Sounds of Insanity: Causes, diagnosis and treatment of tinnitus.

February 20, 2023

Colorado Springs

(719) 309-3000

Grand Junction

(970) 287-1173


Don Cooper Ph.D.

Director of the Medical Science Division at Ramos Law

"I have a constant ringing in my ears, and it makes me feel as though I am going insane."

Tinnitus (TIN-ni-tus), a perception of phantom sounds, is a common condition affecting nearly 15% of the population. The perception of tinnitus is like the phantom perception of an amputated limb, where the loss of feeling from sensory inputs leads to compensation mechanisms in the brain where the amputee still experiences sensations in the missing limb. Research has investigated the connection between hearing-related damage and tinnitus, with some findings suggesting an auditory component in certain forms of the condition. However, tinnitus-related distress is not solely dependent on the auditory characteristics, such as loudness or pitch, but rather the interpretation of the tinnitus experience can have a greater impact on symptom severity. Psychological factors, such as negative attitudes, thoughts, and emotional responses, have been identified as major contributors to the variation in quality of life for those with tinnitus. The emotional neural networks, which are involved in normal emotional behavior, are believed to affect the peripheral-to-central circuit in individuals with tinnitus. The condition can be challenging and disruptive to daily life and may also indicate a more serious underlying issue. In this article, we will explore what tinnitus feels like, its possible causes, how it is diagnosed, treatment s, demographic considerations, and any potential connection to adverse effects from vaccines.

What Does Tinnitus Feel Like?

Tinnitus is a subjective experience and may be different for everyone. For some people, it may be a mild annoyance, while for others (about 3-6% of the population), it can be a debilitating condition that interferes with daily activities and quality of life. The sounds experienced with tinnitus can range from ringing, buzzing, humming, whistling, to even screeching. The sounds may be constant or intermittent, and they can be heard in one or both ears. In some cases, tinnitus can be so severe that it affects sleep and concentration. It is no wonder why Poe described his constant ringing as though he was going insane.

How is Tinnitus Diagnosed?

Diagnosing tinnitus typically involves a combination of a patient’s medical history, physical examination, and various tests. Audiological tests can be used to evaluate a person’s hearing and determine if there is a hearing loss that could be causing the tinnitus. Imaging tests, such as MRI or CT scans, can be used to rule out any underlying physical abnormalities that could be causing the tinnitus. Tinnitus matching tests and questionnaires can also be used to diagnose tinnitus.

Who suffers from tinnitus?

Tinnitus can affect people of all ages and genders, but it is more common in older adults. People who have been exposed to loud noises over a prolonged period, such as military personnel, construction workers, and musicians, are also at increased risk of developing tinnitus. Additionally, individuals with hearing loss and those with high blood pressure or diabetes, are more likely to experience tinnitus.

What are the known causes?

Tinnitus can have many causes, such as exposure to loud noises, ear infections injuries, cardiovascular disease, PTSD, head and neck trauma, and Marfan syndrome. Tinnitus can also be a side effect of several medications, including:

  • Aspirin: When taken in high doses.
  • Antibiotics: Certain antibiotics, such as aminoglycosides and vancomycin.
  • Cancer medications: Chemotherapy drugs, such as cisplatin.
  • Diuretics: Drugs that increase urine output and potentially alter electrolyte balance, such as furosemide (Lasix).
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen and naproxen, can cause tinnitus when taken in high doses or for extended periods of time.
  • Quinine-containing medications: Drugs containing quinine, such as quinine sulfate and tonic water, can cause tinnitus.

Are There Genetic Risk Factors?

The notion that tinnitus may have a genetic component has gained traction in recent research. A better understanding of contributing genetic elements could provide insight into the root causes of tinnitus and pave the way for better treatments in the future. Awareness of the genetic risk factors could also help individuals make informed decisions about their health and seek early intervention if necessary.

Is There a Possible Autoimmune Component?

Evidence suggests that there may be an autoimmune component to tinnitus. Some studies have found antibodies to inner ear antigens, which are proteins found in the inner ear, in the blood of some people with tinnitus that are associated with autoimmune disorders. Furthermore, there have been some reports of tinnitus as a side effect of vaccines, particularly the COVID-19 vaccine. This is an active area research. Many who report serious vaccine-induced vascular neurological symptoms also report tinnitus.

Tinnitus Is a Recognized Injury by the Vaccine Injury Compensation Program

The Vaccine Injury Compensation Program (VICP) is a federal program that provides compensation to individuals who have suffered a vaccine-related injury or death. Tinnitus is included on the list of recognized vaccine-related injuries under the VICP, and compensation may be available to individuals who have developed tinnitus after receiving certain vaccines.

For those who believe they have suffered a vaccine-related injury, including tinnitus, it is important to contact the experts in the Medical Science Division at Ramos Law to learn more about the process for seeking compensation. It is important to note that compensation under the VICP is only available if the injury is determined to be vaccine-related and meets the criteria established by the program.

What are the Treatment Options?

Treatment for tinnitus will depend on the underlying cause, if it can be determined. If tinnitus is caused by a treatable condition, such as a medication side effect or an ear infection, treating the underlying condition can help reduce or eliminate the tinnitus. In other cases, treatment may involve sound therapy, such as white noise machines or hearing aids with tinnitus masking features. Cognitive behavioral therapy and mindfulness-based stress reduction can also be effective in managing tinnitus. In severe cases, surgical intervention may be necessary.

[1] National Institute on Deafness and Other Communication Disorders (NIDCD). (2021, November 17). Tinnitus.

[2] Centers for Disease Control and Prevention (CDC). (2021, November 19). COVID-19 Vaccine Side Effects.

[3] Michielse, S., & van Dijk, P. (2015). The genetic basis of tinnitus: a review. Frontiers in genetics, 6, 174.

[4] Jastreboff, M. M. (2001). Tinnitus retraining therapy (TRT) as a method for treatment of tinnitus and hyperacusis patients. Journal of the American Academy of Audiology, 12(3), 162-177