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The ring of truth about tinnitus

Somewhere between 10 and 15% of Canadians are affected by tinnitus. @NightshiftMD (Dr. Brian Goldman) says much of it is preventable.

Tinnitus is a baffling medical condition that causes patients to hear noise or ringing in the ears.

Singer Bob Dylan, former U.S. president Ronald Reagan and Canada's own William Shatner are among the more notable sufferers. Annoying to some, it drives others to despair and even to thoughts of suicide. A new study points to a disturbing trend.

Researchers from the University of California took data from the National Health Interview Survey, a long-term study that has monitored the health of Americans since 1957.  The researchers found close to one in 10 Americans reported having tinnitus within the preceding 12 months. That works out to an incredible 21,400,000 people in the U.S. complaining of tinnitus.

Of those, just over one in three had nearly constant tinnitus, and just over one in four had it for more than 15 years.

There are similar stats here in Canada.  According to the Canadian Hearing Society, somewhere between 10 and 15 per cent of Canadians are affected by tinnitus.

Potential causes

There are a number of potential causes of tinnitus.  One is damage to the cells of the inner ear that send electrical signals to the brain in response to sounds.  When they're damaged, these cells send random electrical signals to the brain that register as phantom sounds.

Tinnitus can associated with age-related hearing loss.  Another cause is thickening of the bones of the middle ear —  a condition that runs in families.

Earwax can sometimes cause it.  I've cured tinnitus by cleaning out wax from a patient's ears.  There are diseases of the middle ear including cancers that can cause it and vertigo or dizziness.

TMJ arthritis can cause it, as can head and neck injuries.  Medications like antibiotics, water pills, and antidepressants can cause it.  Sometimes, tinnitus can be caused by high blood pressure and hardening of the arteries.  And, not surprisingly, tinnitus is caused by frequent exposure to loud music.

Why do doctors think the number of cases is on the rise?

Loud noise

There are several reasons behind the increase, but the main one is exposure to loud noise. In the study I just talked about, those exposed consistently to loud noises at work and during leisure time reported higher rates of tinnitus.

An unrelated study published earlier this month in Scientific Reports found that an incredible 54.7 per cent of adolescents had a prior experience of tinnitus.  Researchers at the University of Sao Paulo's School of Medicine said those affected were more likely to go to rock concerts, and were also more likely to use ear buds on a continuous basis with the sound turned way up.  They were also more likely to own and operate a gun or attend fireworks displays.

Most people who have tinnitus can live with it and still function normally. But one in five sufferers has insomnia and sleep deprivation, trouble concentrating, poor memory, stress, anxiety, and depression.  At worst, tinnitus affects quality of life quite significantly.  People with tinnitus may feel that no one takes their symptoms seriously.  They feel alone in their suffering and alone in hearing noises that no one else hears.  They withdraw from social activities.  

See your doctor for a physical to rule out treatable causes, and to get referrals for hearing testing by an audiologist and an ear, nose and throat surgeon. The pattern of tinnitus may suggest a possible cause.  Rushing, humming or a noise that coincides with the pulse may be due to an abnormal blood vessel.  A clicking noise may be due to muscles contracting in and around the ears.  Vertigo points to a middle-ear problem.  High-pitch tinnitus suggests noise exposure or a head injury.  Sometimes, a CT or MRI of the brain helps pinpoint the problem.  

If no treatable cause is found, white noise machines can sometimes mask the tinnitus.  Hearing aids can help if you have hearing problems. Tinnitus retraining uses music tones that teach the brain to ignore the unwanted sound.  Antidepressants and anti-anxiety pills can help. So can anti-epileptic drugs.  

The Canadian Hearing Society has a support group for people with tinnitus.  People with tinnitus can take some comfort in knowing that while they may be isolated, they are not alone.

About the Author

Dr. Brian Goldman is a veteran ER physician and an award-winning medical reporter. As host of CBC Radio’s White Coat, Black Art, he uses his proven knack for making sense of medical bafflegab to show listeners what really goes on at hospitals and clinics. He is the author of The Night Shift and The Power of Kindness: Why Empathy is Essential in Everyday Life.


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