A random ringing in your ears can be really annoying. Known as tinnitus, this maddening condition (which can be chronic or temporary) is a common complaint. But what causes ringing in the ears, exactly?
An estimated 15 percent of Americans — that's more than 50 million people — contend with some form of tinnitus over the course of their life, according to the American Tinnitus Association (ATA).
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We spoke with Cecelia Damask, DO, a board-certified otolaryngologist (ENT), to understand the reasons behind ringing ears and the best strategies to find relief.
Tinnitus isn't always a ringing sound — it can also be a buzzing, hissing, whistling, swooshing or clicking noise, per the ATA.
1. Hearing Loss
Ironically, the loud ringing in your ears may signal you're hard of hearing.
"Overall, most tinnitus is thought to be sensorineural, which means that it is due to hearing loss at the cochlea [part of the inner ear] and cochlear nerve," Dr. Damask says.
When the hair cells — specialized cells that transmit sensation into the inner ear — in the cochlea become damaged, the auditory pathways don't receive the signal they are expecting from the inner ear, Dr. Damask says.
As a result, "the brain produces abnormal nerve signals to compensate for the missing input," she says. These abnormal nerve signals translate into the tinnitus you hear ringing in your ears.
Fix it: Visit an audiologist, who can conduct a hearing test to determine if hearing loss might be what causes ringing in your ears. For some people, wearing a hearing aid not only improves hearing but can also help reduce the awareness of the annoying ringing, according to the Cleveland Clinic.
2. Exposure to Loud Sounds
Ever wonder why your ears ring randomly after a concert?
Here's why: "Exposure to loud sound can cause damage to the hair cells in your inner ear," Dr. Damask says. "These hair cells then 'leak' random electrical impulses to your brain, which then cause tinnitus."
People who work in a noisy environment (like a boisterous bar or a construction site) or those who frequently use deafeningly loud equipment (think: power tools, lawnmowers and leaf blowers) have a greater risk for hearing loss and subsequent development of tinnitus, according to the Cleveland Clinic.
Fix it: To reduce the ringing (and harm to your hearing), wear hearing protection like foam ear plugs or earmuff-style headsets when exposed to loud noise, Dr. Damask says.
Earwax might be the reason for random ringing in your ear for a few seconds. If you produce an excessive amount of wax, or it doesn't wash away or fall out like it should, it may accumulate, block your ear canal and affect your hearing, according to the Mayo Clinic.
"However, anything that blocks normal hearing can bring somatic sounds [like ringing in the ears] to our attention," Dr. Damask says. "This can occur when earwax blocks the outer ear canal."
Additionally, "if you get a buildup of fluid in your middle ear (otitis media), you may also have blockage of normal hearing, which could result in tinnitus," Dr. Damask says.
Fix it: "Never try to dig out earwax with something like a Q-tip or paper clip, [as] you may push the wax further into your ear canal and potentially cause damage to the lining of your ear canal or eardrum," Dr. Damask says. "If earwax gets impacted, you'll need to see an ENT for removal." Your primary care doctor may also be able to remove earwax.
There are several ways to extract earwax: Your doctor may use a small, curved instrument (called a curet), gentle suction or water to flush it out, according to the Mayo Clinic.
Over-the-counter ear-cleaning drops and baby oil can also help safely remove earwax.
4. Certain Medications
"Some drugs can cause or worsen tinnitus," Dr. Damask says. Indeed, there's a pretty long list of medications that may mess with your ears, including:
- Over-the-counter pain medicines such as aspirin and other NSAIDS like Advil, Motrin, Aleve and ibuprofen
- Some antibiotics like cipro, gentamicin, vancomycin, tetracycline and tobramycin
- High doses of loop diuretics administered intravenously like Lasix, Demadex and Bumex
- Certain antidepressants such as Elavil
- Certain chemotherapy agents including cisplatin and vincristine
"In general, the higher the dose of these medications, the worse the tinnitus becomes," Dr. Damask says.
