Ringing, buzzing, humming, or other unexplained sounds in the ear are hallmarks of tinnitus, a relatively common condition affecting an estimated 10–25% of adults. The resulting sleep problems, difficulty concentrating, and mental distress can be debilitating.
This article provides a comprehensive look into tinnitus, exploring its causes, symptoms, treatments, and ways to manage it.
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What Is Tinnitus?
Tinnitus is characterized by periodic or continuous ringing, buzzing, or humming in the ears that typically cannot be heard by others. It is best understood as a symptom—often stemming from an underlying issue—rather than a standalone disorder.
Tinnitus is often described as similar to the ringing someone gets when they’ve listened to loud music or had a loud sound next to their ear. However, unlike an acute ringing, tinnitus does not stop after a few moments. Tinnitus is often seen in males, and its prevalence increases with age.
Tinnitus can be broken down into two categories:
Subjective Tinnitus
- This is the most common type of tinnitus.
- Sounds can only be heard by the patient.
- It is not caused by external stimuli.
Objective Tinnitus
- Very uncommon – this makes up less than 1% of all patients.
- This type of tinnitus results from noise near the ear, such as blood flow.
- It can sometimes be heard by the examining physician.
Causes of Tinnitus
There are multiple potential causes of tinnitus:
Physiological Causes
Physiological causes can include the following:
- Abnormal blood flow that results in a pulsing, whooshing sound in the ear.
- Excessive ear wax that results in an echoing or ringing sound.
- Recurring ear infections that have damaged the inner ear.
- Head or neck trauma can have a serious effect on hearing and the processing of sound.
Environmental Causes
These causes result from damage to the ear caused by long-term exposure to:
- Loud music
- Power tools
- Workplace noise
- Firearms
Underlying Medical Conditions
Certain medical conditions can cause tinnitus, especially as a patient ages, are:
- Hearing loss can result in tinnitus as the brain tries to replace missing sounds.
- Neurological disease and damage, such as a stroke, multiple sclerosis, or certain cancers.
- Cardiovascular diseases such as congestive heart failure (CHF).
- Thyroid disease
- Temporomandibular Joint Disorder
- Fibromyalgia
- Meniere’s Disease
Symptoms and Diagnosis
The primary distinguishing symptom of tinnitus is a variety of sounds not coming from outside the body and cannot be heard by people around the patient. The most common symptoms sounds of tinnitus are:
- Ringing in the ears
- Hissing sounds
- Pulsating or beating sounds
The first step in diagnosis is to determine the cause of tinnitus. Diagnostic procedures to determine the cause and severity of tinnitus include:
Treatment Options for Tinnitus
Treatments for tinnitus vary depending on the underlying cause. For example, tinnitus can be caused by hearing loss because the brain, unable to register normal sounds, begins sending a signal to the ear to fill in the sound gaps.
This often results in a high-pitched ringing sound. If hearing loss is contributing to tinnitus, properly fitted hearing aids may substantially reduce or occasionally eliminate the ringing.
Medical Treatments
- Hearing aids
- Neuromodulation, is the use of electrical impulses to modify brain activity.
- Cognitive behavioral therapy (CBT).
Lifestyle and Home Remedies
- Stress reduction
- Sleep improvement
- Avoid loud environments
Dietary Management
While scientific evidence on dietary approaches for tinnitus is limited, some studies suggest that increasing intake of the following may be helpful:
Increase dietary intake of:
- Vitamin B12
- Vitamin D
- Fruits
- Vegetables
- Protein
Avoid dietary intake of:
- High amounts of calcium
- Iron-containing foods
- High-fat foods
Off-label Medications
There are currently no FDA-approved medications to treat tinnitus. However, several medications have been used with some success. They include:
Note: These medications (gabapentin, clomipramine, etc.) have not been approved by the FDA for tinnitus. Their use in tinnitus management is considered off-label and should be done only under the supervision of a qualified healthcare professional.
Alternative Therapies
Therapies using integrative medicine, naturopathic medicine, and traditional Chinese medicine include:
- Acupuncture: Some patients report reduced ringing.
- Mindfulness & Relaxation: Can improve coping and reduce stress-related exacerbations.
- Herbal Remedies: Consult with a trained herbalist or integrative physician for guidance.
Living with Tinnitus
Living with tinnitus can be challenging, as persistent sounds may contribute to anxiety or depression. Seeking emotional support—such as counseling, support groups, or online forums—can be beneficial. The American Tinnitus Association provides additional resources, including support group listings and coping strategies.
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Key Takeaways
- Tinnitus typically arises from another condition (e.g., hearing loss, noise exposure, or other medical issues).
- Identifying and addressing the root cause is crucial.
- Hearing aids or sound therapy may reduce symptoms if hearing loss is a factor.
- Stress management, adequate sleep, and a balanced diet can help.
- Although there is no definitive cure, tinnitus can often be managed with the right combination of treatments and coping strategies.
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