Tinnitus or Ringing Ears

Tinnitus is defined as a sound perceived by the ear without the presence of related sound waves. The sound may be a crackling, buzzing, ringing or similar sounds. Tinnitus is very common in adults and is usually not serious.

Tinnitus can be divided into two categories - pre-cochlear and sensorineural.
Pre-cochlear Tinnitus originates from either the external or middle ear, or from structures close to the ear. It may be present on one or both sides. A Doctor may be able to hear the sound with a stethoscope. Common causes include a clicking jaw, foreign object in the ear, wax build up, normal popping of ears to equalise pressure, and fluttering of the tympanic membrane (eardrum). Rare causes include tumours of the middle ear or atherosclerosis of the ear arteries.
Sensorineural Tinnitus originates in the inner ear. It is difficult to assess and is therefore not very well understood. It usually causes ringing, humming, or 'white noise' sounds which cannot be heard by an examiner. Constant, bilateral sounds are usually related to degeneration and are very common in aged persons. Unilateral or fluctuating sounds may be related to a specific cause, such as Meniere's disease, industrial deafness (from machinery), loud music or trauma. Risk factors for sensorineural Tinnitus include hypertension and obesity. Psychological or stress-related factors may also contribute to Tinnitus. Alcohol, nicotine, caffeine, aminoglycosides, salicylates and quinine are known to exacerbate sensorineural Tinnitus.

TREATMENT OPTIONS
If the underlying cause is identified and treated, most cases of Tinnitus will eventually resolve. However, when the cause is not known the problem may be ongoing. Proper health management can control the effects of Tinnitus.
• Your Doctor will perform an examination to confirm Tinnitus and address any treatable causes. A simple hearing test can be performed with a tuning fork to determine any hearing loss. If significant hearing loss is present, a referral to an Audiologist will be required.
• Do not insert anything into the ear canal. If wax build-up or a foreign body is present, your Doctor will perform ear syringing.
• Wear earplugs or muffs if working with noisy machinery, or when at a rock concert.
• Check your medications with your Doctor as some (aspirin and quinine) may cause Tinnitus.
• Take steps to reduce risk factors such as obesity, hypertension and diabetes.
• Masking techniques may be effective. Playing a radio or TV softly in the background can often suppress the noises of Tinnitus.
• Reduce alcohol, nicotine and caffeine consumption.

Aspirin should not be given to children under 16 years of age unless specified by a Doctor.

DIET HINTS
1. Low Cholesterol. A diet high in cholesterol can increase the risk of noise-related hearing impairment. Avoid brains, liver, kidney, pate, visible fat on meat, fish roe and egg yolks.
2. Low Fat. A diet high in saturated fats can increase the stickiness of the blood, reducing the flow of oxygen and nutrients to the inner ear. Avoid saturated fats such as butter, margarine, lard, processed meats, biscuits, cakes and fried foods.

VITAMINS/MINERALS/HERBS
Supplements may only be of value if dietary intake is inadequate.
• Vitamin A is necessary for auditory functioning.
• Multi B group vitamins may help to reduce the severity of Tinnitus. Supplementing with a B group multivitamin may also be helpful in cases of Meniere's disease (one cause of Tinnitus).
• Vitamin B12 has been found to be deficient in some people with Tinnitus. Taking this vitamin may help to reduce the symptoms of Tinnitus.
• Magnesium is a very important mineral for the nervous system. Adequate magnesium levels are needed for proper functioning of the hearing pathway. Magnesium exhibits a protective in cases of noise-induced hearing loss and Tinnitus.
• Ginkgo biloba has a long history of use in treating Tinnitus. It is thought to improve circulation of blood to the inner ear.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Your Pharmacist can advise you if your medications might be causing Tinnitus.
2. Avoid coffee, tea, cola drinks and alcohol.
3. Avoid loud noises (rock concerts, machinery, traffic and other industrial noises).
4. Your Pharmacist can supply earplugs if needed.
5. Take steps to reduce risk factors such as obesity, hypertension and diabetes.