What is Tinnitus?
Buzzing, hissing, high-pitched whistling… If you hear these and other sounds in one ear, both ears or in the middle of your head, you may have tinnitus. According to the British Tinnitus Association, tinnitus isn’t a disease or an illness,but results from some type of change – either mental or physical – not necessarily related to hearing (i). It’s also very common, with about 10 per cent of the population thought to have mild tinnitus all of the time and around 600,000 people experiencing severe tinnitus (ii).
And while tinnitus is more common in people aged over 65, it can affect people of all ages, including children, says the NHS (ii). Well-known musicians Chris Martin from Cold Play and Ben Drew (also known as Plan B) both suffer from tinnitus (both are also much younger than 65). Other famous people who have been reported as having tinnitus include The Who’s Pete Townsend, Barbra Streisand, comedian Steve Martin and Blondie vocalist Debbie Harry. The artist Vincent Van Gogh is also thought to have been affected by it.
Yet while it may not be a harmful condition, those with severe tinnitus say it affects their quality of life. Even the mild form may affect your concentration as well as cause sleeping problems and depression (ii).
What does tinnitus sound like?
Tinnitus often described as a ringing sound, but that’s just one of the possible effects. In fact, it may present as one or more of several sounds such as buzzing, humming, grinding, hissing, whistling and sizzling. It can be constant or intermittent, loud or quiet, low, medium or high pitched – some people even say it sounds like music. Different people experience tinnitus in different ways. Those who find they are particularly sensitive to everyday sounds have a condition called hyperacusis. Others with mild tinnitus may find they only notice it when they’re in a quiet environment, as background noise can mask the sound of it.
What causes it?
There are several possible causes of tinnitus. Older people may experience it because their auditory nerves have become less sensitive. Younger people, on the other hand, can develop tinnitus because they have inner ear damage as a result of being exposed to excessive noise.
Other causes may include a build-up of earwax that blocks the ear as well as a middle ear infection or glue ear. If you have anaemia, on the other hand, it can also cause tinnitus, as can a perforated eardrum.
Other medical conditions linked to tinnitus include otosclerosis (hearing loss caused by an abnormal bone growth in the middle ear) or Ménière's disease, a condition that affects part of the inner ear. Less commonly it may develop after a head injury or exposure to a sudden or very loud noise (an explosion, for instance).
Tinnitus may also be caused by certain medicines, including some chemotherapy medicines, antibiotics, quinine, non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin. Certain people may find their tinnitus becomes worse when they’re stressed too, or it may become more obvious when they’re sitting or lying down.
But for many people with tinnitus, there may be no obvious cause whatsoever.
How your ears work
There are three parts to the ear – the outer, middle and inner ear. Sound waves are focused onto the eardrum via the outer ear (the pinna and external ear canal). The sound makes your eardrum vibrate, and the vibrations pass through to the middle ear. Three tiny bones inside the middle ear conduct the vibrations through to the inner ear, where they enter the cochlea. The cochlea is a small, curled tube filled with liquid and lined with about 15,000 microscopic hairs. When the vibrations reach the cochlea, they make the tiny hairs move, which triggers an electrical signal that passes through to the brain via the auditory nerve. The signal is then transferred to the auditory cortex via neurons within the brain. The auditory cortex recognises and analyses the signal, allowing you to perceive the signal as sound.
Tinnitus and the cochlea
The exact cause of tinnitus isn’t fully understood, but in terms of inner ear damage it’s thought to be the result of a problem with the cochlea. According to the NHS, if part of the cochlea is damaged, it stops sending signals to parts of your brain (iii). Signals from other parts of the cochlea that still work do get through to the brain, but they are overrepresented, which causes the sounds of tinnitus.
To hear what tinnitus may sound like to someone who’s affected by it, listen to Action on Hearing Loss’s tinnitus simulation.
Protecting your hearing
According to experts, prolonged exposure to noise that's louder than 80 decibels can damage your hearing, which may lead to tinnitus (iv). But how loud is too loud?
Here are some typical noises that could make you vulnerable:
Road works (pneumatic drill)
MP3 player at high volume
Living in the modern world makes avoiding loud noises all of the time almost impossible. So here’s what you could do to reduce your risk of developing problems with your hearing:
If you're exposed to loud noise at work, wear protective earmuffs or earplugs. These should be supplied by your employer, who is also legally obliged to assess and keep a record of the noise levels.
Noise exposure is common outside work too, while riding a motorbike or using electric DIY tools, for instance. Protect yourself by wearing earplugs, which are widely available in shops and online. Choose ones with a simplified noise-level reduction (SNR) figure of 20dB or more to make sure your ears are well protected.
When using your MP3 player, switch off for at least five minutes every hour to give your ears a rest.
Buy some noise-cancelling or sound-isolating headphones so you're not tempted to crank up the volume on your MP3 player just to drown out background noise on the street or on the train.
Avoid standing or dancing near the speakers in clubs and spend time in the chill-out areas to give your ears a break from the noise (better still, wear earplugs that are designed to be used in clubs and at gigs – these are widely available on the internet).
If you have an ear infection, ask your doctor to check it out as untreated infections can damage your hearing too.
For more information on looking after your hearing, visit the Action on Hearing Loss website.
How to manage tinnitus
According to the NHS, tinnitus is rarely a sign of anything serious, and can often improve over time (v). But if it’s having a negative impact on your everyday life, you can be referred to a specialist in your local ear, nose and throat (ENT) hospital department or to your local audiology clinic. If necessary, you may then be referred to a tinnitus clinic.
