Have you ever noticed that some days your tinnitus seems to worsen for no reason? Did you pause to think about what you ate recently? I have learned when I have a salty meal my tinnitus gets worse for several hours. The next day it will improve, providing I haven’t taken more excess salt.

Maintaining a very good diet is critical in the management and lowering of tinnitus sounds. Many foods affect tinnitus, both positively and negatively, and it is important to understand which foods to avoid and which ones to consume. In past articles we have discussed various aspects of diet and tinnitus but have not put it all together in one article, which is what I intend to do here.

Michael Seidman, MD is one of the foremost tinnitus specialists in the US and endorses the use of Arches Tinnitus Formulas for managing tinnitus. Dr. Seidman has known for years that it is imperative that people who suffer from tinnitus consume a very good diet. He has always stressed the need to reduce or eliminate their use of salt, simple sugars, saturated and trans-fats, nicotine, caffeine and alcohol. I realize that for many of us that this is easier said than done.

I will go a step further and say that people who suffer from tinnitus should reduce or eliminate consumption of fast foods and pre-packaged or processed foods. This is due to the addition of large amounts of salt, saturated fats, flavor enhancers and other chemicals meant to prolong shelf-life or enhance the flavor and appearance of the products. These chemicals are not food and have many undesirable side-effects. For the most part they will negatively affect tinnitus and make it louder.

So how do we change our diet to a healthier regimen? One bite at a time. Becoming aware of what you eat is the first step to making better choices. The following are not absolute dietary rules but guidelines to understanding how diet affects tinnitus. No one, least of all me, consumes a perfectly healthy diet. However, being aware of these guidelines and incorporating them into our diet will improve overall health and reduce tinnitus.

Generally speaking, anything that improves health also improves tinnitus. People with high blood pressure will improve after the pressure is lowered, people with high cholesterol will have improvement when it comes under control. Very typically, people who are overweight will have improvement after the extra pounds are shed.

Salt
Salt has an immediate effect on tinnitus and always makes it worse. Excess salt restricts blood vessels, increases blood pressure and reduces blood flow into the ears, eyes and brain. Increased blood pressure is directly linked to increased tinnitus. I speak with many people who are beset with serious tinnitus but don’t make the connection between blood pressure and tinnitus loudness. Many of these people will chow down on chips and other salty snacks, at the same time bemoaning the ringing in their ears. When salt intake is reduced, many of these same people report a lessening of tinnitus sounds.

There are high levels of salt in most processed and pre-packaged foods. A can of soup contains more sodium than the recommended daily allowance for an adult person. This is a primary reason to be very careful of these products.

Sugar
Sugar metabolism has an important role to play in the proper functioning of the auditory system. The brain and auditory system have no inherent food supply. They are completely dependent on the regular delivery of oxygen and glucose (sugar) from the blood supply. When this supply of nutrients is disturbed or interrupted, imbalance and damage can occur.

Studies have shown that 84% to 92% of people with tinnitus have a sugar metabolism disorder known as hyperinsulinemia. This is characterized by increased levels of insulin in the bloodstream. In and of itself, this is not a dangerous condition. However, it is the first step in the long slippery path to Type II Diabetes. Hyperinsulinemia occurs because the body becomes insensitive to insulin and ineffective in delivering sugar to the cells, where it is needed. Therefore the pancreas produces more and more insulin in order to process blood sugar.

Researchers at the Federal University in Brazil conducted a clinical study by treating tinnitus patients with a diet suitable for diabetics. For a period of two years they were instructed to eat every three hours to prevent hypoglycemia; to avoid refined sugar and simple carbohydrates; to restrict their intake of fatty foods, especially saturated or hydrogenated fats; to take no more than 2 cups of coffee per day, limit intake of alcoholic beverages and drink four to six glasses of water per day. At the end of the study, 76% of the participants who observed the diet had improvement ranging from moderate to complete resolution of their tinnitus.

An article with a complete discussion of this study is at How Sugar Metabolism Affects Tinnitus.

Sugar Substitutes
So, refined sugar and simple carbohydrates are something that should be avoided by people with tinnitus. The bad news is that many sugar substitutes are worse than sugar itself. One of the worst is Aspartame, which is used in many diet colas and other diet foods. It is sold under the trade names NutraSweet, Equal, Spoonful and Indulge.

