January 21, 2017

Top 15 Causes and Treatments of Tinnitus

By Dr. Scott Saunders

Salvador is a truck driver in his mid-thirties who rides his bike to my office.  He came to see me for a skin condition, but noted that he was unable to work because of “screaming” in his ears.  We had his hearing tested and he was normal in all ways.  Legally, he was able to continue his work, but felt so distracted by the noise that he didn’t feel safe behind the wheel.

In Latin, tinnire means “to ring,” as in ringing a bell. Tinnitus is the medical term for hearing noise when no external sound exists.

  • It can be ringing, hissing, clicking, or any sort of noise.
  • It may be intermittent or constant, mild or severe in intensity; sometimes it is so deafening the individual may hear nothing else.
  • It can vary from a low roar or throbbing to a high-pitch sound. It may be subjective, audible only to the patient, or objective which is audible to others.
  • It may or may not be associated with a hearing impairment. It affects 1 in 5 people worldwide, and as much as 1/3 of those over 65.

Tinnitus isn’t a disease; it’s a symptom that has multiple causes.

What causes Tinnitus?

These first causes are actually less common, but often need help from a doctor to diagnose and treat.

1. Meniere’s disease

Meniere’s disease is a problem with the inner ear that seems to be related to the fluid in the inner ear.  Both sides are affected with tinnitus that people often describe as “a freight train going through my head.”  It is always associated with vertigo or dizziness.

2. Otosclerosis

Stiffening of the bones in the middle ear can cause intermittent sounds and diminish hearing.

3. Eardrum

A hole in or a rupture of the eardrum sometimes causes unusual noises like wind blowing.

4. Hearing loss

Anything that reduces the hearing can increase the perception of tinnitus.  The following give a 30% hearing loss that causes a relative amplification of tinnitus.

  • Excess wax
  • A foreign body in the ear canal
  • Fluid in the middle ear
  • Damage to the “ear bones”

5. Tumors

One woman came to my office with tinnitus, hearing loss and dizziness on one side only.  She had been to an ear specialist who told her it was nothing and her HMO wouldn’t pay for an MRI.  She had been getting worse over several years so I ordered a brain scan, which she had to pay for!  “Why did I even get insurance?!” she questioned.  Sure enough, she had

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Breaking The Silence…Tinnitus

By Michael Tyrrell
  • Dusseldorf, Germany – 1991
  • We are playing to a sold out crowd at the Phillip’s Sport Halle
  • The sound pressure levels are deafening
  • 10,000 people are screaming
  • The drums sound like cannon
  • Electric guitars, bass and keyboards pushing 110 decibels on stage as we play for two hours straight.

Backstage, Tony – my close friend and drummer for the band – crumbles in my arms and keeps repeating, “I can’t take it anymore! I can’t take it anymore!” This was my introduction to the maddening effect of severe tinnitus.

Recent statistics estimate:

  • Over 50 million Americans experience tinnitus.
  • Of these, 12 million have tinnitus severe enough to seek medical attention.
  • About 2 million are so debilitated by the tinnitus they cannot function at a normal day-to-day level.

What is Tinnitus

Tinnitus:

  • Defined is hearing ringing, buzzing, roaring or other sounds without an external cause.
  • May be experienced in one or both ears by patients.
  • Is diagnosed in two categories: objective or subjective.
    • In objective tinnitus, the doctor can hear the sounds as well as the patient.
    • Subjective tinnitus can only be heard by the patient.

Before I continue, let me stress the importance of seeking professional help to accurately diagnose your tinnitus. Properly diagnosing tinnitus is as difficult as tracking down endless possibilities for an electrical problem in your car.

In cases of objective tinnitus, there is usually a structural issue:

  • Tumors
  • Pressurized blood flow through congested or malformed vessels
  • Muscular spasms

Objective tinnitus is rare; most cases are subjective. Subjective tinnitus is often associated with hearing loss. Some cause of subjective tinnitus are:

  • Impacted earwax
  • Ear infections
  • Hardening of the inner ear
  • Hearing loss do to age or excessive noise
  • Ototoxic medications such as aspirin and quinine
  • Some diuretics
  • Certain antibiotics
  • Head trauma
  • And systemic diseases

Who is at Risk of Tinnitus

Now that we know what tinnitus is, lets discuss who is most at risk.

Obviously, construction workers that work with heavy equipment like jackhammers and power tools face a great occupational hazard. Believe it or not, musicians top our list at risk for tinnitus – with rock drummers coming in at number one!

As a professional musician and music producer, I can tell you first hand how important earplugs are. You see, drummers not only get whacked with the volume of the other musicians, but they get the “rim shot” from their snare drum – which is LOUD!!!

When I looked at the list of musicians that admit suffering with tinnitus in wikipedia’s tinnitus post, I wasn’t at all surprised that my favorite singer Bono of U2 was one of the first names I came across!

