Tinnitus Causes and Treatments

Tinnitus is that sensation of hearing ringing, buzzing, hissing, chirping, whistling or other sounds. The noise can be intermittent or continuous, and can vary in loudness. It’s often worse when background noise is low, so you may be most aware of it in a quiet room. In rare cases, the sound beats in sync with your heart. About 12 million people seek medical help for tinnitus every year.

If you have tinnitus you might find that the volume and pitch of the tinnitus changes when you look far to the side.

What causes tinnitus?

The exact cause of tinnitus is unknown. There are, however, several likely sources, all of which are known to trigger or worsen tinnitus.

Loud Noise – Loud noises can damage and destroy certain cells in the inner ear, called cilia. Once damaged, these cells cannot be renewed or replaced. Up to 90 percent of all tinnitus patients have some level of hearing loss.
Certain medications – Some medications are toxic to the ear and others will produce tinnitus as a side effect without damaging the inner ear. The effects can be temporary or permanent. If you have tinnitus, make sure that your physician is aware this condition before getting any prescription medication and discuss what alternatives that may be available.
Ear or sinus infections – Many people, including children, experience tinnitus along with an ear or sinus infection. Tinnitus caused by infection will lessen and gradually go away as the infection heals.
Wax build-up in the ear – Sometimes people produce enough ear wax that their hearing can be affected and tinnitus results. If you produce a lot of earwax, speak to a specialist, an otolaryngologist (also called an ear, nose, and throat doctor) about having excess wax removed, but don’t try that a home.
Tumors – In rare cases, people have a benign and slow-growing tumor on their auditory, vestibular, or facial nerves. These rare tumors can cause tinnitus, deafness, facial paralysis, and loss of balance.
Cardiovascular disease – A vascular condition can cause a pulsatile tinnitus when the blood flowing through veins and arteries is compromised either by hypertension or hardening of the arteries. People with this type of tinnitus typically hear a rhythmic pulsing, often in time with a heartbeat. About 3 percent of tinnitus patients experience pulsatile tinnitus.
Head and neck trauma – A Physical blow to the head and neck can induce tinnitus. When caused by trama, this tinnitus sometimes accompanied by headaches, vertigo, and memory loss.
Jaw misalignment or TMJ – A misaligned jaw joint or jaw muscles can induce tinnitus. Many dentists specialize in this treatment (called temporomandibular jaw alignment) and can provide relief if your tinnitus is caused by TMJ.

Alternative Treatments

Alternative treatments generally carry little risk to your health and some people do find them helpful. They include but are not limited to the following:

Minerals such as magnesium or zinc
Herbal preparations such as Ginkgo biloba
Homeopathic remedies
B vitamins
Acupuncture
Cranio-sacral therapy
Magnets
Hyperbaric oxygen
Hypnosis

Hearing Aids

Some people with hearing loss experience total or partial tinnitus relief while wearing hearing aids. If you have hearing loss in the frequency range of the tinnitus the hearing aids may bring back the ambient sounds that naturally cover the tinnitus.

Cochlear Implants

Sometimes referred to as electrical stimulation, a cochlear implant has two parts. The first is an electrode array that is threaded into the cochlea, that small bone in the inner ear that is shaped like a snail shell. The other part is a receiver that is implanted just beneath the skin behind the ear. The electrode array then sends electrical sound signals from the ear to the brain. These implants are prescribed only to deaf or near-deaf patients because the implantation destroys whatever healthy hair cells were left inside the cochlea. About half of those with tinnitus experience relief with cochlear implants.

Sound Therapy

There are various treatment strategies that use sound to decrease the loudness or prominence of tinnitus. Sound therapies include both wearable (hearing aid-like devices) and non-wearable devices (such as table-top sound machines or even a whirring fan). Sound is used to partially or completely cover the tinnitus, sometimes referred to as masking. Sound therapies should always be combined with counseling.

Biofeedback

Biofeedback is a technique that teaches you to control some autonomic body functions, such as skin temperature, pulse, and muscle tension. The goal is to help you manage stress, not by reducing the stress but by changing your body’s reaction to stress. Many people notice a reduction in their tinnitus when they are able to modify their reaction to their stress.

