Tinnitus or ringing in the ears is a common symptom of migraine. Migraine and tinnitus can be incredibly debilitating on their own, dealing with both can feel impossible to ignore. Have you noticed a migraine tinnitus link before, during or between your migraine attacks? Researchers are not exactly sure what causes the migraine tinnitus link. But, it may be the result of abnormal neural activity, changes in blood flow or inflammation that happens before, during and after migraine attacks.
Tinnitus is often described as ringing, but it can also sound like hissing, buzzing, clicking, whooshing, roaring and other sounds. Tinnitus pitch and volume often fluctuates meaning it can be present all the time or it may come and go. Thankfully, there are a few things you can do to help manage the noise and reduce your overall symptoms. Keep reading for our top tips!
** 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.
The migraine tinnitus link
Migraine and tinnitus research
Tinnitus is the perception of hearing noise in your ears when there is no external sound present. There are several studies that support the connection between migraine and tinnitus. Let’s talk about two. The Assiut University auditory pathways study published in the American Journal of Otolaryngology: looked at the auditory pathways in 58 patients with migraine. Researchers found that two-thirds of people with migraine had one or more abnormalities in how the brain responds to sound.
University of California Irvine migraine tinnitus study published in Otology & Neurotology: evaluated hearing loss and tinnitus among people with migraine. Researchers looked at nearly13,000 people who reported experiencing migraine. The results found that compared to people without migraine, participants with migraine were 2.1 times more likely to have tinnitus. This same study also found a link with migraine neck pain.
These studies show that for some people with migraine disease, tinnitus and migraine seem to hold hands. Like most migraine symptoms, the intensity & volume of tinnitus comes on stronger during attacks. When attacks hit, volume is turned all the way up.
Does tinnitus cause migraine?
No, tinnitus does not cause migraine. The migraine tinnitus link runs the opposite direction. Neurology Times reports that people with migraine have a three times higher risk of developing tinnitus than those without migraine.
In addition, those with migraine who also experience allodynia are also more likely to experience tinnitus. So experiencing tinnitus alongside your migraine may, and that’s a big may that needs more research, be a sign of migraine chronification.
When it comes to migraine specifically, tinnitus may indicate a problem in the central process of the brain rather than in the inner ear. If you happen to have vestibular migraine or vestibular migraine and Meniere’s disease, the problem may be in both central processing (central) and the inner ear (peripheral).
You can help to minimize tinnitus and migraines by gaining control over your migraine to break the tinnitus migraine link.
Migraine tinnitus comes and goes
Tinnitus is a common symptom of migraine, vestibular migraine and especially those who experience both vestibular migraine and Meniere’s disease. So depending on your migraine diagnosis you may experience tinnitus all day, every day in varying degrees of volume and pitch. Or you may experience that migraine tinnitus comes and goes alongside migraine attacks. For many this very loud noise in our ears comes on suddenly and is a sure sign a migraine attack is on it’s way.
Treatments for migraine tinnitus
The first and maybe most important migraine tinnitus treatment strategy is to treat your migraine in an attempt to lessen the frequency and severity of your attacks. Since tinnitus is typically a symptom of migraine this should be your first line of approach.
There are many ways to treat migraine and your doctor is the best resource for creating a treatment plan specifically for you, but below you’ll find a few general ideas. In migraine strong we prefer a multi-strategy approach that might include…
- Migraine Diet– Heal Your Headache diet, Charleston and Keto are popular choices, but the Mediterranean diet and the idea of simply eating less processed foods are gaining traction too. Trialing diet is a great way to investigate if diet is your tinnitus culprit.
- Migraine 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.
- Migraine preventative medication– Tricyclic antidepressants such as Amitriptyline and Nortriptyline are not only migraine preventative medications. As an added bonus, they might also improve tinnitus, but more research is needed in this area. This article written by Dr. Hain contains a migraine medication flowchart that does a great job reviewing common migraine preventative medications.
- A Multi-modal approach– So many more strategies such as hydration, sleep hygiene, movement and more are available to empower you to reduce the frequency & intensity of migraine attacks. Successfully reducing attacks reduces symptoms like tinnitus that come with them.
