Any Tips for the Cause of My Tinnitus? Couldn't Find Much About Similar Cases

I opened this thread to keep a journal about changes and findings about my case. Around the middle of November I suddenly started having tinnitus, here are the details so far:

- I'm male, 27
- I was sleeping with ear plugs for over a year before it started. They weren't cleaned much But since the tinnitus started I threw them out
- The sounds are bilateral, and they started at the same time. No loud sounds, parties were preceding them. Sometimes one ear gets a bit louder, sometimes the other one, sometimes even.
- There are more sounds, about 5-6. It is completely random, which one comes forward, and which stays in the background, and also the sounds change between the ears, or it can come from the middle of my head.
- My hearing test came back perfect. The sounds I hear also around the middle-upper middle range of sounds, not very high pitched. At that moment my ears didn't ring though, so it could not have been measured.
- It is not that bothersome, I only notice it in silence, since the start there were days in a row, when almost nothing was heard (even in complete silence), sometimes they got a bit louder. It comes and goes, when I'm doing something I don't notice it. Right now one of the sounds is on for the 3rd day in a row though. It sounds like when a TV is on, but there is no signal, the slight hissing. This is the worst. It worries me a bit, that it goes on for the 3rd day though, usually a sound didn't last longer than couple hours before changing.
- I'm taking a drug for secondary hypertension, which can cause temporary tinnitus as a side effect, called perindopril, an ACE-inhibitor. It took down my blood pressure to around 110/65. My doctor said try taking a little less (I was taking 7,5mg, now taking 5mg), around that time it seemed like it got a bit better, but it is still on. Also I was taking this for 4 years now without a problem. Can a side effect appear this late?
- This was also the only drug I took pretty much in my life, or at least in the last years. I only take Vitamin C and D beside this.
- The tinnitus also appeared after a stressful 2-3 months.
- I didn't have vertigo or any other symptoms. Sometimes it feels like a little bit of pressure in both of my ears. Also at the start my right ear used to get clogged after I woke up in the next 30 minutes, but since I decreased my drug, that went away.
- The right side of my jaw always clicked like crazy, you can literally see and hear how it snaps out of its place, but it never caused me any pain. I read jaw problems can cause tinnitus, but my tinnitus is in both ears, not just the right side.

So far these are the facts. My doctor said let's try to take even less of the drug, only 2,5 mg. I'll go back for a more detailed examination around the middle of January. Hopefully it goes away. Thanks for reading

 

What is the name of the drug?

 

When was the last time you were exposed to loud noises?

In my experience, hissing is the easiest to ignore. All of the alternatives (e.g., high pitch tone, crickets) are more disturbing. It sounds like your T is super mild. There is a high chance that it will eventually go away, assuming you will not do more damage to your ears.

 

It is called Coverex 5mg. I'm not from the US, but the tablets and packaging looks eerily familiar to Coversyl 5mg.

Clubs are pretty much the loudest for me (although I haven't been since the onset), also it didn't start after a night of clubbing, or headphone use. Just out of nowhere I noticed some sounds while wearing the earplugs one night, went on 2 weeks without paying any attention to them (I only heard it at night while wearing my earplugs.) I thought it must be earwax anyway, went to the doctor, he said "bad news, my ears are clean, because earwax would have been the easiest to solve". His main guess was stress though at that time, and also said the earplugs can't cause it, only enhance it. I was very stressed out continously the 2 months prior onset.

After that I immediately stressed out about it every night, then it started to go away eventually. Days went on without any attention from me, I only heard the sounds, when I plugged in my ears fully with my fingers. Then it came and went, but even when I heard it, it didn't bother me. There were nights in a row when I didn't hear anything even in complete silence.

On dec. 24 the hissing was bad, it's like constantly hearable just above the current sound level. On dec. 25-26 I heard absolutely nothing. Then dec. 27-28-29 the hissing is constantly on. Even though I just relaxed and did nothing. Before dec. 24, I pretty much wasn't bothered by it at all, I never heard it except maybe in complete silence.

So I don't know what is causing it in the last 3 days, maybe this is my first spike. Or can it be weather related?. Hopefully the hissing goes away, because it was much better earlier. It changes a little bit when I open my mouth fully, or turn my neck left-right or up and down.

Yeah it was super mild, except the last 3 days.

