Is Tinnitus Genetic?
November 27, 2020
Image of genetics researchers

Research has shown that about 25 million adults experience tinnitus, a condition that causes persistent buzzing and ringing sounds in their head and ear. These intrusive sounds don't come from external sources and can only be heard by patients. Despite the prevalence of tinnitus, scientists and medical professionals are yet to find a cure. 


Tinnitus has been found to influence essential life functions like relaxation, interaction, and socialization. The condition negatively impacts a person's hearing or communication, ability to sleep or concentrate, and general health well-being.


In severe cases, tinnitus can interfere with your ability to perform well at work. The frequency of tinnitus and the perceived lack of control can instill fear, which exacerbates the problem. Tinnitus leads to an ever-increasing cycle of distress and contributes to psychological disorders such as 


  • Anxiety and depression,
  • Insomnia 
  • Anger
  • Suicidal thoughts 
  • Post-traumatic stress disorder.

Over the years, professionals have attributed the causes of tinnitus to environmental factors such as


  • Recreational or work-related noise
  • Accidents, surgery, head injuries, or concussion
  • Emotional trauma and stress 
  • Ototoxic medications etc. 

However, new research is forcing us to ask critical questions like


  • Does tinnitus run in the genes?
  • Can people inherit tinnitus from their parents? 

This article will address our concerns and provide answers to these questions. 


Is Tinnitus Genetic?


In the past decade, researchers have attempted several attempts to establish the relationship between genetics and tinnitus. Some of these studies had several limitations, including 


  • Ability to identify significant individual tinnitus-associated single-nucleotide polymorphism (SNPs), the most common type of genetic variation found in humans. 
  • Lack of selectively enriched sample set for tinnitus patients and
  • Comprehensive control for risk factors 

However, recent twin research carried out by researchers at the Karolinska Institutet, Sweden, and members of a European research network, TINNET Consortium, has made a huge step towards linking tinnitus and genetics. These researchers studied the genetics of tinnitus by utilizing critical data from the Swedish Twin Registry, one of the world's largest twin registries.


Let's take a look at the findings of this study.



Findings of the Study

 

Image of researchers pipetting

 

The study shows that certain tinnitus forms are hereditary, especially in men who have bilateral tinnitus - that is, tinnitus in both ears. The research team surveyed twins, and out of 70,186 twins that answered questions related to tinnitus, about 15 percent of them had experienced tinnitus.


But, when the study compared twins based on gender, unilateral tinnitus (tinnitus experienced in one ear) and bilateral tinnitus ( both ears), bilateral tinnitus reached a heritability of 0.68 in men 0.41 in women. 


In earlier studies, the researchers had analyzed all forms of tinnitus and had similar results and conclusions on heritability. But, grouping the study population based on gender, unilateral, and bilateral provided a clearer insight into the correlation between tinnitus and genetics. 


Here's what Dr. Christopher R. Cederroth, one of the researchers at Karolinska Institutet's Department of Physiology and Pharmacology, had to say.


"We've been able to show that different forms of tinnitus have a significant heritability and thus a dominant genetic influence over environmental factors," 

 

Image of researchers pipetting chemicals

According to Dr. Cederroth, the results were astounding and mostly unpredictable. And it shows that although environmental factors primarily drive tinnitus, genetics influences bilateral tinnitus, which is more noticeable in men.


The study also shows that unilateral and bilateral tinnitus is made up of two distinct sub-groups. Albeit, only the bilateral tinnitus subgroup is influenced by genetic factors. 


This discovery is very significant from a medical perspective. Its clinical relevance stems from the belief that understanding the genetic pattern of tinnitus will form the basis for finding a cure. 


Future Outlook 

 

man woman performing lab research

Tinnitus is a critical health concern that can alter the quality of human life. Although 16 million Americans seek medical care for tinnitus, patients need better treatment when compared to the quality they're currently receiving. 


That's one of the many reasons why the findings of the twin study by Dr. Cederroth and his team are essential. 


Current treatment options are designed to manage the symptoms and reduce the burden associated with tinnitus. But, treatment options could be better. 

Extensive genetic research and a better understanding of tinnitus at the molecular level could open unexpected avenues to drug discovery. Typically, the early steps of drug development begin with understanding the root cause. It also involves identifying the molecular entities that may be of value in the treatment of that disease. 


Establishing a genetic link to tinnitus means that scientists, audiologists, and medical professionals will be able to develop preventive therapies or find a cure. Developing preventative treatments is the best way to prevent the surge in the number of tinnitus patients. If scientists can identify the genes that cause tinnitus, health professionals will effectively design a better framework for early diagnosis and prompt treatment.


