What Causes Tinnitus?
“While there are many possible causes of tinnitus, some people develop it for no known reason.” That less-than-definitive answer comes from the National Institutes of Health (NIH). After noting this uncertainty, NIH lists several known causes, including:
- Exposure to loud noises, such as a workplace setting, sporting event, or concert
- Hearing loss from aging or exposure to loud noise (though some people with hearing loss never develop tinnitus)
- Medications such as non-steroidal anti-inflammatory drugs (e.g., ibuprofen, naproxen, and aspirin), certain antibiotics, anti-cancer drugs, anti-malaria medications, and antidepressants
- Blockage of the ear canal by earwax or by fluid from an ear infection
- Head or neck injuries that damage structures of the ear, the nerve that carries sound signals to the brain, or areas of the brain that process sound
Less common risk factors include:
- Ménière’s disease, an inner ear disorder that can also cause balance problems and hearing loss
- Jaw joint problems (the joint that connects the lower jaw to the skull is close to the ear; jaw clenching or tooth grinding can damage surrounding tissue, causing or worsening tinnitus)
- High blood pressure, atherosclerosis, or malformations in blood vessels, especially if they are in or close to the ear (these conditions can alter blood flow and cause tinnitus)
- Diabetes, migraines, thyroid disorders, anemia, and certain autoimmune disorders such as lupus and multiple sclerosis
Tinnitus is the most common service-related disability among veterans because of the loud noise they may have experienced from gunfire, machinery, bomb blasts, or similar sources.
Tinnitus: It’s All In Your Head
Because tinnitus is often perceived as a ringing in the ears, you might think it could be fixed by repairing whatever structural damage is creating that constant sound. Early treatment focused on this mechanical approach to a cure, but theories changed as research identified tinnitus as a function of nerve damage that disrupts neural processing in certain areas of the brain.
To quote the National Institute of Health once again:
One leading theory is that tinnitus can occur when damage to the inner ear changes the signal carried by nerves to the parts of your brain that process sound.
[…] A way to think about this is that while tinnitus may seem to occur in your ear, the phantom sounds are instead generated by your brain, in an area called the auditory cortex.
This understanding, combined with discoveries about the human endocannabinoid system, opened new pathways for research into cannabis as a potential treatment option.
Marijuana And The Endocannabinoid System
Today’s medical marijuana movement began with the 1988 discovery of the human endocannabinoid system (ECS) by renowned cannabis research pioneer Raphael Mechoulam. This whole-body neural network is embedded with switch-like activators known as CB1 and CB2 receptors that provide a chemical bridge between the body’s physical functions and the brain.
Research by Mechoulam and others showed that the ECS controls or influences a wide range of biological functions that include immune responses, hormone levels, pain modulation, blood sugar levels, mood, memory, appetite, and many more metabolic functions.
In a retrospective memoir published in the 2023 edition of the Annual Review of Pharmacology and Toxicology, Mechoulam recalls that his discovery prompted a new wave of research, and launched the possibility that modulating endocannabinoid system activity “may have therapeutic potential in almost all diseases affecting humans.”
The final piece of the puzzle that launched the modern era of cannabis therapy fell into place as a growing body of research indicated that the cannabinoids found in marijuana could engage and interact with the body’s CB1 and CB2 receptors. By the early 2000s, laboratories at institutions such as the NIH were researching the possibilities of marijuana-derived medications for a range of conditions — including tinnitus.
Can Marijuana Help With Tinnitus?
Tinnitus research in the 1990s and early 2000s yielded evidence that the neuropathic dysfunction of tinnitus shared similarities with central neuropathic pain signaling and epilepsy. Additional research showed that cannabis could bond with the body’s CB1 receptors to dampen sensations of neuropathic pain and symptoms of epilepsy. Researchers at the time reasoned that, by extension, cannabinoids in marijuana might influence CB1 receptors in the brain’s hearing centers to reduce the neuropathic signaling of tinnitus.
Unfortunately for tinnitus sufferers everywhere, this line of research did not play out.
In 2016, Hearing Research reported that cannabinoids did not appear to reduce symptoms of tinnitus and might instead excite neural pathways involved in sound processing. A study published in the February 2019 edition of Current Opinions in Neurology reached similar conclusions, with the authors writing:
Despite the fact that cannabinoids have been shown to decrease neuronal hyperactivity in many parts of the brain, the current evidence suggests that in auditory brain regions, they have the potential to facilitate neuronal hyperactivity and exacerbate tinnitus. All of the available experimental evidence from animal studies suggests that cannabinoid CB1 receptor agonists will either have no effect on tinnitus or will worsen it.
A study released in 2020 by the American Journal of Otolaryngology states:
Regular marijuana use is associated with prevalent tinnitus. However, no dose response between marijuana use and tinnitus was observed.
In a concluding statement that hints at marijuana’s potential therapeutic benefits for tinnitus sufferers, the authors write:
The relationship between marijuana use and tinnitus is complex and is likely modulated by psychosocial factors.
For those unfamiliar with the term “psychosocial factors,” the Encyclopedia of Behavioral Medicine offers this explanation:
The term “psychosocial” has a broad meaning when considering health research. It is formed from two words: psychological and social. Psychological factors can be positive, such as happiness, affect, and vitality, or negative, such as anxiety, perceived stress, and depressive symptoms.
