Ringing In The Ears

What Causes Tinnitus?

In order to deal properly with tinnitus we need to understand and — if possible — remove the underlying causes and risk factors.  We need to ask: "What else is going on inside the body that might allow tinnitus to develop?"

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Accurate diagnosis of the factors behind tinnitus consists of three steps:

Step 1: List the Possible Causative Factors

Identify all disease conditions, lifestyle choices and environmental risk factors that can lead to tinnitus.  Here are eight of many possibilities (more below):
  • Meniere's Disease
  • Multiple Chemical Sensitivity
  • Megaloblastic Anemia
  • Chronic Fatigue-Fibromyalgia
  • Hypoglycemia
  • Stress
  • Electrical Hypersensitivity
  • Mercury Toxicity

Step 2: Build a Symptom Checklist

Identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
abnormal taste in mouth
high systolic blood pressure
severe sexual abuse during childhood
dark spots on gums
having foamy urine
poorly-removed amalgams
regular bizarre dreams
severe afternoon/evening fatigue
paying poor attention to detail
fatigue slightly reduced by eating
normal work hours
being easily irritated
... and more than 150 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of tinnitus:
Cause Probability Status
Chronic Fatigue-Fibromyalgia 98% Confirm
Mercury Toxicity 26% Unlikely
Meniere's Disease 18% Unlikely
Hypoglycemia 1% Ruled out
Electrical Hypersensitivity 1% Ruled out
Multiple Chemical Sensitivity 1% Ruled out
Stress 1% Ruled out
Megaloblastic Anemia 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate ear/hearing problems, The Analyst™ will ask further questions including this one:
Do you have Tinnitus (ringing in your ears)? If it sounds like blood rushing then answer the previous question instead of this one.
Possible responses:
→ Never had it / don't know
→ Probably had it / minor episode(s) now resolved
→ Major episode(s) now resolved
→ Current minor problem
→ Current major problem
Based on your response to this question, which may indicate history of tinnitus, tinnitus or severe tinnitus, The Analyst™ will consider possibilities such as:
Megaloblastic Anemia / Pernicious Anemia

In one report, 47% of people with tinnitus and related disorders were found to have vitamin B12 deficiencies.  Supplementation may therefore be of benefit.  [Vitamin B12 deficiency in patients with chronic-tinnitus and noise-induced hearing loss.  Am J Otolaryngol 1993;14: pp.94-9]

Stress

Many people say their tinnitus is worse when they are tired or stressed.

TMJ Problems

A study of twenty patients with tinnitus found that ten tested positive for TMJ dysfunction in all diagnostic tests used, and nine more tested positive to one or more of the diagnostic procedures.  Only one patient of the twenty had no positive evidence of any jaw joint dysfunction.  Dr. Morgan's findings were published in The Journal of Craniomandibular Practice.  ["Tinnitus of TMJ Origin: A Preliminary Report," Vol.10, No.2]

Another research project was headed by Richard L.  Goode, MD, professor of ENT and Head and Neck surgery at Stanford University's School of Medicine.  Drs Morgan and Goode were able to establish the mechanical connection between the ossicles in the middle ear and the capsule and disk of the TMJ.  ["The TMJ-Ear Connection", Journal of Craniomandibular Practice, Vol. 13, No.1).]

You may get an idea if the tinnitus is connected to your TMJ in some way, by:

  • Clenching your teeth – does it change the tinnitus in some way? (Get louder/softer, pitch change)
  • Pushing in hard on the jaw with your palm.  Does the tinnitus change?
  • Pushing in hard on the forehead with your hand.  Resist with the head.  Any changes?

As many as 50% of people using these techniques find a change in their tinnitus and a TMJ correlation they had not known about.

Zinc Requirement

High concentrations of zinc are found in the inner ear.  A Japanese study tested the theory that insufficient levels of zinc may therefore contribute to tinnitus.  Researchers found that tinnitus sufferers with low zinc levels in their blood experienced an improvement in their symptoms when, after two weeks of zinc supplementation, their zinc levels rose significantly.

Another study found that 25% of those with tinnitus and low serum zinc reported improvement after 3 to 6 months of supplementation.  [ Am J Otol 1985;6: pp.116-7]

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