by Neil Bauman, Ph.D.
© November, 2020
A lady asked,
I’ve had ringing in my ears for several months now either due to taking a drug, or a smoke alarm suddenly going off. It is so strange though. For a couple of days, my left ear will have low ringing, then it will stop and go to my right ear and it will ring for a few days . Then , it seems like both ears ring. What is going on with my tinnitus and my ears? This is totally confusing to me. Should I be worried?
Excellent question. It almost seems like your brain can’t make up its mind where your tinnitus is coming from, doesn’t it? And if you think that, you’d be exactly right. Let me explain.
As you know, your brain sits inside your skull. What you may not have thought of is that your brain sits there in total silence and total darkness. It knows absolutely nothing about the world around it of its own knowledge. The only way your brain knows anything of what is going on around it is by the signals it receives from your sensory organs (ears, eyes, nose, etc).
Since we are talking about tinnitus, I will limit this explanation to just our ears and sound signals. Your brain receives voluminous electrical impulses from your ears. As it processes this enormous string of electrical impulses, it begins to form a 3-dimensional picture of the sound environment around it. Since it can’t “see” the real picture itself, this 3-D picture is your brain’s “best guess” from where the various sound signals are coming. Sometimes this “best guess” is very clear and accurate. Other times its “best guess” is “way off”. It all depends on the “quality” of the sound signals it receives.
Tinnitus signals, since they are really phantom sounds, can be rather nebulous at times. Thus, sometimes your brain’s “best guess” is that the sound signal is coming from your left ear. Thus, you perceive tinnitus in your left ear. Conversely, sometimes its best guess is that the sound signal is coming from your right ear. Consequently, you perceive your tinnitus in your right ear.
Furthermore, sometimes your brain’s best guess is that the tinnitus sound signal is coming from both ears. Thus, you “hear” your tinnitus in both ears at the same time.
There is even a fourth possibility. That is that your brain’s best guess is that the sound signals don’t come from either ear, but are just right there in your brain. In this case, you “hear” your tinnitus inside your head without reference to either ear.
As you now can appreciate, a lot depends on how well your brain interprets, and makes sense out of, the very complex sensory input it receives. To be sure, a lot of the time your brain gets it right. So if you had a blow to your left ear, for example, you probably will hear tinnitus as coming from your left ear.
It’s only when the sound signals are ambiguous that your brain has a tough time making sense out of these signals. Thus its “best guess” may be fairly accurate or “way off”.
Thus whether you hear your tinnitus in one ear, both ears or without reference to either ear doesn’t really mean anything as far as you are concerned. It just means your brain is having a tough time figuring out where those phantom tinnitus sound signals are supposedly coming from, and that is subject to change as new signals arrive.
Cold this kind of switching sides tinnitus be an indicative that there is nothing wrong with your inner ear? I mean, if my tinnitus was caused by damage to inner ear hair cells, the phantom sound should always be generated on the same ear and it wouldn’t make sense for my brain to interpret it as coming from the other side.
I’m totally aware that I ignore many details on how the brain actually interpret sound stimuli, so my conclusions may be wrong, but it sounds logical to me.
Hi Martin:
Tinnitus may or may not have anything to do with your ears, but it always has something to do with your brain. So in your case, your tinnitus may not have anything to do with your ears at all.
Your argument sounds logical on the surface of it, but it doesn’t fit the reality of how our ears work and how tinnitus “works”.
Where you hear your tinnitus–left ear, right ear, both ears, in your head–is just your brain’s best guess as to where the sound is coming from. So at different times your brain may change its mind where it is coming from–particularly if the signal is nebulous or weak. So much depends on the kind of tinnitus you have, and how strong the signal is in your brain.
Cordially,
Neil
Hi Dr.Bauman,
I’m back at my parent’s house and I started hearing a new sound in my
right ear all of a sudden. It kind of sounds like a whooshing sound that the the wind makes on a cold night. It’s really bad some nights and not so bad other nights.
