The house is finally quiet, and you are just winding down to go to sleep and then oh flip, that annoying ringing, buzzing and hissing sound called tinnitus kicks in, and then it seems impossible to fall asleep.  

This irritating ringing in your ears can drive you up the wall, but there is hope for more peace from the noise. Nutritional shortfalls might be one of the reasons why your tinnitus is not going away on its own, and this blog shares the how depletions in certain vitamins and minerals, as well as the gut microbiome can play in a role in managing your tinnitus.

Many people suffering from tinnitus find it extremely stressful and it can affect their sleep and mood. Much of the time the advice is just to learn to live with the ringing, to accept it as your new normal, and hope that it might eventually fade on its own. 

Tinnitus is often accompanied by nausea, vertigo and dizziness as well as postural orthostatic tachycardia syndrome (PoTS). It is also well documented to come alongside hearing loss. So living with tinnitus can potentially become extremely debilitating and is more likely to develop the older we get.

Read on to find out more about what causes tinnitus and the nutritional ways you can try to seek out some relief from that damn noise in your ears.

What can cause tinnitus?

Tinnitus can arise from several underlying issues, including:

Noise-induced hearing damage – long term exposure to loud sounds can damage the tiny hair cells within the inner ear, whose job it is to sense sounds, leading to persistent ringing. This is particularly common in people who have spent time working in loud environments like at music concerts, on building sites or in war zones.

Ear infections or blockages – wax build up, inflammation and swelling from infections, or fluid in the ear can block the tubes inside your ear and result in a persistent and distorted sound. The Covid-19 virus triggered tinnitus in many people, and it is thought that this is because the cytokine storm and oxidative stress from the virus damaged the ears somehow.

Medications – some antibiotics and chemotherapy can trigger or worsen tinnitus. Even regular use or high doses of ibuprofen, paracetamol and aspirin may play a role. Antidepressant drugs such as SSRIs are also known to cause or worsen tinnitus in some people.

Hormone changes – tinnitus in women often comes on during the perimenopause whilst her hormones are changing and during the post menopausal years. When oestrogen and progesterone decline this can affect the auditory system.

Circulatory issues – conditions like hypertension and atherosclerosis can affect blood flow to the ears and negatively affect auditory function. Hearing loss and tinnitus may be indicators of cardiovascular disease , so it is important to have cardiac markers checked out if you experience tinnitus. For people with diabetes, tinnitus could be a sign that they might be developing neuropathy or have issues with their small blood vessels within the inner ear and so again seek medical advice.

Neurological disorders – trauma to the head such as concussion or a head injury can lead to tinnitus. Migraines and tinnitus often come alongside each other, as do fibromyalgia and tinnitus. Other neurological issues such as temporomandibular joint (TMJ) disorder and Meniere’s disease can also contribute to the likelihood of tinnitus developing.

Nutrient deficiencies – these will be described in detail below and may be the one of the contributors to some cases of tinnitus. Also optimising the levels of these vitamins and minerals may also well help to support the healing from some of the other causes of tinnitus mentioned above as they can help to reduce inflammation, reduce oxidative stress and improve blood flow.

How nutrition shapes tinnitus

Your diet and underlying nutrition have a strong influence on the factors driving the onset and severity of tinnitus, including nervous system function, inflammation and blood pressure.

Excessive intake of caffeine, sugar, sodium, aspartame and unhealthy fats are potential dietary triggers for tinnitus due to their pro-inflammatory nature and likelihood to raise blood pressure. So the first step you can try is to avoid these drinks and foods, and see if your tinnitus calms down. Ideally at the same time switch to a diet rich in anti-inflammatory foods such as olive oil, oily fish, turmeric, nuts, seeds, pulses, eggs, meats, fruits and vegetables as these support neurological function and reduce inflammation.

Then also, on top of your regular healthy diet, there are specific nutrients you can look out for to help with symptoms of tinnitus and here is some well researched nutritional support to consider.

Antioxidants

Tinnitus has been associated with oxidative stress, which occurs when the hair cells inside the ear are damaged by noise. High levels of oxidative stress produce free radicals, which trigger cell damage. This can lead to hearing loss and tinnitus. Antioxidants neutralise free radicals, preventing any further harm to your cells and enabling damaged but living cells to repair themselves.

Brightly coloured fruits and vegetables with a high polyphenol count such as berries, tomatoes, citrus fruits, dark green and orange vegetables, nuts, red onions and dark chocolate are high in antioxidants, so adding more of these into your diet could help over time to reduce the oxidative stress.

Supplements with strong antioxidant properties such as resveratrol have been suggested to help in some cases of tinnitus. Quercetin may improve hearing loss and reduces oxidative stress in noise-exposed individuals with tinnitus.

