Ringing in the ears, known as tinnitus, affects roughly 10 to 15 percent of adults, and the single most effective thing you can do is identify what’s driving it. For some people, the cause is reversible: a medication side effect, earwax buildup, or an underlying hearing change. For others, managing tinnitus means retraining how your brain responds to the sound. Either way, there are concrete steps worth taking.
Figure Out What’s Causing It
Tinnitus isn’t a disease on its own. It’s a signal that something has changed in your auditory system, your brain, or both. The most common trigger is some degree of hearing loss, even mild loss you haven’t noticed yet. When the inner ear sends fewer signals to the brain, the brain compensates by turning up its own internal volume, essentially generating a phantom sound to fill the gap. Research using brain recordings in 129 tinnitus patients has confirmed that two distinct mechanisms are at play depending on whether hearing loss is present, which helps explain why the condition looks so different from person to person.
Before trying any treatment, it’s worth ruling out straightforward causes. Earwax pressing against the eardrum, a middle ear infection, or jaw tension from a temporomandibular joint (TMJ) problem can all produce ringing that resolves once the underlying issue is treated. A basic hearing test is the most useful first step, since even a subtle dip in hearing at certain frequencies can explain why the ringing started.
Check Your Medications
Several common drug classes can trigger or worsen tinnitus. Harvard Health identifies the following as more likely to cause hearing-related side effects:
- High-dose aspirin and related pain relievers
- Certain antibiotics like azithromycin and clarithromycin, particularly at high doses over long courses
- Loop diuretics used for heart failure and kidney disease
- Chemotherapy drugs such as cisplatin and carboplatin
- Some biologics including immunotherapy and disease-modifying drugs
If your tinnitus started or worsened after beginning a new medication, that connection is worth raising with whoever prescribed it. In many cases, tinnitus from medication is dose-dependent and reversible once the drug is adjusted.
Use Sound to Take the Edge Off
Sound therapy is one of the most accessible tools for tinnitus relief, and clinical guidelines support it for self-care. The idea is simple: introducing background sound reduces the contrast between silence and the ringing, making the tinnitus less noticeable. You can use a fan, a white noise machine, nature sounds through a speaker, or sound apps designed for tinnitus.
Pink noise, which emphasizes lower frequencies and sounds softer and more natural than white noise, has drawn particular interest from researchers. Its power is concentrated in the mid and low frequency range, and it can be customized to match the pitch and intensity of an individual’s tinnitus. Many people find it more tolerable for sleep than the hissing quality of white noise. The goal isn’t to drown out the tinnitus completely. Keeping the background sound just below or at the level of the ringing tends to work better for long-term habituation than blasting noise loud enough to fully mask it.
Hearing Aids Often Help
If you have any measurable hearing loss, hearing aids are one of the most effective interventions for tinnitus. By restoring the sounds your brain has been missing, they reduce the neural overcompensation that generates the phantom ringing. In a study of 19 patients with chronic tinnitus and hearing loss, 13 experienced a clinically significant reduction in tinnitus severity after being fitted with hearing aids. Many modern hearing aids also include built-in sound generators that combine amplification with background masking.
The VA/DoD clinical practice guidelines specifically recommend hearing aids for tinnitus in adults with hearing loss. This is notable because the same guidelines found insufficient evidence to strongly recommend any single tinnitus treatment. Hearing aids, along with cognitive behavioral therapy and sound enrichment, received the strongest available endorsement.
Cognitive Behavioral Therapy for Bothersome Tinnitus
CBT doesn’t make the sound disappear. What it does is change how your brain reacts to it. For people whose tinnitus causes significant distress, sleep disruption, or anxiety, CBT works by breaking the cycle where noticing the sound triggers a stress response, which makes you more aware of the sound, which triggers more stress.
Clinical guidelines recommend CBT delivered by a trained provider for adults with bothersome tinnitus, and suggest it’s even more effective when combined with sound therapy as part of a team approach. Sessions typically focus on identifying thought patterns that amplify distress, developing relaxation techniques, and gradually reducing the emotional charge the tinnitus carries. Over time, many people report that the sound feels quieter, even though it hasn’t objectively changed, because the brain learns to deprioritize it.
Neuromodulation Devices
A newer option called bimodal neuromodulation pairs sounds played through headphones with mild electrical stimulation of the tongue. The idea is to retrain the brain’s auditory processing by combining two types of sensory input simultaneously. One device, Lenire, received FDA clearance in 2023 and is the first of its kind approved for tinnitus treatment in the U.S.
In its pivotal trial, patients with moderate or more severe tinnitus who used the device for six weeks showed clinically meaningful improvement compared to those who received sound alone. A 2025 review of 220 patients in clinical settings found that 91.5 percent experienced a meaningful reduction in tinnitus severity, and about 89 percent reported the device was beneficial. The treatment involves daily sessions at home over several weeks. It requires a prescription and an initial fitting by an audiologist, and it’s not yet widely covered by insurance.
What Doesn’t Work
Clinical guidelines specifically recommend against several popular remedies. Low-level laser therapy has no meaningful evidence behind it. Ginkgo biloba supplements, herbal remedies, and nutraceuticals are not supported, nor are anticonvulsants, antidepressants, or betahistine for tinnitus specifically.
The ginkgo evidence is complicated enough to deserve a closer look. A systematic review found that one specific standardized extract (EGb 761) did outperform placebo in all eight trials that tested it, including measurable reductions in tinnitus volume. However, no other ginkgo product on the market matched those results. The positive studies used a pharmaceutical-grade preparation that’s different from the capsules sold in most supplement aisles. If the bottle doesn’t specify EGb 761, the existing evidence doesn’t apply to it.
Diet and Lifestyle Factors
Despite the common advice to avoid caffeine, the evidence actually points in the other direction. Higher caffeine intake has been associated with a lower risk of developing tinnitus, not a higher one. Two large studies found that caffeinated coffee was linked to reduced odds of persistent ringing. So cutting out your morning coffee is unlikely to help and may not be necessary at all.
Dietary patterns do seem to matter in broader ways. A large analysis found that higher vitamin B12 intake was associated with lower odds of tinnitus, while higher intakes of calcium, iron, and dietary fat were associated with increased odds. A protein-rich dietary pattern was also linked to slightly reduced risk. None of these associations are strong enough to serve as treatment on their own, but they suggest that overall diet quality plays a background role.
Protecting your hearing from further damage is one of the most straightforward things you can do. Wear earplugs or noise-reducing headphones in loud environments. Even moderate noise exposure, sustained over time, can worsen both hearing loss and tinnitus.
When Ringing Is an Emergency
Most tinnitus develops gradually and, while annoying, isn’t dangerous. But if ringing appears suddenly alongside rapid hearing loss in one ear, that combination is a medical emergency. Sudden sensorineural hearing loss, defined as losing at least 30 decibels across three connected frequencies within 72 hours, requires treatment within days to have the best chance of recovery. You may also notice a feeling of fullness in the ear or dizziness. The National Institutes of Health recommends treating these symptoms as urgent. A hearing test (pure tone audiometry) should be performed within a few days of onset to confirm whether inner ear damage has occurred.