Causes of Tinnitus

WHAT IS TINNITUS?

Tinnitus is a medical term for the perception of sound when no external sound is present.  It is often referred to as "ringing in the ears,” although some people hear hissing, roaring, whistling, chirping, or clicking.  Tinnitus is a medical term for the perception of sound when no external sound is present.  Tinnitus can be intermittent or constant - with single or multiple tones - and its perceived volume can range from subtle to shattering.  The sounds, hissing, roaring, whistling, wind, waves, chirping, rustling, pulsating, clicking, etc---and perceived volume can range from a low roar to a high squeal so loud that it drowns out all other sounds.  Tinnitus may be heard in one or both ears and the noise may be constant or intermittent.  When the noise is constant it can be extremely annoying and distracting.  Tinnitus is a symptom, not a disease.  The underlying causes are many and varied. 

According to the American Tinnitus Association, over 50 million Americans experience tinnitus to some degree. For some people, tinnitus is just a nuisance. For others, it is a life altering condition.  In the United States, an estimated 12 million people have severe enough tinnitus to seek medical attention.  Approximately two million patients are so seriously debilitated that they cannot function on a “normal, “day-to-day basis.   

ANATOMY OF THE EAR

The ear is divided into three parts: the outer, middle, and inner ear and they work harmoniously in the processing of sound and balance.

The purpose of the outer ear is to concentrate and direct sound waves into a tube, called the ear canal.  The ear canal connects the outer ear with the middle ear.

The main function of the middle ear is to effectively and efficiently transfer sound waves from air (in the middle ear) to liquid (in the inner ear).  When sound waves enter the middle ear they are transformed into vibrations and amplified against the ear’s three small bones.  These three bones are known as the malleus (or hammer), incus (or anvil), and stapes (or stirrup).  The amplified vibrations are then converted into pressure waves, which pass into the fluid located within the cochlea of the inner ear. 

The auditory and vestibular system resides within the inner ear.  The auditory system allows us to hear and the vestibular system is responsible for the sensations of balance and motion, also know as propreoception.  These two systems are intimately connected.

The cochlea is located within the auditory system and looks like a hollow, spiral snail’s shell. The cochlea contains a watery fluid and thousands of tiny hair cells.  The fluid moves over these microscopic hairs in response to the vibrations that are generated by the middle ear.  The movement creates nerve messages that travel to the brain.  The brain interprets the messages as sound.

WHAT CAUSES TINNITUS?

Tinnitus can occur for many reasons. Tinnitus is a symptom of many ear problems, including ear wax, infections, Meniere’s disease (a condition in which most patients suffer from tinnitus and periodic attacks of dizziness), Temporomandibular Joint Disorder (TMJ), and otosclerosis (a hardening of the three small bones in the middle ear).  Medications such as aspirin, anti-inflammatories, antibiotics, diuretics, antihistamines, sedatives, antidepressants, and chemotherapy drugs as well as mercury and lead poisoning are linked to tinnitus.  Nerve disorders such as neurofibromatosis, brain tumors, concussions, and traumatic head injury can produce tinnitus.  Whiplash, exposure to excessive or loud noises, age related hearing loss, high blood pressure, changes in blood flow, aneurysm, and a tumor can also cause tinnitus.  Stimulants such as alcohol and caffeine, nicotine, quinine, salt, and sugar can increase the noise level.

Is a common condition in which most patients suffer from tinnitus and deafness in one ear and periodic attacks of dizziness.

In the inner ear is the cochlea which looks much like a hollow, spiral snail's shell. This area of the ear contains a fluid and millions of tiny hairs which are all connected to the auditory nerve.  When these hairs or the delicate nerve endings in the cochlea are damaged false nerve signals are sent to the brain resulting in tinnitus. Many things can cause damage, including a severe blow to the head, exposure to high levels of noise, and the shock of a sudden loud noise.

Tinnitus may be due to an altered or increased blood flow near the ears, resulting in a pulsating noise.  This pulsating noise, called pulsatile tinnitus, is heard in conjunction with the heartbeat and results from a build up of atheroscloerotic plaque in the blood vessels surrounding the ear.  In very rare cases pulsatile tinnitus is caused by a carotid artery aneurysm and may pose a potentially life threatening condition.