I find this strange because I was in Florida about a week ago and I couldn’t hear this sound at all. I couldn’t hear this sound in my NYC apartment at all. I did have episodes of hearing this ‘whooshing’ sound when I got my ear wax removed by micro suction earlier this summer and a few times when I was younger but they all went away suddenly.
I asked my mom if she ever heard similar sounds at night and she said that she hears whooshing sounds in her left ear all the time too.
This makes me think of the possibility that it might not be tinnitus, but rather my environment.
I was wondering if you have ever come across a case like this? Is this tinnitus or could it just be the environment I’m in and the fact that I have sensitive ears?
Hi Regina:
When you hear a tinnitus-like sound in one place and not in another, I wonder whether it is a soft but real sound that your brain is changing to an illusion of hearing a different sound. This is called audio pareidolia.
It could really be one of the many tinnitus sounds.
It could be a real sound. But if that is the case, plugging your ears would make the sound stop. So it is easy to tell if it is real or not. The same would occur with audio pareidolia–but in that case, if you turn the background sound off (typically a fan or motor running), the sound stops instantly. If it is tinnitus, you’d typically hear it whether you block your ears or not.
You’ll have to do a quick experiment to see which of the three it really is.
Cordially,
Neil
Hello Dr. Bauman I have had tinnitus and hyperacusis for 5 years. I had many difficult periods with loud tinnitus in the past and pai n hyperacusis but in the last 2 years my hyperacusis is somehow improved so I can live normal life. My tinnitus also became mild. However, 2 weeks ago I took sildenafil for ED issues and my tinnitus is severe. Is it possible that this is only a spike and can return to previous baseline like before? Even if this spike last for a few months is it possible that it can go away or it’s permanent?
Hi Marko:
I don’t have any information on whether tinnitus from Sildenafil is temporary or permanent. If it also caused hearing loss, it could prove to be permanent, otherwise it may be temporary and will eventually return to baseline. Let’s hope it does that.
Cordially,
Neil
Hi Dr. Bauman,
I woke up one day with tinnitus in my left ear. No idea why it started. I thought it would go away in a few days, but it didn’t. So I went to an audiologist/ENT and discovered I had significant hearing loss in my right ear and slight hearing loss in my left ear.
They didn’t offer me much information beyond that.
I eventually developed tinnitus in both my ears. And it actually shifts from day to day on which ear it is more intense in. I will go to sleep with it more intense in my right ear, and then wake up and it’s intense in my left ear.
Is there a sleep issue going on that is making that change? It feels like it is more difficult for me to habituate when the tinnitus keeps moving around.
Also, do you think hearing aids would help?
Thank you.
Nathaniel
Hi Nathaniel:
I doubt that there is a sleep issue causing your tinnitus to change sides. Mine changes when it feels like it for no apparent reason, so I don’t think there is anything wrong.
Now, if your tinnitus came and went depending on how you slept, then that could indicate you neck being out of proper alignment causing your tinnitus.
You wear hearing aids to help you hear, not to get rid of tinnitus. However, when wearing hearing aids, often people aren’t aware of their tinnitus so much because of the real sounds coming in through the hearing aids. But when you take off your hearing aids at night, you’ll likely find your tinnitus coming back.
Thus, to my way of thinking, it is better to habituate to your tinnitus so that whether you wear hearing aids or not, your tinnitus won’t bother you.
Note that most hearing aids now have tinnitus programs built in to make it easier for you to habituate to your tinnitus if it is a problem.
Cordially,
Neil
Thank you.
My tinnitus can be so intense that it seems like it would be impossible to habituate to it, but I am only 8 months or so into experiencing it, so maybe overtime its intensity or perceived intensity will dissipate.
Hi Nathaniel:
Tinnitus can seem very loud, but remember, that is your perception of it. Since it is just a perception, you can change that perception (known as habituating to your tinnitus). You want to remain positive. When you say “it seems like it would be impossible to habituate to it” you are getting close to making a self-fulfilling prophecy that you won’t be able to habituate to it–and thus make it come true.
