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Have you noticed a migraine tinnitus link before, during or between your migraine attacks? Tinnitus is the perception of hearing noise in your ears when no external sound is present. Tinnitus is a symptom of another condition like Migraine, Meniere’s Disease, noise exposure or injury. In many cases an exact cause is never found. It’s often described as ringing, but it can also sound like hissing, buzzing, clicking, whooshing, roaring and other sounds. Tinnitus pitch and volume often fluctuates. It can be present all the time or it may come and go. Researchers are not exactly sure what causes the migraine tinnitus link. It may be the result of abnormal neural activity that happens before, during and after migraine attacks.
** This is not medical advice. Any information shared here is based on my own personal experience in finding control over my symptoms plus my own research. Please consult your doctor before trying any new treatments.
Tinnitus comes and goes
As someone diagnosed with both Vestibular Migraine and Meniere’s Disease, I experience tinnitus all day, every day in varying degrees of volume and pitch. Very loud noise typically comes on suddenly. At times it’s very low pitched, other times it’s more of a high pitched squealing. Both are hideous as they start so loud and out of nowhere it often startles me when it begins.
When my disease is well controlled, my tinnitus sounds like quiet ringing that I can usually push into the background of my mind. That’s what I call my baseline, but don’t let that mislead you. Whether you’re hearing unbearably loud noise or quiet ringing, hearing noise that no one else can hear, can torture you in unimaginable ways. With no ability to escape it, wherever you go, it’s right there with you.
While there is currently no definitive cure for migraine or tinnitus, it doesn’t have to be a life sentence of misery. There are many strategies available to help lessen the burden of this distressing symptom.
The migraine tinnitus link
Tinnitus and migraines seem to hold hands creating a tinnitus-migraine link. Like most migraine symptoms, the intensity of tinnitus comes on stronger during attacks. Migraine attacks seem to carry a tinnitus volume control with them. When attacks hit, volume is turned all the way up. Does tinnitus cause migraine? No. The migraine-tinnitus link seems to run the opposite direction. Neurology Times reports that people with migraine are at a three times higher risk of developing tinnitus than those without migraine. This may indicate a problem in the central process of the brain rather than in the inner ear. You can help to minimize tinnitus and migraines by gaining control over your migraine and breaking the tinnitus migraine link.
Strategies to reduce migraine symptoms include:
- Following a Migraine Diet– Heal Your Headache diet, Charleston and Keto are popular choices. When it comes to diet for tinnitus and migraines, choose just one diet that fits best with your eating preference that you are most likely to stick to.
- Supplements- Many supplements have research backing them for migraine prevention including magnesium, riboflavin and ginger. You can learn more about effective supplements for migraine in our article written by our resident dietitian Danielle.
- Consider a preventative medication– Very low dose nortriptyline ended my daily dizziness helping me go from being housebound for months to successfully working full time. As an added bonus, it’s also on the list of medications that might improve tinnitus. This article written by Dr. Hain contains a migraine medication flowchart that does a great job reviewing common migraine medications. Notice that magnesium and a vestibular migraine diet are recommended at the top of the list.
- Medication- Migraine abortive medications and Meniere’s disease rescue medications may help reduce tinnitus when an attack hits. Working to prevent and abort attacks can in turn reduce tinnitus.
- Many more strategies– So many more strategies are available to empower you to kick your attacks to the curb. Here are a few great ideas as outlined in our Migraine Strong Treatment Pie.
What Makes Tinnitus Worse
There are many things that make tinnitus worse including dehydration, insufficient sleep, noise, stress, MSG and CATS just to name a few! I’m talking about Caffeine, Alcohol, Tobacco and Salt that create the easy to remember acronym CATS. While everyone certainly has different tinnitus triggers CATS are four common triggers that are real risk factors in making tinnitus worse. Caffeine and Alcohol can increase your blood pressure. While tobacco can constrict capillaries and blood vessels. Lastly, salt affects the amount of fluid released in your inner ear.
Some research suggests low salt intake (around 1500 mg per day) is beneficial in reducing tinnitus. While other research suggests keeping a steady amount of daily salt intake is effective. Play with both ideas to see which one is helpful for you.
MSG comes in many hidden forms in processed foods making it important to get to know the cover words that are often used to represent it.
Strategies to Help Ease Tinnitus
It’s easy to be fearful that tinnitus will worsen over time. The good news is that according to the American Tinnitus Association, tinnitus does not usually worsen. It can be effectively managed using a variety of strategies. Read on to learn more about strategies to help you feel better and help you gain control.
