We provide here a list of known ototoxic drugs and herbs that have been known to cause or exacerbate tinnitus. This list is for educational purposes only and is available as a resource to you to use in your discussions with your health care professional. We thank doctor Neil Bauman, Ph.D., for his expertise in this area and for compiling this list for us.

Tinnitus varies dramatically from person to person, so it is important that you visit an audiologist to learn more about your specific circumstances. Some of the causes result in permanent tinnitus and require treatment, while others induce temporary tinnitus that disappears on its own. To find out what causes tinnitus in your specific situation, contact Sound Relief Hearing Center today.
Exposure to Loud Noise: Exposure to loud or excessive noise can damage or destroy hair cells (cilia) in the inner ear. Because the hair cells cannot be renewed or replaced, this can lead to permanent hearing loss and/or tinnitus. Continued exposure can worsen these conditions, so people who work in loud environments should always wear ear protection. This includes musicians, air traffic controllers, construction workers, military personnel, and first responders. In addition, consider lowering the volume on your iPod and wearing earplugs at loud concerts.
Sound Options Tinnitus Treatments Inc. addresses the need for an effective tinnitus treatment by offering a clinically validated, individually customized sound therapy. The sound therapy is based on leading neuroscience and tinnitus research that has been built into our software to produce a treatment that can be conveniently delivered via any music playing device. Sound Options is also heavily invested in community engagement. This includes educating and reaching out to seniors, veteran's groups, and police and firefighter associations, as these segments of our population are most affected by tinnitus. Sound Options is relentless about innovation and we are constantly seeking novel ways to help tinnitus sufferers. Our treatment has been designed with the tinnitus sufferer in mind: it is pleasantly effective, affordable, and individually customized.
We encourage you to avoid anything that can make your tinnitus worse. For instance, you may want to avoid smoking, drinking alcohol, or listening to loud noises. Another precaution is protection. If you’re a construction worker, airport worker, hunter, or regularly exposed to loud noise, you should wear custom earplugs or special earmuffs. Ear protection goes a long way towards preventing your tinnitus from getting worse.

The most common noise is the sound of rapid or turbulent blood flow in major vessels of the neck. This abnormal blood flow may occur because of a reduced red blood cell count (anemia) or a blockage of the arteries (atherosclerosis) and may be worsened in people with poorly controlled high blood pressure (hypertension). Some small tumors of the middle ear called glomus tumors are rich in blood vessels. Although the tumors are small, they are very near the sound-receiving structures of the ear, and blood flow through them can sometimes be heard (only in one ear). Sometimes, blood vessel malformations that involve abnormal connections between arteries and veins (arteriovenous malformations) develop in the membrane covering the brain (the dura). If these malformations are near the ear, the person sometimes can hear blood flowing through them.
For some people, the jarring motion of brisk walking can produce what is called a seismic effect which causes movement in the small bones or contractions in the muscles of the middle ear space. You can experiment to find out if this is the cause by walking slowly and smoothly to see if the clicking is present. Then, try walking quickly and with a lot of motion to see if you hear the clicking. You can also test for the seismic effect by moving your head up and down quickly. 

Masking. Masking devices, worn like hearing aids, generate low-level white noise (a high-pitched hiss, for example) that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. A specialized device isn't always necessary for masking; often, playing music or having a radio, fan, or white-noise machine on in the background is enough. Although there's not enough evidence from randomized trials to draw any conclusions about the effectiveness of masking, hearing experts often recommend a trial of simple masking strategies (such as setting a radio at low volume between stations) before they turn to more expensive options.
The best supported treatment for tinnitus is a type of counseling called cognitive behavioral therapy (CBT) which can be delivered via the internet or in person.[5][77] It decreases the amount of stress those with tinnitus feel.[78] These benefits appear to be independent of any effect on depression or anxiety in an individual.[77] Acceptance and commitment therapy (ACT) also shows promise in the treatment of tinnitus.[79] Relaxation techniques may also be useful.[3] A clinical protocol called Progressive Tinnitus Management for treatment of tinnitus has been developed by the United States Department of Veterans Affairs.[80]
Copyright ©2019 NORD - National Organization for Rare Disorders, Inc. All rights reserved. NORD is a registered 501(c)(3) charity organization. Please note that NORD provides this information for the benefit of the rare disease community. NORD is not a medical provider or health care facility and thus can neither diagnose any disease or disorder nor endorse or recommend any specific medical treatments. Patients must rely on the personal and individualized medical advice of their qualified health care professionals before seeking any information related to their particular diagnosis, cure or treatment of a condition or disorder.
Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Roughly 10 percent of the adult population of the United States has experienced tinnitus lasting at least five minutes in the past year. This amounts to nearly 25 million Americans.
Cochlear Implants. These implants are a treatment option for patients that have a severe hearing loss along with tinnitus. Cochlear implants are designed to bypass any damaged parts of the inner ear and send the electrical signals sound makes directly to the auditory nerve. By bringing in outside noise, these implants can effectively mask your tinnitus, as well as stimulate your neural circuits to change.
The exact biological process by which hearing loss is associated with tinnitus is still being investigated by researchers. However, we do know that the loss of certain sound frequencies leads to specific changes in how the brain processes sound. In short, as the brain receives less external stimuli around a specific frequency, it begins to adapt and change. Tinnitus may be the brain’s way of filling in the missing sound frequencies it no longer receives from the auditory system.
Inspection of the eardrum may sometimes demonstrate subtle movements due to contraction of the tensor tympani (Cohen and Perez, 2003). Tensor tympani myoclonus causes a thumping. Another muscle, the stapedius, can also make higher pitched sounds. See this page for more. Opening or closing of the eustachian tube causes a clicking.    The best way to hear "objective tinnitus" from the middle ear is simply to have an examiner with normal hearing put their ear up next to the patient.  Stethoscopes favor low frequency sounds and may not be very helpful.
The degree of loudness or annoyance caused by tinnitus varies greatly from one individual to another. Loudness and annoyance do not always covary. An individual with loud tinnitus may not be troubled, while an individual with soft tinnitus may be debilitated. Most individuals with subjective tinnitus have hearing loss that shows up in a standard clinical audiogram. Tinnitus can sometimes worsen or sometimes improve over time.
Atherosclerosis. With age and buildup of cholesterol and other deposits, major blood vessels close to your middle and inner ear lose some of their elasticity — the ability to flex or expand slightly with each heartbeat. That causes blood flow to become more forceful, making it easier for your ear to detect the beats. You can generally hear this type of tinnitus in both ears.
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