Silent Sounds: Understanding and Managing Tinnitus

Imagine this: You are relaxing in your home, perhaps it has been a long day. You would like to finally wind down, close your eyes and get some well-deserved sleep. You make the right atmosphere – the lights are low, the room is quiet, your bed is extremely comfortable, and just as your head hits the pillow – a loud, high-pitched ringing disturbs your rest.
You may get off the pillow and look around, but the room is silent. And as soon as you get back in bed, the ringing returns too. Soon enough, as the world outside also quietens down, you hear the sound no matter what you do or where you are. You realize the sound is not anywhere around you. It’s coming from inside your ears, and it’s here to stay.
This is the reality for an uncomfortably large number of people who suffer from Tinnitus: a high-pitched ringing or buzzing in one or both ears that may present suddenly and can be acute or chronic, depending on the person. Some others complain of a hissing, whooshing, or whistling noise, and it may also be accompanied by hearing loss, dizziness, and vertigo in some cases.

Besides senior citizens, multiple studies have shown that people in urban cities are more likely to develop tinnitus and/or hearing loss thanks to the unavoidable noise pollution they are immersed in^(1,2,3). Another study stated that tinnitus is so common, it affects nearly 7% of the Indian population. Additionally, innovations in the field of audio devices like earphones or loudspeakers enable us to listen to music at very high volumes – leading to rising rates of tinnitus cases. One study showed that earphones-users had a 1.27 times greater chance of tinnitus.

The story doesn’t end there. Not only is there a huge correlation between tinnitus and hearing loss – which is bad enough on its own – sufferers of tinnitus also present with anxiety and depression, lack of sleep, compromised social lives, difficulty in concentrating, increased irritability, and a generally reduced quality of life. It is therefore important to understand what places you at risk of developing tinnitus.

What Leads to Tinnitus?

The brain sometimes tries to fill in the gaps when it does not hear sounds of a certain frequency (within the audible range of humans), leading to subjective tinnitus. This sound is audible only to the person who has tinnitus. Objective tinnitus, on the other hand, is when the sound from the ear canal can be heard by another person if checked. This type is generally caused by some sort of physiological abnormalities, and it is rare.

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From a broad viewpoint, one can classify the causes of tinnitus as external or internal.
External causes for tinnitus include but aren’t limited to:

• One-time exposure to loud noises such as fireworks or gunshots.
• Repeated exposure to loud noise, such as listening to loud music for long durations, or being in loud environments like music concerts, construction sites, and traffic, without adequate ear protection.
• Traumatic brain injury.
• Injury to the eardrum or sensory hair cells of the inner ear.

While internal risk factors may be:

• Vitamin B12 and Vitamin D deficiency^{(4, 5)}
• Diets low in protein⁽⁶⁾ 
• Use of ototoxic medication like NSAIDS (Non-steroidal anti-inflammatory drugs), loop diuretics, etc.⁽⁷⁾
• High blood pressure.
• Chronic stress.
• Migraines.
• Hearing loss.
• Jaw problems.
• Fluid build-up.
• Congestion in the Eustachian Tube – a tube that connects the inner ear to the back of the throat.
• Ear infections and inflammation.

Certain diseases and conditions like Meniere’s Disease and Otosclerosis (when bones inside the middle ear fuse together), among others, can also cause tinnitus and hearing loss. Recent studies also suggest a genetic link for the condition, and would then place you at risk of inheriting it if your famiy has a history of tinnitus.
Some researchers are also looking for a link between covid vaccines and tinnitus when a large number of people complained of tinnitus after receiving the dose, however studies did not find a proven link between the jab and the condition, and more research is needed for conclusive evidence.

Now that we’ve understood some of the risk factors for Tinnitus, here are some ways to manage life with the condition.

Managing Tinnitus:
Try these methods to deal with your tinnitus for a calmer, quieter life:

1. Identify Root Cause: Functional medicine focuses on how to holistically heal your body and do away with health woes, and reverse chronic illnesses. To this effect, we recommend getting your blood tested to discover the Root Cause of your tinnitus, so that you can figure out exactly what treatment plan is best for you.
2. Get the Right Vitamins: Studies show that tinnitus can be linked to deficiencies of Vitamin B12 and D. If your blood biomarkers indicate that you are deficient, natural ways to up your vitamin intake are via sunlight, and through foods like eggs, fatty fish, and chicken.
3. Protein Rich Foods: Research has shown that diets high in protein are linked with reduced odds of tinnitus.⁽⁶⁾ Eggs, chicken, and organ meats like liver are a great way to get more protein in your diet.
4. Use Himalayan Salt: Excess table salt in the body can lead to fluid buildup, including in the middle ear which may lead to tinnitus. We recommend reducing your table salt intake and replacing it with Himalayan salt.
5. Herbal Supplementation: While natural is always best, sometimes using supplements can help to give bioavailable forms of vitamins and minerals to your body. It is believed that Ginkgo Biloba could have a role in helping to manage tinnitus as well, due to its anti-inflammatory properties.
6. Use Earphones Appropriately: The responsible use of audio devices at appropriate volumes and for healthy durations only, with breaks in between, can make a world of difference for people with tinnitus, especially if it is not yet severe and has not presented with hearing loss. For 1 hour of listening, consider taking a 30-minute break after the fact.
7. Use Protection: If you live in an environment that is at high risk for hearing loss and tinnitus, we recommend that you use ear protection such as earbuds or earplugs to protect your ears from damage. 

Take the appropriate measures to protect your ears and prevent the onset of tinnitus. If you already have tinnitus, know that you are not alone.

Tinnitus takes you by surprise, and it can get frustrating and overwhelming at times. Especially since the people around you may not relate to the disturbance caused by sounds that they cannot hear. It is also linked to anxiety, stress, worry, depression, and understandably so.

We recommend meditation and yoga to reduce stress and tension. Follow the tips in this article to manage your Tinnitus and walk towards a more peaceful, quiet life.

References:

1:
https://lacanadahearing.com/blog/how-to-protect-yourself-city-noise#:~:text=People%20who%20live%20in%20cities,10%20to%2015%20years%20older

2:
https://www.hindustantimes.com/lifestyle/health/link-between-traffic-noise-and-risk-of-tinnitus-research-101675576198134.html

3: https://www.noisyplanet.nidcd.nih.gov/have-you-heard/noisy-city-may-lead-to-hearing-loss

4 & 6: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664714/#:~:text=Higher%20intakes%20of%20calcium%2C%20iron%20and%20fat%20were%20associated%20with,with%20reduced%20odds%20of%20tinnitus.

5: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8372974/#:~:text=Our%20findings%20suggest%20that%20a,assessment%20for%20all%20tinnitus%20patients.

7: https://www.asha.org/public/hearing/ototoxic-medications/#:~:text=Ototoxic%20medications%20cause%20damage%20to,cause%20hearing%20and%20balance%20problems.

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8: https://www.rupahealth.com/post/natural-approach-to-tinnitus
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