Treating Tinnitus: Part Two

Treating Tinnitus: Part Two

As discussed in the previous newsletter, tinnitus (pronounced as either tih-NITE-us, or TIN-ih-tus) is sound in the head with no external source, that ranges in severity from irritating to debilitating. “For many, it’s a ringing sound, while for others, it’s whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance.” (Source)

Tinnitus and Vitamin D

A group of researchers, observing that there are vitamin D receptors in the inner ear, and noting “the high prevalence of vitamin D deficiency in patients with inner ear diseases”, could not help but wonder if this deficiency might also influence symptoms of tinnitus.

And, though many studies have demonstrated a direct link between vitamin D and ear diseases, there were no studies on the influence of vitamin D on tinnitus. Something they set out to rectify: “Thus, in the present study, we aimed to further examine the relationship between vitamin D and tinnitus, to determine the prevalence of vitamin D deficiency in patients with tinnitus and its effect on tinnitus parameters, especially its severity.”

The study included 201 tinnitus patients (and 99 controls), who were assessed for tinnitus characteristics and severity, along with having their blood levels of vitamin D recorded. As we might expect, the levels of vitamin D in tinnitus patients was significantly lower than that of the control subjects: 51% of the tinnitus group were vitamin D deficient, versus only 22% of the control group.

Those tinnitus patients with the lowest blood levels of vitamin D had the highest degree of tinnitus severity, and they also had higher triglyceride and TSH (thyroid-stimulating hormone) levels, and lower HDL (“good” cholesterol) levels, than the controls. (High TSH levels indicate a tendency towards hypothyroidism.)

This study concluded that, since a large percentage of tinnitus patients suffer from vitamin D deficiency (which corresponds with the severity of the condition), going forward, all tinnitus patients should undergo vitamin D testing. (Study)
Quick D

Tinnitus and Diet

Many studies have provided evidence that both hearing loss and tinnitus are associated with “modifiable lifestyle factors including noise exposure, smoking, alcohol consumption, exercise, and diet”.

Since diet may have an impact on how susceptible the inner ear is to hearing loss and tinnitus, and diet is a “modifiable lifestyle factor”, understanding the relationship between diet and tinnitus could be an important clue for those suffering from this condition.

However, until the study we are about to examine was carried out (in 2020), there was little research on the role of dietary factors contributing to tinnitus.

For example, “two small controlled studies reported a reduction in tinnitus among people with tinnitus and hyperinsulinemia following a diabetic diet rich in nutrients and low in fat and calories”.

Another study found “that higher caffeine intake was associated with lower risk of incident tinnitus in women”. And, a Korean study from 2018 “reported that lower intakes of vitamin B2 and B3, protein, and water…were associated with tinnitus and tinnitus annoyance in a Korean population sample”.

Given the dearth of data on the subject, some scientists from the UK set out to do a detailed examination of the “associations between tinnitus and nutrient intakes and dietary patterns…in a large population study sample”.

For the purposes of this study, tinnitus was defined as “ringing or buzzing in one or both ears that lasts more than five minutes at a time and is currently experienced at least some of the time”.

Results of the Study

The usual diet of 34,000 UK citizens, aged from 40 to 69, was examined over the course of one year. (Subjects who were regular supplement users were excluded from the study so that diet alone could be examined.)

“After adjusting for confounders, higher intakes of calcium, iron, and fat were associated with increased odds of tinnitus, while higher intakes of vitamin B12 and a dietary pattern high in meat intake were associated with reduced odds of tinnitus.”

With regards to hearing loss, “higher intake of vitamin D and diets high in fruit, vegetable, and meat were associated with reduced odds of hearing difficulties, and a high-fat diet was associated with increased risk of hearing difficulties”. Therefore, it may be that a low fat diet high in antioxidants and vitamins is required for hearing health. (Remember that the nutrients discussed here all came from the diet, not from supplements.)

However, the authors point out that “adjustment for hearing difficulties made no difference to patterns of associations between tinnitus and dietary factors, suggesting that possible impacts of diet on tinnitus are independent of hearing”. In other words, if your problem is tinnitus, pay attention to that dietary advice, and if your problem is hearing loss, look only at that relevant data.

