Tinnitus is the perception of sound within the ear or head when no external sound is present. This phenomenon is a symptom of an underlying issue, rather than a disease itself. While often a consistent experience for those who have it, fluctuations in tinnitus severity are common and can stem from various identifiable triggers.
Common External Factors
Exposure to loud noise is a frequent cause for a sudden increase in tinnitus intensity. Both acute incidents, such as attending a concert or being near a gunshot, and chronic exposure from noisy work environments can damage the delicate hair cells in the inner ear.
Stress and anxiety also play a significant role in amplifying tinnitus perception. Heightened stress levels can increase the body’s awareness of internal sounds, making tinnitus more noticeable. This physiological link involves stress hormones and can lead to muscle tension, particularly in the jaw and neck.
Insufficient or poor-quality sleep can exacerbate tinnitus by reducing the brain’s ability to filter out or habituate to the sound. Lack of adequate rest often increases overall stress and fatigue.
Certain dietary factors may also influence tinnitus severity for some individuals. While the links are often anecdotal and vary by person, high intake of caffeine, excessive salt, and refined sugar have been reported to trigger spikes in tinnitus. Alcohol and saturated fats can also contribute by affecting blood pressure and circulation to the ears.
Medication and Substance-Related Causes
Many pharmaceutical and recreational substances can influence tinnitus perception. A broad category of drugs known as ototoxic medications are recognized for their potential to cause or worsen tinnitus. These include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, certain antibiotics like aminoglycosides, loop diuretics, and some chemotherapy agents.
The effect of ototoxic medications can sometimes be dose-dependent. In some cases, the tinnitus may subside or reverse once the medication is discontinued, but this is not always guaranteed. It is important to discuss any concerns about medication side effects with a healthcare provider.
Changes in a medication regimen can also trigger a worsening of tinnitus. Starting a new drug, adjusting the dosage of an existing one, or even discontinuing a medication can sometimes lead to temporary increases in tinnitus as the body adapts. This can occur even with drugs not typically considered ototoxic.
Stimulants and depressants can impact tinnitus perception. Nicotine, for instance, can constrict blood vessels, potentially affecting blood flow to the inner ear. Excessive caffeine intake may overstimulate the nervous system, while alcohol, although it might temporarily suppress tinnitus, can worsen it during withdrawal or by disrupting sleep patterns.
Underlying Health Conditions
Various medical conditions can lead to or worsen existing tinnitus. An accumulation of earwax, for example, can block the ear canal, altering how sound reaches the eardrum. Removing this blockage often resolves the issue.
Ear infections, whether in the middle or outer ear, can cause inflammation and pressure. This internal swelling and fluid buildup can contribute to tinnitus severity. Treating the infection typically leads to an improvement in tinnitus symptoms.
Dysfunction of the temporomandibular joint (TMJ), which connects the jawbone to the skull, can also impact tinnitus. Problems with this joint and the surrounding muscles can refer pain or sound perception to the ear due to their close anatomical proximity and shared nerve pathways.
Cardiovascular issues, such as high blood pressure or atherosclerosis, can affect blood flow to the ear. Conditions that cause turbulent blood flow may lead to pulsatile tinnitus, a rhythmic sound often synchronized with one’s heartbeat.
Meniere’s disease, a specific inner ear disorder, is characterized by fluctuating hearing loss, episodes of vertigo, a feeling of fullness in the ear, and often worsening tinnitus. This condition involves a buildup of fluid in the inner ear that disrupts balance and hearing signals.
Less common but notable neurological conditions, such as an acoustic neuroma, a benign tumor on the auditory nerve, can also manifest as tinnitus. This type of tumor affects the nerve responsible for hearing and balance, and its growth can lead to symptoms including unilateral tinnitus and hearing loss.
Thyroid dysfunction, encompassing both an underactive (hypothyroidism) and overactive (hyperthyroidism) thyroid, has been linked to changes in tinnitus. Thyroid hormones play a role in maintaining the health of nerves and the inner ear, and imbalances can contribute to auditory symptoms.