Tinnitus is a medical condition that affects 1 in 8 people and is defined as the perception of sound that does not have an external source, usually characterised by a ringing, whooshing, or buzzing noise in the ear¹. Tinnitus patients can experience the condition in different ways. Some describe the noise as a slight annoyance that can be shrugged off with a simple shake of the head, also known as temporary tinnitus, whereas patients with severe tinnitus describe the noise as constant and debilitating.

Medical professionals split the condition into four different categories:

1. Subjective tinnitus is the most common form of tinnitus. The noise can come and go suddenly. Symptoms may last for a few months or in severe cases may develop into chronic tinnitus and continue indefinitely.
2. Neurological tinnitus results from problems with the brain’s auditory functions.
3. Somatic tinnitus is a form of tinnitus related to the sensory system.
4. Objective tinnitus is the only form of tinnitus that is audible to an outside observer and is caused by muscle spasms or vascular deformities.

All types of tinnitus are complex diseases, which are characterised as diseases with genetic and environmental risk factors. This blog post will explore the latest research into these risk factors to answer the question is tinnitus hereditary.

What is a hereditary disease?

A hereditary disease is a disease caused by the genes you inherit from your parents². Hereditary diseases are inherited from one or both parents, and in some cases, neither of your parents will display symptoms, but you may have other family members who do display symptoms. There are many different types of hereditary diseases from rare diseases, such as Cystic Fibrosis and Huntington’s, to more common conditions, such as heart disease and cancer where family members have a higher-than-normal risk of developing the disease.So, is tinnitus hereditary? Let's first take a look at the known environmental causes of the disease.

Environmental Causes

There are several environmental factors known to increase your risk of developing tinnitus. The most well-documented risk factor for tinnitus is noise exposure, particularly repeated exposure to loud noise in a workplace setting, sporting event, or concert. Incident rates of tinnitus are also high among veterans because of their repeated exposure to loud noise from gunfire, heavy machinery, and explosives.

Other common environmental factors that can cause tinnitus include:

• Hearing loss due to old age or exposure to loud noise.
• Ear wax blockage of the ear canal.
• Inner ear infections, especially repeated infections, that cause a fluid blockage of the ear canal.
• Head or neck injuries where damage has been caused to the structure of the ear, the nerves that carry signals between the ear and the brain, or areas of the brain that process these signals.

Less Common Environmental Causes of Tinnitus

Other studies have shown a small association between tinnitus and the following risk factors:

• Eustachian tube issues
• Ménière’s disease
• Ear bone changes
• Abnormal bone growth
• Jaw joint problems
• Muscle spasms in the ear
• Tumor-related disorders, e.g., a vestibular schwannoma
• Blood vessel problems
• Diabetes
• Migraines
• Thyroid disorders
• Anemia
• Autoimmune disorders, such as lupus and multiple sclerosis

Medications That Can Cause Tinnitus

Some medications are associated with an increased risk of developing tinnitus. Those medications are:

• Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, naproxen
• Antibiotics called aminoglycosides, such as neomycin
• Chemotherapy drugs
• Diuretics
• Hydroxychloroquine and other antimalarial drugs

Genetic Causes of Tinnitus

A handful of academic studies have suggested there is a hereditary component to tinnitus. For example, a 2017 study of the Swedish twin registry, organised by the Karolinska Institutet, split identical twins into groups based on their gender and the type of tinnitus they had. The results suggested that some types of tinnitus could be hereditary. Specifically, when they examined men with bilateral tinnitus it was found that both twins had the same condition, and thus suggested there was a hereditary component to their disease.

The results from the 2017 study in Sweden prompted more research into the genetic factors of tinnitus. Another twin study conducted in 2019 focused on adoptees suffering from tinnitus and the objective was to investigate whether their tinnitus was linked to their adoptive family or their biological family. The findings of this study revealed a significant positive association between tinnitus in the adoptees and tinnitus in at least one of their biological parents. However, there was no noticeable correlation between tinnitus in the adoptees and their adoptive parents.

A genome-wide association study (GWAS) published in 2020 conducted a genetic analysis of the genomes of almost 175,000 people to look for genetic mutations associated with tinnitus. The results identified 6 different genetic locations and 27 genes with a positive association for tinnitus. The results were further supported by an examination of another 260,000 adults where 3 of the same 6 locations and 8 of the same 27 genes were identified, thus these genetic studies strongly support the theory that mutations in these genes might have a causal factor in developing tinnitus.

It’s important to recognise that statistically significant positive associations alone cannot guarantee a causal relationship and more research is needed to determine if there is a causal relationship between developing tinnitus and the genes identified in these studies. However, based on the current research it is very likely that there is a genetic link to tinnitus.

Can You Prevent Tinnitus?

If one or more of your family members has tinnitus you might now be wondering if you can prevent tinnitus. Although you can't guarantee that you will never develop tinnitus, there are many things you can do to reduce your risk of developing tinnitus.

The best way to prevent tinnitus is to protect your hearing. Always wear earplugs if you're in environments where the noise is above 85 decibels. Also, be careful not to play music too loudly when using headphones and definitely don't ignore your smartphone when it notifies you that your music is too loud. If you already suffer from hearing loss you should consider using a hearing aid to prevent your hearing from getting worse, which will in turn reduce your risk of developing tinnitus.

Other healthy behaviours, such as regular exercise, healthy diets, stress reduction, and quitting smoking are also thought to reduce your chances of developing tinnitus.

Treating Tinnitus

There is no one-size-fits-all treatment for tinnitus patients and treatment plans are designed based on the results of a patient's initial evaluation and the type of tinnitus diagnosed. However, most treatment plans will incorporate the use of prescription sound therapy and/or cognitive behavioural therapy, both of which are incorporated into Oto's programs. The goal is for the patient to habituate, or in other words, change the brain's reaction to tinnitus by pushing it into the background.

Patients with objective tinnitus may benefit from surgery, particularly if the doctor believes the tinnitus is caused by an abnormal ear bone change, such as otosclerosis, or by a head or neck injury. However, other types of tinnitus cannot be treated by surgery and will need to explore other treatment options.

Conclusion

There are many different factors that influence your risk of developing tinnitus and current research suggests that some types of tinnitus are hereditary. However, even if you have a family history of tinnitus, you can reduce your risk of developing tinnitus by adopting a lifestyle that reduces your exposure to environmental risk factors, such as protecting against loud noise and lowering your blood pressure.

About the Author

This guest blog post was written by Chris Williams, an epidemiologist and the founder of Tiggo Care, an award-winning home care and live-in care agency based in London, United Kingdom.

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