Let’s take a closer look at a few of these findings.


A higher intake of fat (and starch) had already, in previous studies, been found to be associated with an increased risk of tinnitus, especially when accompanied by a low intake of fruits and vegetables (sources of antioxidants). Since a diet high in saturated fat is also associated with hearing loss, one interpretation of that link between fat and tinnitus is that it occurs by way of “cardiovascular disease pathways”.

Now, as discussed in previous newsletters, cholesterol and saturated fat are not directly responsible for cardiovascular disease. However, if one follows the SAD (Standard American Diet) approach to eating, the high amount of degraded fats (deep fried foods, damaged vegetable oils, oils from GMO foods, etc), and the high amount of sugars and refined carbohydrates, will lead to a hardening of the arteries, and a calcification of the blood vessels. This impediment of blood flow prevents nutrient delivery and toxin removal from the blood vessels, which is required for proper hearing. As well, this vessel calcification can cause nerve damage, at the very least disrupting nerve signal connections (one potential cause of tinnitus).


Higher intakes of calcium and iron were also implicated as a cause of tinnitus.

With regards to high calcium intake the authors had this to say: “Abnormalities in the calcium signaling pathway in outer hair cells have previously been linked to tinnitus, and calcium channel blockers have been investigated as a treatment for tinnitus.”

Now, since “vitamin K-dependent proteins, including matrix Gla-protein, have been shown to inhibit vascular calcification” (Source), it would be advisable for those with tinnitus to supplement with vitamin K2 in order to prevent this from occurring. In fact, limited studies have suggested that supplementing with levels of vitamin K2 higher than a maintenance dose can actually reverse blood vessel calcification.

The reason for high iron levels impacting hearing may be more difficult to explain.
The authors state that, “iron levels could conceivably impact hearing health via oxygen transport and oxygenation of the organs of hearing”. But, from my understanding, if oxygen delivery is required for good hearing, only low levels of iron would impact hearing. But, its effect on tinnitus may be via a different mechanism since, as we have seen, the impact of diet and nutrients on hearing and tinnitus are not always the same.

In fact, in the same Korean study referenced earlier, there was no association between dietary iron intake and tinnitus.

To further confuse things, a “higher intake of iron associated with increased odds of tinnitus seems contradictory to the finding of a high-protein diet linked to lower odds of tinnitus; meat, fish and poultry are sources of iron”.

And, meat, fish, and poultry are also good sources of vitamin B-12, of which a high intake is associated with reduced occurrence of tinnitus. Since we cannot at this time solve the iron conundrum, let’s turn to vitamin B-12.

Vitamin B-12

This study claims to be the only study suggesting a direct association between tinnitus and levels of dietary B-12, though I find this odd given the necessity of B-12 to repair and maintain myelin sheath around nerves. All the more so since the authors go on to state that, “the specific mechanism of action is unclear”.

Nonetheless, given the link between a high protein diet (specifically meat, fish, and poultry) and reduced odds of tinnitus uncovered by their study, the researchers concluded that it is most likely the high amount of vitamin B-12 found in these foods that provided the protective effect.

They also cite another Korean study which “reported that lower intakes of protein, vitamin B2, and vitamin B3 were associated with increased tinnitus (Lee & Kim 2018)”.

Another study “reported vitamin B12 deficiency in a sample of soldiers with tinnitus and noise-induced hearing loss compared with a control group with hearing loss only (Shemesh et al. 1993)”.

Those who have had their B-12 levels tested, and were informed by their physician that their levels are adequate (or even too high), should have a read of this blog of mine, Testing for Vitamin B-12. Therein, you will see that the common medical test for B-12 deficiency is inaccurate for a fair percentage of the population, especially among those who do not methylate, which could be up to 30% of people.

If you have tinnitus, and suspect that you may not methylate well, it is important to take vitamin B-12 in the form of methylcobalamin (Quick B12), in order to facilitate nerve repair.

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