MD Review of Vitamin D and Tinnitus

Many of my patients want to know about Vitamin D and Tinnitus. It’s actually one of the core supplements that I recommend for my tinnitus patients. Here I answer the following questions:

• Does Vitamin D Deficiency Cause Tinnitus?
• How does low Vitamin D affect tinnitus?
• What are the Vitamin D tinnitus benefits?
• Why do I use vitamin D for my chronic tinnitus patients?
• How do you take Vitamin D for Tinnitus?

Does vitamin D deficiency cause tinnitus?

The best place to answer this question is to evaluate the clinical evidence. Multiple studies now show that vitamin D deficiency is linked to tinnitus.

In a 2023 meta analysis, researchers looked at the connection between vitamin D and tinnitus. Around 50% of those in the tinnitus group were found to have vitamin D deficiency. Further, serum vitamin D levels in tinnitus subjects were significantly decreased compared to those without tinnitus (levels were around 22% lower in the tinnitus group) [1].

This association between vitamin D and tinnitus means that it’s an important modifiable risk factors for hearing health.

Does Vitamin D affect tinnitus severity?

Vitamin D and tinnitus severity are linked. In a recent study investigating how Vitamin D levels influence tinnitus severity, they found that lower levels of serum vitamin D correlated with higher tinnitus severity scores (tinnitus loudness assessed by the Tinnitus Handicap Inventory (THI) and tinnitus severity measured by visual analogue scale) [2].

How does low Vitamin D affect tinnitus?

Vitamin D is a fat-soluble nutrient crucial for various physiological functions in the body. Deficiency in vitamin D is widespread, particularly for people who have limited sunlight exposure. The vitamin D serum level should be in the range of 40 to 80 ng/mL; levels below 20 ng/mL are considered deficient. Deficiency can lead to multiple different metabolic and neurological diseases.

Can too much vitamin D affect your hearing?

No, but too little can affect your hearing. In some cases, low vitamin D can cause cochlear deafness from demineralization of the inner ear structures. It’s unclear if this demineralization can also influence subjective tinnitus.

For elderly patients with age-related hearing loss and tinnitus, low vitamin D levels are associated with low frequency hearing difficulties. This type of hearing loss may lead to a lower tinnitus characteristics such as buzzing or humming noises (i.e the tinnitus pitch is lower).

In another connection with hearing, a recent cohort study showed that 70% of people with sudden sensorineural hearing loss were vitamin D deficient [3]. This is important because idiopathic acute hearing loss may influence tinnitus development.

Can low vitamin D cause ear infections?

Yes, there is a consistent association between low serum vitamin D and acute middle ear infections (otitis media). This affects tinnitus patients because a history of ear infections is associated with a 60% enhanced risk of developing tinnitus. This is likely due to its impact on sensorineural hearing.

Can low vitamin D affect mental health?

Yes, low vitamin D has been linked to several mental health issues, such as depression, anxiety, and stress. This is important because you can get tinnitus exacerbation from anxiety symptoms. Stress will also increase tinnitus perception.

Can vitamin D deficiency cause vertigo?

Yes, recent studies have established a significant correlation between vertigo conditions like benign paroxysmal positional vertigo (BPPV) and vitamin d deficiency. Additionally, a randomized clinical trial found that treatment of BPPV patients with vitamin D deficiency lead to a decrease in the number of attacks [4]. Tinnitus patients suffer from BPPV frequently and some notice that tinnitus onset corresponds with the vertigo attacks.

Does low vitamin D affect migraines?

Yes, a recent meta analysis showed that migraine patients have statistically lower levels of serum vitamin D [5]. Furthermore, another meta analysis of randomized clinical trials that looked at vitamin d as treatment for migraine found that it significantly reduced the frequency of monthly headaches [6].

This is important because tinnitus etiology is strong linked to migraine. The migraine process in the brain can affect the auditory nerve and can account for tinnitus loudness variation and tinnitus initiation. This makes the role of vitamin d deficiency in migraines important for tinnitus management.

What are the Vitamin D tinnitus benefits?

Vitamin D supplements help tinnitus patients correct deficiencies, which per above, is directly related to severe tinnitus loudness. Also, adding extra vitamin D may help with some of health issues that come with tinnitus, such as hearing loss, ear infections, mental health problems, vertigo, and migraine. But the most exciting benefits of vitamin D concern the effects it has on the brain.

