What Makes Tinnitus Worse? Avoid These 8 Things.

I can empathize with everyone who suffers from tinnitus — I suffer from it too. It's in both of my ears and has an ever-present high-pitched tone of about 12 kilohertz that I've had for as long as I can remember. 

There are occasions when it varies or even spikes. I can sometimes attribute these tinnitus spikes to certain factors, such as being tired, stressed, or unwell. However, there are times when it seems to take control for no apparent cause. That is why I wanted to write this piece: to help others in similar situations.

There is no remedy for tinnitus at the moment. However, this article should assist you in identifying factors that are either causing or exacerbating your tinnitus.

HearingTracker Audiologist Matthew Allsop provides information about tinnitus and recommendations for dealing with its symptoms. Closed captions are available on this video. If you are using a mobile phone, please enable captions clicking on the gear icon.

How to tell if you're having a tinnitus spike

A tinnitus spike might mean different things to different people, but it usually manifests as a shift in the volume or tone of your tinnitus sound.

Tinnitus spikes might frequently seem to be entirely random. However, external and internal variables often worsen your tinnitus, with some being easier to manage or control than others.

Common Tinnitus Triggers

Although there is a lot of discussion about using technology and various strategies to cope with tinnitus—ranging from hearing aids and sound generators to counseling—most people are unaware that technology isn't the only option. Here I look at some common triggers for spikes in tinnitus and then offer ways to lower the risk of that happening to you.

#1) Excessive Noise

We've all walked out of a noisy place, whether a club, a concert, or a wedding, with ringing ears that may persist for a few days, if not weeks. Because ears are very resilient, they may recover from the harm caused by this exposure to loud noises.

That healing process, however, will not last forever. We live in a very noisy world, and it is almost difficult to escape noise daily, whether strolling down the street, entering a bar or club, or viewing fireworks. Some of these noisy situations are more easily avoided than others. And, in my view, the key is to protect your ears as much as possible.

This does not mean that you should wear hearing protection all the time, since this might have the opposite effect of making you more sensitive to loud noises (a condition known as 'Hyperacusis'). However, if you know you're heading somewhere where you'll be exposed to loud noises, I strongly advise you to wear hearing protection.

Hearing protection comes in a variety of styles. They may vary from simple foam ear plugs you squeeze up and insert into your ears to earplugs with built-in attenuation filters.

My personal favorites are the custom-made earplugs with filters built in. While this type of hearing protection minimizes exposure to potentially hazardous noises, it still allows you to converse with others around you. For example, if you're at a concert, you can still hear the music without the distortion you'd hear with standard foam earplugs.

#2) Anxiety, Stress, and Depression

Anxiety, despair, and stress are typical causes of your tinnitus worsening. Patients in the clinic often tell me that their tinnitus is causing them stress. However, they rarely think that, in truth, it's stress that is causing their tinnitus.

According to numerous research studies, it would appear that roughly 50% of tinnitus is physiological and caused by some form of underlying bodily damage, while the other 50% is psychological, often arising from stress and anxiety. More often than not, there is nothing that can be done to repair the physiological damage since it is permanent, whatever the physical origin of the tinnitus. That suggests we should be doing more to help conquer our tinnitus from a psychological standpoint instead.

I realize how difficult it is to prevent stress since it is linked to more profound mental and emotional struggles. Rather than telling you to avoid stress altogether, here are some tips on where to start:

• Determine the sources of stress. It's tough to address challenges unless you identify whether your stress comes from your job, personal life, or relationships.
• Consider stress-relieving activities. You can take positive steps to counterbalance your stress by increasing your physical activity, whether by jogging, going to the gym, or practicing yoga.
• Take a look at Cognitive Behavioral Therapy (CBT) and Mindfulness. These therapies may help you change your brain's reaction to tinnitus and reverse unfavorable emotional sensations about it. According to research, although tinnitus maskers may give temporary relief from your tinnitus, the most effective type of tinnitus therapy is to engage in CBT and mindfulness.

When stress and tinnitus work in tandem, it's a huge challenge. Tinnitus often overwhelms my patients, raising their stress levels. This, of course, leads to an increase in tinnitus, and the cycle continues.

Hopefully, the above techniques will help you break that cycle.

#3) Excessive Ear Wax

Earwax accumulation is another prevalent cause of tinnitus but is luckily the easiest to address. All you need to do is visit an audiologist to remove the wax, which can be done by micro suction, irrigation, or other methods.

When the wax is removed, you should notice an instant improvement in your tinnitus.

#4) Certain Medications

There are several drugs available that may aggravate your tinnitus. These could be prescription or non-prescription medications. As a result, it's always a good idea to read the fine print on any drug you're taking.

