Diabetes: The Tinnitus Connection

People with diabetes are at an 18% higher risk of developing tinnitus. They are also twice as likely to experience hearing loss. Those with prediabetes are “30% more at risk for both tinnitus and hearing loss” compared with people with normal blood sugar levels.

Moving your head, neck, or eyes may change the perceived sound of existing tinnitus. Let’s explore the connection between diabetes, tinnitus, and possible hearing loss.

What is Tinnitus?

Ten percent of Americans develop tinnitus at some point in their lives, not only those with diabetes. Early detection is extremely important. The earlier tinnitus is detected and identified, the better the chance of learning to live with it. It is not considered a disease but rather a symptom of an underlying condition.

Tinnitus is the medical term for ringing or buzzing in the ears. It can also be perceived as hissing, throbbing, clicking, humming, beating, roaring, or whooshing without an external sound source. Tinnitus is a phantom auditory experience – a perception of sound. It is like a phone line filled with static.

The brain does not receive a clear signal and fills in the missing sound, usually ringing or buzzing. Tinnitus is a signal that something in your hearing system needs attention. Even with constant ringing or buzzing in your ears, you can still hear other sounds and noises, though perhaps not as clearly.

Different Types of Tinnitus

Subjective. About 99% of cases are considered subjective. This means the noise is heard only by the patient. It is usually a constant, high-pitched sound.
Objective. This type is rare. The noise can be heard by another person, such as a health care provider. It is a highly individualized experience.
Pulsatile. This type of tinnitus has the same rhythm and timing as your heartbeat and resembles a pulsating sound. Common causes include hypertension and anemia (a low red blood cell count).

Stress and anxiety can make tinnitus worse. Tinnitus is still not completely understood. “It is a companion to hearing loss.” According to the American Academy of Otolaryngology Head and Neck Surgery, tinnitus can affect your stress level and ability to sleep, make you feel frustrated, anxious, annoyed, or depressed, lead to poor concentration, and affect your overall emotional well-being.

Tinnitus may come and go, be temporary, or become chronic. If it lasts more than three months, it is considered chronic. It tends to occur equally in both ears. Tinnitus in one ear may require urgent evaluation by a medical professional.

Causes of Tinnitus

There are many possible causes of tinnitus, including those listed below:

Diabetes

According to the Centers for Disease Control and Prevention (CDC), 38 million Americans had diabetes in 2024, or about 1 in 10 Americans. Ninety percent of those people had type 2 diabetes. Type 2 diabetes is now being diagnosed in younger people.

Tinnitus is often related to nerve damage and poor blood circulation, both of which commonly accompany diabetes. People with diabetes are also twice as likely to experience hearing loss. Insulin resistance, the inability to use insulin properly, is part of type 2 diabetes and may affect tinnitus.

High blood sugar levels can damage the eighth cranial nerve, which is responsible for hearing and balance. Uncontrolled blood sugar can narrow the small blood vessels in the ears. The CDC states that people with diabetes are more susceptible to noise-induced hearing damage.

Impaired functions of the inner-ear hair cells can disrupt hearing signals. These tiny hairs translate sound vibrations into electrical signals for the brain. They may not receive enough oxygen or nutrients because of reduced blood flow. Poor circulation associated with diabetes impairs blood flow to the inner ear and affects cochlear function.

Diabetes promotes inflammation and oxidative stress, which can damage auditory structures and contribute to tinnitus. It also increases the risk of ear infections due to high blood sugar, which may eventually lead to tinnitus.

Episodes of hypoglycemia, or low blood sugar, may cause dizziness and ringing or buzzing in the ears. Remember that permanent ear and hearing damage cannot be reversed.

Things to Explore with Tinnitus

Genetics. Hearing problems and tinnitus often run in families.
Environment. Can you change the noise level?
Medical factors. Consider current illnesses and medications.

Noise-Induced Hearing Loss

Using heavy equipment, working in a loud environment, and attending large music events can increase the likelihood of developing tinnitus. Exposure to sudden loud noises, such as fireworks, explosions, or gunfire, may also cause tinnitus. Damage to the inner ear can alter how the brain processes sound. Damage to the tiny bones in the middle ear or to the eardrum can also interfere with how you hear sound.

Migraine Headaches

Tinnitus may also be a “migraine-related phenomenon.” A history of migraine headaches is a risk factor for developing ringing and buzzing. Migraines are a neurological condition that can cause headaches, nausea, and aura. Sometimes, a migraine first presents with ringing in the ears.

