An estimated 50 million Americans have experienced tinnitus, ringing in the ears that can stop and start or continue non-stop. In addition to ringing in the ears, tinnitus can include sounds that resemble a roar, squeal, whine, buzz, click, hiss, or hum and can affect one ear or both. In two million cases, tinnitus or ear ringing is severe enough to interfere with daily activities; the disorder is so distracting that people can’t hear, work or even sleep.
Tinnitus isn’t a disease but rather a symptom. Most cases are due to damage to the microscopic endings of the hearing nerve in the inner ear, commonly from exposure to loud noise. Other causes include allergy, high or low blood pressure, a tumor, diabetes, thyroid problems, and a head or neck injury. Some drugs including anti-inflammatories, antibiotics, sedatives, antidepressants and aspirin can cause tinnitus. If this is the case, changing drugs or lowering the dosage usually helps stop the problem of ringing in the ears.
As far as treatment is concerned, I’ve seen little evidence suggesting that NAC (N-acetyl-L-cysteine) is effective for tinnitus. Though the research is weak, there are multiple anecdotal cases of successful therapy with standardized Ginkgo biloba. I recommend trying ginkgo, two tablets of standardized extract three times a day (not to exceed a total dose of 240mg a day) with meals to treat ringing in the ears. Ginkgo may help by increasing blood circulation in the head and neck. Give it at least a two-month trial. You might also explore craniosacral therapy, a gently manipulative technique for the bones in the head that’s performed by osteopathic physicians. This approach seems to take the pressure off the auditory nerves. If high blood pressure seems responsible for your tinnitus, try to get the problem under control through diet, exercise, and weight loss.
In addition, you can try these five self-help steps suggested by the American Academy of Otolaryngology-Head and Neck Surgery:
- Avoid exposure to loud sounds and noises
- Get your blood pressure checked. If it is high, get your doctor’s help to control it
- Exercise daily to improve your circulation
- Get adequate rest and avoid fatigue
- Use physical (sound machine) and mental techniques to push the perception of tinnitus to the background; the more you think about the tinnitus, the louder it will seem. If you cannot do this on your own, seek help as outlined above.
To all of that, I would add that you try not to worry about your tinnitus or ringing in the ears. You might want to investigate tinnitus retraining therapy with otolaryngologists (ear, nose and throat specialists) or audiologists who can help you learn to cope better with the disorder. And because stress can worsen tinnitus, practice breathing exercises or other relaxation techniques.
Andrew Weil, M.D.