With over 30 possible causes, tinnitus is a complex and often mysterious symptom afflicting more than 50 million Americans making their ears ring.
This guide covers everything from the most common to the most obscure causes to help you figure out what might be the source of that ringing in your ears – and what you can do about it.
Without a doubt, hearing loss is the number one cause of tinnitus.
The second leading cause is being around loud noises too much.
Even with all that, 40% of people can’t pinpoint what exactly has caused their tinnitus to start.
Discovering what might be the cause of your tinnitus is the first step in finding a treatment plan to help you deal with your ears ringing.
Not only are there many possible causes for tinnitus, there are also many things that can make it worse.
To help you understand this condition read on for the definitive guide to what’s causing that ringing in your ears.
From hearing loss and loud work environments to simple ear infections or damage to your inner ear, the most common cause of tinnitus is a physical one.
1. Old Age
The group most likely to suffer from tinnitus are adults aged 60 and up.
The medical term for this type of hearing loss is Presbycusis and one of its earliest symptoms is the sensory loss of high-frequency sounds.
Without these high-frequency sounds to block out external noise, the ringing or buzzing associated with tinnitus becomes more and more noticeable.
For some, it’s nothing more than a vibrating hum that you hear off and on.
But at its worst, the ringing sound affects both ears and feels like it comes from four locations all at once.
2. Hearing Loss
Similar to age-related tinnitus, hearing loss associated with tinnitus is connected to the complex relationship between your inner ear and hair cells along with your brain and the neurological pathways that allow you to “hear.”
For most people, tinnitus isn’t coming from your ear.
It happens because of changes in the central auditory pathways (where your ear is sending its messages to your brain to interpret into “hearing”).
Scientifically speaking, the ringing in your ears that you are hearing is not because of the loss of the hair cells or damage to the inner ear.
It is actually because your brain has been partly disconnected from your ear because of the physical degeneration.
Most people who suffer from tinnitus also have some kind of hearing loss.
Whether that’s from noise exposure, an ear disease, injuries or simply aging.
Sometimes, parts of your inner ear are dead and no longer working, but you might still feel like you are hearing just fine.
But the disconnect from those dead areas with your brain could be causing you to “hear” tinnitus.
This is a trick from your brain similar to the phantom pain that amputees can experience.
3. Exposure To Loud Noise
If you’ve been constantly around loud noises because of your work or hobbies, you run a high risk of developing tinnitus.
What happens when tinnitus is caused by loud noises is that this exposure damages the delicate hair cells that allow you to hear.
When that happens, your brain is looking for the signals those hair cells usually send to it.
If it’s confused and can’t find those signals, it could start to make up noises to fill the void.
This ear-brain-nerve cell connection is so strong that even though there are many causes for tinnitus, they are usually because of something going wrong with not just your physical inner ears, but your brain, nerve cells, neuropathways and central nervous system.
It’s a good idea to read up on things that can be making your tinnitus worse to help you get that ringing in your ears under control.
4. Wax Build-up In Your Ears
Sometimes, something as simple as earwax build-up can be what’s causing your tinnitus.
Your ears are self-sufficient.
They produce earwax to keep germs out with antibacterial and antifungal properties.
And they (usually!) clean themselves out.
But sometimes earwax can build-up and clog your ears – especially if you live in a warm and dry climate.
When that happens, pressure builds up in your inner ear, your eardrum gets irritated and you start to have trouble hearing.
Then, your brain tries to make up for the lost sound input by making up noises that don’t exist, like that buzzing or ringing you’re hearing.
This kind of blockage can be from anything – not just earwax.
Dirt, pieces of cotton from Q-tips or even loose hair from your ear canal can be causing the problem.
5. Ear Infections
When bacteria or a virus infects your middle ear, you can develop tinnitus from the pressure and irritation to your ear.
Or, if you already suffer from tinnitus, it can make your symptoms worse.
Usually, your ear infection will clear up on its own.
If it persists or worsens over several days, you may need an antibiotic to treat it.
Ear infections are usually caused by colds, allergies or the flu.
After treating your ear infection, you should see improvement in your tinnitus symptoms.
6. Sinus Infections
You may have noticed that tinnitus tends to worsen when you have a cold, especially when you blow your nose too hard.
That’s because the middle ear and the back of your nose are connected via a canal called the eustachian tube.
Nasal congestion related to a sinus infection causes the inner lining of the nose to swell up.
This creates abnormal pressure in the ear that causes mild hearing loss as well as tinnitus.
If this is the case, the ringing noise is only temporary and can be easily treated by your usual anti-allergy medication.