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 treatment strategies. Since there is no one medication that works to control tinnitus, relying on natural treatment strategies offers practical ways to cope with tinnitus. Read on to learn more about some of the most effective treatment options for migraine tinnitus to help you feel better and gain control.
Dietary supplements for tinnitus show promise, but more research is needed here. In general supplements that increase blood circulation, reduce inflammation and support a healthy central nervous system are encouraged. Because every supplement on the market has contradictions to medications, other supplements and health conditions you should run every supplement by your doctor to be sure it’s safe for you.
- Lemon Bio-Flavonoids– May work by widening small capillaries and arteries helping to increase blood flow and reducing tinnitus. 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 at last check. Nature’s Life Lemon Bioflavonoids is an option to consider from Amazon.
- Vinpocetine – This one also increases blood circulation. Those who take it for tinnitus report it takes many weeks or even months to begin to reduce (and per some reports) even eliminate tinnitus. A positive side effect is that increased circulation may reduce brain fog as well.
- Ginkgo Biloba- Ginkgo Biloba also increases circulation through the inner ear and decreases damaging free radicals. It is the most studied supplement for tinnitus with some showing positive results while others show no effects at all.
- Melatonin- It’s currently unclear exactly how melatonin helps improve tinnitus. It’s speculated that melatonin helps to improve sleep problems associated with tinnitus, not tinnitus itself.
- 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 for tinnitus
Magnesium- Magnesium is well researched as an effective migraine treatment. It helps nerve function, protects the nerves in the inner ear, relaxes muscles and blood vessels and is a powerful glutamate inhibitor.
Low levels of magnesium have been associated with tinnitus. More research needs to be done, but magnesium has also showed good results in lowering the volume of tinnitus.
Even more promising, magnesium may benefit the function of the inner ear & improve tinnitus by lowering your risk to damage caused by noise. Since migraine patients are often more sensitive to noise, protecting your hearing between attacks is a strategy to consider.
B vitamins for tinnitus
- B12– In one small study B12 was found to be particularly helpful in reducing the severity of tinnitus in those who are deficient.
- B2 Ribolavin- B2 is another well researched supplement for migraine prevention. The migraine tinnitus link may explain why some have success lowering the volume of tinnitus by supplementing with B2.
Natural treatment strategies for tinnitus
- Essential Oils- One of our wonderful members 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 also recommend dabbing behind your ear. These products won’t eliminate tinnitus, but may help soothe the effects of living with it.
- Cognitive behavioral therapy– There is a real link between tinnitus, anxiety and depression. Living with the torment of tinnitus can be emotionally draining. Intervention to help teach coping skills can be one of the most effective strategies to help improve your quality of life.
- CBD- Strategies to combat the stress, anxiety and sleep disturbances are another important piece of your tinnitus treatment arsenal. CBD may help to relieve minor pain and reduce stress promoting relaxation.
Habituation for tinnitus
Habituation is the process of training our brains to turn tinnitus into meaningless background noise. It simply means change your focus! Our brains truly are amazing. I understand this is easier said than done, but 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, it will learn to compensate for tinnitus as well. Because there is more to habituation than just “don’t think about it,” consider seeking the help of an expert in this area the same way you would seek the expertise of a physical or cognitive behavioral therapist.
Tinnitus habituation device
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 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.
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 feelings of empowerment. Use 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 releases stress & 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, Curable, Insight Timer and Headspace. These apps often include progressive muscle relaxation, guided imagery and many more techniques to help soothe you.
- 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.
What Makes Tinnitus Worse
There are many triggers that can make tinnitus worse including dehydration, insufficient sleep, noise, stress and dietary triggers like MSG, alcohol and caffeine. A healthy diet isn’t only important for a healthy body, it’s important for a healthy central nervous system and healthy ears too. A good way to remember tinnitus dietary triggers is through the easy to remember acronym CATS. Cats stands for Caffeine, Alcohol, Tobacco and Salt. While not everyone everyone will experience dietary tinnitus triggers, CATS are four common dietary tinnitus triggers that are real risk factors in making tinnitus worse because they influence capillaries and blood flow.
Some research suggests low salt intake (1500 mg or less per day) is beneficial in reducing tinnitus. Especially in those who have migraine and meniere’s disease. While other research suggests keeping a steady amount of daily salt intake is effective as well. Play with both ideas to see which one is helpful for you.
