| 15°C Dublin

Dear Doctor: Tinnitus

What can I do to stop the annoying buzzing in my ear? The noise is driving me insane

I am in my 30s, and recently developed a buzzing noise in my ears. My doctor said it was tinnitus. What causes it?

Tinnitus is often described by people as a ringing, swishing, buzzing or humming noise heard inside one or both ears. One of the most common causes of tinnitus is damage to the microscopic endings of the hearing nerve in the inner ear. Exposure to loud noise is a very common cause of tinnitus.

Sometimes medications such as aspirin, NSAIDS (anti-inflammatory drugs), certain antibiotics and diuretics can also cause tinnitus. Fluid, infection or disease of the middle ear bones or ear drum are other causes. Rarely, it can be a symptom of more serious problems such as an aneurysm or a brain tumour (acoustic tumour).

If you notice that the buzzing mainly occurs on one side only, or you develop vertigo (loss of balance) or deafness, ask your doctor to refer you for a ENT assessment. Anyone with persisting unexplained tinnitus needs a hearing test (audiogram). Other tests such as the ABR (auditory brain stem response), CT or MRI may be suggested by your doctor.

What treatments are available for tinnitus?

In many cases there is no specific treatment for tinnitus. It may simply go away on its own, or be a permanent condition that you learn to live with. Some doctors have recommended niacin, but patients' response to this has been variable.

Smoking and caffeine can all aggravate tinnitus as they tend to increase the body's uric acid levels associated with this condition. Decrease your salt intake. Avoid aspirin and related products if at all possible.

Tinnitus is usually more bothersome when the surroundings are quiet, especially in bed. Background noise may help mask tinnitus. There are small hearing aid-like devices can also help reduce the awareness of the tinnitus. Get adequate rest and avoid fatigue.

A diet rich in vitamins, especially the B vitamins and zinc, is best. Foods rich in zinc include spinach, Brussels sprouts, cucumbers and asparagus, or you can take zinc in supplement form. The herbal remedy gingko biloba has been shown to help some people.

What else can I do if the symptoms continue?

If symptoms of dizziness persist, vestibular rehabilitation exercises -- a form of physical therapy -- can help retrain the brain to compensate for any disturbance in the balance system of the inner ear.

Some studies have shown that patients who receive psychological treatments, such as tinnitus retraining therapy, have shown marked improvement. Counselling, of whatever type, can help lower the ear noise level that is perceived. The way counselling works is to identify reactions a person might have to the noises, and learn how to respond differently to the stimuli. Support and education groups can also help, as can bio-feedback.

For most people tinnitus improves with time. Worrying about it can lead to a vicious circle of increasing distress and more intrusive tinnitus.