Here are some of the treatments you may be offered – plus a few things you can do to help yourself:
Tinnitus clinics often use sound therapy to help mask the noise of tinnitus, but you can also try this yourself at home. Many people notice their tinnitus more when it’s really quiet – sound therapy works by providing soft background noise, which distracts your brain and makes you less aware of the tinnitus noise. It can also help you get to sleep at night.
The type of sounds used for tinnitus include white noise (a soft crackling that sounds like a de-tuned radio) and natural sounds such as a bubbling brook, ocean waves, falling rain and birdsong. Sound therapy products are available from the British Tinnitus Association . Alternatively, you could try leaving a TV or radio on quietly in the background.
Cognitive behavioural therapy (CBT)
CBT is a talking therapy that can be used for tinnitus as it may help people to think differently about it. This may reduce any anxiety you experience as a result of having tinnitus, as well as help you to accept the sounds, and in time they may well become less obvious.
Tinnitus retraining therapy (TRT)
If you have severe or persistent tinnitus, you may be eligible for TRT on the NHS. This therapy helps you to train your brain so that the noise becomes part of your subconscious, which means you don’t notice it so much.
Tinnitus is often associated with stress, which is why many experts recommend relaxation as a way of dealing with it. If you find it difficult to wind down, try listening to relaxation CDs or practice relaxation techniques such as meditation, yoga or t’ai chi. Look out for details of your nearest classes at your local library or health centre.
Tackle hearing loss
If you also suffer from some hearing loss it can make your tinnitus worse. But if you get that hearing loss corrected – by wearing a hearing aid, for instance – your tinnitus may be less noticeable because you may start to hear other sounds that drown out the sound of the tinnitus. The first step to tackling hearing loss is to see your GP, who can refer you to a specialist.
Natural Tinnitus Remedies
Currently, there is no medication available to treat tinnitus directly, but where the condition causes anxiety and depression, doctors sometimes prescribe antidepressants.
There are a few natural treatments that may help, some of which may support ear health generally, including the following:
Natural therapy practitioners often recommend ginkgo biloba for tinnitus as it may help to boost poor circulation in parts of the brain that affect the inner ears. There are also a few studies that have come up with positive findings regarding using ginkgo biloba for tinnitus. One, which included 103 tinnitus out-patients over a 13-month treatment period and carried out by ENT (ear, nose and throat) specialists, found ginkgo biloba extract effective, with all patients claiming their tinnitus had improved (vi). Another study of 60 tinnitus patients, some of whom received an infusion of ginkgo extract followed by taking the extract orally for just 10 days, also found there was a moderate improvement when compared to others who received a placebo (vii). Similarly a review of 19 clinical trials shows that in some of those studies a ginkgo extract performed better as a treatment for tinnitus than a placebo, while in other studies patients said their tinnitus had improved after taking gingko (viii).
Since magnesium helps to maintain normal nerve function, it may also be useful for people who have tinnitus in helping to keep the nerves involved in the auditory system healthy. Some experts believe a chemical called glutamate may play a role in the development of tinnitus, and that magnesium may be one of several substances that blocks the production of glutamate (ix).
It may also be beneficial to take fish oils to improve blood circulation to the ear, as one of the omega-3 fatty acids found in fish oil – namely eicosapentaenoic acid (EPA) – helps the body to manufacture hormone-like substances called eicosanoids. Some of these eicosanoids are thought to help improve blood flow not just to the ears, but around the body.
If you’re a vegetarian or vegan you can still benefit from an omega-3 supplement, thanks to the availability of products that contain the natural triglyceride (TG) form of omega-3, which is sourced from plant organisms called microalgae rather than fish oils.
Some people who have tinnitus have sleep problems because it’s difficult to be distracted from the noise of tinnitus during the quiet of the night. The herbal remedy valerian may not act on tinnitus directly, but it could help you get a better night’s sleep. With a long traditional use for insomnia, some studies back valerian's effectiveness as a natural remedy for sleep disturbances. For instance, in a review of studies looking at valerian as a remedy for insomnia, researchers concluded that the remedy might improve sleep quality without producing side effects (x).
If you experience tinnitus, following the steps above can help you to mitigate the symptoms, and avoid the more negative effects of the conditions. To find out more about treatments for common health conditions, visit our dedicated resources in the health library.
Available online: https://www.tinnitus.org.uk/all-about-tinnitus
Meyer. B. Multicenter randomized double-blind drug vs. placebo study of the treatment of tinnitus with Ginkgo biloba extract. Presse Med. 1986;15:1562-1564. Available online: https://pubmed.ncbi.nlm.nih.gov/2947100-multicenter-randomized-double-blind-drug-vs-placebo-study-of-the-treatment-of-tinnitus-with-ginkgo-biloba-extract/
Morgenstern. C, Biermann. E. The efficacy of ginkgo special extract EGb 761 in patients with tinnitus. Int J Clin Pharmacol Ther. 2002 May;40(5):188-97. Available online: https://pubmed.ncbi.nlm.nih.gov/12051570-the-efficacy-of-ginkgo-special-extract-egb-761-in-patients-with-tinnitus/
Holstein N. Ginkgo Special Extract EGb 761 in Tinnitus Therapy. An Overview of Results of Completed Clinical Trials. Fortschr Med Orig. 118(4):157-64.Available online: https://pubmed.ncbi.nlm.nih.gov/11217680-ginkgo-special-extract-egb-761-in-tinnitus-therapy-an-overview-of-results-of-completed-clinical-trials/
Seidman M. Medicines to treat the inner ear. Tinnitus Today. 2001 Mar:16-19.
Bent S et al., Valerian for Sleep: A Systematic Review and Meta-Analysis. Am J Med. 2006 Dec;119(12):1005-1012.Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394901/
Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.