When it comes to MSG it is important to know its many hidden forms in processed foods. Get to know the cover words that are often used to represent MSG on food labels below.
Dehydration makes tinnitus worse
Dehydration is a trigger that makes tinnitus worse. Your ears rely on oxygen to stay healthy, blood is the only thing that carries oxygen to the ears. Failing to provide proper hydration reduces blood pressure and the flow of oxygen your ears desperately need. Dehydration also increases sodium levels in the blood which negatively effects the delicate fluid balance in the inner ear.
Dehydration is also a trigger for migraine attacks making it a central (brain) and peripheral (ears) migraine tinnitus trigger. Those with migraine often grow tired of being told to hydrate. But, hydration really should be the first treatment you reach for to improve migraine tinnitus. 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.
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. Confusingly, these same medications end up on lists of medications that make tinnitus worse. More research is needed here so talk to your doctor for expert advice.
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 vestibular suppressants 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.
Preventing and Minimizing Tinnitus
Protecting Your Hearing Between Attacks
Many with migraine and Meniere’s disease experience inappropriate response to sound that makes our perception of noise louder than it actually is. This means taking extra precaution to protect 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. 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 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.
Is there hope for migraine tinnitus?
Whether you’re hearing unbearably loud noise or quiet ringing with your migraine attacks, hearing noise that no one else can hear can torture you in unimaginable ways. With no ability to escape the noise you hear in your head, migraine ear ringing can feel hopeless and overwhelming.
While there is currently no definitive cure for migraine or tinnitus, hold on to your hope because it doesn’t have to be a life sentence of misery. There are many tinnitus treatment strategies available to help lessen the burden of this distressing symptom. If you are experiencing tinnitus, talk to your doctor about strategies that may work for you.
You can visit the American Tinnitus Association at ata.org to listen to sample tinnitus sounds and for more information on tinnitus.
9 thoughts on “The Migraine Tinnitus Link: Simple Strategies to Help Tune It Out”
Wow! Great article. There are times when I feel I will go insane because of the Tinnitus. There is nobody I can talk to that really understands what I am going through. It’s been a year and a half and I still have tinnitus and came to the realization not to long ago that I might very well always have it. But I do the diet and the pie and it improves very very slowly like a turtle with a broken leg. A month or two ago you recommend the Lemon Bio-Flavonoids on the Migraine Facebook group so I tried it. Oh my god, this stuff really works. I felt a good hit right away in the reduction of the loudness, but it slowly keeps on working. This week so far I have had 3 almost quiet days. Quiet meaning I have to specifically listen for it to know it’s there. It gives me hope. I am currently on 50 mg of nortriptyline and hope to be able to get that down to 25 mg in the next year or so. That would be great, I could live with that. Anyways thank again for all you do for this group.
Thank you so much for your sweet words Nancy. The way you describe your tinnitus is exactly how mine feels too. I’ll take super quiet sound over the loud intrusive version any day. Keep working your treatment plan. You’re so right about improvement being slow but we’re improving…that’s all that matters. We’re snailing it!! 🐌🐌😂 Jenn
Great article! Where can you buy the Lemon Bio-Flavonoids? I’m in Florida
Hi Kathryn. I buy them directly from Nutrition Express online. I believe I linked directly to their website in the blog. Amazon sells them as well, but they cost twice as much so go with Nutrition Express. 😘
I lost al hearing in my left ear years ago & qualified for a cochlear implant to help mask my extremely loud tinnitus. But Covid seems to have now tripped up some of that constant firing and some of it is now firing laterally across my forehead giving me one constant migraine that never stops. It begins in my left ear and travels straight across my forehead. Any ideas would be helpful. Thanks!.
I bm don’t see the list of medications making Migraines worse in your Mayo Clinic link?
Hi DawnRae, sometimes links like this one are updated. I’ll look into it. Thanks for letting us know. xo, Jenn
Thank you for this fantastic, well researched and written article! May I ask the amount, dosage etc you take of the Lindberg Bioflavanoid?
In gratitude, Jean
Hi Jean, I take one tablet per day. Some have success with just a half a table while others need two so try this one to meet your personal need. xo, Jenn