Top treatments for tinnitus

Tinnitus – experiencing ringing, buzzing, whirring or hissing noises in one or both ears – affects most people from time to time, after attending a loud concert, for example. But for 10 to 15 percent of the population, it’s a chronic condition, and up to 6 percent find it seriously interferes with everyday life, causing problems like insomnia and trouble concentrating.1

Defined as the perception of sound in the absence of an external source, tinnitus affects all age groups, although it can be a feature of age-related hearing loss. Other potential causes include repeated exposure to loud noise, ear infection, Ménière’s disease, temporomandibular joint (TMJ) disorders (affecting the jaw joints just in front of your ears), or even something as simple as ear wax buildup.2

The first thing to do is consult with your doctor to work out if there is an identifiable cause of your tinnitus; addressing it, if possible, may improve the condition or even resolve it completely.

Commonly though, there’s no obvious cause, and although counseling and drugs to deal with associated problems like insomnia and depression may sometimes be offered, sufferers are often told they just need to learn to live with it.

Fortunately, there are several strategies showing success for easing tinnitus and the distress it causes.

Soothe with sound therapy

A useful self-help technique is sound therapy, or sound enrichment, which involves the use of external sound to reduce the awareness of tinnitus or the distress associated with it. This could be simply opening a window to expose yourself to environmental sound, or it could involve the use of a tabletop sound generator, which provides a choice of soothing sounds such as gentle rain or crashing waves. These have been found to significantly improve sleep in tinnitus sufferers.3 Listening to Mozart for an hour a day has also proved helpful, even reducing the intensity of tinnitus.4 Just be sure to avoid loud music or sounds, as they could make tinnitus worse.

Consider EMDR

A form of psychotherapy initially developed to ease the distress associated with traumatic memories, EMDR, which stands for eye movement desensitization and reprocessing, is showing promise as a treatment for tinnitus. It involves side-to-side eye movement, tapping and other forms of stimulation to reprogram negative associations. Although the gold-standard randomized controlled trials have yet to be done, two preliminary trials have found EMDR to be effective for alleviating tinnitus symptoms5 and tinnitus distress,6 even several months after the treatment ended. To find a practitioner visit www.emdr.com.

Try tinnitus retraining therapy

A combination of sound therapy and educational counseling, tinnitus retraining therapy (TRT) aims to train the brain to ignore the sounds of tinnitus. Studies suggest it’s effective for most sufferers who try it and can even lead to the tinnitus disappearing completely.7 Speak to your doctor about finding a TRT specialist near you. If you live in the UK, the therapy is sometimes available through the National Health Service.

Do mind-body exercise

Yoga training for three months significantly improved tinnitus, sleep and quality of life in one small study.8 The traditional Chinese technique of qigong, another form of mind-body exercise, can also help. Regular practice dramatically reduced the severity of tinnitus, and the effects lasted for at least three months after stopping.9

Try TMS

Several studies show that transcranial magnetic stimulation (TMS), a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain, can be useful for tinnitus.10 Those with more severe cases may benefit the most.11

Bump up your Bs

Not getting enough vitamin B2 (riboflavin) and B3 (niacin) in your diet may play a role in tinnitus and how much it annoys you.12 Aim to include B-rich foods, like the ones listed on the right, in your daily diet. Getting enough protein, drinking plenty of water and generally eating healthily also seem to be important.13

Foods high in B vitamins

Vitamin B2

  • Beef
  • Salmon
  • Organ meats
  • Eggs
  • Mushrooms
  • Spinach
  • Avocados

Vitamin B3

  • Tuna
  • Chicken
  • Turkey
  • Brown rice
  • Sunflower seeds
  • Peanuts
  • Asparagus