7. Head And Neck Trauma
In a study conducted by the Oregon Health and Service University Tinnitus Clinic, one out of 10 people suffering from tinnitus ascribe their condition to some sort of head or neck trauma.
Tinnitus which occurs as a direct consequence of a head injury is sometimes referred to as somatic tinnitus.
It often develops as a result of trauma to the nerves and tissues connecting the brain to the auditory system.
Most patients with head injuries often report not only a louder ringing noise but also a greater frequency coming from all locations around the affected ear.
8. TMJ (Temporomandibular Joint Disorders)
Tinnitus is one of the earliest signs of temporomandibular joint disorder (TMJ).
What happens is the joints on both sides of your head where your jawbone meets your skull has some kind of problem.
It could be a physical trauma like a pulled muscle, a dislocated disc or even arthritis in the joint itself.
You’ll know you have TMJ if your jaw is hard to open and makes a clunking sound.
Because the joint that is affected is so close to your ears, it shares the same nerve connection as your middle ear.
When that joint is damaged, it causes a ringing noise.
Most of the time, when you fix the TMJ issue, your tinnitus will resolve.
9. Jaw Misalignment
Like TMJ, if your jaw is misaligned, that nerve that is used for both your jaw and your hearing will be affected and could cause the ringing in your ears.
Your whole facial area is deeply connected and very complex.
Even if you simply have problems with your neck muscles or the muscles of your mouth, you could develop tinnitus.
Your dentist should be able to recommend treatment for any jaw misalignment.
If that is what is causing your tinnitus, getting that fixed should resolve your tinnitus.
10. Barometric Trauma
Chances are, you’ve already experienced this once or twice before.
Barometric trauma usually occurs when there are sudden changes in air or water pressure, like when flying or scuba diving.
This often leads to a perforated eardrum – a small hole or tear in your tympanic membrane or the thin tissue that divides your middle ear and outer ear canal.
Some of its most common systems include hearing loss and tinnitus.
This typically needs no treatment, as eardrums usually heal themselves after a few days.
11. High Impact Aerobics
High impact aerobics (HIA) is a big (yet little-known!) trigger for tinnitus.
High impact aerobics are fast-paced, intense exercises where you put a lot of stress on your body and joints where you regularly lift both feet off the floor at the same time.
A few examples are:
- Intense cardio workout programs at fitness gyms
- Step aerobics
High impact aerobics require you to repeatedly jar your body.
Teachers and participants can injure their delicate inner ear system leading to dizziness, balance issues, hearing loss and tinnitus.
If that wasn’t enough of a trigger, often these sports and exercises have loud music to keep up the pace and excitement.
Those harsh body movements coupled with the loud music wreak havoc on your sensitive ears.
Some easy fixes are:
- Reduce or eliminate the loud noise when you’re doing these exercises
- Wear better shoes that will take more of the impact for you
- Find a gentler exercise while you allow your ears to heal
Like other head and neck trauma, whiplash can cause tinnitus.
In fact, 10% of people who experience whiplash develop various ear-related problems such as hearing loss, vertigo (dizziness) and tinnitus.
What’s interesting is that some people who’ve developed tinnitus after whiplash have perfectly good ears, and they pass hearing tests and MRI scans.
When that happens, doctors have no clue why tinnitus is showing up.
Studies have shown that what could be happening is the injury is deep inside the brain where the auditory nerves are.
Mental & Neurological Triggers
Your brain and central nervous system play a large role in producing the sound of ringing or buzzing in your ears.
Like a phantom pain, your brain can create the sound without anything physical triggering it.
13. Brain Injury
Just like we explored with whiplash, brain injuries often trigger tinnitus.
There are two ways that a brain injury can cause tinnitus:
- Tinnitus that results from a brain injury is usually a type of phantom pain. Everything could be perfectly fine with your ears physically, but your brain is overcompensating or trying to heal and is creating sounds that aren’t really there.
- What could be happening is that after a brain injury your brain can’t easily ignore stimulation like it could before your injury. Most of a healthy brain’s job is to know which sensations to alert us to. What to notice, to see, smell, hear and feel.
Depending on where a brain is injured or how bad the injury is, it might not know what to drown out anymore and so everything could sound overwhelming.
Brain trauma is often only healed through time.
How long have we been hearing that stress is the hidden plague of modern life?
Well, believe it or not, a lot of tinnitus sufferers have noted the onset of their condition with emotional stress as the trigger.
When you’re stressed, your body deals with it by producing hormones that increase your blood pressure and that can cause confusion in your brain where your auditory nervous system is located.