Cognitive Therapy

Cognitive therapy is a type of counseling based on treating your emotional reaction to tinnitus rather than the tinnitus itself. A counselor helps you identify negative thought patterns and then alter them. Cognitive Therapy programs are individually designed for patients and are most effective when coupled with other tinnitus treatments.

TMJ Treatment

A dysfunction of the jaw joint can sometimes result in Tinnitus (temporomandibular joint, or TMJ). This can happen because muscles and nerves in the jaw are closely connected to those in the ear. Problems with bite alignment can sometimes interfere with nerves in the ear. When a dentist realigns the bite this can help relieve TMJ pain and associated tinnitus. See your dentist if you think you have this problem.

Drug Therapy

Many drugs are being researched and used to relieve tinnitus, however, there is no single drug designed specifically to treat tinnitus. Some drugs that have been studied include;

anti-anxiety drugs like Xanax
antidepressants like nortriptyline
antihistamines
anticonvulsants like gabapentin
anesthetics like lidocaine

All successfully quieted tinnitus for some people. Remember to talk to your doctor about the side effects of the medications you currently take.

Drug Induced Tinnitus

On the other hand, that ringing in the ears may be caused by one of your medications. Many drugs have tinnitus listed as a side effect. Here’s a partial list:

Abilify(r) – aripiprazole
Accutane(r) – isotretinoin
Aceon(r) – perindopril erbumine
Aciphex(r) – rabeprazole sodium
Actiq(r) – transmucosal fentanyl citrate
Actonel(r) – risedronate sodium
Adalat(r) cc – nifedipine
Aggrenox(r) – aspirin/dipyridamole)
Agrylin(r) – anagrelide hydrochloride
Alferon n injection(r) – interferon alfa-n3 (human leukocyte derived)
Alka-seltzer(r)
Aloxi(tm) – palonosetron hydrochloride
Altace(r) – ramipril
Ambien(r) – zolpidem tartrate
Ambien – zolpidem
Amerge(r) – naratriptan hydrochloride
Amnesteem(r) – isotretinoin
Anaprox ds, anaprox, naprosyn, ec-naprosyn
Anzemet(r) – dolasetron mesylate
Aralen(r) – chloroquine phosphate
Aricept(r) – donepezil hydrochloride
Asacol(r) – mesalamine
Aspirin –
Atacand hct(r) – candesartan cilexetil – hydrochlorothiazide
Atrovent(r) – ipratropium bromide
Avelox(r) – moxifloxacin hydrochloride
Axert(r) – almotriptan malate
Azactam(r) – aztreonam for injection
Bayer(r) children’s chewable tablets – aspirin
Bc(r)
Bextra(r) – valdecoxib
Biaxin(r) – clarithromycin
Bicillin(r) l-a – penicillin g benzathine suspension
Blocadren(r) – timolol maleate
Buprenex(r) – buprenorphine hydrochloride
Bupropion hydrochloride (Zyban)
Caduet(r) – amlodipine besylate/atorvastatin calcium
Campral(r) – acamprosate calcium
Capastat(r) sulfate – capreomycin
Carbatrol(r) – carbamazepine extended-release capsules
Cardene(r) – nicardipine hydrochloride
Cardizem(r) la – diltiazem hydrochloride
Cataflam(r) – diclofenac potassium
Celebrex(r) – celecoxib
Celexa(r) – citalopram hydrobromide
Cellcept –
Cipro(r) i.v. – ciprofloxacin
Clinoril(r) – sulindac
