Tinnitus causes and risk factors

 

According to the National Institutes of Health (NIH) anywhere between 10-25% of adults experience tinnitus. Often described as a ringing or buzzing in the ears, tinnitus is a complex condition with many potential causes and risk factors. 

While the exact cause of tinnitus isn't always known, identifying possible causes can guide treatment. Understanding your risk factors can help you take steps to protect your hearing and lower the chances of symptoms developing or worsening.

What causes tinnitus?

Hearing loss is the most common cause

Hearing loss and tinnitus are very intertwined. It's estimated that up to 90% of people with tinnitus also have some degree of hearing loss. 

The connection between hearing loss and tinnitus isn’t fully understood, but experts believe it has to do with how the brain responds to reduced sound input.

When you experience hearing loss, your brain gets less stimulation than before. This can lead to changes in how it processes sound, making it more sensitive and creating the perception of ringing, buzzing, or other phantom noises in the ear.

Aging and loud noise exposure increases tinnitus risk

While many things can cause hearing loss, aging and noise exposure are two leading factors.

Hearing loss due to aging is called presbycusis, and it often starts around the age of 60. This gradual loss of hearing as the inner ear deteriorates can cause tinnitus. 

Exposure to loud noise, either at lower levels for a prolonged period of time, or a single exposure to extremely loud noise (like a blast or explosion) can lead to hearing problems and tinnitus as well. 

Ringing or buzzing in the ears from loud noise is sometimes temporary—for example, after exposure to loud noise at a concert or sporting event. However, if the inner ear's hair cells are significantly damaged, tinnitus and noise-induced hearing loss can become permanent. Tinnitus is very common in veterans due to on-the-job noise exposure.

Severe hearing loss makes tinnitus more likely

The worse the hearing loss, the more likely you are to have tinnitus, too.

"Those with a hearing impairment have a higher risk for tinnitus, and the associated increase in risk is dependent on the severity of hearing impairment," state the authors of a large survey of U.S. adults.

Medical conditions that can cause tinnitus

Conditions that cause tinnitus often cause hearing loss, too (both temporary and permanent). However, that is not universally true. These conditions include: 

Ear problems

• Otosclerosis 
• Third mobile window syndrome
• Meniere's disease 
• Impacted earwax

Head injuries and brain diseases

• Head injuries, such as a concussion that damages the inner ear structures
• Neurologic and autoimmune diseases, including multiple sclerosis (MS)
• Acoustic neuromas (tumors) on the auditory or vestibular nerve 

Heart and blood vessel problems

If your tinnitus resembles a pumping, beating or pulsating sound that's in time with your heartbeat, it could be caused by damage to your blood vessels. This may indicate that you have pulsatile tinnitus. Seek prompt medical care if you hear pulsing sounds to determine the cause.

Other illnesses that can cause ringing in the ears

• Anemia
• Allergies
• Diabetes
• Hypothyroidism

Can medications cause ringing in the ears?

Yes. Certain medications are ototoxic, meaning they have the potential to damage the ears and lead to hearing problems, tinnitus and issues with balance. 

The most common drugs known to cause tinnitus are:

• Non-steroidal anti-inflammatory drugs (like aspirin and other OTC pain relievers) 
• Diuretics 
• Certain antibiotics
• Chemotherapy drugs 
• Quinine, which is used to treat malaria

But many others can cause tinnitus, too, including high blood pressure drugs.

If you experience a buzzing in the ear after starting any new medication, or changing a dosage, discuss it right away with your pharmacist or physician to determine if you should stop, reduce, or change the medications you are currently taking. 

Did you know? One of the most common drugs known to cause tinnitus is aspirin, especially when taken in high doses.

Lifestyle habits that can increase tinnitus risk

In addition to the health problems listed above, certain lifestyle factors can increase your risk for tinnitus as well. These include:

• Excessive alcohol consumption
• Smoking
• Frequent fatigue
• Chronic stress

Additionally, some people find that certain foods or drinking caffeine can worsen the ringing in their ears. However, others find no link between what they eat and drink and their symptoms.

Understanding the complex nature of tinnitus

There are many different places in the inner ear and auditory nerve pathways where damage could occur, meaning tinnitus is likely not just one disease—with one simple treatment. A person often has multiple risk factors and medical conditions, making it hard to know if there's a single culprit.

Seeing a doctor for ear ringing

If you're experiencing persistent tinnitus, your first step is usually to see a hearing care professional, such as an audiologist, who can assess your hearing and help determine the cause.

Depending on your symptoms and medical history, you may also be referred to an ear, nose, and throat (ENT) doctor for further evaluation.

In some cases, other specialists—like a neurologist (if a nerve issue is suspected) or a dentist (if jaw issues like TMJ are involved), or even a cardiologist (pulsatile tinnitus) may be part of your care team. 

What if no cause is found?

Even if single or multiple causes can't be found, there are numerous tinnitus treatment options that can help manage your symptoms and reduce the stress that can come with constant ringing in your ears.

Find tinnitus treatment near me

If you're living with tinnitus, you don’t have to navigate it alone. Visit our directory of hearing health care professionals to find a clinic that tests for tinnitus near you. Please note that not all hearing clinics treat tinnitus, so you may need to browse several clinic pages to find the right provider.