Researchers are still studying the connection between these conditions and do not yet fully understand the relationship. Triggers shared by migraines and tinnitus include:

Stress
Hormonal changes and fluctuations
Certain foods, including processed foods, alcohol, aged cheeses, deli meats, artificial sweeteners, and sugary drinks
Sleep patterns
Bright lights

Other Factors Associated with Tinnitus

It is more common in males
Age-related hearing loss. Tinnitus is seen more often in older adults. Up to 30% of older adults experience some form of tinnitus. As you age, you become less sensitive to high-pitched sounds. The brain may fill these gaps with other sounds, such as ringing or buzzing.
Middle-ear blockage
Dehydration. A lack of fluid can trigger ringing because it affects the fluid-filled structures of the ear.
Head or neck trauma
Traumatic brain injury (TBI)
Autoimmune conditions
Allergies
Ear injury
Earwax buildup. Earwax forms to trap dirt and protect the ears. Excessive buildup may trigger tinnitus.
Ear infection
Thyroid disease
Meniere’s disease, a chronic inner-ear disorder associated with hearing loss, vertigo, and tinnitus
Hyperacusis, a heightened sensitivity to noise, often associated with physical trauma or a shock to the nervous system
High blood pressure, which can restrict blood flow in the body and ears
High cholesterol
Sinus problems, including sinus pressure and infections
Heavy tobacco use. Tobacco increases blood pressure and narrows blood vessels
High alcohol intake. Alcohol can increase blood pressure and widen blood vessels in the short term but constrict them over time.
Being overweight or obese
Blood vessel malformations
Aneurysms
Temporomandibular joint (TMJ) disorders, including teeth clenching and grinding

Can Certain Foods Trigger Tinnitus? Why Does This Happen?

Yes. Salty, fried, sugary, and processed foods, as well as sugar substitutes, alcohol, and caffeine, may trigger tinnitus. These foods and beverages are sometimes considered “tinnitus triggers” and may be worth limiting, especially if you have diabetes, migraines, or a history of ringing and buzzing in the ears.

Salt can lead to fluid retention and increased pressure in the ears. Processed foods and canned goods, including soups, sauces, and vegetables, are often high in sodium. Caffeine, alcohol, and aspartame may contribute to neuroinflammation, stimulate the nervous system, and influence blood flow.

Trans fats in fried foods can promote inflammation. Fatty foods can raise LDL (“bad”) cholesterol, limiting blood flow throughout the body, including to the ears. Limited blood flow to the ears may “amplify the ringing.” Aspartame, a sugar substitute, may excite neurotransmitters and increase electrical activity in the brain. Foods high in tyramine and histamine, such as smoked fish, eggplant, and tomatoes, may also influence inflammation and blood flow.

Can Certain Medications Cause or Worsen Tinnitus?

Yes. Some “ototoxic” medications can cause or worsen tinnitus through a phenomenon called ototoxicity. They may affect the cochlear (hearing) and vestibular (balance) parts of the ear. Tinnitus and hearing loss caused by these medications may be temporary or permanent.

Not everyone who takes these medications will be affected. The medications can damage the inner ear’s sensitive hair cells, which convert sound vibrations into electrical signals in the nervous system.

Disrupted sound processing can lead to tinnitus and hearing loss. The risk often depends on the dosage. The higher the dose, the greater the potential risk.

Ototoxic medications may include:

Antidepressants
Antimalarial medications
Ibuprofen
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Naproxen
Neomycin
Aspirin, especially at very high doses
Gentamicin
Loop diuretics used to treat high blood pressure, such as Lasix
Certain anti-cancer medications, including cisplatin, carboplatin, and methotrexate
Biologics. Medications made from living cells that can alter immune activity and reduce inflammation. They may be used to treat rheumatoid arthritis, migraines, Crohn’s disease, diabetes, multiple sclerosis, colitis, psoriasis, and some cancers.

What to Look for When Taking These Medications

Did the ear ringing or hearing loss come on immediately after the medication was started?

Has your balance been affected? Are you dizzy?

What impact has the medication had on your sleep, mood, and ability to function?

Even if symptoms develop, never stop taking medication without consulting your health care provider. Your provider can weigh the risks and benefits of the medication.

Would taking steroids help prevent further problems? Keep in mind that steroid medications can raise blood sugar levels.

Tips to Help Prevent Tinnitus and Possible Hearing Loss

Sometimes, the cause of tinnitus cannot be identified. There is no single cure, but many strategies may help you cope and reduce the risk of future problems:

