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How to Stop the Ringing in the Ears Called Tinnitus

Causes and symptoms, plus treatments for quick and long-term relief


a woman wearing large blue headphones undergoing a hearing test at a hearing clinic for tinnitus
Artemenko_Daria / Getty Images

Key takeaways:

Tinnitus is when you have noise present in your ears that others don’t hear. About 26 million adults in the United States have tinnitus, says Joy Onozuka, director of community engagement and communications at the American Tinnitus Association. For some, the effects of tinnitus are minor but for about 20 percent of those who have tinnitus, constant ringing in the ears can distract their sleep and concentration, and cause anxiety and depression.

What is tinnitus? 

Tinnitus is when you hear phantom sounds, like clicking, buzzing, whistling or ringing in the ears, even though there’s no outside source for the sounds and nobody else can hear them. They can be whisper soft or uncomfortably loud, and intermittent or constant.

“Tinnitus is truly a symptom, it’s not a disease,” says Douglas D. Backous, M.D., president of the American Academy of Otolaryngology—Head and Neck Surgery. “There are like 26 million people in the country who have tinnitus and probably 27 million reasons why they have it.”

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Researchers say people experience tinnitus when their brains pick up on a phantom sound and try to identify it but can’t. So, their brain continues to focus on that sound and tries to solve the puzzle.

“Because the brain can’t make sense of it, the sound becomes the forefront of attention,” says Grant Searchfield, head of the audiology department at the University of Auckland in New Zealand. Focusing on the sound makes it more important, and therefore louder. “It’s an unfortunate side effect of how the brain works.”

What causes tinnitus? 

Though it’s unclear what exactly causes tinnitus, it’s usually linked to sensorineural hearing loss, Backous says, which is when sound doesn’t get to your inner ear. Most cases of tinnitus are subjective, which means only you can hear the sound.

Other times tinnitus is tied to a treatable medical condition. The sounds may pulsate with your heartbeat and your doctor might be able to hear it using a stethoscope. But these cases, which are known as pulsatile tinnitus, are rare.

Common causes of tinnitus include:

  • Age-related hearing loss
  • Noise-induced hearing loss
  • Injury or trauma to ears
  • Earwax impaction
  • Ear infections
  • Certain medications

Less-common causes include:

  • Ménière’s disease
  • Temporomandibular disorders like TMJ
  • Chronic blood vessel issues like high blood pressure

When should you see a doctor for tinnitus?

If your tinnitus doesn’t bother you, it’s probably OK not to see your doctor. If the ringing in your ear is annoying or disrupting your life, talk to your primary care physician. They can determine if you have an underlying medical cause or if you need to see an otolaryngologist for more tests.

Call your doctor right away if your symptoms of tinnitus show up after an upper respiratory infection, or you feel dizzy, anxious, depressed or have hearing loss.

Tinnitus treatments 

Treating tinnitus depends on whether it’s caused by another health problem that can be managed. If so, your doctor may recommend some of the following ways to treat common underlying causes of tinnitus.

  • Change medications. Some everyday medications can cause tinnitus, including analgesics like aspirin, NSAIDs, diuretics, cancer drugs and certain antibiotics. The Center for Hearing Loss Help has a list of medications that may be connected to tinnitus. Talk to your doctor about all medicines you’re taking, including over-the-counter medicines. They may want to consider alternatives.
  • Get earwax removed. If impacted earwax is the cause of your tinnitus, your doctor can remove it safely and that may solve the problem.
  • Try a hearing aid. Tinnitus and hearing loss are associated, particularly in older adults. “I don’t prescribe hearing aids for tinnitus, but I prescribe hearing aids for hearing loss,” Backous says. “Oftentimes that reduces their tinnitus because they are hearing what they want to hear.”

Noise suppression therapies 

If your tinnitus can’t be helped with a hearing aid, earwax removal or change in your medication, you need to focus on managing your symptoms. One way to do that is by using techniques to silence or quiet the noise.

  • Sound therapy. Sometimes called acoustic therapy, sound therapy simply adds background noise to help your brain disengage and quiet your tinnitus, especially at night. “It can be any sound you find pleasant and calming,” Onozuka says. You can use a white noise machine, fan, music or air conditioner. Even smartphone apps can be used to make soothing sounds.
  • Mask the sound. ​Masking devices are like hearing aids but they provide a continuous white noise sound that can help alleviate the noise from your tinnitus. Some hearing aids also offer masking options.
  • Levo. Levo is an FDA-cleared sound therapy that uses your own sensitivity to tinnitus and hearing loss to generate a custom set of tones you listen to while you sleep. The sounds and frequencies help train your brain to ignore the symptoms of your tinnitus.