Vitamin D and Tinnitus Rehabilitation in the Brain

Of equal importance is the effect of this vitamin on the brain. Researchers are now finding that vitamin D plays a crucial role in several functions related to the nervous system. Many of these Vitamin D benefits are critical for helping the tinnitus rehabilitation process, including:

Brain Function	How Vitamin D Helps
Neurotransmitter Regulation	Vitamin D receptors are present in various areas of the brain involved in neurotransmitter synthesis and signaling, suggesting a role in regulating neurotransmitter function.
Neuroprotection	Vitamin D has been shown to possess neuroprotective properties, potentially reducing the risk of neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease.
Cognitive Function	Adequate vitamin D levels have been associated with improved cognitive function, including memory, attention, and executive function.
Mood Regulation	Vitamin D has been linked to mood regulation, with low levels of vitamin D being associated with an increased risk of depression and other mood disorders.
Brain Development	Vitamin D plays a crucial role in brain development during fetal development and early childhood, potentially influencing cognitive function later in life.
Neuroinflammation	Vitamin D has anti-inflammatory effects that may help reduce neuroinflammation, including lowering calcitonin gene related peptide (CGRP).
Neuroplasticity	Vitamin D may influence neuronal plasticity, the brain’s ability to adapt and change in response to experiences and environmental factors.
Neurogenesis	Vitamin D has been shown to promote neurogenesis, the formation of new neurons, which may contribute to brain health and function.
Pain Perception	Some research suggests that vitamin D may modulate pain perception and sensitivity, potentially affecting pain processing in the brain and nervous system.

Why do I use vitamin D for my chronic tinnitus patients?

The strongest reason for using vitamin D to treat tinnitus is that nearly 1/2 of tinnitus patients are deficient. It’s not the main tinnitus risk factor, but it’s an easily correctable one. The same thing holds for the other inner ear disorders linked to vitamin D deficiencies, like sudden hearing loss and vertigo.

Can Vitamin D stop tinnitus?

No single supplement can stop tinnitus. However, using vitamin D supplements as part of a comprehensive tinnitus rehabilitation program makes sense. It not only takes care of any deficiencies that might be making tinnitus worse, it can also help treat the underlying brain process that drives tinnitus.

What does migraine have to do with tinnitus?

One of the recent discoveries from my academic clinic is that migraine affects structures involving central auditory processing, not just those responsible for headache pain. We’ve found that the migraine process is responsible for a host of inner ear diseases, including tinnitus. This is called “otologic migraine”.

Can you get a migraine without a headache?

It’s critical to understand that migraine is not just about headaches. What we now know is that migraine is primarily a sensory processing disorder. When inflammation of the nervous system occurs (called neurogenic inflammation), it triggers sensory hypersensitivity. The nerve that is affected will determine the sensations we feel:

• Headache: Sensory nerves of the head.
• Light sensitivity: Sensory nerves of the eye.
• Vertigo: Sensory nerves of balance.
• Tinnitus: Sensory nerves of hearing.

Treating Tinnitus as a Migraine Disorder

Drugs that lower CGRP have revolutionized migraine treatment in the past decade. CGRP is the main molecule that drives neurogenic inflammation, and therefore, sensory hypersensitivity. Treatment with vitamin D has been shown to directly reduce CGRP levels.

As noted above, vitamin D supplements significantly improve migraine. In studies that evaluated this treatment, they found that taking vitamin D directly reduces serum CGRP levels [f].

So in terms of vitamin D and tinnitus, I use it to both correct any vitamin D deficiency and to address the neurogenic inflammation that drives the migraine process responsible for loud tinnitus.

How do you take Vitamin D for Tinnitus?

I’m pretty aggressive about correcting vitamin D deficiency for my patients. I don’t want to publish my recommended dose for tinnitus here because when I use it, it is under direct medical supervision where we can do vitamin D testing if necessary.

Typical doses to correct vitamin d deficiency are around 1000 IU daily (IU stands for International Units). We use higher doses than this. It’s generally recommended that you get a vitamin D assessment before you start taking supplementation.

Sunlight, Vitamin D, and the Circadian Rhythm

One of its unique aspects of vitamin D is its ability to be synthesized by the body upon exposure to sunlight, making it both a vitamin and a hormone. Getting out in the sun can be very healthy, especially if you get morning sunlight. This can help vitamin D deficiency naturally, while also helping to optimize your body’s sleep wake cycle (circadian rhythm).

It’s because of this connection that I generally recommend that my patients with tinnitus take their vitamin D supplements in the morning.

