Why Do I Have Ringing In My Ears? Understanding Tinnitus

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Why Do I Have Ringing In My Ears? Understanding Tinnitus

If you’ve ever attended a loud concert or have suffered the incessant drone of a powerful leaf blower, you might have noticed ringing or buzzing in your ears afterwards. Chances are, that ringing or buzzing disappeared a short while after. However, for many people, ringing in the ears is an ongoing occurrence and may be due to tinnitus. What is tinnitus and how is it linked to having diabetes?

What is tinnitus?

Tinnitus (pronounced either as tin-NY-tus or TIN-u-tus) is a condition that is described as ringing, buzzing, roaring, clicking, or hissing in the ears. In some people, tinnitus may be soft or loud, high pitched or low pitched. And it might occur in one ear or both ears.

Tinnitus is also quite common: According to the National Institute on Deafness and Other Communication Disorders, about 10% of adults (that’s about 25 million) in the U.S. have had tinnitus lasting for at least five minutes in the past the year. For many people, tinnitus greatly impacts quality of life, interfering with sleeping, working, or reading, and can lead to stress, anxiety, and depression.

What are the symptoms of tinnitus?

Ringing in the ears is one of the more common symptoms of tinnitus, but other symptoms include:

  • Buzzing
  • Humming
  • Roaring
  • Clicking
  • Hissing
  • Chirping

The sounds caused by tinnitus are only heard by that person, and they may be constant or sporadic. These sounds may also be so loud as to interfere with hearing. In some cases, tinnitus can sound like pulsing, usually in time with your heartbeat. This is a condition called pulsatile tinnitus. A doctor may be able to hear this pulsing by pressing a stethoscope against your neck.

What causes tinnitus?

Tinnitus is not a disease; rather, it’s a symptom that occurs from other factors, including some health conditions. Some of the more common causes of tinnitus include:

  • Hearing loss from loud noises
  • Ear and sinus infections
  • Buildup of ear wax or having a foreign object in the ear
  • Dental issues, including a temporomandibular joint (TMJ) disorder
  • Head or neck injury
  • Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDS), certain antibiotics, diuretics, antidepressants, and cancer drugs

Tinnitus might result from less common factors, such as:

  • Meniere’s disease, a disorder of the inner ear that affects balance and hearing, causing dizziness
  • Heart and blood vessel disorders, including atherosclerosis, high blood pressure, or blood vessel abnormalities
  • Eustachian tube dysfunction, in which the tube connecting the middle ear to the upper throat remains expanded, creating a full feeling in the ear
  • Muscle spasms in the ear
  • Otosclerosis, which is abnormal bone growth in the middle ear
  • Acoustic neuroma, a noncancerous tumor that can develop on the cranial nerve
  • Brain tumor
  • Hormonal changes in women (from menstruation, pregnancy, or menopause)
  • Hypothyroidism, which can cause tinnitus, vertigo, and hearing loss
  • Diabetes

Sometimes tinnitus occurs for no apparent reason in people who are healthy.

You might be wondering why having diabetes might lead to tinnitus. At a higher level, hearing loss and diabetes are connected; in fact, National Institutes of Health research indicates that hearing loss is twice as common in adults with diabetes compared to adults without diabetes. Possible reasons include damage to the nerves and blood vessels in the ear due to long-term hyperglycemia (high blood sugars). Hair cells in the cochlea, which transforms sound vibrations into a nerve signal, can deteriorate due to a lack of blood circulation. Once hair cells are damaged, they don’t regenerate, leading to permanent hearing loss. Tinnitus may be an early sign of impending hearing loss.

What are risk factors for tinnitus?

While the exact cause of tinnitus isn’t known, there are certain factors that can put you at risk:

  • Exposure to loud noise on a regular basis, especially from jet engines, heavy equipment, chain saws, and firearms, as well as loud music
  • Aging — people over the age of 60 are at a higher risk
  • Being male
  • Smoking
  • Alcohol use

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How is tinnitus diagnosed?

If you have ringing, humming, or buzzing in your ears, or if you notice you aren’t hearing as well as you used to, see your health care provider. They should check your ears for ear wax, blockage, or signs of infection, and also review your current health and medical conditions, as well as the medications you are taking.

You may be referred to an ear, nose, and throat doctor (ENT), also called an otolaryngologist, who will examine your head, neck, and ears and test your hearing. You might also meet with an audiologist who can further measure your hearing and evaluate your tinnitus. Depending on findings, you may need imaging tests, such as an MRI or CT scan, and you may have blood work to check for thyroid problems, heart disease, anemia, or vitamin deficiencies.

How is tinnitus treated?

The treatment for tinnitus depends on the severity of symptoms. There isn’t a cure for tinnitus and there is no specific medication that can treat it, but there are ways to help lessen the severity and improve your quality of life. These may include:

  • Hearing aids, especially if you have hearing loss along with tinnitus
  • Wearable sound generators, which are electronic devices that fit in your ear and create a soft sound to mask the tinnitus
  • Use of white noise machines to help you relax and sleep
  • Treating any blood vessel condition
  • Changing your medication Removing ear wax
  • Surgery to remove an acoustic neuroma
  • Limiting alcohol, caffeine, and nicotine — these substances can affect blood flow

You might also benefit from behavioral treatments, as well. An example is tinnitus retraining therapy (TRT) which combines the use of a sound masking device with counseling to help you notice tinnitus less and feel less stressed by it, too. Cognitive-behavioral therapy (CBT) is useful for learning coping techniques and relieving stress and anxiety resulting from tinnitus. Some people may find relief with acupuncture.

Various dietary supplements are touted as possible treatments for tinnitus. Some research indicates that B vitamins and a higher protein and water intake are linked with a lower risk of tinnitus, while a higher calcium, iron, and fat intake is associated with a higher likelihood of tinnitus.

There are also supplements on the market that are touted for providing tinnitus relief — these include gingko biloba, zinc, melatonin, flavonoids, magnesium, and CBD (cannabidiol) oil. Unfortunately, these supplements are not regulated by the FDA, and there isn’t enough evidence to support their use in the treatment of tinnitus. If you are interested in trying a supplement, be sure to discuss this with your health care provider before doing so.

How can you prevent tinnitus?

While not all cases of tinnitus can be prevented, you can take steps to limit your chances of developing this condition:

  • Protect your hearing — use ear protection and headphones
  • Turn down the volume when listening to music
  • Eat healthfully and stay active to support your heart health and manage your blood sugars
  • Cut back on alcohol and caffeine
  • Stop smoking

For more information about tinnitus, visit the American Tinnitus Association website.

Want to learn more about hearing and diabetes? Read “The Ears Have It: All About Hearing Loss” and “Hearing Aid Basics.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

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