Mind-body techniques

If your tinnitus is causing extreme anxiety, there are other options for reducing its severity. Research has shown that therapy, like cognitive behavioral therapy (CBT) and retraining therapy, is one of the most successful ways to manage your symptoms.

  • Cognitive behavioral therapy. One of the most common treatments for tinnitus, CBT helps you reduce your emotional response to tinnitus. You work with a therapist to focus on positive changes to lessen the impact of tinnitus. A 2022 review of studies on tinnitus treatments published in the journal Clinical Psychology & Psychotherapy  found that “CBT is nonetheless widely regarded as a gold standard for the treatment of subjective tinnitus.” 
  • Tinnitus retraining therapy. This form of therapy combines counseling and sound therapy to “retrain” your brain. The goal is so you won’t hear your tinnitus symptoms. TRT can take months to be effective, but studies have shown it can work, if you stick to it.
  • Bimodal stimulationBimodal auditory-somatosensory stimulation combines acoustic therapy with electric stimulation, usually on the tongue, neck or vagus nerve. The therapy helps stimulate your brain so it changes your tinnitus symptoms.
  • Lenire. The FDA approved Lenire, the first bimodal stimulation treatment, in 2023 and it became available to patients in April 2024. It’s a prescription therapy you in 30-minute sessions at home that sends mild electrical shocks to your tongue while you listen to music or sounds through headphones. The journal Communications Medicine published the first study on its real-world clinical effectiveness. Researchers determined that Lenire was safe and effective at reducing tinnitus in the 220 patients who participated.

Medications

There currently are no FDA-approved drugs for tinnitus. But your doctor has several options to help you with stress, anxiety and even depression caused by tinnitus. These medications won’t cure your tinnitus, but may help you deal with some of the symptoms it causes.

Common antidepressants prescribed for tinnitus:

  • Clomipramine (Anafranil)
  • Desipramine (Norpramin)
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Protriptyline (Vivactil)

Common antianxiety prescribed for tinnitus:

  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Diazepam (Valium)
  • Lorazepam (Ativan)

New tinnitus treatments and research 

Because so much evidence suggests tinnitus is caused by changes in the brain, much of the research is focused on ways to reprogram the brain.

  • Repetitive transcranial magnetic stimulation (rTMS). This is a painless procedure that uses an electromagnetic coil to send short magnetic pulses to your brain. Numerous published studies show that rTMS can be effective at treating chronic tinnitus, but others found it to be no more successful than placebo. More large-scale trials are needed to determine if rTMS will be a possible treatment for tinnitus.
  • Deep brain stimulation. This invasive treatment involves surgery to implant electrodes deep in your brain to regulate activity, similar to DBS for Parkinson’s. It’s begun showing promise as a treatment for severe refractory tinnitus, though most studies have been small. A systematic review published in the journal Brain Sciences found DBS to be safe and effective, but the authors cautioned about the small size of the study and the need for more research.  
  • New biomarkers for diagnosing tinnitus. Researchers at Mass General Brigham found that the pupils of people with severe tinnitus were almost always dilated extra wide when they heard any sounds. They hope to expand on this and develop new therapies to quiet or eliminate the sounds of the tinnitus.
  • Genetic risk factors. A large genome wide association meta-analysis published in the journal Nature Communications found several genetic links between tinnitus and hearing loss. The study determined tinnitus was genetically linked to several psychiatric disorders, as well, which could help open new opportunities for treatments.

How Your Diet Might Affect Tinnitus

Few studies have proven a direct link between specific foods or drinks to tinnitus, though emerging research suggests your diet may play a role. One such study was published in the journal Nutrients and included 185 incident idiopathic tinnitus cases and 198 controls. Participants answered questionnaires about their diets, including about what they ate before their symptoms appeared. The results showed that those who ate the most varied diet (at least 20 foods) had a decreased risk of tinnitus compared to those whose diets include less than 16 different items. The study also confirmed that eating certain protein-rich foods like poultry and legumes, can decrease the onset of tinnitus.

Editor’s note: This story, originally published January 9, 2023, has been updated to reflect new information.

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