The sad thing is that a lot of health professionals don’t know that stress can trigger tinnitus so they might be looking for another cause – all while you’re suffering and wondering why you’ve developed this frustrating condition.
Learning how to manage your stress yourself is the best thing you can do.
And getting plenty of good, deep sleep also goes a long way in helping with stress and tinnitus.
Similar to stress, anxiety can be the root cause of your tinnitus.
And many doctors don’t even know that anxiety itself can be what’s causing the ringing in your ears.
Studies show that nearly 50% of tinnitus patients have also suffered from lifelong anxiety.
Making matters worse, if you have anxiety, it’s going to affect you more than someone without anxiety because you’ll focus on it more and that makes it sound louder and more intense.
Another issue is that some anti-anxiety medications can also be what’s causing the tinnitus.
One of the best tinnitus treatments is CBT (cognitive behavioral therapy) which is also really great to help with anxiety.
Another cause of tinnitus is depression.
And like anxiety, some of the meds for depression can also be the culprit.
Some things that you can do to help ease your depression are:
- Do things that you enjoy (or used to enjoy)
- Make sure you get a healthy 8 hours of sleep
- Get out for a walk with a friend
- Move your body
- Eat healthy by cutting down sugar and carbs
- Try some stress and relaxation techniques
- Boost your vitamin intake – especially vitamin D and B vitamins
A lot of those tips will also help your tinnitus.
If you are on a medication for depression and also experiencing tinnitus, take a look into whether it might be what’s triggering the ringing in your ears.
Food, Drugs & Medications
Another cause of tinnitus is certain foods, drinks, medications and drugs.
If the buzzing in your ears is caused by one of these, usually once you cut out the source your tinnitus will go away on its own.
17. Side Effect Of Some Medications
More than 600 types of medications can cause or worsen tinnitus symptoms.
These are called ototoxic drugs, meaning they have a toxic effect on your ear or its nerves.
The higher the dose of these medications, the worse tinnitus becomes.
Some of the most common drugs that cause or worsen tinnitus include:
- Pain-relieving and anti-inflammatory drugs like Advil, Tylenol and naproxen
- Certain oral antibiotics
- Aspirin when taken in high doses
- Cancer medications like Platinol
- Medications that are used to treat malaria
- Anti-anxiety and anti-depressant drugs
- Some blood-pressure-lowering medication
- An ingredient used to treat acne that is found in many brands of treatment
- Heart failure and high blood pressure medication
Caffeine can affect tinnitus in several ways – whether you drink it, take pills for it or even when it’s hidden as an ingredient in your medication.
- First, in some cases, it can be what’s causing your tinnitus.
- Second, because it is a stimulant, it can make your tinnitus seem louder and more intense.
- And third, it can cause anxiety. You will have more trouble dealing with your tinnitus if you are experiencing anxiety as well.
Completely eliminating or at least really cutting down your coffee intake might help you get rid of your tinnitus.
Because tinnitus has so many variables, you might be completely fine with caffeine.
But it could be worth trying out a 2-week trial with no coffee or caffeine to see if it helps at all.
Here’s a list of easy ways to cut down caffeine intake and a helpful guide for some healthy alternatives to coffee.
Even if your tinnitus isn’t 100% improved with the lower coffee intake, as a side-effect it might help your sleep quality, which can be a big issue with tinnitus.
If you’re having trouble with sleeping, we have some sleep tips specifically for tinnitus sufferers like you.
Alcohol affects many aspects of your body when you drink it.
For some people, it is the cause of their tinnitus.
And if it’s not the root cause, it definitely doesn’t help your tinnitus when you drink.
Studies show that more than 80% of tinnitus sufferers noticed that the ringing in their ears got worse when they drank.
There are many ways that alcohol can affect your tinnitus:
- Similar to salt, alcohol affects blood pressure leading to more tinnitus issues
- It is metabolized as sugar, leading to the same tinnitus issue as eating sugar directly
- It restricts blood vessels, which causes more ringing and buzzing in your ears
- And like caffeine, it’s a diuretic that dehydrates you, which aggravates tinnitus
Not a pretty picture when trying to find a solution for your tinnitus.
Research suggests that heavy drinking is the key factor in triggering or worsening tinnitus.
Most tinnitus patients said that if they have a drink or two, things don’t seem to get worse.
But when they overindulge, that’s when it gets out of hand.
20. Nicotine and Smoking
Nicotine is a highly toxic alkaloid. An alkaloid is a type of chemical that is found in some plants.
The plants that have this chemical are often turned into strong prescription medications, intense drugs or even poison.
Research has shown that there is a high risk of developing tinnitus if you are a smoker.