External triggers. Watch for bright, flashing, or flickering lights, changes in weather and barometric pressure, noise pollution, strong odors, and overly intense exercise or physical exertion. Strong perfumes, cooking odors, cleaning products, and plug-in fragrances may trigger tinnitus in some people.
Stress and emotional triggers. Pay attention to stress, emotional strain, and hormonal changes, which may influence tinnitus.
Internal triggers. Sleep patterns, medications, and allergies may play a role in tinnitus and hearing loss.
Loud noises. Protect your ears and take breaks after exposure. Wear protective earmuffs or hearing protection when appropriate and lower the volume whenever possible.
Listening to music. If you use earbuds or headphones, monitor the volume and how long you wear them. At live events, move away from speakers and consider wearing earplugs.
Evaluate what you eat. Interest in nutrition-focused management of tinnitus is growing, although more research is needed. A Mediterranean-style diet may be helpful. Emphasize fruits, vegetables, lean protein, healthy fats, and fiber. Consider limiting salt, monosodium glutamate (MSG), fatty and fried foods, processed foods, artificial sweeteners, and tyramine-rich foods such as fermented foods, aged cheeses, and cured meats. Avoid unusually large or heavy meals.
Limit caffeine and alcohol. People respond differently to these substances. Heavy alcohol use may increase tinnitus risk. Caffeine may worsen symptoms for some people, have no effect on others, or improve symptoms for a few. Track your personal response in a journal.
Do not smoke. Smoking causes blood vessels to constrict and reduces blood flow to the heart and ears.
Vitamin B12. Vitamin B12, also known as cobalamin, is essential for nervous system health. A deficiency may contribute to nerve damage and disrupt auditory signal transmission. A blood test can identify deficiency.
Vitamin D. There is no confirmed evidence that low vitamin D causes tinnitus, but research is ongoing. A blood test can identify deficiency.
Use relaxation techniques. Stress and anxiety can intensify tinnitus. Yoga, deep breathing, and meditation may help reduce stress.
Exercise regularly. Walking, biking, swimming, or other cardiovascular exercise can improve circulation.
Schedule regular hearing tests and evaluations with an audiologist.
Ask your health care provider whether a CT scan or MRI may be needed to support an accurate diagnosis.
Ask your provider about blood tests for anemia or thyroid problems, which may be associated with tinnitus.
Document hearing changes and share them with your internist or audiologist.
Dry your ears after bathing, showering, or swimming. Over-the-counter drying drops may help but seek medical treatment promptly if you suspect an ear infection, especially if you have pain or discharge.
Avoid cotton swabs. Do not insert cotton swabs into your ears to remove wax. If you produce excessive earwax, have it removed by a physician or audiologist.
Aromatherapy. Essential oils with scents such as vanilla and jasmine have shown some benefits for people with ear ringing, although evidence is limited.
Avoid daytime naps if they interfere with restorative nighttime sleep.
If you cannot sleep, get out of bed briefly rather than tossing and turning. Return when you feel tired. High-quality sleep may improve your ability to cope with tinnitus.
Medications. No medication is specifically approved to cure tinnitus. Medications for anxiety or depression may be prescribed to improve coping, and muscle relaxants may sometimes be used.
Over-the-counter remedies. Evidence for supplements and topical remedies is limited and mixed. Products sometimes suggested include zinc, magnesium, grape-seed extract, vitamin C, ginkgo biloba, turmeric or curcumin, garlic, melatonin, and Lipo-Flavonoid supplements. None is guaranteed to treat or relieve tinnitus. Consult your health care provider before starting any supplement and never put topical products inside your ears.
Acupuncture. This form of traditional Chinese medicine uses thin needles placed at specific points on the body. Evidence for tinnitus relief remains limited.
Active noise cancellation (ANC). Ask your audiologist whether ANC headphones are appropriate before purchasing them.

What Else May Help?

Silence can make tinnitus seem louder, which is why external sound may provide a helpful distraction. “When you hear real sounds, your brain has less need to make its own noise.” Constant, low-level background sound may help.

Cognitive behavioral therapy (CBT) is a form of talk therapy that can help manage anxiety and improve coping responses to tinnitus.

Tinnitus retraining therapy (TRT) combines sound therapy with counseling to help reduce awareness of tinnitus. It follows a specific treatment protocol and aims to retrain the brain to pay less attention to ringing or buzzing.

Neuromonics uses a specialized device, such as Oasis, Sanctuary, or Haven, to customize music with neural stimuli and help patients filter out tinnitus. It is a commercial treatment that may cost more than TRT and may not be covered by health insurance. Studies have not shown a significant advantage over TRT. Ask your audiologist whether it is appropriate for you.

Masking devices—These devices may help camouflage ringing and buzzing. Options include fans, air conditioning, music, television, humidifiers, dehumidifiers, and sound machines. White noise is a uniform mixture of sound frequencies. Pink, brown, red, blue, and violet noise emphasize different frequency ranges and may resemble sounds such as waterfalls, ocean waves, rushing water, or crackling. Any masking sound should generally be played at a lower volume than the perceived tinnitus.

Sleep. Seven to eight hours of quality sleep each night can support coping and physical recovery, with or without tinnitus.

Apps. Smartphone apps such as Calm, Headspace, or Insight Timer may help regulate mood and support relaxation.

Controlling blood sugar. Managing blood sugar is essential for reducing the risk of diabetes complications, including tinnitus and hearing loss.

Hearing aids. If you have hearing loss, whether it is related to tinnitus, ask your audiologist about hearing aids. Some include built-in masking features that may help reduce the perception of ringing and buzzing.

TMJ care. Consider jaw exercises and stretches.

Wear a TMJ night guard if recommended by a dental or medical professional.

Try neck exercises and stretches if recommended by a health care professional.

Deep brain stimulation is currently being investigated as a possible treatment option.

Support groups. Meetings for people with tinnitus may provide practical coping ideas and peer support.

Tinnitus can be annoying and may cause difficulties in daily life or personal relationships. If you experience tinnitus or hearing loss, seek help from your health care provider as soon as possible. Although tinnitus is not curable, many strategies and devices can help make the condition more manageable.

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