Instead of thinking of yourself as a victim of tinnitus and that your tinnitus will negatively affect your well-being, you need to think of your tinnitus as NOT a threat to your well-being, but rather just an unimportant, useless background that it is safe to ignore–then ignore it. When you do this, you give your limbic system permission to habituate to your tinnitus.
Habituation comes in two steps. The first step is habituating to the annoyance of your tinnitus so it no longer bothers you. The second step is to habituate to the volume of your tinnitus so you perceive it as less loud and you may go for hours without even being aware you have tinnitus.
I am habituated to my tinnitus, yet every time I think about it, there it is. For example, so far this morning I wasn’t aware I had tinnitus, but now that I am answering your post about tinnitus, it suddenly sprang up and my ears are ringing away now. One of the hazards of having tinnitus and helping people with tinnitus.
However, the good news is that within 5 minutes of completing this post, assuming I do not go on to answer another question about tinnitus, I’ll no longer be aware I have tinnitus.
You, too, can achieve this level of habituation, if you do the right things.
Cordially,
Neil
I really appreciate your answers, Neil. They are very helpful.
Hello i recently did the bad choice of firing i new pistol i got for Christmas and i forgot my ear protection, i only shot one mag so 10 times and that was on Jan 4th and its Jan 18th now so exactly two weeks.
ive not noticed any change really in hearing other then the first day or so which is normal muffled, and i did a self test and i can hear up to 15,900 hz which seems to be normal for my age of 32.
may be rambling sorry but with that being said what’s the time frame for it to possibly go away seeing as it seems my hearing is intact.
also, on a separate recent days I’ve started having symptoms of a ear infection including my throat bothering me some and I’ve read that antibiotic which will probably be what i need can make tinnitus louder now is that a premiant loudness increase or do they mean while on the meds.
Hi Austin:
Tinnitus from noise trauma can be temporary or permanent. A lot depends on how you consider your tinnitus. If you think of your tinnitus as a threat to your well-being in any way, it tends to be permanent and often gets worse.
However, if you treat your tinnitus as just a useless, unimportant background sound that is safe to ignore, and then ignore it, it typically fades into the background in time and doesn’t bother you. This is called becoming habituated to your tinnitus.
Some drugs cause tinnitus only while you are on them and it fades away in a couple weeks after you stop taking them. For other drugs, the tinnitus is permanent. Some antibiotics such as the aminoglycosides and the fluoroquinolones tend to be permanent. Others tend to be more temporary such as the macrolides and the cephalosporins.
Whether you get tinnitus from a given drug often depends on the dose–a higher dose is more likely to cause tinnitus–and the length of time you take it. So taking a given drug for say 5 days is less likely to cause tinnitus than taking the same drug at the same dose for say 15 days. So the key is to take the least ototoxic drug that will do the job, at the lowest dose that will do the job, for the shortest time you can–and often you will fly under the tinnitus radar.
Cordially,
Neil
thank you that helpful info and i read about Habituation. if a tinnitus is just temporary is the a window like that it will go away in like my hearing level seems to be normal all im having is the noise. and thanks for the info on antibiotics reason i asked was like a week ago the tinnitus got louder and shifted to my left ear and then i started getting ill and that come to find out was vertigo so im wondering if i might have a ear infection and could it be a coincident that i got it after this stupid mistake and that maybe its making it worse idk ill take all the info you can give.
Hi Austin:
When you get a cold, the cold virus can get into your inner ears and cause some balance problems such as vertigo. That is usually just temporary and should go away in a day or two. Hearing loss, if in the middle ear, is typically temporary, whereas inner ear hearing loss is typically permanent. The former is a conductive loss, the latter is a sensorineural hearing loss.
I’d say your ear problems are mostly due to your cold virus, but there was some tinnitus, etc. from the shooting episode too.