Clomid(r) – clomiphene citrate
Colazal(r) – balsalazide disodium
Copaxone(r) – glatiramer acetate
Coreg(r) – carvedilol
Corzide(r) – nadolol and bendroflumethiazide
Cosopt(r) – dorzolamide hydrochloride-timolol maleate
Covera-hs(r) – verapamil hydrochloride
Cozaar(r) – losartan potassium
Cuprimine(r) – penicillamine
Cytovene(r) – ganciclovir sodium
Dapsone tablets jacobus
Daranide(r) dichlorphenamide
Demadex(r) – torsemide
Depacon(r) – valproate sodium
Depakene(r) – valproic acid
Depakote(r)
Desferal(r) – deferoxamine mesylate
Diovan hct tablets –
Dipentum(r) – olsalazine sodium
Diprivan(r) – propofol
Divalproex sodium coated particles
Dolobid(r) – diflunisal)
Doxil(r) – doxorubicin hcl liposome
Dynacin(r) – minocycline hcl
Ec-naprosyn
Ecotrin – aspirin
Effexor(r) – venlafaxine hydrochloride
Eldepryl(r) – selegiline hydrochloride
Elmiron(r) – pentosan polysulfate sodium
Emend(r) – aprepitant
Engerix-b(r) – hepatitis b vaccine
Eskalith(r) – lithium carbonate
Evoxac(r) – cevimeline hydrochloride
Excedrin(r) pain reliever
Exelon(r) – rivastigmine tartrate
Flexeril(r) – cyclobenzaprine hcl
Floxin(r) otic – ofloxacin otic
Flumadine(r) – rimantadine hydrochloride
Fortovase(r) – saquinavir
Gabitril(r) – tiagabine hydrochloride
Gastrocrom(r) – cromolyn sodium
Gengraf(r) capsules – cyclosporine
Geodon(r) – ziprasidone hcl and ziprasidone mesylate
Gleevec(r) – imatinib mesylate
Hivid(r) – zalcitabine
Hytrin(r) – terazosin hydrochloride
Hyzaar(r) – losartan potassium-hydrochlorothiazide
Imitrex(r) – sumatriptan
Indocin(r) indomethacin
Infergen(r) – interferon alfacon-1
Intron(r) a – interferon alfa-2b
Invirase(r) – saquinavir mesylate
Isoptin(r) sr – verapamil hcl
Kaletra(r) – lopinavir/ritonavir
Kaopectate(r)
Lamictal(r) – lamotrigine
Lariam(r) – mefloquine hydrochloride
Levaquin
Levitra(r) – vardenafil hcl
Lexapro(r) – escitalopram oxalate
Lidoderm(r) – lidocaine
Lipitor(r) – atorvastatin calcium
Lotensin hct tablets
Lotrel capsules
Lupron depot(r) – leuprolide acetate
Maalox(r) – bismuth subsalicylate
Marinol(r) – dronabinol
Maxalt(r) – rizatriptan benzoate
Meridia(r) – sibutramine hydrochloride monohydrate
Miacalcin(r) – calcitonin-salmon
Micardis(r) – telmisartan
Micardis(r) hct – telmisartan and hydrochlorothiazide
Midamor(r) tablets – amiloride hcl
Mintezol(r) thiabendazole
Mirapex(r) – pramipexole dihydrochloride
Mobic(r) – meloxicam
Moduretic(r) amiloride hcl-hydrochlorothiazide
Motrin(r) ibuprofen suspension
Mustargen(r) – mechlorethamine hcl
Nadolol – mylan
Namenda(tm) – memantine hydrochloride
Naprosyn
Naropin(r) – ropivacaine hcl
Neoral(r) – cyclosporine
Neurontin –
Nexium(r) – esomeprazole magnesium
Nipent(r) – pentostatin
Noroxin(r) – norfloxacin
Norpramin(r) – desipramine hydrochloride
Norvasc(r) – amlodipine besylate
Norvir(r) – ritonavir
Orthoclone okt(r)3 muromonab-cd3
Oxycontin(r) – oxycodone hcl
Parnate(r) – tranylcypromine sulfate
Paxil cr(tm) – paroxetine hydrochloride
Pediazole(r) – erythromycin ethylsuccinate and sulfisoxazole acetyl
Pepcid(r) – famotidine
Pepto-bismol(r)
Permax(r) – pergolide
