Find the Causes of Tinnitus

Are you bothered by a ringing, buzzing, or humming in your ears? Then you have a condition that is known as tinnitus. Tinnitus is a common problem that affects an estimated 50 million adults in the U.S. For most people the condition is just annoying but for others it can interrupt sleeping and eventually cause difficulty concentrating and working. Without successful treatment, tinnitus can result in psychological stress, which can adversely affect your personal and work relationships. The good news is that in many cases tinnitus can be treated. To be able to do this, however, you first need to find the cause.

Steps

Discovering the Causes of Tinnitus

1. Consider potential environmental triggers. Environmental factors are influences you experience from the world around you. Prolonged exposure to loud noises is the most common cause of tinnitus. Repeated exposure to loud noises, such as amplified music, gunshots, aircrafts, and heavy construction, damage the tiny hairs in the cochlea that send electrical impulses to the auditory nerve if sound waves are detected. When these hairs are bent or broken, they send electrical impulses to the auditory nerve even though no sound waves are detected. The brain then interprets them as sound, which we know as tinnitus.
   • Individuals who have the greatest job-related risk of developing tinnitus include carpenters, street-repair workers, pilots, musicians, and landscapers. Individuals who work with loud equipment or who are repeatedly around loud music have increased risk of developing tinnitus.
   • A single exposure to a sudden and extremely loud noise can also cause tinnitus. For instance, tinnitus is one of the more common disabilities among individuals who have served in the armed forces and were exposed to bomb blasts.
2. Assess potential lifestyle and health causes. There are several different health-related causes for tinnitus, including aging, poor lifestyle habits, and changing hormones.
   • The natural aging process can affect the development of tinnitus. This aging process causes a deterioration in the cochlea, which can be aggravated by exposure to loud noises in the environment over time.
   • Smoking or drinking caffeinated or alcoholic beverages can trigger tinnitus. In addition, stress and fatigue, if not properly managed, can pile up and lead to the development of tinnitus.
   • Although no direct causation has been found, anecdotal evidence suggests that changes in hormone levels for women can and have triggered tinnitus. These changes occur in pregnancy, menopause, and while using hormone replacement therapy.
3. Think about whether you've experienced any issues with your ears. Blockages in the ear canal can change the way that sound reaches the sound-sensitive cells in the cochlea and therefore trigger tinnitus. These blockages can be the result of ear wax, ear infections, sinus infections, and mastoiditis (an infection of the mastoid bone behind the ear). These health conditions change the ability of sound to travel through the middle and inner ear, which triggers tinnitus.
   • Meniere’s disease can trigger tinnitus or muffled hearing. This is a disorder that has no known cause but affects the inner ear and triggers severe dizziness, ringing in the ears, hearing loss and a feeling of fullness in the ear. It often affects just one ear and may trigger an attack separated by long periods of time or trigger attacks after only several days. It can develop at any age but is more likely to occur in individuals between 40 and 60 years old.
   • Otosclerosis is a hereditary disorder that results in an overgrowth of the bones in the middle ear, leading to deafness. This condition makes it difficult for sound to travel to the inner ear. White, middle-aged women are at the greatest risk for developing otosclerosis.
   • More rarely, tinnitus can be caused by a benign tumor on the auditory nerve, the nerve which allows sound to be transmitted to the brain and interpreted. This tumor is called an acoustic neuroma and develops on the cranial nerve that runs from your brain to your inner ear, often causing tinnitus on only one side. These tumors are rarely cancerous, but can grow to be quite large — it's best to seek treatment when they are still small.
4. Determine whether you have any pre-existing medical conditions associated with tinnitus. Diseases of the circulatory system, such as high blood pressure, malformation of the capillaries, diabetes, heart disease, anemia, atherosclerosis, and coronary artery disease also affect the circulation to other parts of the body, including the supply of oxygen to the cells in the middle and inner ear. Loss of oxygen and blood supply can damage these cells and increase the potential risk of developing tinnitus.
   • Individuals affected byTreat TMJ Problems Without Surgery (TMJ) have a higher risk of developing tinnitus. There are some different theories as to why TMJ affects tinnitus. The chewing muscles are very near to those muscles in the middle ear and can affect hearing. There could be a direct connection between the ligaments that attach to the jaw and one of the bones in the middle ear. Alternately, the nerve supply from TMJ has some connection with the part of the brain that is involved in hearing.
   • Trauma to the head or neck can also affect the inner ear or the nerves that affect hearing or brain function that is linked to hearing. These injuries generally cause tinnitus only in one ear.
   • Brain tumors can affect the area of the brain that interprets sound. In these cases you may have tinnitus in one or both ears.
5. Consider your medications. Medications are another factor which can trigger tinnitus. Certain medications can cause medication-induced ototoxicity, or “ear poisoning.” If you are taking any medications, look on the package insert or ask your pharmacist to find out if tinnitus is listed as a side effect. Often there are other medications in the same family of drugs that your doctor can prescribe for you that can treat your condition without causing tinnitus to develop.
   • There are over 200 different drugs which list tinnitus as a side effect, including aspirin, certain antibiotics, anti-inflammatory medications, sedatives, antidepressants, and quinine medications. Cancer medications and diuretics also make the list of medications related to tinnitus.
   • Antibiotics frequently associated with tinnitus include vancomycin, ciprofloxacin, doxycycline, gentamycin, erythromycin, tetracycline, and tobramycin.
   • Generally the higher the dose of medication used, the worse the symptoms become. Most of the time when the medication is discontinued, the tinnitus also resolves.
6. Know that there can also be no cause. Even with all these associated conditions and triggers, some people can develop tinnitus for no known reason. Most of the time it isn’t serious, but if it doesn’t resolve it can trigger fatigue, depression, anxiety, and problems with memory.

