Mastering Tinnitus Management: Avoiding Triggers

Tinnitus, even when being properly treated, can be triggered, or exacerbated by a variety of factors. Let’s take this chapter to review some of the more common triggers that you can (hopefully) avoid to reduce your experience of tinnitus even further. These triggers are broken into three categories: chemical, physical, and mental!

To learn more about tinnitus triggers and how to manage them, please visit www.excellenceinaudiology.org.

Chemical Triggers

Medications: Many medications can aggravate tinnitus; however, please do not stop taking any medications before speaking with your doctor and pharmacist (phew - now we can’t get sued!). Your doctor may explore different medication alternatives that could potentially not aggravate your tinnitus.

Alcohol: Drinking alcohol can impact your blood pressure – which, in turn, can worsen your tinnitus. In addition, over time, alcohol can impair your cognitive performance and potentially increase your risk of cognitive decline. 

Tobacco Products: No matter how long we spend scouring the internet and scientific journals, we’ve yet to come up with anything good that smoking does for you. But you already know that. But did you know that the nicotine found in cigarettes, vaping and chewing tobacco can increase tinnitus symptoms? Nicotine can elevate blood pressure and narrow blood vessels, thus decreasing the amount of oxygen traveling to the ears and brain — both increasing the experience of tinnitus! If you have tinnitus and are a nicotine user, you just found another great reason to quit! Oh, and let us not forget that smoking increases your risk of developing dementia significantly.

Caffeine: Please know, as coffee lovers, it pains us to write about this. Sadly, caffeine (often found in coffee, tea, soda, energy drinks and supplements) can raise blood pressure and trigger tinnitus. We’ve met many patients over the years who don’t realize the strong connection between caffeine and tinnitus and notice near-instant relief from tinnitus once they cut back on the Joe!

Refined Sugars: Over the years, we’ve had many patients tell us they notice a spike in their tinnitus after eating sugary foods. And there is science to back this up. One research report found that nearly 90% of people with tinnitus had too much insulin in their blood (aka hyperinsulinemia). Insulin’s job is to open cells and allow sugar to enter. When blood sugar levels rise, insulin is released to move sugar from the bloodstream into cells to avoid the sugar damaging tissue in veins, arteries, and nerves. Untreated high blood sugar levels can also damage the nerve that controls how the brain interprets sound and may cause tinnitus. Avoid overindulging in sweets to keep your blood sugar in check and your tinnitus symptoms under control. 

Salt: While sodium is one of the body's most important chemical substances, like everything in life, too much can be a bad thing! If you have tinnitus, you must monitor your salt intake. Salt can increase blood pressure, which may then drive up the ringing. If you believe this is one of your triggers, be sure to read nutrition labels for salt content.

Physical Triggers

Loud Noises: Loud noises are not only a root cause of tinnitus but can also be a serious trigger and cause tinnitus to flare up.  Loud noise, even at levels not considered ‘damaging’, can cause tinnitus to intensify for hours, perhaps even days. People with pre-existing tinnitus must wear hearing protection in all situations where loud noises may be present. For example, using hearing protection when at concerts, using tools, mowing the lawn, going to weddings, sporting events, loud restaurants, etc.  When using headphones or earbuds to enjoy music, always make sure to never go over 70% on the volume dial.

Earwax: Although earwax is suitable for your ears by providing lubrication and protection from dirt and bugs, too much wax can be a bad thing. If earwax accumulates and becomes impacted (a solid wall of wax), it can reduce your ability to hear and ramp up your tinnitus. If you think you have too much earwax, ask your hearing healthcare provider to remove it and ask for tips on how to stop it from becoming an issue. Oh, and never use a Q-tip inside your ear canal – all you are doing is pushing the wax further down the ear canal and causing it to build up and eventually become a problem.

Congestion: Allergies, colds, ear infections and sinus infections can cause congestion, which can worsen tinnitus. If congestion triggers your tinnitus, be sure to ask your doctor about options for reducing the congestion.

Blood Pressure: Tinnitus can be triggered by either low or high blood pressure. Remember – what’s good for your heart is good for your ears and your brain! If you notice your tinnitus comes and goes with spikes or decreases in your blood pressure, talk to your heart doctor about how to best manage this.

Stress Triggers

Sleep Problems: Tinnitus and sleep have a very unhealthy relationship. Many patients complain that they can’t sleep because of their tinnitus, and a lack of sleep only causes the tinnitus to be much worse. To help avoid this vicious cycle, you may try homeopathic remedies for sleep, including relaxation exercises and natural supplements (Melatonin). For many patients, introducing an external noise, i.e., a sound machine, leaving the TV on at night, etc., can help drown out the tinnitus and help you fall asleep.

Nervous Tension: Mental and emotional strain can make most things in life worse, including tinnitus. Although this is easier said than done - avoiding stress and developing stress-relieving habits can decrease the effect that stress has on your tinnitus. For many people, regular exercise, relaxing hobbies, counseling, deep breathing, meditation, and massage can reduce stress and help drive down the experience of tinnitus. 

Anxiety and Depression: There is a long history of published research that indicates people with a history of anxiety and depression suffer more with their tinnitus (compared to people with no history of mental illness). Many coping mechanisms exist and are outside the scope of this book. Talk to your doctor and hearing healthcare provider to find a mental health specialist in your area who specializes in helping patients manage anxiety, depression, and tinnitus. Keep in mind that some medicines prescribed to treat anxiety and depression may worsen the tinnitus.

Unlock a world of better hearing and improved quality of life – visit our comprehensive hearing health website today www.excellenceinaudiology.org to discover expert advice, cutting-edge solutions, and personalized care that will transform your auditory experience.

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