Tinnitus – a sound in your ears or head with no external source – is not a disease. Tinnitus is a symptom that can be triggered by a variety of different conditions.

Common sources of tinnitus include hearing loss, earwax, ototoxic medications, and ear bone changes. No matter what the cause, the condition interrupts the transmission of sound from the ear to the brain. Other parts of the hearing system are often involved as well, whether the outer, middle, and/or inner ear.

Most of the causes of tinnitus alter neurological activity within the auditory cortex, the portion of the brain responsible for hearing. The transmission of sound is interrupted, so some of the neural circuits fail to receive signals. Instead of causing hearing loss, as you might expect due to the lack of stimulation, the neural circuits begin chattering. First, they chatter alone. Then, they become hyperactive and synchronous. When we experience this deviation, our brains attempt to compensate for the change by interpreting the neurological activity as sound. This can resemble ringing, buzzing, hissing, whistling, or roaring, amongst a variety of other noises.

Tinnitus varies dramatically from person to person, so it is important that you visit a Doctor of Audiology to learn more about your specific circumstances. Some of the causes result in permanent tinnitus and require treatment, while others provoke temporary tinnitus that disappears on its own.

According to the American Tinnitus Association, there are approximately 200 health disorders that can produce tinnitus as a symptom. Below we’ve listed some of the most common provocations of tinnitus.

Hearing Loss

Most people who suffer from tinnitus also experience hearing loss to some degree. As they often accompany one another, the two conditions may be correlated. In fact, some researchers believe that subjective tinnitus can only occur if the auditory system has been previously damaged (source). The loss of certain sound frequencies due to hearing loss may change how the brain processes sound, causing it to adapt and fill in the gaps with tinnitus. The underlying hearing loss typically results from exposure to loud noises or advanced age:

Exposure to Loud Noise: Exposure to loud or excessive noise can damage or destroy hair cells in the inner ear. Because the hair cells cannot regenerate, this can lead to permanent hearing loss and/or tinnitus. Continued exposure can worsen these conditions, so people who work in loud environments should always wear ear protection. This includes musicians, air traffic controllers, construction workers, military personnel, and first responders. In addition, consider lowering the volume on your iPod and wearing earplugs at loud concerts.
Age-Related Hearing Loss: Also known as presbycusis, age-related hearing loss results from the cumulative effect of aging on hearing. This permanent, progressive, and sensorineural condition is most pronounced at higher frequencies. It commonly impacts people over the age of 50, as all people begin to lose approximately 0.5% of the inner ear’s hair cells annually starting at age 40.

Sometimes people who suffer from tinnitus are unaware that they have lost the ability to hear certain frequencies. For this reason, it is important that you schedule an appointment with an audiologist, who can conduct audiometric tests and precisely measure the extent of your hearing loss.

Ear Wax Buildup

If cerumen (more commonly known as ear wax) accumulates in your ear canal, it can diminish your ability to hear. Your auditory system may overcompensate for the loss, fabricating noises that do not exist. Your audiologist can safely remove the buildup, and in most cases, this will immediately alleviate your tinnitus. However, sometimes earwax buildup causes permanent damage, resulting in chronic tinnitus.

Earwax is not the only obstruction in the middle ear that can increase pressure in the inner ear, producing tinnitus. Other examples include dirt, foreign objects, and loose hair from the ear canal.

Ménière’s Disease

A disorder of the inner ear, Ménière’s disease typically affects hearing and balance and may cause debilitating vertigo, hearing loss, and tinnitus. People who suffer from Ménière’s disease often report a feeling of fullness or pressure in the ear (it typically affects only one ear). The condition most often impacts people in their 40s and 50s, but it can afflict people of all ages, including children. Although treatments can relieve the symptoms of Ménière’s disease and minimize its long-term influence, it is a chronic condition with no true cure.

Ototoxic Medications

When a medication is ototoxic, it has a toxic effect on the ear or its nerve supply. In damaging the ear, these drugs can cause side effects like tinnitus, hearing loss, or a balance disorder. Depending on the medication and dosage, the effects of ototoxic medications can be temporary or permanent. More than 200 prescription and over-the-counter medicines are known to be ototoxic, including the following:

Certain antibiotics
Certain cancer medications
Certain anticonvulsants
Diuretics and water pills
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), including aspirin, ibuprofen, and naproxen
Quinine-based medications
Tricyclic antidepressants

If you experience tinnitus after you begin taking a new medication, contact the prescribing physician. In addition, if you already have tinnitus, let your physician know before he or she prescribes a new medication, as effective alternatives to ototoxic drugs may be available.

Various Disorders & Diseases

Ménière’s disease is not the only disease that can trigger tinnitus. In fact, numerous disorders and diseases can cause or worsen the condition, including all of the following:

Hypothyroidism
Hyperthyroidism
Fibromyalgia
Thoracic Outlet Syndrome
Temporomandibular Joint Disorder (TMJ)
Diabetes
Lyme Disease
Thyroid Disorders
Depression
Anxiety

Other Health Conditions

Investigating what causes tinnitus in a particular case can be tricky, because so many health conditions can provoke this side effect. If you hear ringing in your ears, your audiologist may explore whether one of the following health conditions is to blame:

Allergies
Tumors
Ear infections
Acoustic neuromas
Issues involving the heart
Issues involving the blood vessels
Issues involving the ear bones (such as otosclerosis, the stiffening of the bones in the middle ear)
Jaw misalignment
Head or neck trauma (this can impact the inner ear and hearing nerves)
Stress (physical or emotional stress can act as a catalyst for tinnitus)

How to Prevent Tinnitus from Intensifying

If you suffer from tinnitus, do your best to avoid activities that can aggravate the condition, including the following:

Smoking
Drinking alcohol
Drinking caffeine
Listening to loud sounds without protection

Ear protection can mitigate the negative effects of loud noises and prevent the exacerbation of tinnitus. This is especially important if you work in a loud environment or regularly visit loud places, like shooting ranges, concerts, and clubs. Wearing custom earplugs or special earmuffs can go a long way toward preventing your tinnitus from worsening.

In addition, a healthy lifestyle can reduce the impact of tinnitus. Avoid physical and emotional stress, as these can cause or intensify tinnitus. You may be able to reduce your stress levels through exercise, meditation, deep breathing, or massage therapy. If you suffer from high blood pressure, consult your doctor for help controlling it, as this can also impact tinnitus. Finally, get plenty of rest to avoid fatigue and exercise regularly to improve your circulation. Although this won’t eliminate the ringing in your ears, it may prevent it from worsening.

What Now?

If you suffer from tinnitus, contact Heartland Hearing Center today to explore your treatment options. Our Doctors of Audiology specialize in tinnitus treatment, and we have provided life-changing relief to patients through tinnitus treatments.