N Acetyl Cysteine which is a powerful antioxidant has been found to help hearing loss and tinnitus in soldiers from being in combat. It has also been used prophylactically to prevent tinnitus and hearing loss in young people attending music concerts when combined with magnesium.

Gingko biloba is an east Asian herb rich in antioxidants, flavonoids and beneficial compounds. Some studies have successfully found that gingko biloba improves inner ear health and tinnitus by neutralising free radicals, improving blood flow and supporting the nervous system. Gingko biloba can be taken as a dietary supplement but should be avoided if you are taking blood thinning medication such as heparin, warfarin or aspirin.

B vitamins

B vitamins, particularly vitamin B1 (also known as thiamine) and vitamin B12 (cobalamin), play a well-established role in tinnitus severity due to their importance in maintaining nervous system health.

A vitamin B1 deficiency can trigger several symptoms and if you have become less tolerant of alcohol, you get car sick or insect bites swell up, or you have long term gastric issues on top of the tinnitus, then this is a vitamin that may help you. Pork, beef, fish, whole grains such as brown rice and wholemeal bread, legumes including beans, lentils and peas as well as nuts and seeds are particularly high in vitamin B1. It is difficult to test for a thiamine deficiency, and since your body flushes out any excess, most people with these symptoms benefit from high doses between 100mg and 500mg a day, especially if the tinnitus is accompanied by fatigue.

Vitamin B12 supplements are usually recommended for those following a plant-based diet or for those who choose a flexitarian diet or just mainly eat carbs and highly processed foods. Signs over and above the tinnitus symptoms of a B12 deficiency include a sore tongue, mouth ulcers and fatigue, as well as memory problems, OCD or depression. Meat, fish, dairy and eggs are high in vitamin B12; and then top up with a supplement if you know you are deficient through a blood test or urinary organic acid test.

Zinc

Because of zinc’s role as an antioxidant and in nervous system transmission, scientists wondered whether it could also be implicated in tinnitus. Study results confirmed their suspicions – when given zinc supplements, patients with tinnitus experienced a significant decrease in their symptoms.

I suggest you add more zinc into your diet and supplement if your immune system seems low or you struggle with your skin or you don’t have a great sense of smell and taste in addition to the tinnitus. Zinc-rich foods include meat, fish, seafood, dairy, beans, nuts and wholegrains.

Iron

Iron is vital to transport oxygen around the body and tinnitus is a lesser-known symptom of low iron stores or anaemia. Anaemia and low ferritin levels (iron stores) result in increased and irregular blood flow in the ears, often also resulting in a pulsating sound.

Red meat, brown meat from poultry, liver, eggs yolks, seafood, dark leafy green vegetables, beans and pulses are high in iron. Supplements can help you to increase your iron intake if you find it hard to get enough in your diet or your ferritin levels are always on the low side.

Magnesium

Magnesium is needed for hundreds of enzymatic reactions, so a lack of it can cause lots of potential problems. We also get depleted if we do lots of intense exercise or are highly stressed.

Magnesium protects the nervous system and dilates the blood vessels – both functions that are likely to improve symptoms of tinnitus. Studies have supported the idea that magnesium can improve tinnitus, even in the case of damaged ears from loud noises.

Leafy green vegetables, dark chocolate, wholegrains, nuts, seeds and bananas are great sources of magnesium. If you are not be getting enough magnesium through your diet then magnesium baths and supplements can help you out.

Manganese

Low levels of manganese are associated with the regularity and severity of symptoms in people with tinnitus. Your body only needs a small amount of manganese – about 2.3mg for men and 1.8mg for women. Excessively high levels of manganese can cause other problems, so you may wish to test your manganese levels before taking a supplement.

You can top up your diet with shellfish, legumes, green leafy vegetables, nuts, wholegrains and tea which are all excellent sources of manganese.

Vitamin D

Low vitamin D levels have been closely associated with lots of ear problems, including tinnitus. This is thought to be due to the role vitamin D plays in reducing inflammation and supporting immune function, as well as being involved in calcium metabolism – calcium is found in the bones of the inner ear.

Vitamin D is usually associated with sunlight – just a few minutes outside with exposed arms and legs is usually enough for your skin to absorb as much as you need. However, if you live in a colder climate with cloud and rain and you don’t get much sunshine, you can add more vitamin D into your diet with oily fish, egg yolks, red meat and liver. You can also use vitamin D supplements to boost your daily intake, especially during the winter.

Care for your gut and aural microbiome

Learning how our gut microbiome influences your aural health is now emerging. Studies have found that an imbalanced gut microbiome with too many inflammatory bacteria and not enough anti-inflammatory bacteria is strongly associated with the onset and persistence of tinnitus. Even though your gut is a long way from your ears, your gut microbiome influences your aural microbiome via the “gut-brain-ear” axis. A healthy gut microbiome can support the neurological system and helps to reduce inflammation in the ears which in turn can help to ameliorate the ringing in the ears.

