The Tinnitus-Alcohol Connection

The topic of tinnitus and alcohol is of great importance many of my patients with chronic tinnitus. Here I'll cover the following important topics:

• Does alcohol make tinnitus worse?
• If I Stop Drinking Alcohol, Will My Tinnitus Go Away?
• The Elimination Diet Approach for Tinnitus and Alcohol
• Fermentation Byproducts and Alcohol-Induced Tinnitus
• Does alcohol cause hearing loss?
• Tinnitus and Alcohol Withdrawal

Does alcohol make tinnitus worse?

While the relationship between drinking alcohol and tinnitus is complex, it's clear that drinking can worsen tinnitus in some people. Reports from individuals developing tinnitus after drinking suggest that the consumption of alcohol may influence the intensity of their symptoms. Factors such as alcohol type, quantity, and individual susceptibility contribute to the complexity of this relationship.

Even though the exact mechanisms in the inner ear are not fully understood, there are several mechanisms where alcohol and tinnitus intersect: 

Alcohol Affects Inner Ear Blood Flow

Alcohol dilates blood vessels and can increase pressure in the brain and thus lead to an increase in the brain sensitivity which makes tinnitus louder. It can also dilate the blood vessels of the inner ear. This follows a migraine-like process.

Alcohol-Related Dehydration and Tinnitus

Alcohol causes you to lose more water through the kidneys and leads you to become a bit dehydrated. For every drink you consume (e.g., 1 ounce of vodka), you lose 5 oz of water through your kidneys. Dehydration increases brain sensitivity which makes tinnitus louder. 

Fermentation Byproducts in Alcohol Can Cause Tinnitus

Ears ringing after drinking may be related to byproducts of the fermentation process. Fermentation causes an accumulation of the molecule tyramine in fermented alcohol (e.g., wine and beer). The distilled alcohols (e.g., vodka) don’t have that molecule. That is why your tinnitus may get much louder after drinking wine (especially red wine) and it may not after vodka (provided you drink plenty of water). 

If you're serious about trying to recover from tinnitus, you may want to consider avoiding alcohol.

High Blood Pressure Connects Tinnitus and Alcohol

Alcohol is known to cause high blood pressure:

• Excessive alcohol consumption can elevate blood pressure to unhealthy levels.
• Consuming more than three drinks in one sitting can temporarily increase blood pressure.
• Repeated binge drinking can result in sustained elevation of blood pressure over the long term.

Aside from causing heart disease, high blood pressure can aggravate tinnitus. This is another reason to put the drink aside when trying to recover from tinnitus.

If I Stop Drinking Alcohol, Will My Tinnitus Go Away?

Because there's a known connection between tinnitus and alcohol, there’s a good chance that stopping drinking can help relieve the tinnitus at times. However, chronic tinnitus is a complex condition, involving the inner ear structures, the auditory cortex, and neural connections in the brain. Just stopping drinking may not solve the ringing problem.

For true and lasting relief from chronic tinnitus, people must combine positive lifestyle changes (including significantly reducing or stopping alcohol) with a comprehensive rehabilitation program.

How long does alcohol-induced tinnitus last?

For those grappling with alcohol-induced tinnitus, a common concern is the duration of its persistence after ceasing alcohol consumption. The timeline for improvement can vary widely, but it is generally expected to improve in a few hours after body undergoes recovery and adjustment (although sometimes it can take 24-48 hours).

How much alcohol does it take to cause Tinnitus?

Interestingly, ear ringing doesn't have to be from a night of heavy drinking. A sip of wine may not make your ringing loud, but a full glass certainly can. This type of reaction is most likely related to fermentation byproducts in the alcohol (more below). Rarely, some patients state that alcohol improves their ear ringing and that is likely due to the anti-anxiety effect of alcohol. 

Did drinking alcohol cause tinnitus? Or was it the music?

Tinnitus is always made worse with loud sounds. The sound level at busy restaurants can be above 80 dB, enough to cause exacerbation of tinnitus. If you're drinking at a nightclub with loud music, the sounds can reach 110 dB (that's like hearing a jackhammer), enough to cause permanent tinnitus. So, the effect alcohol's effect on hearing may not be the issue; it might be toxic noise levels.

The Elimination Diet Approach for Tinnitus and Alcohol

Ears ringing after drinking can be disconcerting, particularly if you're unsure if the drinking caused it. Examining your hearing history after drinking through exercises like journaling or practicing an elimination diet can contribute to solving the mystery of how tinnitus and alcohol interact for you. 