Fix it: "If you start a new medication and notice tinnitus, notify the physician who prescribed it," Dr. Damask says. "They may refer you to an ENT for an audiogram for further evaluation."
Fortunately, tinnitus often disappears when you stop using these medications, Dr. Damasks says. Still, always talk to your doctor before you stop taking a prescribed medicine.
5. Dental Issues
Believe it or not, the ringing in your ears may relate to a problem in your jaw or teeth, Dr. Damask says.
For example, temporomandibular joint (TMJ) disorders can cause clicking or popping sounds when you open your mouth, according to the Mayo Clinic.
What's more, teeth grinding, jaw clenching and muscle tension can also make tinnitus more noticeable, Dr. Damask says.
Fix it: If you suspect your ear ringing is related to dental or jaw issues, you should see a dentist or TMJ specialist to help you manage the underlying issue. For some people, wearing a night guard can provide relief from grinding and clenching and may even reduce the ringing in your ears, per the Cleveland Clinic.
6. Head Injuries
The meaning of ringing in just your right or left ear could have to do with your noggin.
"Trauma to the head or neck can injure the inner ear, hearing nerves or brain functions associated with hearing," Dr. Damask says. "These injuries may cause tinnitus in only one ear."
In addition, ear ringing after a head injury may also be a side effect of a biomechanical problem of the head, neck or jaw, according to the Cleveland Clinic. For example, tinnitus is a possible symptom of whiplash, which occurs when the neck bends forcibly forward and then backward, per the Mayo Clinic.
Fix it: Talk to your doctor if you're experiencing any strange symptoms like ear ringing after a head injury.
And if you play high-contact sports or work at a high-risk location, such as a construction site, always wear head protection to help prevent a head injury, according to the Cleveland Clinic.
7. Underlying Medical Conditions
Other serious underlying health issues may be what causes ringing in the ears.
For example, tinnitus can be a sign of Meniere's disease, which is characterized by the buildup of abnormal fluid pressure in your inner ear, according to the Cleveland Clinic.
Conditions that affect blood vessels, like high blood pressure, can also result in ear ringing. That's because they cause blood to move through arteries and veins with more force, Dr. Damask says. This turbulent flow can create a loud ringing or thumping sound in your ears.
Additionally, diabetes, thyroid disease and certain tumors, like an acoustic neuroma, can also be associated with tinnitus, Dr. Damask says.
Fix it: See your doctor, who can perform a thorough evaluation to diagnose or rule out any underlying medical conditions. Often, once the primary health issue is properly treated, the tinnitus tends to go away.
8. Certain Vitamins Deficiencies
Certain vitamin deficiencies can cause or contribute to major health problems. And this is especially true in the case of tinnitus.
For instance, a lack of vitamin D, which is important for strong bones, muscles, nerves and immune function, is associated with a greater risk for ear ringing. Indeed, an August 2021 study in PLOS One found a strong correlation between lower levels of vitamin D and tinnitus.
Not getting enough vitamin B12, which is essential for red blood cell formation and the function and development of brain and nerve cells, may also play a role in your ear ringing.
A March 2016 study in Noise and Health found that people with a vitamin B12 deficiency experienced significant improvement in tinnitus after being treated with weekly vitamin B12 shots for six weeks.
Fix it: Speak with your doctor, who may perform a blood test to determine whether you have a vitamin deficiency. In many cases, receiving the nutrients you need can help remedy your tinnitus.
- Cleveland Clinic: “Tinnitus: 5 Strange Reasons for Ringing Ears”
- American Tinnitus Association: “Understanding the Facts”
- Mayo Clinic: “Earwax blockage”
- Mayo Clinic: “TMJ disorders”
- Mayo Clinic: “Whiplash”
- PLOS One: “The role of vitamin D in subjective tinnitus—A case-control study”
- Noise and Health: “Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study”
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.