Other causes of tinnitus can be the result of muscle spasms.  Muscles spasms occurring in and around the middle ear can cause a crackling or clicking noise.  Tinnitus can also be a symptom of otosclerosis.  Otosclerosis is a condition that occurs in the middle ear and is characterized by the stiffening or hardening of the three small bones, the malleus (hammer), incus (anvil) and stapes (stirrup), which are located behind the eardrum in the middle ear. 

The hypothalamus, also known as the “master gland,” is one area of the brain that can be implicated in tinnitus.  The hypothalamus connects the nervous system to the endocrine system by way of the pituitary gland. Emotions are controlled by the endocrine system and if emotions are long term or severe enough they may cause a mental or physiological reactions.  Therefore, emotions such as anxiety, depression, grief, and stress can be a factor in the cause of tinnitus.  The muscles controlled by the nervous system and muscle tension in the upper part of the body may also play a role in tinnitus.  It is extremely important that stress be reduced.    

DIET

Many people notice that their tinnitus seems to worsen for no apparent reason.  This may be in part due to ones diet.  Some people find that foods with high-sugar content, salt, or any amount of quinine (tonic water) make their tinnitus seem louder.    Many people find that alcohol, nicotine, and caffeine can worsen their tinnitus. 

Nicotine, for example, affects the vascular system by narrowing blood vessels that carry important oxygen to your ears, thereby increasing the level of tinnitus.  Salt will almost have an immediate increase in the noise level due to narrowing the blood vessels and increasing blood pressure.  Increased blood pressure is directly linked to an increase in noise level.  

Studies have shown that many people with tinnitus have a sugar metabolism disorder such as diabetes.  Sugar can cause an imbalance in the oxygen and glucose levels in the blood supply.  Also, sugar substitutes such as Aspartame and Glutamate excite the neuro-transmitters in the brain, causing the neurons to fire repeatedly until they are depleted or die. This results in tinnitus and other neour-degenerative diseases.

Saturated fats increase bad cholesterol (LDL) and triglycerides and decrease good cholesterol (HDL) and can lead to atherosclerosis.  Atherosclerotic plaque not only is a risk factor in heart disease and stroke but greatly reduces blood flow.  Anyone suffering from tinnitus needs to have an increase not a decrease of blood flow to the middle and inner ear.

Persons with tinnitus should limit or eliminate their intake of salt, sugar, caffeine, alcohol, and saturated and trans-fats.  Balance the diet with normal amounts of fruits and vegetable, nuts, fish, and poultry.            

EXERCISE

Include in your daily routine some type of stress reduction   Meditating, deep breathing exercises, yoga, or T’ai Chi offer a variety of ways to relax. Exercise is also important.  Find something that you enjoy doing.  Working out at the gym, playing tennis, swimming, golf, walking, hiking, and dancing are excellent ways to get the blood flowing and reduce stress as well as keeping in shape.  Also, massage and acupuncture are excellent in helping the body to relax and improving the immune system.

SLEEP

As difficult as it may seem, getting enough sleep is paramount in keeping the body and mind relaxed.  A natural approach to a restful relaxing night of sleep is preferred over prescription medications, which may cause chemical dependency. Try a relaxing herbal tea, melatonin, or Kava Kava before bedtime.

IN SUMMARY

1. Avoid exposure to loud noises and sounds.
2. Aim for a low-normal intake of salt, sugar, saturated and trans-fats.
3. Avoid stimulants such as alcohol, caffeine and nicotine.
4. Exercise daily and get adequate rest,.
5. Avoid ototoxic medications known to increase tinnitus such as aspirin, non-steroidals and quinine containing preparations.   
6. It is usual for tinnitus to fluctuate with diet, stress, and tiredness.    

Clear Tinnitus® has been proven to reduce or eliminate the noise associated with tinnitus.  In a study done by the Martha Entenmann Tinnitus Research Center, Inc., in Forest Hills, NY it was stated in the International Tinnitus Journal: VOL: 13, NO.1 that patients with tinnitus demonstrated “in this study and responding to Clear Tinnitus® reported tinnitus relief accompanied by improvement in or maintenance of MEP [Middle Ear Pressure] in the middle ears.”     

With a proper diet, exercise, and rest Clear Tinnitus® can help reduce, eliminate, and maintain the noise level associated with tinnitus.

About the Author

Dr. Stas' Ozog III, PhD. (AM)
LAc., Dipl A. & C.H. (NCCAOM)