Cordially,
Neil
thank hope its not to crazy if i keep asking but whats a time period on loud sound induced tinnitus roughly and
one big question is it ok to use headphones the ones that go over the ear not in
Hi Austin:
There’s not way to really answer your question. Tinnitus could have gone away in a few days to two weeks, and it could never go away–so there’s an enormous range. So much depends on a number of factors with the chief being how you view your tinnitus. If you view it as a threat to your well-being it likely will never go away. Whereas if you view it as a useless, unimportant background sound that is safe to ignore, and then ignore it, you should find it slowly fading away. This could take a month or it could take 2 years or more. There is no set time or even a reasonably accurate “average” time. The general rule is the less you focus on your tinnitus, the faster it fades away.
Now, can you use headphones or not. Some professionals say “no”, but I don’t buy into that. The trick is to keep the volume down–about the level you’d comfortably listen to a lecture when wearing headphones would be about right. Since all the sounds are “trapped” by the headphones if you turn the volume up the louder sound waves have no where to go but to assault your eardrums–and that is bad and can make your tinnitus worse.
Cordially,
Neil
so when i see my doc or talk to him about this pressure and he decides to give me a antibiotic can he give me specific ones that dont affect tinnitus
Hi Austin:
I don’t know of any antibiotics that do not cause tinnitus in some people. So there is always a risk. The trick is to choose the drug that will do the job and yet minimize the risk of tinnitus and other ototoxic side effects.
Cordially,
Neil
so my Doctor gave me Cefdinir and idk i really dont want my tinnitus to get any worse then it is and end up being permanent
Hi Austin:
Cefdinir has a few reported cases of tinnitus, but in my opinion the risk of getting (worse) tinnitus from taking this drug is very low. All antibiotics can cause tinnitus, so the trick is to pick one with a very low risk and I think this drug fits the bill–but there are no guarantees.
Cordially,
Neil
thank you i think im going to see if this sinus infection or whatever goes away in a few more days and if not then ill take it
I saw a audiologist Friday and they did tests my hearings seems to be normal and I don’t seem to having hearing lose from the one time loud exposure
. They couldn’t tell me a lot about T and I forgot to ask some things. I’m wondering if people get tinnitus without hearing damage will that be more likely to go away it’s been just over a month since it started
Hi Austin:
Since tinnitus often accompanies hearing loss, it can persist just like the hearing loss. So, if your tinnitus is not caused by hearing loss, you could expect it to more likely be temporary once the causative agent is corrected–for example–stop taking a drug that is causing the tinnitus. But even that is not a given.
In my opinion, whether your tinnitus persists and becomes bothersome is more likely caused by how you view your tinnitus. If you view it as a threat to your well-being, it will generally persist, whereas if you treat it as a totally useless, unimportant sound that is safe to ignore, and then you ignore it, it will probably fade away in time.
Cordially,
Neil
My tinnitus is from shooting a gun on Jan 4th without my ear plugs that I forgot at home this is the cause the tinnitus started at that moment and hasn’t faded which is odd since like you said tinnitus usually happens in connection to hearing loss but tests say my hearing is intact and normal I’ve been trying to keep busy or mask it night time seems to be the worse when I’m alone during the day it’s become bearable but I still have hope it will dissapeat
Hi Austin:
Don’t give up hope. If you are alone during the day and your tinnitus is bothering you, listen to some music or pink noise, or water sounds to lessen the contrast between your tinnitus and quiet. This often helps make your tinnitus seems less intrusive.
Focus on things other than your tinnitus. At the same time, don’t think of your tinnitus as a threat to your well-being, but as a useless, background sound that is safe to ignore–then ignore it by focusing on the loves of your life.
Cordially,
Neil
I have been using a tens unit on my vagus nerve (clip on concha of the ear and ground on back) I use 200ms 30hz and normal setting for 35min a night. It seems to help a bit along with tinnitus 8000hz tones. Do I need to vary this procedure, or do you have any comments on this method.
Hi Grace:
I’m no expert on TENS, but one study showed that TENS works better on people with low-frequency tinnitus and have mild hearing losses. Thus, if you have high-frequency tinnitus and more severe hearing loss, you probably won’t find TENS as effective.