Aspartame, along with Glutamate, is an excitatory neuro-transmitter in the brain. It causes neurons to fire repeatedly until they become depleted and die. This causes untold damage to the nervous system and can lead to neuro-degenerative conditions including tinnitus. The complete story is at Neurotoxins and Tinnitus – Part 1.

Furthermore, Aspartame does not seem to lead to weight loss. Instead, it creates a craving for sweets and carbohydrates which more than makes up for the sugar that is not consumed. When people stop drinking diet sodas, they typically lose weight.

Natural sugars found in fruits and vegetables are perfectly safe and nutritious. Natural, unrefined sugars take longer to digest and do not provide a sugar rush to the bloodstream that triggers excess insulin production. Stevia and Xylitol are two natural sweeteners that are low on the glycemic index and are safe for diabetics. They can generally be found in health food stores.

Flavor Enhancers
Most processed, pre-packaged foods contain flavor enhancers that make the food taste better. The primary flavor enhancer used by the food industry is Monosodium Glutamate (MSG). MSG breaks down to Glutamate in the body. Glutamate, like Aspartame, is an excitatory neuro-transmitter that triggers neurons to fire until they become depleted and die. In fact, for many of us, Glutamate is the primary villain causing our tinnitus.

When hearing hair cells in the cochlea are damaged, by noise exposure, ototoxic medications, infection or many other causes, they release excess amounts of Glutamate. This Glutamate floods the neuro-receptors in the auditory pathway and excites them to the point where they fire continuously. During the course of neuron death, tremendous amounts of free radicals are released which continue the damage to the neurons. This type of tinnitus known as Cochlear-Synaptic Tinnitus is the exact condition experienced by those of us with hearing loss and tinnitus.

The manufacturers of MSG have a long and checkered past with the United States Food and Drug Administration. MSG has long been liberally used in Chinese food. During the 1960’s there was an outbreak of sickness from people eating in Chinese restaurants. There was actually quite a bit of publicity about “Chinese Restaurant Syndrome” which was characterized by sudden onset of headache, heartburn, palpitations, sweating, swelling, and flushing of the face. MSG was getting a bad reputation and people were staying away from it.

However, through a loophole in FDA labeling laws, MSG only has to be listed on a label if it is added in its free form. If it is combined with other additives it does not have to be listed. Now there are about 20 widely used food additives that contain MSG but don’t list it on the label. These additives include hydrolyzed vegetable protein, vegetable or plant protein, natural flavoring, spices and many others. The complete story on MSG and food additives that incorporate it can be seen at Neurotoxins and Tinnitus – Part 2.

Fats
Saturated and trans-fats have multiple negative effects on the body and tinnitus. Saturated fats are not recommended for those with diabetes or hyperinsulinemia. They also increase bad cholesterol (LDL), decrease good cholesterol (HDL), increase triglycerides and lead to atherosclerosis. Atherosclerosis is not only a risk factor in heart disease and stroke but also significantly reduces blood flow. People with tinnitus need to increase blood flow to the inner ear to remove toxins and maintain healthy cells. Tinnitus, in fact, can be caused by nothing more than decreased blood flow to the inner ear.

Unsaturated fats from vegetables, nuts and fish are very healthful. These fats are necessary for life; they lower undesirable cholesterol levels, lower blood pressure, reduce inflammation and are energy sources for the brain. Cooking oils such as olive oil are widely used in the Mediterranean area, noted for its low incidence of heart disease.

Omega 3 fatty acids found in fish oil have been shown to reduce inflammation and pain. They act as anti-depressants and are helpful for regulating mood. They increase insulin sensitivity and are helpful for people with diabetes and hyperinsulinemia. The list of health benefits of fish oil is very long. The complete story can be seen at Inflammation, Omega-3’s and Tinnitus.

Mediterranean Diet
The best diet to consume, for all people as well as those of us with tinnitus, consists of whole, freshly prepared foods, plenty of fruits and vegetables, whole grains, beans and nuts. This diet is laid out nicely in what has popularly become known as the “Mediterranean Diet”. This diet recommends daily physical exercise. It employs plenty of whole grained bread or pasta, fruits, vegetables, olive oil, cheese and yogurt on a daily basis. Several times a week fish, poultry eggs and sweets and several times a month red meat is consumed. It also allows for wine in moderation.

A healthy diet is not difficult; in fact, it is very simple. A general rule of thumb is the closer to its original state the food is when consumed, the better it is for us. Conversely, the more processed and changed to food is, the more we must exercise caution and restraint. The best part of this is that fresh food tastes much better than processed food.

Bon appetit!