I mentioned earlier that dehydration is a factor that makes tinnitus worse so hydration is a great and simple strategy to try to improve it. Hydration is actually the first line of defense in treating Meniere’s disease in Eastern medicine. Recommendations vary, but the 8 by 8 rule is easy to remember. You can follow this rule by drinking at least 8, 8 ounce glasses of water each day.
With a quick internet search you’ll find all kinds of products on the market promising to make tinnitus better. The products below are worth trialing to see if they work for you.
- Lemon Bio-Flavonoids– This is the supplement I personally cannot be without. It’s theorized they work by widening small capillaries and arteries helping to increase blood flow and reducing tinnitus. For me this supplement works. In addition to quieter tinnitus, I have noticed reduced ear pressure and fullness since beginning this supplement as well. The only caution is it MUST be real lemon bio-flavonoids and not generic citrus bio-flavonoids that are found in many supplements. I use Lindberg Brand found online at Nutrition Express. Amazon sells it as well, but it’s about twice the price.
- Vinpocetine – This one takes many weeks or even months to begin to reduce, and some report, even eliminate tinnitus. A positive side effect is that many report a reduction in brain fog as well.
- Ginkgo Biloba- Ginkgo Biloba is the most studied supplement for tinnitus. Some show positive results while others show no effects. It’s speculated that ginkgo biloba works by improving circulation in the brain and inner ear and decreasing damaging free radicals.
- B12– In one small study B12 showed encouraging results in reducing tinnitus volume in patients who are deficient.
- B2 Ribolavin- The migraine tinnitus link may explain why some have success lowering the volume of tinnitus by supplementing with B2. The recommended dose for migraine is up to 400mg daily. The recommended riboflavin dose for tinnitus ranges from 25mg to 500mg. It’s best to talk with your doctor for dosage advice.
- Melatonin- It’s currently unclear exactly how melatonin helps improve tinnitus. What we do know is melatonin helps improve sleep. Since poor sleep makes tinnitus worse, many theories point to using melatonin for tinnitus to help regulate sleep and reduce this risk factor.
- Zinc- One small study showed a decrease in loudness of tinnitus by supplementing with 50mg of zinc daily particularly in those who are deficient.
- Magnesium- Magnesium helps nerve function, protects the nerves in the inner ear, relaxes muscles and blood vessels and is a powerful glutamate inhibitor. Supplementing magnesium may benefit the function of the ear & improve tinnitus by lowering your risk to damage caused by noise. Since Migraine and Meniere’s disease patients are often more sensitive to noise, protecting your hearing between attacks is something to be considered.
- CBD- CBD is a fairly new addition to my preventative treatment arsenal. It helps to relieve minor pain and reduce stress promoting relaxation. Reduced stress leads to reduced tinnitus.
- Essential Oils- One of our wonderful moderators of Migraine Strong, Abby Angelico recommends helichrysum essential oil. She rubs a bit behind her ears to reduce the intensity of her tinnitus. Amazon sells a product called Goodbye Tinnitus. It’s a blend of lavender & helichrysum oils that they recommend dabbing behind your ear.
Habituation is the process of training our brains to turn tinnitus into meaningless background noise. It simply means change your focus! Our brains are amazing. If you stop focusing on tinnitus, your brain is absolutely capable of pushing tinnitus into the background. Due to the neuroplasticity of our brains we can either cement that distressing neural pathway into our brains by focusing on the torment. Or we can prune out that distressing neural pathway by changing the way we react to the sound. Through intentional practice our brains can and will tune it out!
Just like our brains learn to compensate for dizziness from vestibular migraine and Meniere’s disease, it will learn to compensate for tinnitus as well. So even though we’re told over and over that there is no cure for tinnitus this strategy fills me with hope for successfully managing it.
Masking devices for tinnitus can be worn in the ear similar to hearing aids to help train your brain to habituate. These devices produce an individually programmed continuous tone specific to the frequencies of your tinnitus and over time, encourages habituation and helps you to stop focusing on it. To learn more about tinnitus habituation definitely check out Glenn Schweitzer’s Rewiring Tinnitus blog along with this great article written by Glenn explaining habituation.
Tinnitus sleep strategies
The noise of tinnitus can make it very difficult to sleep. A common strategy to help improve sleep in spite of tinnitus is sound masking. Fans, white noise machines and pillow speakers are great tinnitus maskers. I recently wrote a vestibular migraine sleep blog chock full of ideas about how to sleep with tinnitus. Take a minute to look it over to learn more about other helpful tinnitus sleep strategies.
Medication: Can benzodiazepines cause tinnitus?
Antidepressants- The Mayo Clinic reports tricyclic antidepressants like amitriptyline and nortriptyline, have been used with some success to help treat tinnitus.
