Is there finally a cure for tinnitus?

I’m often asked for suggestions on how to treat tinnitus because there’s no surefire conventional fix. 

It’s a common complaint, afflicting thirteen to seventeen percent of people. This includes fully one third of the senior population.

Tinnitus (properly pronounced with an accent over the first syllable, as in “all of us”, not “tin-night-us”) consists of noise, buzzing, ringing, hissing or whining sounds arising spontaneously without an environmental stimulus.

I occasionally hear ringing in my ears, after a loud music performance, scuba diving, or very heavy weightlifting, but it quickly resolves. For a formal diagnosis of tinnitus to be rendered, it must be more than sporadic—“consciously perceived over a period of time longer than six months and unrelated to external stimuli”.

How is tinnitus treated?

Efforts are underway to develop “masking” technologies that deliver white noise via earpieces as with noise-canceling headphones. The problem is that the sounds emanate from within the ear and may originate in the brain, unlike environmental noise. 

A common gambit is to prescribe anti-depressants, with a two-fold rationale: These drugs have nerve effects, which may dampen activity within brain centers that interpret noise; and, secondly, many sufferers of tinnitus find it so annoying that they become depressed, developing obsessive worry over their affliction, thus amplifying their attention to tinnitus in a vicious cycle.

Recognition of this psychological component has led to promotion of cognitive behavioral therapy (CBT) as a way of treating tinnitus. The goal is not to eliminate intrusive sounds, but to help sufferers contextualize and make peace with their predicament.

Natural solutions for tinnitus

Natural therapies have included acupuncture, ginkgo biloba, lipoflavonoids, and nicotinamide riboside, but reviews are mixed and studies have been inconclusive. 

Now, a pair of research papers reveal that a considerable tranche of tinnitus sufferers could obtain relief through lifestyle measures. 

The first (“The Role of Diet and Lifestyle in the Tinnitus Management: A Comprehensive Review”) surveyed the scientific evidence and concluded:

“While there is no definitive cure, emerging research suggests that diet and lifestyle factors may play a role in tinnitus management. This comprehensive review explores the relationship between diet, lifestyle, and tinnitus, examining the existing evidence and potential mechanisms. The key findings highlight the influence of dietary patterns, hydration, stress management, physical activity, and sleep hygiene on tinnitus severity and frequency.”

Specifically, they noted that “a healthier diet, as indicated by a higher Healthy Eating Index (HEI) score, was correlated with reduced odds of reported persistent tinnitus in cross-sectional analysis.”

Moreover, “. . . regular physical activity has demonstrated notable benefits in enhancing health-related and overall quality of life while concurrently diminishing levels of tinnitus distress. A study revealed a significant association between higher physical activity levels and improved health-related and global quality of life, coupled with reduced tinnitus distress.”

Hence, they propose:

“Healthcare professionals are encouraged to integrate discussions about diet and lifestyle into tinnitus management protocols, offering tailored guidance and support. Simultaneously, individuals affected by tinnitus are urged to actively engage in their care by adopting healthy dietary habits, managing stress levels, prioritizing sleep hygiene, and embracing other lifestyle modifications conducive to symptom alleviation.”

Metabolic syndrome and its impact on tinnitus

A second study—“Effectiveness of lifestyle-modification approach (a randomized-controlled program of diet restriction and treadmill walking exercise) on elderly’s metabolic syndrome-associated subjective tinnitus”—put some of these findings to the test.

Metabolic syndrome is a constellation of factors—overweight, insulin resistance, hypertension, elevated triglycerides and adverse cholesterol to HDL ratios—that is estimated to afflict 40-50% of U.S. adults over 60. 

Another study, applying rigorous criteria, found a shockingly low 12% of U.S. adults “metabolically healthy”. 

While some tinnitus sufferers are thin, fit and eat well, there’s a strong correlation between overweight and tinnitus incidence. On the other hand, if you’ve been a thin, fit jack hammer operator, gunnery range instructor, heavy metal rock musician, or if you’ve had chemotherapy-induced damage to your auditory nerves, healthy lifestyle measures alone might not reverse the damage.

But for the average tinnitus sufferer, there may be hope.

For the study, 60 adults with metabolic syndrome and clinically-diagnosed tinnitus were recruited and randomly assigned to a treatment group and a matched control group (30 v. 30).

The treatment group underwent a twelve-week exercise treadmill training program accompanied by diet restriction. 

As might be expected, the treatment group saw reductions in weight, hip circumference, fasting glucose, triglycerides, blood pressure, and increases in beneficial HDL cholesterol. 

They also experienced improvements in their tinnitus vs. the control group, which saw no improvements.

Why did diet modification and weight loss help? The study authors propose several biological underpinnings: 

1. Better control of blood pressure. Hypertension is generally a silent condition, but sufferers sometimes note ringing in their ears when their blood pressure spikes. High blood pressure may damage inner ear nerves, creating static. Moreover, certain antihypertensive medications list tinnitus as a side effect.
2. Reversal of obesity. Excess body fat is associated with oxidative stress and inflammation, which can damage the hearing apparatus.
3.  Improvements in blood sugar. As in the eyes and in the lower extremities, diabetes is associated with nerve damage, to which cochlear receptors may be particularly susceptible.
4. Lipid reduction.  Excess triglycerides sludge the tiny blood vessels in the auditory apparatus; long-term exposure allows harmful lipoproteins to accumulate in the inner ear’s arterial walls, impairing cochlear circulation which compromises oxygenation.

What do the skeptics say?

Some may quibble that this study was small, and of short duration. Clearly it should be replicated with larger numbers of subjects followed for longer periods. I’d wager that the results would be even more robustly supportive of using lifestyle measures to ameliorate tinnitus if the study period were to span years, or even decades. 

I’d also caution that since tinnitus is subjective, it’s hard to control for placebo effects in studies like these. People actively engaged in changing their eating habits and exercising are powerfully under the spell of belief.
But in the end, who cares? If the only side effects are weight loss, better blood pressure and sugar control, and improved lipid panels, why split hairs over whether the tinnitus improvements these subjects experienced are “real”?