Tinnitus

     The CDC has estimated as much as 15% of the population of the United States suffers from tinnitus, or ringing in the ears. A recent study of 2500 audiology referrals at the VA in Atlanta revealed that over a quarter reported tinnitus as their primary complaint. Simply defined, tinnitus is when a person perceives a sound when there is not one. Most often it’s ringing, but may also include a buzzing or whooshing sound. You have probably experienced ringing in your ears at some point in your life. It’s common after an intense noise exposure like a gunshot or a concert, but it’s also a warning that you’ve likely suffered permanent damage to your hearing.

Why do my ears ring?

     The most common cause of tinnitus is hearing loss. In the inner ear, or cochlea, there are tiny sensory hair cells. When sound reaches the inner ear, these hair cells are stimulated and they send a signal up the auditory nerve to the brain. Repeated exposure to loud sound is one of the primary causes of damage to the inner ear. When the sensory hair cells are damaged or destroyed, they can no longer send a signal to the brain. If the brain is not receiving a signal from the ear, it will try to create one to fill in the gap. This is where tinnitus usually comes from. Even though there is nothing in the environment causing it, a person hears a constant ringing.

     There are also several medical conditions that can cause tinnitus. These generally result in a roaring or pulsing tinnitus. Infections, viral attacks, Ménière's disease, or even a tumor may all be the cause. Any ringing in your ears should be taken seriously and you should have your hearing tested by a doctor of audiology who can help you understand your hearing loss and what steps should be taken.

Is there a cure for my tinnitus?

     I’m sure you’ve seen ads for a pill that “kills” tinnitus. I had a junk email in my inbox today that claimed “try this one weird trick before bed and eliminate tinnitus.” Unfortunately, there is no way to completely eliminate the ringing. If there was a medical treatment that was actually effective, the FDA and the major pharmaceutical companies would be all over it. An effective medication would undoubtedly be a multi-trillion dollar product.

What about supplements?

     A lot of the different tinnitus pills that are available do not show significant efficacy in clinical trials. By marketing them as a “supplement” rather than a drug, it’s possible to sidestep regulations that would require proof of effectiveness. They are often a cocktail of different vitamins and herbal extracts, but some contain dangerous chemicals. They may provide some relief, but not any more than a good daily vitamin. The hair cells in the inner ear need sodium and potassium to generate the current necessary to send a signal through the auditory nerve. If you’re low in potassium, a daily vitamin may help. 

Why are some days worse than others?

     There are things that can make your tinnitus worse. Caffiene, sugar, salt, nicotine, and stress can all have a major impact on the ringing in your ears. None of these things are actually the source of tinnitus, but they can affect the intensity of the ringing. I’m not saying you should give up a morning cup of coffee, but if you’re drinking a whole pot, or having two or three energy drinks in a day, I’d suggest cutting back. Excessive salt and sugar are also detrimental to your entire health. Stress is horrible for the human body. If you’re experiencing especially troublesome tinnitus, take a minute to take an inventory of your day. Have you had a lot of caffiene? Was your lunch extra salty? Has this been an especially stressful day? Take care of yourself. Drink some water, take a short break, and give yourself some grace!

Is there anything I can do?

     YES! There is hope, and there are a lot of different treatment options to alleviate the ringing! Again, the first step is having an audiologist perform a full test including tinnitus matching. This is a far more in depth evaluation than the “free” tests that are offered by salesmen or big box retailers. Once we understand your healing loss, and are able pinpoint the primary pitch of your tinnitus, we can then work on a custom and effective solution.

     1. Hearing aids offer relief to many people suffering from tinnitus. A properly fit hearing aid can compensate for the hearing loss that is causing the ringing. This can provide stimulation to the auditory cortex where tinnitus originates.

     2. Masking noise, or sound generators are another coping strategy. Tinnitus can be like a candle in a dark room. If there is no other light source, that candle is very prominent. Masking noise is an attempt to turn on the lights so to speak. By adding sound near the same frequency range of the tinnitus, it can help to distract your mind from focusing on it. It’s a good way to make your tinnitus less prominent. The point is not to drown out the ringing, but rather to have something in the background that’s just barely there. Hearing aids have different noise patterns and even soothing ocean wave sounds that are effective maskers. If you are having trouble sleeping, a sound generator with a timer may be a good solution. These may include sounds like rain, water, or white noise to distract you long enough to fall asleep.

     3. Cognitive behavioral therapy (CBT) is also effective at combating tinnitus. CBT is used to challenge cognitive distortions (negative thoughts or attitudes), and employ coping strategies.  A good friend of mine from Powell, who is also a Navy veteran, has severe tinnitus. He’s been able to accept his tinnitus as a part of himself and has told me, “As long as I can hear the ringing, I know I’m still kickin’!” His attitude is great, and even though he still has tinnitus, he’s not allowing it to control his life.

Is it really that bad?

     Many people suffer profoundly from tinnitus. It seems like a simple thing, but it can lead to anxiety, depression, and sleep disturbances. It can affect your emotions and cause social isolation. It can also have a negative impact on working memory and make it difficult to concentrate. Tinnitus is a very real problem and it’s okay that it’s upsetting. You are not alone.

Future hope

     At this time there is no medication that can directly target tinnitus. There are some experimental drugs that do show promise. Researchers are also hard at work looking for ways to repair damaged hair cells. 

Take the first step!

     We’re ready to help you at Big Horn Basin Hearing and Speech. We have two doctors of audiology who can test your hearing and help create a course of treatment. We’ve recently upgraded our equipment to be able to test the extremely high pitches where tinnitus is common. We have lots of demo hearing aids that we’ll let you take home and try for free. Call us at 307-527-6475 to schedule an evaluation today, we’re waiting to hear from you! 

By Dr. Levi Asay Au.D.