Q: Two years or so ago I read with interest your article on tinnitus. You mentioned it is often a symptom of something wrong in the auditory system, including a thyroid abnormality. Could you elaborate on this? I suffer from tinnitus and also take thyroid medication.

A: Tinnitus affects millions of Americans and includes ringing, swishing, buzzing, roaring, clicking and other noises in the ears that can vary in intensity and may be heard in one or both ears. It may be present all the time, or may come and go. There are two kinds of tinnitus – the subjective form that only the affected person can hear and the objective form that a physician can hear during examination. The initial form is common, the latter is rare and may be caused by muscle contractions, blood vessel issues, or other reasons. Tinnitus isn’t a condition itself but is a symptom of an underlying disorder. Pulsatile tinnitus (that which is in rhythm with the heartbeat) is commonly related to blood flow, either through normal or abnormal blood vessels near the ear. Causes can include pregnancy, head and neck tumors, anemia high blood pressure, atherosclerosis causing turbulent flood blood, and an overactive thyroid.

Tinnitus can result from a wax buildup; when too much wax accumulates, irritation of the ear drum and hearing loss can result. Aging comes in to play, with men more commonly affected than women. Almost 12% of men between the ages of 65 and 74 are affected. Exposure to loud noises such as a chain saw, being in close proximity to an automobile that backfires, music played at high volume, and using a lawn mower without ear protection can contribute. Then there are outside issues such as a possible acoustic neuroma or head and neck injuries. Meniere’s disease can result from abnormal inner fluid pressure. Medications (of which there are more than 200), are known to cause tinnitus and include diuretics, quinine, specific antidepressants and aspirin taken in unusually high doses.

There are tiny hairs in the inner ear that move with pressure exerted against them by sound waves. An electrical signal is released through the auditory nerve to the brain that interprets the signals as sound. If those hairs within the ear are bent or broken, they can emit random electrical impulses to the brain, causing tinnitus.

Diagnosis will likely begin with a history, examination and audiology done in an otolaryngologist’s office. This may be followed with a CT or MRI, based on findings. Once results are obtained, steps can then be taken toward correcting or reducing the intensity of your tinnitus.

Hyperthyroidism is a condition in which the thyroid gland produces too much hormone. This can result from Graves disease, inflammation, excessive amounts of iodine in the system, and because of other reasons. Symptoms may include a goiter, fatigue, irregular menses in women, weight loss, hair loss, hypertension, heat intolerance, insomnia, anxiety or nervousness and more.

Treatment is based on the underlying cause and severity of symptoms but may include medication, radioactive iodine, or surgery to remove the gland. Generally speaking, hyperthyroidism is treatable and some of the causes may disappear without treatment; however, if caused by Graves disease, progression is common and complications will present.

I do not know if you have hyper-or-hypothyroidism, nor do I know if there is a connection with your tinnitus. You should begin by seeing your primary care physician for appropriate testing to get to the bottom of both issues so answers can be provided and appropriate care can begin.

Readers who would like related information can order Dr. Gott’s Health Reports “Ear Infections and Disorders” and “Thyroid Abnormalities” by sending a self-addressed, stamped number 10 envelope and a $2 (for each report) US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) or print an order form from www.AskDrGottMD.com.