head injury or trauma to the head, neck or ear, seek immediate medical assistance for ear ringing.
- Do not start or stop taking any medication, herb or supplement without first consulting a physician.
- Do not attempt to treat tinnitus without first investigating the cause with help from a medical professional. Treating tinnitus with certain approaches could be dangerous if the ear ringing is caused by something you don’t suspect.
- According to the Mayo Clinic and the American Academy of Otolaryngology – Head and Neck Surgery, there is no evidence that gingko biloba, melatonin, zinc, lipoflavenoids and vitamins are helpful in the treatment of tinnitus. (1, 3)
Key Points About Ringing in the Ears
- Tinnitus, or ringing in the ears, is a very common condition. For many people, it is temporary and fades on its own. For others, however, it can last longer than six months.
- Symptoms vary. The way people describe the noise may range from a low roar or pulsing sound to a high-pitched squeal, and anywhere in between. It may be in one or both ears, and may be constant, pulsing like a heartbeat or something that only happens when there was exposure to an irritant (such as alcohol).
- People who notice their ears ringing may not be able to identify the cause. However, some cases of tinnitus can be traced to hearing loss, ear infections or earwax buildup, or a wide range of other health conditions. The causes may be mundane (such as loud music in the headphones) or very serious (a brain tumor or heart disease).
- There is no cure for tinnitus, although some treatments help stop the sound or mask it effectively. Options may include a hearing aid, hearing protection, avoidance of irritants, and certain medications, such as antidepressants.
- If you have ringing in the ears, you should visit an audiologist and an ear, nose and throat specialist to try to determine the severity of your condition and whether a serious health risk is at its root. They can also guide you on appropriate treatment options.
Natural strategies for managing ringing in the ears are actually favored by many physicians. Recommendations tend to center on protecting hearing, avoiding triggers and finding ways to cope with the noise.
7 Natural Tinnitus Tips include:
- Protect your ears.
- Mask the sound.
- Avoid dietary irritants.
- Treat underlying health conditions.
- Tackle stress, anxiety and depression.
- Consider transcranial magnetic stimulation (TMS).
- Ask about acupuncture.
The post What Cause Ringing in the Ears? (+ 7 Natural Tinnitus Treatments) appeared first on Dr. Axe.
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