what causes tinnitus

What really causes tinnitus?

Tinnitus symptoms are usually fairly simple — a ringing, buzzing, whistling, or humming heard constantly, especially at times of great stress, and most noticeable when the immediate environment is very quiet.  It’s a frustrating health condition to deal with and can dramatically impact quality of life — especially because it’s entirely internal and invisible to others in everyday life.

Despite having such a relatively simple symptom, tinnitus can be caused by a myriad of factors, some unavoidable as we age, and some related to excessive noise and trauma.  Because it is so hard to diagnose (even the most reliable tests are self-administered) it was hard for medical professionals to determine what caused it for many decades.

We’ve been researching Tinnitus for months now, and it’s constantly shocking just how many ways the ear can be damaged in such a way that there’s little hearing loss but persistent injury that often never gets better.  In this page we take a quick look at the different ways tinnitus can be caused.

Age-Related Hearing Loss

With the medical name Presbycusis, hearing loss due to aging often starts around the age of sixty. It presents as a slow and gradual loss of hearing as the sensitivity of the inner ear deteriorates to where it no longer conducts and interprets sound waves at normal volumes.

With all of our research, exactly why this would lead to tinnitus isn’t very clear. It seems to be because the overactive nerves in the inner ear don’t have as much to do since sound isn’t being transferred.  This causes the hairs and nerves in the ear to try to interpret the silence, and thus generate a ringing in the ears that isn’t really there.

Exposure to Loud Noise

Permanent damage, hearing loss and tinnitus can all be caused by exposure to loud noise, such as at music gigs, around gunfire, or explosions.

The ringing you might experience in the ears after hearing a loud noise (or series of them) is a common side effect of minor trauma to hair cells in the inner and middle ear canal.  The damage changes the signals these sensitive hairs send to the brain and this can temporarily cause a ringing. More severe auditory trauma (for example that caused by frequenting live rock shows or working with loud machinery) is highly correlated with tinnitus. This can result in both tinnitus and hearing loss.

The two most common past times to cause hearing damage and put one at a higher risk for tinnitus are:

  • Rock concerts which can get as loud as 135 decibels – levels the World Health Organisation states is around that which pain starts to occur immediately and hearing damage is inevitable (to some degree – source).
  • Firearm noise is also an issue, but less sustained than other sources of noise such as gigs or jet takeoffs.  Guns produce very loud and sharp sounds that average over 140 decibels for small arms, including even .22-caliber rifles.  Larger bore rifles and handguns can produce sounds of beyond 160 decibels, guaranteeing hearing damage unless protection of some kind is used (we’ll be reviewing hearing protection here).

Stress and Anxiety

Temporary hearing loss due to extreme stress and anxiety can cause people to experience tinnitus for short periods.  These instances of ringing, whistling, or buzzing in the ears will usually go away

Tinnitus is also aggravated by high blood pressure, a serious health side effect from high levels of stress.  Stress induced persistent ear noise can present as sounding similar to a heartbeat (called pulsatile tinnitus). This is caused by increased pressure from the blood flow in the tissues surrounding the inner ear.

Such conditions that cause tinnitus are fortunately some of the easiest to remedy, since they can be tackled by both pharmaceutical and lifestyle interventions.  Relaxation techniques, meditation, and reduced emotional demands can all positively improve stress and anxiety related conditions. Thus, these can reduce blood-pressure causing better blood flow around the ears.

For more information on reducing stress and anxiety we recommend seeking help from your physician or psychologist.

Ear Infections

Viral and bacterial ear infections can increase the likelihood of ringing in the ears by interfering with the signal transmissions from the ear’s hairs and nerve endings.

Ear infections are usually easy to identify, with the symptoms including:

  • Pain and swelling in the ear
  • Some hearing loss is common
  • The ear being tender to touch
  • Discharge from the middle ear (not blood)
  • Often accompanied by a high temperature of fever.

Infections of the ear are usually caused by the ducts that connect the ears to the throat becoming blocked, most often through inflammation. For example, like that experienced when we have a cold or flu.  The blockage of these Eustachian tubes can lead to a buildup of fluid or debris in those areas, creating the ideal environment for bacteria or virus to habit themselves and populate.

Depending on the cause, a doctor will likely prescribe antibiotics. However, other interventions may be necessary if the cause isn’t bacterial.

Ear Wax Build Up

Often caused by other conditions, the buildup of earwax can often create an echo-chamber effect, dulling outside noise and amplifying the sounds of blood flow of the inner ear, for example.

While we recommend not using cotton buds (or Q-Tips) to clean the inner ear, booking an appointment with a general physician or ENT doctor, will ensure if earwax is the cause it’s quickly identified and removed safely.

Since earwax is natural and the ear is self-cleaning, it’s not recommended to actively try to remove earwax. It’s more effective to see a physician if you suspect a problem or have hearing issues.

Ménière’s Disease

A long term condition of the inner ear, Ménière’s Disease affects approximately 0.1% of people and can cause severe bouts of vertigo, nausea, and vomiting.  The attacks are infrequent and unpredictable, sometimes lasting seconds, other times hours.

Ménière’s is a progressive disease with its symptoms’ severity increasing over time.  Tinnitus is caused in this case by damage the disease has on the hair cells in the inner ear.  Generally in Ménière’s, the cells responsible for detecting lower frequencies are damaged first. More frequencies will be affected as the illness progresses.

The treatment of Ménière’s is slow and not always recoverable, but its symptoms can be treated, including tinnitus. Roughly half of all people with Ménière’s suffered annoying tinnitus symptoms according to a survey.

If you suspect Ménière’s Disease may be at the root of your tinnitus — especially if you have a family history of the disease, or vertigo — please consult your physician.

Glue Ear

Most often occuring in children, Glue Ear presents as a buildup of fluid in the middle ear canal.  It’s a health condition that usually clears itself up within several months, the ear is self cleaning and usually has appropriate access to the throat and lymphatic systems.  Most often doctors won’t need to issue treatment, but will advise on how to care and protect the ear while suffering from this problem.

Glue ear seems to cause tinnitus by dramatically reducing the passage of sound waves through the ear canal. This leaves the ear’s hair cells to try to interpret the silence or change in sound ineffeciently.

Perforated Eardrum

Trauma to the eardrum can cause massive damage to both the physical workings of the inner ear as well as the hairs and conducting nerves. These are so important because they relate the electrical impulses back to the brain that represent the sound waves that hit the eardrum.

Such critical damage can often heal itself over time, but can result in a whining or ringing that’s hard to block out.  This form of tinnitus is often temporary while the delicate tissue heals itself, but depending on the severity, it can last longer.

Seeking the advice of an ENT physician would be highly encouraged.  They will be able to accurately evaluate the damage and suggest an appropriate course of treatment. This will promote healing faster and more fully, with a better chance of eliminating the tinnitus.

Quiet Mind is a blog dedicated to turning a critical eye to tinnitus treatments and supplements.  So many don’t work and are overhyped, we’re here to shed some light on some of the scams and successful products that claim to stop the ringing.


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