An elimination diet is when you systematically remove certain foods from your diet to examine their effect on your health. We use this technique to identify foods that trigger tinnitus. If you’re wondering if alcohol is causing your tinnitus, try cutting it out to see what happens. You can always slowly reintroduce it into your diet later if there is no meaningful change.

That being said, lifestyle components can have cumulative effects. For example, when your stress is high you may drink alcohol and get symptoms, whereas drinking on low stress days may not give you symptoms. If you’re determined to become tinnitus free, it's best to put the alcohol aside while you’re in an active tinnitus rehabilitation program. 

Fermentation Byproducts and Alcohol-Induced Tinnitus

The underlying mechanisms linking tinnitus and alcohol are not fully understood, but as discussed above, we believe the effect is related to issues like changes in blood flow, the body’s ability breakdown of alcohol, and one’s personal reaction to the byproducts of fermentation.

For instance, tyramine and histamine are both present in wine and beer. These two byproducts are known to instigate migraine-like reactions in the brain that can trigger tinnitus to become louder. Your tinnitus may get louder for up to 6-8 hours after drinking beer or wine, so the response is not immediate necessarily. Importantly, you don't have to engage in excessive drinking to see this effect.

Does alcohol cause hearing loss?

A recent meta analysis looked into alcohol-induced hearing loss. After pooling 27,849 people, the researchers found that there was a very slight positive association between drinking and hearing loss. The authors suggested that it may be because drinking is a risk factor for having low vitamin B12, which is important for your hearing [1].

What is “cocktail deafness”?

“Cocktail deafness” or “cocktail party deafness” refers to the acute effects of alcohol on hearing. Several studies document that hearing thresholds are altered during alcohol consumption, even in normal hearing people. It also affects the ability to hear in noisy environments. This effect on hearing may amplify tinnitus.

Tinnitus and Alcohol Withdrawal

Stopping alcohol consumption, particularly during withdrawal, is associated with its own set of challenges, including ringing in the ears. Alcohol withdrawal can be a brutal and even life-threatening process for those who drink heavily and suddenly stop.

Stopping heavy alcohol use increases stress hormones in the brain which leads to increased sensitivity to sound and increased ringing sounds in some people. Understanding the dynamics of alcohol withdrawal and its connection to tinnitus is essential for unraveling the broader relationship between alcohol and auditory perceptions.

If you've recently stopped drinking and were a heavy drinker to begin with, you should consider getting your doctor involved. Alcohol withdrawal can be fatal.

Seeking Professional Guidance for Alcohol Dependence

Recovering from a pattern of heavy drinking often requires professional guidance. Your provider  can conduct thorough assessments to determine the specific factors contributing to your tinnitus. Our clinicians at NeuroMed are experienced in figuring out what is triggering your tinnitus and what needs to be done to relieve the bad tinnitus days. Seeking support from healthcare professionals during alcohol withdrawal is crucial for managing associated symptoms, including tinnitus.

Conclusion: Alcohol-Induced Tinnitus is Preventable

So the good news is that not all alcohol is bad for tinnitus; the bad news is that beer and wine are probably not good for tinnitus.

People who are troubled by the impact of alcohol on their tinnitus and hearing can do things to manage both conditions effectively. Lifestyle modifications, such as reducing alcohol intake, staying adequately hydrated, and ensuring proper sleep, contribute not only to overall well-being but may also positively influence tinnitus symptoms.

While the connection between tinnitus and alcohol remains a subject of interest, it’s clear that alcohol-induced tinnitus is one of the few preventable causes of ear ringing and hearing loss. For this reason alone, those seeking to reduce the burden of tinnitus on their life should consider abstaining from alcohol. Understanding personal triggers and responses is crucial in determining the most effective approach to manage both tinnitus and alcohol consumption.

The question of whether abstaining from alcohol will lead to the disappearance of tinnitus is complex, involving a myriad of factors. However, here's the bottom line: if you're prepared to go to any lengths to reduce your tinnitus, you may have to put away the alcohol.

Tinnitus and Alcohol References

[1] Qian P, Zhao Z, Liu S, Xin J, Liu Y, Hao Y, Wang Y, Yang L. Alcohol as a risk factor for hearing loss: A systematic review and meta-analysis. PLoS One. 2023 Jan 20;18(1):e0280641