 

Sorry I misunderstood the question. I thought you asked what, not when.
Last time I was at a club which is known to be loud was around the end of October. About 2-3 weeks before the start of tinnitus.
Headphones maybe? I'm not sure, like it didn't happen after using them. Also hearing test is perfect.

So far in my opinion it is probably either the drug, the stress or the jaw.

 

The pages
https://www.ehealthme.com/ds/Coversyl/tinnitus/
https://www.ehealthme.com/ds/Coverex/tinnitus/
https://www.ehealthme.com/ds/Perindopril/tinnitus/
don't exist. This is a very good sign. It looks like nobody who took it had reported to the FDA getting T as a side effect.

I was looking for a report like
https://www.ehealthme.com/ds/aspirin/tinnitus/

Those reports show what fraction of people report side effects more than a month/a year after beginning taking the medication.

 

Hi @Darastonius, have you had your ears checked for compacted wax? Earplugs tend to push wax up against your eardrums which can cause Tinnitus. The different sounds coming and going around your head is a normal, quite common, attribute of tinnitus. The hardest part is not stressing out about it too much, because you will inevitably focus on it even more.

Do you have any cold symptoms? Blocked Eustachian tubes caused by allergies or a cold can also create noises in your head.

Do you have a history of noise exposure? Industrial work, musician, frequent clubbing, military etc?

 

My T began 10 days after my acoustic trauma. Did you experience any ear fullness after attending that club?

 

It is listed as common side effect on its leaflet, also lots of google search gives it, and the other doctor who takes care of my hypertension says it has happened before. But it seems strange that it would come out after 4 years of using it.

The doctor took a little cone looking thing, put it in my ear, looked into it, and that was it, he said no earwax there.

Last time I was sick was last winter. Also no allergies I know of.

Nope, nothing. Frequent clubbing maybe, but I always avoided the loud ones, or the dancefloor. Recently didn't party much.

No, I don't remember anything. But still, if it would be too loud music, then I should have some kind of hearing loss no? Like I was tested for sounds lower and higher than the tinnitus sounds I hear, I mean I was tested in the range of my tinnitus too.

But now I downloaded a frequency generator to my phone, going through every 100 Hz up to 20000 using minimal volume, maybe I discover some hearing loss myself. Did it up to 10000 so far, but I heard everything with each ear on minimal.

This is my problem, looked through everything, but nothing checks out. When it becomes loude, I start looking up stuff, but find nothing. When it went away, didn't even bother with it. Now it is back in the last 3 days out of nowhere, I'm looking through the net all day.

 

My advice: don’t. Try to relax and switch off. Don’t sit listening to it and don’t read about it.

There could be any number of reasons you have it. Do you know how to open your Eustachian tubes? If not, try yawning or swallowing and see if you notice any clicks.

Have you been under any stress lately? Working too hard, burntout? Bereavement?

Sometimes we never know what caused it, but I would try and move on before you turn it into an obsession. Just make sure in future you protect your ears in loud environments.

 

No. My T is a result of an acoustic trauma, and I have no hearing loss (at least as far as a standard hearing test is concerned).

It does not seem to be listed in
http://hlaa-sbc.org/wp-content/uploads/2013/11/Ototoxic_Brochure.pdf

Perhaps this has to do with the fact that this drug is not popular in the U.S.

 

I was under more or less, but constant stress in the last 2 years. It got really bad in the last 2 months before the tinnitus appeared, I burnt myself out badly, became very unpassionate, thoughts like "if I would die now, it wouldn't be that bad" and stuff.

Maybe my nerves gave in eventually, that would explain a lot, the bilateral sounds, all these switches between the ears and the pitches of the sound, and the long stretches of silence between the spikes. Now the head hissing is much better though than it was in the last 3 days, it is still there a bit, but much less noticable.

Thanks for the help guys, periodically I'll update this thread about changes and improvements. One thing is sure, from now on even if I recover, I'll constantly watch out for my ears. Funny thing is, before the tinnitus I was just planning to start hitting the clubs hard.

 

Burnout is a known cause. Could well be down to this. Try not to let this continue if you haven’t tried to calm things down yet. I’ll paste an old post of mine below which may shed some light on the effects burnout can have on people:

A common feature of burnout syndrome, for example, is tinnitus. Why is this? You could find a relationship between excessive cortisol levels in the bloodstream - over an extended period of time - and problems with tinnitus arising or getting worse. There is certainly a lot of evidence to support this from the frequent reports of tinnitus arising after intense periods of emotional stress. Excessive cortisol is not good for us and can cause all kinds of problems if left unchecked. Another issue is that many people are simply unaware that their cortisol levels are high, as they adapt or get used to it. Stress in this instance is a hidden danger.