And, if you're worried that your prescription is causing tinnitus, you should talk to the doctor who prescribed your current meds before changing them yourself.

#5) Smoking

Smoking not only worsens your tinnitus, but it also leads to the development of hearing loss. According to research, smokers have a 70% higher probability of developing hearing loss than non-smokers. And the more you smoke, the more likely you will acquire hearing loss.

There are two leading causes for this:

• Tobacco use might result in an irritated Eustachian tube. Your Eustachian tube links the back of your throat to your middle ear and generally equalizes pressure fluctuations outside your body, such as while flying or swimming. After smoking, this may become inflamed and ineffective, resulting in a blockage of the Eustachian tube and perhaps hearing loss or tinnitus.
• Cigarette smoking elevates blood pressure. The structures in your ear rely on a steady flow of blood. Your ear and hearing will be affected if your auditory system is not adequately supplied. Worryingly, this danger applies to more than just the smoker. Even if you are a non-smoker who lives with someone who smokes, you are more likely to get tinnitus and hearing loss.

#6) Sleep Deprivation and Insomnia

Sleep loss or sleeplessness can also trigger tinnitus. Because laying in bed is arguably the quietest period of your day, you may become more conscious of your tinnitus than at any other time.

Suppose your mind begins to spiral downhill, as mine has. This might cause your mind to go into overdrive, causing you to become more nervous and concerned that you won't be able to sleep. In that case, your tinnitus feeds your anxiety, and your worry stimulates your tinnitus, ending in a downward spiral with sleep becoming almost impossible. And, once again, the dread builds until you go to bed, at which point it repeats itself. You'll be exhausted the following day.

Therefore, some general tips to improve restful sleep are in order:

• Avoid coffee throughout the day since it might change your sleep habits.
• Even though you are tired, try to exercise to expend what little energy you have left.
• Make the last hour of awake time screen-free. Instead of staring at your phone or watching television, read a book.
• As a last resort, consult your doctor. If sleep aids are the only way to help you sleep, it might be worth it, if only to break the pattern.

#7) High Blood Pressure

Increasingly, researchers are finding that high blood pressure and hearing loss are connected. The link relates to how blood circulates throughout your body, including your ears. Tinnitus is also a frequent complaint among patients with high blood pressure, with up to 44% of people with tinnitus having high blood pressure.

The vessels in your auditory system are involved in the relationship between the two disorders. Tinnitus may occur when pressure builds up in the system and may be connected to your blood pressure if you hear a thumping or pumping sound.

Talk to your doctor about measures to lower your blood pressure.

#8) What about my diet? Could that spike my tinnitus?

There is currently little evidence to suggest that particular foods may exacerbate your tinnitus symptoms. As a result, it's pretty hard to identify specific foods you should avoid if you have tinnitus. You should question any sources that advise you what to avoid since many assertions aren't supported by research. And what works well for one individual may not work at all for the next.

If you feel that specific foods are aggravating your tinnitus, I suggest maintaining a journal to see if any trends develop over time. Then examine what happens if you remove certain foods or beverages from your diet.

On the flip side, there is no doubt that a balanced diet has numerous benefits on the body, which may reduce the impact of your tinnitus.

A well-balanced diet can:

• lower blood pressure or weight
• boost blood flow to your auditory system
• improve energy levels
• enhance your emotional well-being

How to Spot Tinnitus Spikes

I've discovered that keeping a tinnitus diary is an ideal way to determine what's causing your tinnitus to worsen.

I advise all of my tinnitus patients to keep track of the days when their tinnitus is bad and to think about the common triggers mentioned above, going over each item one by one and noting whether anything internal or external has changed the days preceding that spike.

By following this approach will you be able to uncover common patterns and causes and better manage those issues.

When Should You Consult a Doctor About Tinnitus?

The following situations need emergency medical attention:

1. Tinnitus that follows your heartbeat (known as pulsatile tinnitus).
2. Tinnitus that only occurs in one ear.
3. If the nature of your tinnitus has altered in a short period.
4. If your tinnitus prevents you from sleeping or contributes to your anxiety or depression.

If you fall into any of these categories, you should see your doctor, who will send you for additional testing.

On that point, if you have a sudden sensorineural hearing loss, with or without tinnitus, you should go to the emergency room or an urgent care ENT clinic as soon as possible to get treatment.

Although there is no known treatment for tinnitus, I hope I have shown that some tried-and-proven ways can assist in reducing the everyday effect that your tinnitus will have on you. It will take patience and time, but it will be worth it in the end.