Phenergan(r) – promethazine hcl
Plaquenil(r) – hydroxychloroquine sulfate
Pletal(r) – cilostazol
Prevacid –
Prevpac(r) – lansoprazole, amoxicillin, and clarithromycin
Prilosec otc(tm) –
Primaxin(r) i.m. – imipenem and cilastatin
Prinivil(r) tablets – lisinopril
Prinzide(r) tablets – lisinopril-hydrochlorothiazide
Prograf(r) – tacrolimus
Prosom(tm) – estazolam tablets
Protonix(r) – pantoprazole sodium
Prozac(r) – fluoxetine hydrochloride
Rapamune(r) – sirolimus
Recombivax hb(r) – hepatitis b vaccine (recombinant)
Relafen(r) – nabumetone
Relpax(r) – eletriptan hydrobromide
Requip(r) – ropinirole hydrochloride
Rescriptor(r) – delavirdine mesylate
Reyataz(r) – atazanavir sulfate
Rifater(r) – rifampin, isoniazid and pyrazinamide
Risperdal(r) – risperidone
Romazicon(r) – flumazenil
Rythmol(r) sr – propafenone hydrochloride
Salagen(r) tablets – pilocarpine hydrochloride
Sandimmune –
Sandostatin lar(r) depot – octreotide acetate
Sedapap(r) tablets – butalbital and acetaminophen
Septra(r) tablets – trimethoprim and sulfamethoxazole
Seroquel(r) – quetiapine fumarate
Sonata(r) – zaleplon
Soriatane(r) – acitretin
Sporanox(r) – itraconazole
St. Joseph 81 mg aspirin
Streptomycin sulfate injection
Sular(r) – nisoldipine
Surmontil(r) – trimipramine maleate
Sustiva(r) – efavirenz
Symbyax(tm) – olanzapine and fluoxetine
Tambocor(tm) – flecainide acetate
Tarka(r) – trandolapril/verapamil hydrochloride
Tasmar(r) – tolcapone
Tegretol –
Tequin injection, tequin tablets
Teveten(r) – eprosartan mesylate
Teveten(r) hct – eprosartan mesylate/hydrochlorothiazide
Thalomid(r) – thalidomide
Tiazac(r) – diltiazem hydrochloride
Ticlid(r) – ticlopidine hydrochloride
Timolide(r) tablets – timolol maleate-hydrochlorothiazide
Timolol gfs – timolol maleate
Timoptic(r) – timolol maleate
Tobi(r) – tobramycin solution for inhalation
Topamax(r) – topiramate
Toprol-xl(r) – metoprolol succinate
Toradol(r) – ketorolac tromethamine
Tricor(r) – fenofibrate
Trileptal(r) – oxcarbazepine
Trisenox(r) – arsenic trioxide
Twinrix(r) – hepatitis a inactivated & hepatitis b (recombinant) vaccine
Ultracet(tm) – tramadol hydrochloride/acetaminophen
Ultram(r) – tramadol hydrochloride
Uniretic(r) – moexipril hcl/hydrochlorothiazide
Univasc(r) – moexipril hydrochloride
Vancocin(r) hcl – vancomycin hydrocloride
Vantin(r) – cefpodoxime proxetil
Vaseretic tablets
Verelan(r) pm – verapamil hydrochloride
Vfend(r) i.v. – voriconazole
Viagra(r) – sildenafil citrate
Vicoprofen(r) – hydrocodone bitartrate and ibuprofen
Vioxx(r) – rofecoxib
Vivactil(r) – protriptyline hcl
Voltaren(r) – diclofenac sodium
Wellbutrin(r) (Zyban) – bupropion hydrochloride
Xanax(r) – alprazolam
Xifaxan(tm) – rifaximin
Zegerid(tm) – omeprazole
Zithromax(r) – azithromycin
Zoloft(r) – sertraline hydrochloride
Zomig(r) – zolmitriptan
Zonegran(r) – zonisamide
Zosyn(r) – piperacillin and tazobactam
Zyban(r) – bupropion hydrochloride
Zyprexa intramuscular, tablets, orally disintegrating tablets
Zyrtec(r) – cetirizine hydrochloride

For questions and answers about tinnitus, see the Tinnitus forum.

Most recent post: April 9, 2017