The longer you’ve been smoking, the higher your risk.
There are a few ways that nicotine and smoking cause or worsen that ringing in your ears.
First, nicotine narrows your blood vessels and increases your blood pressure. No matter if you’re smoking it, chewing it or vaping it.
Second, nicotine irritates your middle ear lining and Eustachian tube, which triggers tinnitus or makes it worse.
Third, you decrease the oxygen levels that reach your ear, which is bad news for tinnitus.
Another issue is that because nicotine is a stimulant, it can be making the ringing in your ears sound louder.
Many tinnitus sufferers take cannabis to help with their symptoms.
But studies have shown that patients who used marijuana were more likely to experience tinnitus.
If you think the ringing in your ears could be related to your cannabis intake, try keeping track of how often you experience tinnitus, how long it lasts and when you get the symptoms.
This will help you when you meet with your tinnitus specialist.
Your tinnitus might be linked to a heart or blood problem.
Below we will explain how they are connected.
22. Cardiovascular Disease
The type of tinnitus that sounds like your pulse or heartbeat is called “pulsatile tinnitus.”
This type of tinnitus is usually caused by problems with your blood vessels from various cardiovascular diseases.
Some cardiovascular diseases are:
- Angina of the heart
- Hypertensive heart disease
- Rheumatic heart disease
- Congenital heart disease
- Abnormal heart rhythms
If you have a heart condition, it’s very likely this is what is triggering the ringing in your ears.
23. High Cholesterol (Atherosclerosis)
High cholesterol (atherosclerosis) causes plaque to build up in your blood vessels.
Your middle and inner ear is closely connected to very tiny blood vessels.
When you have high cholesterol, those blood vessels get tighter and can make you hear your heartbeat or cause ringing in your ears.
Of course, high cholesterol isn’t healthy for anyone.
Adding tinnitus onto that is another stress that you don’t need.
There are some easy things you can do to help your high cholesterol – and in turn your tinnitus:
24. High Blood Pressure
High blood pressure is a huge problem affecting more than 100 million Americans.
Not only does high blood pressure lead to heart disease, strokes, kidney problems and loss of vision, but it’s also a big tinnitus trigger.
Similar to high cholesterol, high blood pressure is when the force of your blood pushing against the walls of your blood vessels is too high.
Your blood pushing too hard again your blood vessels causes less oxygen to reach your inner ear.
Your ear needs oxygen delivered to it by your blood to keep on working correctly.
There are lots of ways you can take your health into your own hands and start to reduce your high blood pressure naturally.
When your tinnitus is linked to high blood pressure, treating it will help you get that buzzing in your ears under control.
Diseases that affect your inner ear, the nerves around your face and ears, your hormones and autoimmune diseases can all cause tinnitus.
Read on for some of the most common (and surprising!) diseases that might be the source of that ringing in your ears.
25. Meniere’s Disease
Tinnitus itself is not a disease. It’s a symptom of something else going on.
When it comes to which disease can be causing your tinnitus, the most common is Meniere’s disease – a rare disorder of the inner ear.
In most cases, Meniere’s disease only affects one ear.
Researchers aren’t entirely sure what causes this disorder or why it happens.
The symptoms of this disease (vertigo, tinnitus, hearing loss) seem to be because there is an abnormal amount of fluid in the inner ear.
There isn’t a cure for this disease, but some things that can help are:
- Medications to help with the dizziness
- Injections to your middle ear to also help with the dizziness
- Surgery might be an option in some cases
Some natural remedies appear to help as well.
Diabetes is a disease that affects how your body uses blood sugar, called glucose.
Glucose is a big source of energy for all of your cells but it’s also your brain’s main source of fuel.
Research shows that about 50% of diabetes patients suffer from tinnitus. Age, gender and hearing loss don’t change those stats.
One of the main ways that diabetes causes tinnitus is through nerve damage, known as “neuropathy”.
You probably know that this nerve damage can cause tingling, numbness or pain in your legs.
What you probably don’t know is that this same nerve damage can be happening to your delicate hearing organs and the neuropathways that are connected to hearing.
Which is what is causing the ringing in your ears.
Another thing to keep in mind is that, surprisingly, sugar can affect all types of tinnitus.
It’s a good idea to take a look at ways to cut down sugar intake if you have tinnitus – whether or not it’s connected to diabetes.
27. Thyroid Problems
Your thyroid plays a huge role in your everyday life and health.
It controls how quickly your body burns energy, makes proteins and how sensitive your body is to other hormones.