Also, TENS seems to work better on people with the more common neurophysiologic tinnitus than for people with somatosensory tinnitus. I think this is because if you have somatosensory tinnitus (varies with head/neck/jaw movements) you want to calm down those nerves, not stimulate them further.
Having said that, if it is helping, then keep on doing it. If not, then stop it. Also be aware that some people find that TENS makes their tinnitus worse. If that happens, then stop it and for most, their tinnitus will go back to its former level, but in a few cases the increased tinnitus is permanent.
I don’t know anything about the settings and timing of using the TENS unit so I can’t say whether you are using appropriate settings or not. You could try varying settings and length of time you use your TENS unit and see whether you get better results or not. Of course, the place to start is in the instructions that come with your TENS unit.
Cordially,
Neil
Hello. I got tinnitus three weeks ago because I was blasting my ears with loud music. It was accompanied with ear pressure and ear fullness. I went to 3 ENT’S and all told me my hearing was perfect. After 3 weeks my tinnitus is a lot softer and less perceivable and I don’t feel any pressure, however my ears keep crackling so I’m suspecting I might have an Eustachian tube dysfunction. I’m just worrying if tinnitus will be permanent since I still hear it, though it’s a lot more bearable. How likely is it that the soft roaring/static noise I hear will go away? Am I stuck with it?
Hi Anthea:
It’s always hard to predict whether tinnitus will go away totally or just drop to a low level. You are lucky you didn’t wreck your hearing, etc. but only have the tinnitus as a reminder of this episode.
If your tinnitus is continuing to get softer with time, it may fade to such a low level you are not aware of it most of the time unless you listen for it. So much depends on you and how you deal with your tinnitus now. If you focus on it and think of it as a threat to your future well-being, then it will stick around and often become worse. However, if you treat it as NOT a threat to your well-being, but just as a useless, unimportant background noise that is safe to ignore–and then you ignore it and get on with your life, you will find that you habituate to your tinnitus and thus even if you do hear it from time to time, it is not a problem and won’t bother you.
And of course, you want to protect your ears from loud music and other loud sounds in the future or it can come back with a vengeance.
Cordially,
Neil
Hi, just looking for some opinions . I woke up a few days ago with tinnitus in both ears. Don’t have hearing loss or been exposed to loud noises . Not on any drugs either. Any thoughts on this? Cud this be temporary or permanent?
Hi John:
It could be because you were particularly stressed or anxious–but you don’t mention that so that is probably not the cause.
My best bet is that you are experiencing a form of somatosensory tinnitus–possibly because you twisted your neck while you slept or have TMJ. Was your neck or shoulders “tight” when you woke up?
Somatosensory tinnitus is typically temporary and goes away when things go back into proper alignment.
Cordially,
Neil
Thank you for your reply. It’s so strange . I don’t remember being stiff but I had been waking up previously with sore necks. Will an ENT appointment be able to confirm this? Noise is driving me crazy 🙁
Hi John:
If I were in your situation, I sure wouldn’t go to an ENT. This is not his areas of expertise. Rather, I’d go to a chiropractor, preferably an upper cervical chiropractor, not a conventional one, to get your neck properly aligned. It may take several treatments–but once the treatments “hold” and your nerves calm down, the tinnitus should go away. (All this is assuming that you have somatosensory tinnitus from this cause.)
You can find an upper cervical chiropractor at http://www.upcspine.com/ and click on practitioners.
Cordially,
Neil
Hello, I’m a 16 year old high school student that randomly started having whooshing sounds in my left ear one random morning. This lasted for 2 weeks and I was prescribed ear wax drops to remove extra ear wax I had that was believed to cause the noise. I even got my ears flushed but the tinnitus never left. Another 48 hours passed after the cleaning and I have had ear ringing now for about three weeks. The noise is only noticeable at times at it almost never noticeable outside. It has been stressing me out a lot but the noise has been getting quieter but then some days it’s louder and then back to quiet. There are also some times where it’s loud for a few seconds and then back to quiet . I have went to an ENT and have gotten a hearing test and my hearing is just fine. I have no clue what caused this and want to get it over with fast. Note I also have like a cackling noise when I swallow i don’t know if that means anything but my best guess is that I have ETD. Thank you for your time and please update me if there is anything I can do or if you know what the problem is.