What are symptoms of too much vitamin D?

Too much Vitamin D is called vitamin D toxicity (hypervitaminosis D). The symptoms are actually secondary to the effect Vitamin D has on calcium levels (it increases calcium, leading to hypercalcemia). Symptoms of Vitamin D toxicity include:

• Appetite Decrease
• Dehydration Risk
• Excessive thirst
• Frequent UrinationNausea/Vomiting
• Constipation
• Confusion/Fatigue
• Muscle Weakness
• Bone Pain
• Kidney Stones

How common is vitamin D toxicity?

Vitamin D toxicity is a serious medical illness, but fortunately is extremely rare with only around 4,500 cases reported per year in the US. The majority of these cases are pediatric. Also, many of the cases of toxicity relate to accidental injections of over one million IUs.

“Vitamin D Cured My Tinnitus”

I don’t expect you to be saying this, because there is no quick fix for tinnitus. However, for the reasons outlined above, supplementing with vitamin D can be a powerful component of tinnitus treatment.

Supplements for tinnitus have gotten a bad name because of all of the aggressive marketing that promises to cure tinnitus. However, I frequently used natural supplements as a core component of my tinnitus treatment protocols because of their role in healthy brain functioning and low side effect profiles.

The key is to stick to evidence-based interventions when evaluating natural remedies for tinnitus.

Conclusion: Vitamin D Helps Tinnitus

Here are some summary thoughts on Vitamin D and tinnitus:

• Vitamin D deficiency is common among those with tinnitus. When deficiency is present, it leads to increased tinnitus loudness and severity.
• Taking Vitamin D not only corrects deficiencies but also offers therapeutic benefits for related health issues like hearing loss, ear infections, mental health disorders, vertigo, and migraines.
• Vitamin D’s neuroprotective and anti-inflammatory properties, along with its role in brain function, make it a promising adjunct in tinnitus management.
• Integrating vitamin D supplements into treatment protocols can offer safe and effective relief for tinnitus sufferers.

At NeuroMed, we integrate natural treaments for tinnitus (like Vitamin D) with other powerful treatments, such as sound therapy and to get optimal results. This is called an “integrative medicine” approach. By using a science-based approach to tinnitus rehabilitation, we’re able to reach success rates that exceed most other treatment protocols. We’ll keep you posted about any new research on vitamin D and tinnitus as it comes out.

Vitamin D and Tinnitus References

1. Nocini R, Henry BM, Mattiuzzi C, Lippi G. Serum Vitamin D Concentration Is Lower in Patients with Tinnitus: A Meta-Analysis of Observational Studies. Diagnostics (Basel). 2023 Mar 8;13(6):1037.
2. Nowaczewska M, Osiński S, Marzec M, Wiciński M, Bilicka K, Kaźmierczak W. The role of vitamin D in subjective tinnitus-A case-control study. PLoS One. 2021 Aug 18;16(8):e0255482.
3. Zandi A, Mehrad-Majd H, Afzalzadeh MR. Association between Serum Vitamin D Levels and Risk of Sudden Sensorineural Hearing Loss: A cross-sectional Study. Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):2974-2978.
4. Jeong SH, Kim JS, Kim HJ, Choi JY, Koo JW, Choi KD, Park JY, Lee SH, Choi SY, Oh SY, Yang TH, Park JH, Jung I, Ahn S, Kim S. Prevention of benign paroxysmal positional vertigo with vitamin D supplementation: A randomized trial. Neurology. 2020 Sep 1;95(9):e1117-e1125.
5. Liampas I, Siokas V, Brotis A, Dardiotis E. Vitamin D serum levels in patients with migraine: A meta-analysis. Rev Neurol (Paris). 2020 Sep;176(7-8):560-570.
6. Hu C, Fan Y, Wu S, Zou Y, Qu X. Vitamin D supplementation for the treatment of migraine: A meta-analysis of randomized controlled studies. Am J Emerg Med. 2021 Dec;50:784-788.
7. Ghorbani Z, Rafiee P, Fotouhi A, Haghighi S, Rasekh Magham R, Ahmadi ZS, Djalali M, Zareei M, Razeghi Jahromi S, Shahemi S, Mahmoudi M, Togha M. The effects of vitamin D supplementation on interictal serum levels of calcitonin gene-related peptide (CGRP) in episodic migraine patients: post hoc analysis of a randomized double-blind placebo-controlled trial. J Headache Pain. 2020 Feb 24;21(1):22.