Benzodiazepines- Can benzodiazepines cause tinnitus? Not likely. The Mayo Clinic reports Xanax may help reduce tinnitus symptoms. This leaves Vestibular Migraine and Meniere’s Disease patients in a tough spot since Xanax is one of the benzos not recommended for us. Due to the short life of its effect, it may prompt patients to use it more often and increase the risk of addiction. Plan to talk with your specialist about the possibility of using a different benzo recommended for dizzy patients like valium or ativan best used short term as a rescue.
Medication Caution- Be aware some medications are ototoxic and can make tinnitus worse including antibiotics, aspirin, diuretics and other types of antidepressants. The Mayo Clinic put together a comprehensive list of medications that can make tinnitus worse.
Do hearing aids help tinnitus?
If you have Meniere’s Disease or vestibular migraine you may also experience hearing loss or fluctuating hearing loss. Those with tinnitus due to hearing loss may find relief with the help of a hearing device. Talk to your ear specialist about hearing aid options to minimize the impact of tinnitus.
Protecting Your Hearing Between Attacks
Many with migraine and Meniere’s disease experience sensitivity to sound making protecting your ears between attacks important. Tiny hairs in your inner ear move in response to sound waves. Exposure to loud sounds break and bend these delicate hairs preventing them from properly carrying sound to your inner ear. Both long and short term loud noise exposure can cause permanent damage to these delicate hairs and increase tinnitus as a result. When you know you’re planning to attend a function with loud noise protect them from damage by using earplugs and noise canceling headphones. Carry earplugs with you for times you come across unexpected noise.
Tinnitus and Anxiety
Tinnitus and anxiety often coexist. It’s unbelievably difficult to hear an irritating sound that just won’t go away. But, the volume of your tinnitus doesn’t usually dictate how tormented you become by it. What determines your torment is how much it bothers you. The number one thing you can do to improve your tinnitus is to work on controlling your stress response to it. Controlling your stress response encourages habituation. You can do this by intentionally working on calming down your nervous system. Practice calming your stress response to tinnitus and anxiety through…
- Mindful breathing techniques– Relaxing your body by controlling your breath can reduce the impact of tinnitus. Breathe in slowly and deeply through your nose. Hold and release slowly through your mouth. Repeat until you feel your body relax.
- Music therapy– Music is a great strategy to mask tinnitus. It distracts and it aids in relaxation. It can change your mood and the emotional reaction you feel about your tinnitus. Rather than listening to music that is louder than tinnitus, encourage habituation by listening to music a bit quieter than tinnitus to train your brain to focus on the music instead of the noise.
- Create a mantra– A mantra is simply words you repeat silently in your head to help bring yourself a sense of calm. Phrases such as, “I am safe, I am calm, I can handle this.” create a feeling of empowerment. Create any phrase that feels calming to you.
- Exercise– Regular exercise can help to keep your blood vessels healthy and increase circulation resulting in reduced intensity and volume. It also just improves your overall sense of wellness helping you cope with tinnitus better.
- Meditation– Consider apps to help you practice this valuable strategy to help you relax. Migraine Strong members recommend Calm, Calmer, Insight Timer and Headspace. These apps often include progressive muscle relaxation, guided imagery and many more techniques to help calm you down.
- Anything that helps YOU feel calm– Tapping, massage, acupuncture and even creative and nature filled hobbies can help calm your nervous system. Occupy your mind with activities you enjoy. Those pleasant activities take up so much room in your mind that tinnitus is naturally pushed into the background encouraging habituation.
Tinnitus and Depression
If your tinnitus is causing you distress, getting help is crucial. The American Tinnitus Association is there to provide general guidance on tinnitus management. You can reach them at 1-800-634-8978. Cognitive Behavioral Therapy is a great strategy to help manage tinnitus and depression. Tinnitus experts can help teach you the skills necessary to cope and to begin tinnitus re-framing to encourage habituation. Facebook has many support groups available for you to join filled with people who understand what it’s like to hear sounds no one else can hear. If your tinnitus and depression feels overwhelming, in the U.S. call the Suicide Prevention Hotline at 1-800-273-8255.
Have you been diagnosed with tinnitus and migraines? Help hope grow.
While there is currently no cure for tinnitus and migraines, it is not something you have no control over. Trying the strategies above in an attempt to get to the point where your tinnitus doesn’t bother you is the key to feeling better. Don’t try everything listed above all at once. Try a strategy or two that feels the most helpful to you. If you’re still left with no relief, seek a tinnitus professional. Hope happens through communication. Share what works for you and keep fighting to end the stigma of invisible illness by telling your story. Contact us for publishing or post it in online forums to help others feel less alone. You can visit the American Tinnitus Association at ata.org to listen to sample tinnitus sounds and for more information on tinnitus.
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