Hi Abubakr:
Do you still hear the whooshing sound or is that gone now, and you just have another tinnitus sound?
The crackling sound is typically caused by congestion in your Eustachian tube/middle ear. Have you had a cold, virus or allergies in the past few weeks?
Cordially,
Neil
Thank you for the reply, the wooshing noise for the almost 2 weeks now it’s been completely gone and it’s just ringing that sometimes is more noticeable at times and has recently been more noticeable. If it helps, throughout random times of the day I feel a pop in my ear this usually happens about twice a day at max. I’ve also recently had random spikes of the ringing that last for a few seconds, this happens 1-3 times a day with no apparent cause.
I have not had any cold virus or allergies in the past, in the morning or when I make up on the middle of the night I notice my throat being sore sometimes however.
Hi Abubakr:
At this point I can’t see anything in particular you need to do, apart from not focusing on your tinnitus. The more you focus on it the louder and more intrusive it becomes. Therefore, basically ignore it and focus on the loves of your life.
These random spikes you experience–do they just come out of nowhere, are tonal (whistling) in nature, occur in only one ear, rise to a loud level in a matter of a second or so, then fade away to nothing in another few seconds? If so, this is a natural phenomenon called Transient Tonal Tinnitus that everyone experiences from time to time. It is thought that your brain is recalibrating your auditory system. Nothing to worry about.
Cordially,
Neil
Thank you so much, my tinnitus is pretty easy to ignore so I can live with having it. I have noticed however that sometimes there is some sort of tension feeling in my jaw and ear which I feel like maybe I should visit a chiropractor and see if they can do anything.
The random spikes are at random times of the day and only last a few seconds in one ear, it might not matter but I’ve noticed that the cackle noise after I swallow is louder in my left ear and at times I don’t have the noise when I swallow, other times I do. It’s also louder at random throughout the day but it’s always louder in the left ear.
Hi Abubakr:
You can see a chiropractor or dentist that specializes in TMJ issues. They may be able to help, but there are no guarantees.
Cordially,
Neil
Neil Bauman,
First, thank you for taking the time to discuss this topic on this forum. It is very kind of you.
My tinnitus can fluctuate between ears. The pitch increases when I clench my jaw. I wondered if the pitch changing from my jaw is a sign that it is TMJ related and thus curable?
Can tinnitus from loud sound also change in pitch when clenching one’s jaw
Thanks,
Matt
Hi Matt:
When you tinnitus gets louder when you clench your teeth, it is a sign that the louder tinnitus is related to your TMJ or cervical vertebrae are out of proper alignment. But it is not a sign that your baseline tinnitus is due to this cause. You probably have two kinds of tinnitus–the baseline tinnitus from exposing your ears to loud sounds or from taking ototoxic drug for example, and your louder tinnitus from TMJ or neck issues.
And yes, existing tinnitus can change in pitch when clenching your teeth. Typically it goes up in pitch.
Cordially,
Neil
Hi,
I have a question as well. I have tinnitus for more than a year right now. And it went really well after like 3 months, but i am right now in a stressful period with my study. I studying medicine and i am getting less sleep than usual since this week. So i right now have very loud ringing compared to the beginning when i habituated. Is this normal? Does my body need to get used to the stress? I am trying to be more kind to myself and take more breaks, but so far it is really loud in the evening when i finally lay down… Do you have tips or more info about this phenomenon?
Hi Valerie:
Stress exacerbates tinnitus–there’s no doubt about it. And lack of sleep is a stressful. So in order to keep your tinnitus under control you need to get more sleep and learn to relax and learn how to properly deal with stress. Your body doesn’t get used to stress. It reacts to it and that affects your health. That’s why it is so important to learn how to properly deal with stressful situations.
Cordially,
Neil