Tinnitus affects many veterans, but help exists

Many people hear phantom noises in one or both ears, which can sound like a persistent whistle, buzz, chirp or ringing sound. Known medically as tinnitus, this auditory condition is the number one cause of disability among veterans.

Veterans are at increased risk of tinnitus due to loud noise exposure, head injuries and working near ototoxic chemicals. All of these things can damage the delicate organs and cells of the inner ear. This damage likely leads to improper misfiring of the auditory nerve cells as they transmit sound to the brain, researchers theorize.

For some veterans, it's simply a matter of habituating and learning to tune out tinnitus. But others may find it nearly impossible to ignore the tinnitus without professional help, losing sleep and even developing depression or other mental health issues in the process.

How to get help from the VA

If this sounds like you, audiologist Katie Edmonds urges you to contact the VA, which has a tinnitus program available at most of its medical centers.

“The most common mistake is assuming that since tinnitus cannot be cured, there is nothing that can help,” said Edmonds, who works in the Bay Pines, Florida Veterans Affairs Health System.

As a first step, make sure you are enrolled in VA health benefits for hearing care and tinnitus management.

After your benefits are approved and you make a hearing care appointment, your audiologist will likely recommend you get your hearing checked, Edwards noted. Many people live for years with damaged hearing, which is strongly linked to tinnitus. But sometimes the problem is as simple as having too much earwax, which is easy to fix.

If hearing loss is detected, hearing aids may be recommended, since hearing aids can help with tinnitus. Most veterans in the program are also given in-depth instructions for progressive tinnitus management. This research-backed method uses sound therapy, education and counseling.

In depth: What causes tinnitus in veterans?

Hearing loss

Tinnitus and hearing loss usually co-occur. In fact, about half to 90 percent of people with tinnitus have hearing loss. If your tinnitus is a high-pitched sound, the hearing loss is likely to be in those registers, which are key to understanding speech. Hearing loss is more common as we age.

Loud sounds and head injuries

Loud sounds are a prime cause for both hearing loss and tinnitus, especially among veterans who are exposed to blasts and gun noise. Loud noises rattle not just the eardrum, but also the little bones in the inner ear and the cochlea, a fluid-filled organ with thousands of tiny hair-like structures that convert sounds into electrical impulses. Even a single gunshot can permanently damage your ear. Combat and infantry veterans are especially likely to have a hearing loss pattern called “shooter’s ear.”

In 2019, researchers at the VA San Diego Healthcare System assessed the hearing of 2,600 Marines before and after they were deployed into combat. Predictably, combat tended to aggravate any tinnitus they had before. Both PTSD and traumatic brain injury (TBI) were linked to worsening tinnitus, especially among the Marines who had a TBI because they were exposed to a blast.

Ototoxic chemical exposure

Numerous hazardous chemicals can damage hearing if proper protection protocols are not followed. These include solvents, metals and metal compounds, asphyxiants, nitriles, pharmaceuticals, pesticides, among others. Many of these chemicals are commonly used in the military.

Certain medications

Likewise, a number of drugs are linked to hearing loss and tinnitus. As veterans get older and are more likely to use medication, their risk of drug-related hearing loss and tinnitus increases.

Some medical conditions

In some cases, tinnitus can indicate an underlying health condition, including Ménière's disease, thyroid issues, high blood pressure, head and neck trauma, jaw pain, and even severe nasal congestion.

The mental impact

Living with tinnitus can leave you feeling constantly on edge, activating your nervous system and leading to anxiety. This constant stress can lead to more intense or frequent tinnitus, since stress often worsens tinnitus. It's important to get behavioral help to help stop this cycle.

More: Tinnitus, powerlessness and PTSD: Is tinnitus an acute stress disorder?

Is tinnitus ever an emergency?

Usually tinnitus is harmless (though annoying). However, if you hear a pulsing heartbeat, or have ear pain, ear discharge or dizziness, seek out prompt medical care. If you're having extreme anxiety, depression, or suicidal thoughts, get emergency help immediately. Healthy Hearing also has prepared a page on dealing with suicidal thoughts when you have tinnitus.

The views and opinions expressed in this article are those of the individuals interviewed and do not necessarily reflect the views or positions of the Department of Veterans Affairs or any entities they represent.