There are several ongoing efforts to find a cure for tinnitus. And the discovery that genetic factors cause tinnitus offers a glimmer of hope that scientists will someday develop medications that will treat the affected genes and eliminate tinnitus.

 

 

Of course, we have a long way to go. The process of drug development usually takes a series of steps and several years. Researchers hope that supplementary research will validate previous findings and offer more insight leading up to clinical trials. 


 More useful treatment or cure for tinnitus is the goal of all tinnitus research. The most promising data are yet to emerge. Albeit, this data will generate paths for future research and offer more in-depth insights into the role of genetics in tinnitus.


While we are waiting for a cure, there are a couple of measures that can prevent future complications and keep tinnitus at bay, such as 

  • Frequent medical checkups
  • Using earplugs when you face exposure to loud noise and more. 

How To Know if You Have Genetic Tinnitus 


Whether you are experiencing unilateral and bilateral tinnitus, the sounds you hear may manifest in different forms. 


Tinnitus is associated with underlying health conditions. So, it's essential to visit your audiologists and explain the kind of sounds you are hearing. This information will help your doctor to diagnose the ailments and identify the underlying cause. 


For instance, Otosclerosis is a genetic condition and abnormal bone growth that causes tinnitus and hearing loss. Tinnitus, in this case, maybe progressive, and patients may hear low-pitched to high-pitched noises.


Acoustic neuroma is a non-cancerous tumor that grows on the vestibular and auditory nerves leading from the inner ear to the brain. Patients suffering from this condition can experience ringing on the ear’s side where the tumor is located.


If you are exposed to intense noise during a concert or recreation, you may experience high-pitched ringing that fades off after a few hours. But when this exposure becomes frequent, the high-pitched sounds may become permanent.


Presbycusis or age-related hearing loss can cause you to hear buzzing sounds and high-pitched sounds. Also, Meniere's disease may cause you to hear a loud noise and feel like your surroundings are spinning. The condition usually starts with one ear and may affect both ears later. 


Obstructions in the ear caused by ear wax, dirt, and loose hair can cause patients to hear low-pitched noises. Sinus pressures resulting from blocked nasal passages can cause loud clicking noises and tinnitus. 


Patients that have acute barotrauma hear intrusive rushing or humming sounds. This condition is due to extreme water and air pressure from 

  • Flying 
  • Diving and
  • Explosive blasts

Your doctor may not find the underlying cause of the intrusive noises in your ears in most cases. But he should be able to proffer solutions to help you reduce the impact of tinnitus or help you cope with it. 


Diagnosis of Genetic Tinnitus 


If you have a history of tinnitus in your family or a gene-related disease like otosclerosis, you need to visit your audiologist for an evaluation. Your doctor will perform some medical and hearing tests to determine the future course of action.  


Physical Checks and Body Movements


Your audiologist may ask a series of questions about your symptoms and your family's medical history during your initial visit. And then, he will check your ear for possible blockages. He may also ask you to move your body’s physical parts like your eyes, arms, and legs. 


These checks will help your doctor identify other underlying health conditions and the most effective treatment methods.


Hearing Test and Audiological Examination

 

Image of doctor performing ear exam

After the physical examinations, your audiologists will perform a hearing test to determine your hearing sensitivity. Hearing tests are typically carried out in a specially designed booth that's soundproof or a quiet environment. And you will be required to wear earphones or headsets. If you suspect hearing loss, you can even take a free online hearing test before seeing your audiologist. 


Here are the most common types of hearing tests. 


Pure Tone Audiometry


This hearing test uses air conduction to measure your ability to hear sounds at different frequencies, volumes, and pitches. Your audiologist will play a couple of sounds and ask you to either write what you hear, raise your hand, or press a button. Then he will go ahead to chart the results on an audiogram.


Other Types of Hearing Tests


The bone conduction testing technique uses a conductor positioned behind your ear to transmit tiny vibrations (air) to your inner ear. 


Speech Testing measures your speech reception threshold and your ability to separate the faintest speech from background noise. 


Tympanometry helps identify ear blockages like wax or fluid buildup, tumors, or perforations in the eardrum.


Auditory Brainstem Response (ABR) test measures your brain activity in response to different sound intensities. It is mostly used to determine hearing abilities for newborns and infants. 


Acoustic reflex testing helps identify specific parts of the ear, such as the auditory nerves, cochlea, ossicles, etc., where there's a hearing problem. It also allows doctors to identify hearing loss.