When your thyroid isn’t working right, you can have lots of problems like:
- Low energy
- Weight gain
- Pain sensitivity
Both hyperthyroidism (making too much thyroid hormone) and hypothyroidism (making too little thyroid hormone) can lead to tinnitus.
The worse your thyroid problem is, the worse your tinnitus symptoms will appear.
28. Otosclerosis (A Bone Disease)
Otosclerosis is a bone disease that hardens your tiny ear bones.
It seems to affect more women than men, usually between the ages of 15 to 45, and more Caucasians than other races.
This condition usually starts with hearing loss in one ear but then eventually both ears are usually affected.
Most people with otosclerosis have tinnitus.
Usually, they experience high-pitched or “white noise” tinnitus.
Sometimes in the early stages of this disease, the tinnitus is “pulsatile” – which means it sounds like a pulse or heartbeat.
Some people with otosclerosis actually have better hearing in noisy environments.
There is a specific surgery related to this disease called a stapedectomy which has been shown to improve hearing in 90% of the patients.
If your tinnitus is caused by this rare disease, then the surgery that is performed to help your hearing loss has a good chance of helping your tinnitus, too.
If you have arthritis and you are also dealing with tinnitus, there are two possible explanations.
- The disease itself is causing the tinnitus.
- The drugs you are using to treat your arthritis are the culprit.
In the first case, what is happening is that similar to how arthritis is a faulty response in your body that is attacking your joints and other tissues, the same thing could be happening to your sensitive ear bones and tissues.
Your immune system could be turning around and attacking them as well.
However, in most arthritis cases with tinnitus, it’s the second case: Your pain medication is the problem.
Researchers suspect that pain-reducing medication could be reducing the blood flow to your ear, leading to tinnitus.
Another problem is that some of those medications also reduce an antioxidant and vital protein called glutathione.
Glutathione has been shown to protect your inner ear from damage.
High doses of aspirin, Advil or Tylenol can cause tinnitus.
The good news is, once you cut them down or switch to something else, tinnitus usually clears up.
As an alternative to high-levels of pain meds, studies show swimming is a great way to help reduce the joint pain and stiffness that you get from arthritis.
The clinical trial reported “there were significant reductions in joint pain, stiffness, and physical limitation accompanied by increases in quality of life.”
As discussed in the Mental & Neurological Triggers section above, a lot of tinnitus is related to your central nervous system not working properly.
Fibromyalgia is a condition that is often misunderstood.
Researchers believe that the main issues causing fibromyalgia are changes in your brain, nervous system and the chemicals in your brain that signal pain.
Many who suffer from fibromyalgia also have tinnitus.
Because we know how much the brain and nervous system cause you to hear that ringing in your ears, it is easy to see why a condition that is rooted in your brain and nervous system changes could trigger tinnitus.
Many medications can help with this disorder.
31. Lyme Disease (Borreliosis)
Studies show that over 75% of people with Lyme disease complain of suffering from tinnitus.
Lyme disease is an infection that affects many organs including your nervous system and your facial nerve, like Bell’s palsy, which we’ll look at next.
Research has shown that if Lyme disease is the base of your tinnitus problem, treating the disease with the appropriate antibiotics can help the tinnitus that you’ve developed.
32. Bell’s Palsy
A type of facial paralysis, Bell’s palsy causes temporary loss of your facial muscles. Some cases are mild and others are severe.
Among other things, one of the side-effects of Bell’s palsy is tinnitus.
When Bell’s palsy strikes, the main issue is that your facial nerve doesn’t function correctly – just like with Lyme disease.
Although the cause of Bell’s palsy is unknown, many believe it is due to a viral infection that causes some swelling.
The good news is most people who get Bell’s palsy start to regain their normal facial function within 3 weeks, even without any professional treatment.
33. Tumors Affecting The Auditory System
It is extremely rare, but tumors can be a cause of tinnitus.
Either a tumor in the auditory cortex or tumors along the auditory tract or in the area of the brain that controls hearing.
If this is the cause of the ringing in your ears, having the growth surgically removed usually resolves the issue.
No matter what has caused your tinnitus, there are a lot of things you can do to try to alleviate the ringing in your ears.
- Stay away from foods that make tinnitus worse
- Get plenty of sleep
- Reduce your blood pressure
- Cut down caffeine, salt and sugar
- Check if any medications you are on are making your tinnitus worse
- Start an easy exercise routine
- Quit smoking
- Make sure you aren’t lacking any important vitamins
Consulting a tinnitus specialist can help you find the right treatment plan for your tinnitus.
There are many proven treatments that doctors prescribe for tinnitus.
And many researchers are hopeful that a tinnitus cure is just around the corner.