Studies have found that taking live bacteria supplements can restore an imbalanced gut microbiome. Omega 3 fatty acids play a dual role in reducing inflammation in the ears and promoting healthy gut and aural flora. One study from 2023 found taking both friendly bacteria and omega 3 together can help to reduce the likelihood of tinnitus episodes and helped with middle ear health overall.

You can support a healthy microbiome by eating lots of fibre to feed the gut bacteria, also known as prebiotics. Garlic, onions, bananas, asparagus, mushrooms, cabbage, oats, legumes and wholegrains are particularly useful. Probiotic rich foods also help your gut microbiome by replenishing helpful bacteria with live strains. Probiotic strains can be found in cultured and fermented foods like sauerkraut, kombucha, yoghurt, kefir, tamari soya sauce and miso.

Round up

Living with a noise coming from within your ears can be irritating and draining, and you may be desperate to be in more peace from that buzzing, ringing or hissing. A positive first step is to look at your nutrition and gut health to see when you make these changes that things calm down – maybe you will get fewer tinnitus episodes, or they will be shorter lived?

If your tinnitus is driving you crazy and you want to explore whether you have nutrient deficiencies or an out-of-sync gut microbiome that are contributing to it, then our NatureDoc clinical team can run some tests and work with you 1 to 1, to help you to enjoy the peace and silence again.

References

• The Role of Diet in Tinnitus Onset: A Hospital-Based Case-Control Study from Italy
• Relationship Between Diet and Tinnitus: Korea National Health and Nutrition Examination Survey
• The Association between Dietary Intakes of Vitamins and Minerals with Tinnitus
• The Effect of Antioxidant Supplementation in Patients with Tinnitus and Normal Hearing or Hearing Loss: A Randomized, Double-Blind, Placebo Controlled Trial 
• Antioxidant therapy in the elderly with tinnitus
• Pathogenesis of tinnitus: any role for oxidative stress?
• The use of distortion product otoacoustic emissions (DPOAE) records to estimate effect of vitamin B complex on changing severity of tinnitus
• Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study
• The Role of Plasma Melatonin and Vitamins C and B12 in the Development of Idiopathic Tinnitus in the Elderly
• Recurrent Wernicke’s Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features
• Is Hypozincemia Related to Tinnitus?: A Population Study Using Data From the Korea National Health and Nutrition Examination Survey
• Vestibular Evaluation Using Videonystagmography of Chronic Zinc Deficient Patients Due to Short Bowell Syndrome
• Zinc supplementation for tinnitus
• Zinc to treat tinnitus in the elderly: a randomized placebo controlled crossover trial
• The Role of Zinc in the Treatment of Tinnitus
• Effects of oral zinc supplementation on patients with noise-induced hearing loss associated tinnitus: A clinical trial
• Characteristics of tinnitus found in anemia patients and analysis of population-based survey
• NHS – Iron deficiency anaemia
• Phase 2 study examining magnesium-dependent tinnitus
• Relationship between serum magnesium level and subjective tinnitus 
• Magnesium therapy in acoustic trauma
• Micronutrients in tinnitus: A National Health and Nutrition Examination Survey analysis
• Serum Vitamin D Concentration Is Lower in Patients with Tinnitus: A Meta-Analysis of Observational Studies
• The role of vitamin D in subjective tinnitus—A case-control study
• Vitamin D Deficiency as a Risk Factor of Tinnitus: An Epidemiological Study
• Herbal medicines in the treatment of tinnitus: An updated review
• Ginkgo biloba Extract EGb 761 Improves Vestibular Compensation and Modulates Cerebral Vestibular Networks in the Rat
• Standardized Ginkgo biloba Extract in the Treatment of Vertigo and/or Tinnitus: A Review of the Literature
• Ginkgo biloba extract in the treatment of tinnitus: a systematic review
• Otoprotective Effects of Quercetin Against Oxidative Damage in the Rat’s Cochlea Induced by Noise and Silver Nanoparticles
• Protective Effect of Resveratrol in an Experimental Model of Salicylate-Induced Tinnitus
• Resveratrol prevents hearing loss and a subregion specific- reduction of serotonin reuptake transporter induced by noise exposure in the central auditory system
• Treatment of military acoustic accidents with N-Acetyl-L-cysteine (NAC)
• Using prophylactic antioxidants to prevent noise-induced hearing damage in young adults: a protocol for a double-blind, randomized controlled trial
• Characteristic alterations of gut microbiota and serum metabolites in patients with chronic tinnitus: a multi-omics analysis
• Modulation of Gut Microbiome as a Therapeutic Modality for Auditory Disorders 
• A review of the auditory-gut-brain axis
• The Role of Gut Dysbiosis in the Pathophysiology of Tinnitus: A Literature Review