Diagnosing Tinnitus

1. Understand what tinnitus is. Tinnitus isn’t a condition but actually a symptom of other problems or condition that range from age-related hearing loss to hearing damage or circulatory system disorders. The treatment for the condition will be based on the underlying cause of tinnitus, which is why finding the cause matters. Tinnitus can be primary or secondary. Primary tinnitus occurs when no cause can be identified other than hearing, and secondary tinnitus occurs as a symptom of another condition. Determining which type of tinnitus you have will increase the potential of successful treatment.
   • Tinnitus can be classified in two categories. First, objective tinnitus, also called pulsatile tinnitus, happens in just 5% of the cases and is audible to an observer who is listening with a stethoscope or is standing close to the individual. This type of tinnitus is associated with vascular or muscular disorders to the head or neck, such as brain tumors or brain structure abnormalities, and is often synchronized to the individual’s heartbeat. Second, subjective tinnitus is audible only to the individual and is more common, occurring in 95 percent of the cases. This is a symptom of many different ear disorders and is reported in over 80 percent of people who suffer from a sensorineural hearing loss.
   • Tinnitus may affect individuals differently, even though they are experiencing identical loudness or pitches in sound. The severity of the condition can be a function of the individual’s reaction to the condition.
2. Recognize the symptoms of tinnitus. Tinnitus is often described as a ringing in the ears but it can also sound like buzzing, hissing, roaring, or clicking. The pitch and tone can vary from individual to individual and the sound may also change. You might hear the noises in one ear or both, which is an important distinction your physician should know for diagnostic purposes. Aside from the ringing in the ears, a person may also exhibit other symptoms such as dizziness or lightheadedness, headaches, and/or neck pain, ear or jaw pain (or other TMJ symptoms).
   • Some people will experience a loss of hearing while others don’t experience any difficulty hearing. Again, this distinction is important during diagnosis.
   • Some also become hypersensitive to certain frequencies and volume ranges of sound, a condition called hyperacusis. This is strongly associated with tinnitus and individuals can suffer from both at the same time.
   • Secondary effects of tinnitus include difficulty sleeping, depression, anxiety, problems at work and home, and a deterioration of an individual’s emotional state.
3. Reflect on potential causes and recent events. Think about what has happened in your life recently and search for situations or circumstances which may have caused tinnitus. To prepare yourself for a medical appointment for diagnosis and treatment of your tinnitus, record your symptoms and any other information that may be relevant to the development of your symptoms. For example, note if you:
   • Have been exposed to loud noises
   • Have a current or chronic sinus, ear, or mastoid infections
   • Are taking or have recently taken any of the medications listed above
   • Have been diagnosed with a circulatory problem
   • Have diabetes
   • Have TMJ
   • Have suffered a head or neck injury
   • Have a hereditary disorder, osteosclerosis
   • Are a woman and recently experienced a change in hormonal levels, such as pregnancy, menopause or start/stop of hormonal replacement therapy
4. Consult your physician. Your physician will perform a thorough history to determine any past environmental exposures or medical conditions which may have triggered tinnitus. Treatment for tinnitus will depend upon the underlying medical cause of the condition.
   • If you are taking medications which are associated with tinnitus, you may want to discuss changing the medication with your physician.
   • Auditory nerve retraining may be necessary if you experience hyperacusis.

Tips

• Although it is associated with hearing loss, tinnitus does not imply you have hearing loss, nor does a loss of hearing cause tinnitus.

Warnings

• Some causes of tinnitus are not completely treatable, and in some medication-induced causes, the therapeutic effect of the drug offsets the side effect of tinnitus: in these instances, people learn to cope with the ear ringing or buzzing.
• Do not ignore the onset of tinnitus. As with many symptoms, ringing or buzzing in the ears is a warning. Your body is telling you that something is wrong.

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