Otoacoustic Emissions (OAEs) test stimulates the cochlea and measures the sounds it generates. Normal hearing generates sounds and emissions, while people with hearing loss do not produce sounds at all. This test helps determine if there is ear canal blockage or damage to the cochlea’s hair cells.


Your audiologists may need to perform a combination of these tests to determine your tinnitus level and effective treatment options. 


Imaging Tests 

 

Image of physician showing results of imaging tests to patient

 

Beyond audiometry, your doctor can recommend magnetic resonance imaging (MRI) or computerized tomography (CT) scans. These scans may reveal tumors or other abnormal growth near the ear or auditory nerve.


With imaging tests, doctors can examine changes in the ear’s critical organs and the underlying medical condition causing tinnitus.


Treatment of Genetic Tinnitus


As previously mentioned, tinnitus is associated with a wide range of medical conditions. However, scientists are yet to find a cure. So recommended treatment options are designed to help you manage tinnitus.


 Identifying the underlying health condition causing tinnitus is a critical step towards an effective treatment plan. For instance, if your tinnitus is due to obstruction in the ear, removing the blockages may eliminate the tinnitus. 


Similarly, if ototoxic medications cause your tinnitus, discontinuing the medication may stop the tinnitus symptoms. Before you stop or change your medication, please consult your healthcare provider.


Here are some of the recommended treatment options for tinnitus.


Sound Masking Devices

 

Image of Sound Masking Device

Sound masking involves using external sounds that are loud enough to cover the tinnitus sound either partially or wholly. Most sound masking devices produce ambient sounds, white noise, red noise, pink noise that aid sleep and relaxation. 


White noise machines produce "shh" sounds typically found in radio and television static. Other noise applications may make simulated environmental sounds such as ocean waves or rain.


Multiple sound-producing devices like radios, TV, fans, computers can also serve as sound masking devices. 


Hearing Aids

 

Image of Audien Hearing Device

Hearing aids are electronic sound therapy devices that improve hearing for tinnitus patients with hearing loss. The device amplifies sounds in the environment and masks patients from hearing tinnitus sounds. With hearing aids, tinnitus patients can listen, communicate, and regularly participate in daily activities. 


Sleep Apps


Most tinnitus patients experience mental exhaustion and insomnia. But sleep apps can help them get a good night's rest. These apps are available for download on the Google Playstore and Apple App Store. 


Medications

 

Image of medications (audien hearing)

Currently, there are no approved medications for tinnitus. But some medicines can help to alleviate the psychological effect of tinnitus. 


Some of the antidepressant drugs used to manage tinnitus include Clomipramine (Anafranil), Nortriptyline (Pamelor), Protriptyline (Vivactil), etc. 


Anti-anxiety medications that can help reduce anxiety include Diazepam (Valium), Clonazepam (Klonopin), Lorazepam (Ativan), and more. 


Some of these prescription drugs are not without their side effects. So it would be best if you took these treatments under the strict guidance of a healthcare professional. Your doctor will help you to determine the benefit of the drugs exceeds the potential side effects.


Lifestyle Changes and General Wellbeing


Subtle and major lifestyle changes can help you cope with tinnitus. Here are some tips that may help you live an unencumbered life free of tinnitus-related anxiety and worry.


Stay Away from Loud Noises or Use Hearing Protection

 

Image of individual using ear plugs

Exposure to deafening noises can cause tinnitus. More so, noise can exacerbate tinnitus for patients already living with the condition.


Hearing protective devices like earplugs, earmuffs, earplugs, canal caps, and sound mufflers can shield you from hurting sounds and prevent further damage to the ear and auditory system.


Stress Management


Tinnitus is often associated with psychiatric disorders like stress, anxiety, and depression. And of the most effective ways of managing tinnitus is dealing with stress. Here are some useful tips that may help you


  • Engage in hobbies and recreational activities
  • Eat healthily and exercise daily
  • Try hypnotherapy and 
  • Participate in social activities

Final Words


There you go. Recent research has shown that tinnitus can be linked to genetics. Although the study is still in its infancy, the discovery represents a massive advancement in the field. This study will provide a basis for the development of preventive and optimized therapies for tinnitus patients. 


It is also critical to note that tinnitus is associated mainly with underlying health conditions like otosclerosis, a rare condition that can be hereditary. So, if you experience any of the symptoms we have mentioned in this article, you need to consult your audiologists for further evaluation, diagnosis, and treatment. 

Profile photo for Drew Sutton

Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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