Opt for antioxidants

Oxidative stress is thought to be involved in tinnitus, and antioxidants are showing a lot of promise as a treatment. In one high-quality trial, those taking alpha-lipoic acid along with a multivitamin and mineral tablet for three months saw significant improvements in the discomfort and intensity of their tinnitus compared to those taking a placebo.14 Another study reported similar results with a mix of antioxidants including vitamins C and E.15

The potent antioxidant coenzyme Q10 has also been found to improve tinnitus in people with low blood levels of the nutrient.16

Suggested dosages: 100 mg coenzyme Q10 (as ubiquinol) three times per day; 300 mg alpha-lipoic acid twice per day; a high-quality multivitamin and mineral supplement containing vitamins C and E

Assess your minerals

Some studies suggest that a deficiency in certain essential minerals, such as magnesium or zinc, may be involved in tinnitus,17 so get your levels checked and supplement if needed. Ideally, work with a qualified practitioner who can assess your results and recommend appropriate supplements and dosages. Indeed, zinc supplements have improved tinnitus in some sufferers who are lacking in the mineral.18

Check your meds

A number of prescription and non-prescription drugs can cause or worsen tinnitus,19 so check with your doctor about any you are taking and find out about alternatives if necessary. Here are some to watch out for:

  • Chemotherapy drugs such as cisplatin
  • Antimalarial drugs like quinine
  • Antibiotics such as clarithromycin and ciprofloxacin
  • Analgesics such aspirin and ibuprofen
  • Anticonvulsants including carbamazepine and amitriptyline.

Go for Ginkgo

A standardized extract of the herb Ginkgo biloba, known as EGb 761, can be effective for tinnitus.20 According to herbalist Meilyr James, ginkgo is most likely to be effective if the cause of tinnitus is related to poor circulation to the head, signs of which include problems with memory and concentration and “brain fog.”

Suggested dosage: James recommends 2-5 mL of a 1:4 tincture taken three times daily

Top tips

  • Limit talking on your mobile phone, as the electromagnetic radiation may worsen tinnitus.21
  • Avoid playing music too loud or cranking up the volume on your TV.
  • Wear hearing protectors if you’re going to be exposed to loud noise, for example at work or a concert.

References

1

The Lancet, 382(9904), 1600-1607; Drugs Aging, 2004; 21: 297-305; Tinnitus Handbook, 2000 pp.1-23 (Singular, San Diego)

2

BMJ Clin Evid, 2012; 2012: 0506; Front Neurosci, 2019; 13: 879

3

Acta Otolaryngol Suppl, 2006; (556): 59-63

4

Acta Otolaryngol, 2012; 132: 1172-7

5

Laryngoscope, 2019; 129: 2384-90

6

Eur J Psychotraumatol, 2018; 9: 1512248

7

Rev Laryngol Otol Rhinol (Bord), 2007; 128: 145-8; Indian J Otolaryngol Head Neck Surg, 2019; 71: 95-8

8

Complement Ther Clin Pract, 2019; 36: 7-11

9

J Psychosom Res, 2010; 69: 299-304

10

Eur J Neurol, 2010; 17: 38-44; B-ENT, 2009; 5: 89-100

11

Trials, 2017; 18: 64

12

Clin Exp Otorhinolaryngol, 2018; 11: 158-65

13

Int J Audiol, 2017; 56: 716-22

14

Nutrients, 2019; 11: 3037

15

Arch Med Res, 2007; 38: 456-9

16

Otolaryngol Head Neck Surg, 2007; 136: 72-7

17

Kulak Burun Bogaz Ihtis Derg, 2016; 26: 225-7; Am J Otolaryngol, 2015; 36: 230-4

18

Am J Otol, 1989; 10: 156-60; Nihon Jibiinkoka Gakkai Kaiho, 1997; 100: 915-9

19

BMJ, 2005; 330: 237

20

Neuropsychiatr Dis Treat, 2011; 7: 441-7; Int J Clin Pharm, 2018; 40: 1335-41

21

Braz J Otorhinolaryngol, 2016; 82: 97-104