Here is a link explaining more on the subject; I will copy and paste the content below:
http://www.deutsche-tinnitus-stiftung-charite.de/en/projects/tinnitus_and_stress/

"Many people who suffer from tinnitus believe that stress is the cause. And first studies indicate that there is indeed a connection. What is lacking is scientific proof.
The project “Influence of emotional stress on auditory functions” (for short: “Tinnitus and Stress”) is contributing to remedying this lack. It draws on research done by the molecular biology research laboratory of the ENT Clinic and the Tinnitus Center Charité.

It is established that chronic stress can in general induce and exacerbate changes to the auditory system. They include above all thehypersensitization of auditory perception (hyperacusis), tinnitus, and Menière's disease, a disorder of the inner ear that leads to attacks of rotatory vertigo, one-sided hearing loss, andringing in the ears.

But how does stress arise? As a rule it develops when people cannot cope with the growing and/or unexpected demands of their environment. They live under constant emotional pressure. The most frequent reaction is to deny any physical risk in an effort to enhance one's own achievement potential and staying power.

The physical effects of stress include increasedproduction of the stress hormone cortisol. This raises the blood sugar level (gluconeogenesis) and intensifies the breakdown of stored fat (lipolysis),as well as protein breakdown (proteolysis), making more energy available. Higher blood pressure, a high pulse rate, and constipation are the result. But the immune system also suffers. Many patients complain of sleeplessness and a lack of appetite, psychomotor disturbances, and growing feelings of anxiety.

According to Professor Birgit Mazurek, “All these stress-induced mental changes can also influence auditory phenomena, leading, for example to the development of tinnitus or the exacerbation of an existing tinnitus. In the ear, cortisol causes a massive release of glutamate into the neurons. This ultimately leads to a greater accumulation of calcium, which damages auditory sensory cells and nerve cells in the ear.”

With the “Stress and Tinnitus” project, the Foundation seeks to promote research in this field to develop better individual therapeutic approaches for patients with tinnitus and hyperacusis.

The HEINZ AND HEIDE DÜRR FOUNDATION is contributing € 150,000 over a period of three years to fund the research project."

Here is another study that finds evidence of stress having a direct effect on tinnitus. Again, I will quote some excerpts below, but I highly recommend reading the whole study:

http://www.biomedcentral.com/1472-6815/12/4

"We report three novel findings that establish differences between tinnitus participants and controls in terms of cortisol hypersuppression, longer-lasting effects of the DEX test on basalcortisol levels, and hearing discomfort threshold. The first novel finding is that tinnitus participants had more strongly suppressed cortisol levels than controls after pharmacological challenge, despite similar basal cortisol levels. This is consistent with the normal diurnal and blunted response to psychosocial stress in tinnitus participants described in a previous study [23], and supports the hypothesis that tinnitus participants have greater sensitivity to HPA axis negative feedback. Hypersuppression in the presence of normal or near-normal basal cortisol levels has also been found in other clinical populations, such aspatients with chronic fatigue syndrome [45–47] and burnout [48]. All these findings are consistent with the notion that basal cortisol and post-DEX cortisol suppression are mediated by two separate receptor feedback systems. More importantly, the suppression effect wasindependent of hearing loss. This is a key finding, because these factors are difficult to disentangle in tinnitus studies [19, 23], and it argues for a true effect of tinnitus in addition to, but unrelated to, hearing loss. Our findings therefore directly link tinnitus to a stress-related disorder, and not just to a hearing-related disorder, as some recent population studies suggest [12, 49].

The second important finding is that tinnitus participants showed a long-lasting carryover effect of cortisol manipulation. They had lower basal cortisol the day after the post-DEX day assessment compared to the two other basal cortisol assessment days, indicating not only cortisol hypersuppression, but also a longer-lasting effect of DEX administration. Although it cannot be excluded that these findings could berelated to slower DEX clearance in these patients, this possibility is unlikely, because there is no rationale for altered liver function in this particular group, which moreover did not differ from controls in terms of age, BMI, or physical or mental health. Furthermore, the carryover effect was observed in the tinnitus participants approximately 36 hours after DEX administration, whereas cortisol and DEX levels should return to baseline 24 hours after oral administration of 0.5 mg DEX [50]. A likely interpretation is that the carryover effect might have been due to HPA axis homeostatic vulnerability, and that hypersuppression might have been caused by increased glucocorticoid sensitivity."