You see, some musicians have suffered with tinnitus or frequency loss because they were not aware of the danger and played loud music for years without wearing earplugs. Today, musicians are far more informed. In fact, there are websites dedicated to helping musicians save their hearing. This is my personal fave: www.hearnet.com

H.E.A.R. is a volunteer network dedicated to helping musicians retain their hearing. One thing I have learned the hard way is… whenever you are exposed to noise, wear your earplugs!

Another statistic on the rise is ear damage from car stereos and mp3/iPod players with earbuds. High SPLs (Sound Pressure Levels) are very damaging unless they are deflected. In-ear monitors and earbuds send high decibel sound directly into the ear cavity. When using your earbuds, make sure you are not turning the volume up too high, which can cause permanent hearing impairment including tinnitus.

Damages of Tinnitus

Now, here is where it gets interesting…

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End Tinnitus with Weight Loss

If you have suffered from tinnitus, then you have probably tried almost anything to stop the constant ringing in the ears.  But, have you stopped to consider weight loss as a tinnitus cure? Scientists have identified a link between intracranial hypertension, which causes tinnitus, and obesity.  The answer to stopping the ringing may be as simple as weight loss.

The Nerve of Tinnitus!

I apologize in advance for the technical talk. If tinnitus has been persistent for years, then you might be suffering from something called “idiopathic intracranial hypertension.” This is also known as PTC (or pseudotumor cerebri), which is basically extra fluid around the brain resulting in immense pressure. Don’t worry, it isn’t all that scary.  “Idiopathic” simply means the cause is unknown. “Pseudotumor” doesn’t mean you have a tumor, but that the symptoms reflect the same results as if there was a tumor present.  (Thankfully, there’s not!)

PTC is classified as a neurological disorder because the cerebral nerves are affected by the pressure it creates.

Tinnitus: Your Heart In Your Ear

One of the many symptoms associated with PTC is pulsatile tinnitus.  This is when the heartbeat can be felt in the ear! It is like you ear has a whooshing pulse! You may already know there are many causes of tinnitus, from ear damage to chemical poisoning, but pulsatile tinnitus is specifically caused by brain blood vessels that become swollen, triggering the cranial nerves into producing ear ringing and pounding sounds in the ear that are in time with your heartbeat.

PTC Symptoms

The most common symptoms of PTC are the following, though worse when coughing or sneezing:

  • Altered sense of smell
  • Disorientation
  • Double vision
  • Headache
  • Muscular feebleness, including facial muscles
  • Nausea
  • Neck and shoulder pain
  • Numbness in the hands and feet
  • Pulsatile tinnitus
  • Untreated, may lead to vision loss
  • Vomiting

Tinnitus and Obesity

Similar to many medical scenarios, scientists cannot ascertain the exact cause of PTC. However, they have seemed to identify a connection in people between obesity and tinnitus, as previously mentioned. Many studies have also been conducted linking elevated cerebrospinal fluid with severe headaches, pulsatile tinnitus and morbid obesity.

Losing weight has many benefits, including relieving PTC and pulsatile tinnitus. The following study summary has proven this.

  • 16 women with body mass indexes (BMIs) from 33 to 70 (the median being 45, over 30 is obese) had weight loss surgery.
  • All women suffered from pulsatile tinnitus.
  • After the weight loss surgery, women lost between 55 and 218 pounds, averaging about 100 pounds per person.
  • Before the weight loss surgery, average cerebrospinal fluid pressure measured at 344 mm H2O.
  • After surgery, cerebrospinal fluid pressure was 198 mm H2O.
  • 13 out of 16 patients reported a complete cessation of pulsatile tinnitus symptoms.
  • Scientists concluded that losing weight is effective at relieving pulsatile tinnitus and PTC.

Bye-Bye Tinnitus

If you are obese or overweight and weight loss surgery is not an option, Home Cures That Work provides you with other effective and natural ways to relieve tinnitus symptoms and the aweful ringing in the ears:

  • Lose weight naturally. 
    Even if you are considering weight loss surgery, the importance is of a healthy diet should be not underestimated. So why not bypass the gastric bypass, and lose weight the good old-fashioned way?  Scientifically speaking, if you expend more energy than you put in, then you will lose weight. Exercise more, and count your calories by following a food diary.
  • Limit salt. 
    Salt is known to cause swelling, and by limiting your salt intake, you decrease your chances for suffering from stroke, heart attack, and tinnitus.
  • Try natural supplements. 
    Many vitamins, herbs, and holistic medicines are helpful for alleviating tinnitus by reducing blood pressure.  Some good ones to try are ginkgo biloba, black cohosh, Coffea cruda, and Carbo vegetabilis.

 

Sources:
Pulsatile tinnitus in patients with morbid obesity: the effectiveness of weight reduction surgery- PubMed, NCBI
Gastric surgery for pseudotumor cerebri associated with severe obesity- PubMed, NCBI
Pseudotumor Cerebri: Idiopathic Intracranial Hypertension

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