In simple terms, anxiety, fatigue, and stress may worsen tinnitus symptoms.
Tinnitus And Stress
“There’s a close relationship between psychological disorders, including stress, and the occurrence and maintenance of tinnitus.” This was the conclusion from a Brazilian study titled, “Tinnitus: The Sound of Stress?”. The authors reported that 65% of tinnitus sufferers surveyed showed elevated stress levels. In addition, about half of those surveyed showed symptoms of anxiety and more than a quarter had depression.
Similar conclusions come from a study published in 2023 by the World Journal of Clinical Cases. Based on surveys of 230 patients suffering from chronic tinnitus for a period of one year or more, the authors wrote:
There are several psychiatric conditions and disorders in sufferers of tinnitus, which may contribute to its persistence and increased severity. They include stress, anxiety, depression, sleep disturbance, increased forgetfulness, major depression and anxiety, and somatoform disorders.
These and similar findings suggest that tinnitus sufferers might benefit from stress-reducing therapies. This brings us back to cannabis.
Marijuana Is A Popular Choice For Stress Relief
Relaxation and anxiety relief are among the most common reasons why people seek cannabis therapy. According to a survey of cannabis users published in the Annals of Internal Medicine, half of all users surveyed found marijuana helpful for relieving anxiety, stress, and depression.
The latest insights on marijuana’s stress-relieving and relaxing potential come from research at The University of New Mexico published in the Journal of Cannabis Research. After crunching the numbers from more than 2,300 smoking sessions from 670 cannabis users, the authors found that marijuana was far more likely to reduce anxiety than to create anxiety. About 95% of users reported that cannabis sessions reduced their feelings of agitation/irritability, anxiety, and stress.
The authors state:
Despite the conventional wisdom that smoking cannabis makes one paranoid, we found consumption much more likely to be associated with relaxation and a sense of calm, with users most likely to report feelings of peacefulness, optimism, and happiness.
Researchers also offered an explanation for these overwhelming positive experiences, based on the fact that the use of legal marijuana (medical and recreational marijuana is legal in New Mexico) may not evoke the same fears as illegal use, writing:
One potential explanation for the disparity between our findings and popular perceptions of cannabis is that the “paranoia” users may have historically reported could have arisen in part from cannabis’s illicit status anxiety over committing an illegal act, rather than the plant’s typical endemic pharmacodynamic effects.
Marijuana And The Bliss Molecule
A potential explanation for marijuana’s stress-relieving effects was reported in the February 2024 edition of Cannabis and Cannabinoid Research. Researchers from the King’s College London analyzed the blood plasma of subjects who inhaled a 10mg THC cannabis vapor combined with CBD in ratios ranging from 0:1 to 3:1 CBD/THC. The results showed subjects had elevated levels of anandamide (AEA) and 2-arachidonoylglycerol (2-AG) for up to 90 minutes after the inhalation session, and that these levels were the same for all CBD/THC ratios.
Anandamide (AEA), popularly known as the “bliss molecule,” is a natural cannabinoid produced by the human body. It binds with CB1 receptors to regulate mood. Boosting AEA levels typically lowers stress and improves mood. Studies show that 2-AG also plays an important role in reducing stress, anxiety, and depression.
How Do You Lower The Volume Of Tinnitus?
While marijuana therapy is a popular choice for coping with tinnitus, sufferers may wish to consider additional mechanisms for “lowering the volume.” Harvard Health offers two suggestions that may help tinnitus sufferers:
- Masking: Adding background sounds may eliminate awareness of tinnitus. This could involve listening to music, watching TV, or using a “white noise” generator. More involved masking options include wearing special hearing aids or using phone-based apps.
- Habituation: Also known as sound therapy, this practice involves extended periods of exposure to sounds on the same frequencies as the patient’s internal audio perceptions. The concept is to train the brain to ignore the sensations of tinnitus.
Yoga, meditation, and mindfulness exercises have also shown potential for reducing tinnitus symptoms. The International Archives of Otorhinolaryngology reports on a small-scale study in which men and women with an average five-year history of chronic tinnitus engaged in three months of yoga practice.
Based on self-reported results, the study authors wrote:
Yoga practices may reduce life stress and symptoms of subjective tinnitus.
In a study published in Psychotherapy and Psychosomatics, tinnitus sufferers participated in eight weeks of mindfulness-based cognitive therapy (MBCT) focused on relaxation or mindfulness meditation. Results showed that both practices reduced the symptoms of chronic tinnitus, with mindfulness meditation being the more effective of the two.
A systematic review of literature published in Frontiers in Neurology evaluated the reported effectiveness of mindfulness-based interventions (MBI) for tinnitus relief. Based on the results of seven studies involving 425 patients, the authors concluded:
We found beneficial effects of MBIs on a decrease in tinnitus distress score. No effects of MBIs were observed for depression and/or anxiety.
Marijuana Isn’t A Cure, But It Can Be A Comfort
Both current research and anecdotal user experiences indicate that marijuana isn’t a cure for tinnitus. However, as stated at the beginning, it is a popular choice for coping with the condition – providing stress and anxiety relief that can help relieve some of the major factors that trigger tinnitus effects.
Do You Have Questions About Medical Marijuana?
CannaMD’s state-certified network of medical marijuana doctors is available to provide advice and assistance with your medical marijuana questions and needs. Contact CannaMD’s experienced team at (855) 420-9170 today.
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