"Subjective tinnitus ("tinnitus") is the perception of sound in the ears or head in the absence of an external sound and difficult to treat. Individuals with tinnitus can experience severe emotional distress, depression, anxiety, and insomnia [1–5]. A recent study in 14,278 adults reported an overall prevalence of 25.3% for any experience of tinnitus in the previous year and 7.9% for frequent or constant (at least once a day) tinnitus [6]. Prevalence increases with age, peaking at 31.4% and 14.3% from age 60 to 69 years for these two tinnitus frequencies, respectively [6]. The increasing prevalence with age is not surprising, because hearing loss is known to be an associated risk factor for tinnitus [7]. With increasing life expectancy, and because hearing loss and noise exposure are increasingly affecting military personnel [8, 9] and youth [10], tinnitus has become a significant public health issue.

Hearing loss predicts tinnitus presence, but not severity [11, 12]. Conversely, individuals with hearing loss do not necessarily experience tinnitus. There is therefore a need to determine other factors for this debilitating hearing disorder and its consequences for health in order to better prevent and treat it. One likely candidate is stress. Because stress has long been identified as a trigger or co-morbidity of tinnitus, based mainly on anecdotal and retrospective reports, this idea has been taken for granted in classical teachings on tinnitus [13]. In addition, recent large population studies have established thatemotional exhaustion and long-term stress are predictors of hearing disorders, including tinnitus [14, 15]. Functional and electroencephalographic brain imaging studies have also shown aberrant links between limbic (involved in emotions) and auditory systemstructures [16–18]. Structural brain differences (i.e., grey matter decrease) in tinnitus involving parts of the limbic system have alsobeen reported. More specifically, less grey matter in the nucleus accumbens [18, 19] and the left hippocampus [20] suggests a depletion that could be related to long-term exposure to stress, among other factors."

"Our findings suggest heightened glucocorticoid sensitivity in tinnitus in terms of an abnormally strong GR-mediated HPA-axis feedback (despite a normal MR-mediated tone) and lower tolerance for sound loudness with suppressed cortisol levels. Long-term stress exposure and its deleterious effects therefore constitute animportant predisposing factor for, or a significant pathological consequence of, this debilitatinghearing disorder."

 

Thanks for the study @Ed209

Some strange thing happened lately. I was having a great day, one of those days when pretty much no disturbance from any tinnitus. Then I thought about continuing the testing of my hearing with the frequency generator on my phone. It was on the absolute minimal volume far away from my ears, the sounds were barely hearable, and only played them for a second. 15000-15200-15400 Hz ok, then as I reached 15600 Hz, played it for a second, heard the sound with both ears, but the sound got stuck in my ears. Like it triggered the tinnitus quite badly actually, the middle of my head with both ears is ringing the same way as the sound the frequency generator made at the moment in the last 15 minutes. I'd be very unhappy if this would last forever just because of this very silent 1 second beep, but still it might provide some information for the future.

 

So after the New Year's Eve party I had another absolute silent night, even though it was a house party (not too loud though). Same things happened during Christmas when there were family gatherings and stuff. To me this seems like another evidence that my T is stress related. When I'm having fun and my mind is focused on something else it goes away, when I'm alone and stress on it it creeps in again. From now on I'll strive to keep myself occupied and not stress on the T and life in general.

That brutal spike 2 days ago in my previous post went away moderately after 4 hours and disappeared in the next 2 hours following that.

I'm no scientist, but I wonder if it is possible that the constant stress made my brain and nerves scramble a bit and that's why I had/have these constantly changing pitches in each ear and between the ears. Any T spike I had, whether it is middle, high or utra high pitched didn't last more than a few hours, then some types never came back for a while. Maybe as I'm working on destressing my mind slowly recalibrates itself out of these phantom sounds.

 

So my tinnitus went away actually, posted my final thoughts in the following thread

https://www.tinnitustalk.com/threads/got-a-second-chance-at-silence.26471/