Tinnitus is the perception of noise, such as ringing or buzzing, when no external sound is present. This internal sound can vary greatly in pitch and intensity. High doses of aspirin, a common pain reliever, have a known, typically temporary, link to the development of tinnitus.
How Aspirin Affects Hearing
Aspirin’s active component, salicylate, influences structures within the inner ear, specifically the cochlea. Salicylate interferes with outer hair cells (OHCs), which amplify sound and contribute to hearing quiet sounds. This interference reduces the cochlea’s capacity to detect low to average level sounds, leading to changes in neural pathways within the brain.
Salicylate also impacts neurotransmitter activity in the auditory system. It can activate N-methyl-D-aspartate (NMDA) receptors in the cochlea and affect inhibitory neurotransmitters like gamma-aminobutyric acid (GABA) and serotonin in the central auditory system. Aspirin can reduce blood flow to the cochlea by inhibiting the production of prostaglandins, which regulate blood flow and fluid balance in the inner ear. These combined effects on hair cell function, neurotransmission, and blood flow contribute to tinnitus, with the effects being dose-dependent.
Factors Influencing Aspirin-Induced Tinnitus
Aspirin-induced tinnitus is often tied to the amount of medication consumed. It is most commonly associated with high doses, frequently exceeding 2,400 milligrams (2.4 grams) per day, such as those used for anti-inflammatory or rheumatic conditions. Regular strength aspirin pills contain about 325 milligrams, meaning several pills would be needed to reach such levels.
Low-dose aspirin, typically less than 100 milligrams daily, is used for cardiovascular health. This dosage has generally not been linked to an increased risk of tinnitus.
Prolonged use of high doses can also contribute to tinnitus. Individual factors can increase susceptibility, including pre-existing hearing loss, making individuals with such conditions more cautious when using aspirin. While age is a general risk factor for tinnitus, some research suggests that frequent moderate-dose aspirin use may be associated with a higher risk of persistent tinnitus in younger women (under 60). Aspirin is considered an ototoxic medication, and its effects can be compounded by concurrent use of other drugs known to be harmful to the ear, such as certain antibiotics or antimalarial medications.
Addressing Aspirin-Related Tinnitus
Aspirin-induced tinnitus is generally reversible once the medication is discontinued or the dosage is reduced. The symptoms typically resolve within 24 to 72 hours after stopping or lowering aspirin intake. It is important to consult a healthcare professional before making any changes to medication, especially if aspirin has been prescribed for a specific medical condition. A doctor can evaluate the situation and recommend appropriate adjustments or alternative treatments.
If tinnitus persists, some measures can provide symptomatic relief. Sound therapy, which involves introducing external sounds such as white noise, can help mask the internal ringing. Avoiding complete silence can also be beneficial, as it prevents the brain from focusing solely on the internal sounds. These strategies aim to manage tinnitus during the recovery period.