Why Do I Have Tinnitus? The Causes, Explained

If that definition seems vague, it’s because many things can lead to tinnitus. “There are a lot of reasons why a person might have tinnitus, which is why it’s a symptom as opposed to an actual disorder itself,” says Kit Frank, an audiologist in Nevada.

There are several simple (and very treatable) problems that can lead to tinnitus, such as excessive earwax or fluid in the middle section of the ear, says Ileana Showalter, MD, an otolaryngologist with Mercy Medical Center in Baltimore. “The first step is to go to the physician and get a full examination of the condition of your ears,” she says.

• Hearing Loss “When someone comes in to me complaining of tinnitus, the first thing we check for is hearing loss,” Frank says. “Hearing loss is typically the most common cause of tinnitus.” People who complain of moderate to severe hearing loss almost always also experience tinnitus, Dr. Showalter says. But even though there’s a strong link between hearing sensitivity and tinnitus, they’re not predictive of each other, adds Lori Zitelli, an audiologist with UPMC Eye & Ear Institute in Pittsburgh.
• Ear Bone Changes A condition called otosclerosis, which tends to run in families, can result in ear bones growing abnormally and can lead to tinnitus.
• Exposure to Loud Noises Being exposed to loud noises at work, at home, or in your free time can lead to hearing loss over time, which can lead to tinnitus. Construction workers, for instance, might permanently damage tiny sensory hair cells in the ear over the course of their career, while members of the military often develop tinnitus as a result of explosive sounds.

Less common causes of tinnitus include:

• Temporomandibular Joint (TMJ) Disorder If the joint where the jawbone connects to the skull gives you problems, you might experience tinnitus.

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• Concussion Frank says concussions can result in tinnitus. The injury can cause issues in the nerves or with blood flow. Usually, if you experience tinnitus as a result of a concussion, you’ll experience it in one ear instead of both, likely near where the trauma occurred.

• Diseases that involve the blood vessels, such as high blood pressure, head and neck tumors, atherosclerosis, arteriovenous malformation, and turbulent blood flow.
• Ménière’s disease, an ear disorder that is caused by having abnormal fluid pressure inside the ear, can cause tinnitus. One of the first signs of the disease is tinnitus.
• Acoustic neuroma, a tumor in the brain that plays a role in both hearing and balance, can cause tinnitus. It likely causes tinnitus in one ear only.
• Depression and anxiety, which can be complications of tinnitus, but which research has also noted can be a cause of the hearing condition as well.

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• Migraine
• Smoking
• Hypothyroidism
• Hyperthyroidism
• Lyme disease
• Fibromyalgia
• Thoracic outlet syndrome

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Here are some that can lead to tinnitus or make it worse:

• Aspirin, when taken in very high doses
• Some antibiotics, including erythromycin and polymyxin B
• Certain medications used to treat cancer and malaria
• Water pills
• Some antidepressants

Zitelli says if you’re concerned about whether there’s a tinnitus risk associated with a medication you’re taking, be sure to ask your prescribing doctor.

Certain foods and drugs may also increase the likelihood or the intensity at which you experience tinnitus. “Any sort of stimulant — alcohol, tobacco, caffeine, all of those things — can lead to an increase in tinnitus,” Frank says. She says she’ll often hear from patients that they went out drinking and experienced tinnitus really intensely for a few hours that night and that it wore off over time.

Many people with tinnitus have been told to avoid salt, caffeine, and alcohol because these are believed to possibly exacerbate the tinnitus, Zitelli says. She says she’s heard this anecdotally from patients, but research is tough to conduct since there’s no objective way to measure exactly what a person with tinnitus is hearing — or to confirm that tinnitus has gotten better or worse.

Since the biggest predictor that you’ll experience tinnitus is hearing loss, your best line of defense is to limit how often you’re exposed to loud noises, which will keep the sensory hair cells in your ear intact.