Have you ever imagined that that ringing in the ear may be related to a lack of vitamin D? That’s that tinnitus is defined as the perception of a sound in the absence of vibration of something external. In addition, it can be subjective or objective, that is, it can be heard by an external observer or not, and it can be pulsatile or not.
This condition has consistently increased during the COVID-19 pandemic, due to sensorineural hearing aid injury, aggravated by COVID-19-related psychosocial conditions in the general population (e.g., stress, anxiety, and depression).
These epidemiological data portray the picture of a serious public health problem, since the consequences on the quality of daily life of people affected by permanent tinnitus can be devastating, ranging from hyperacusis, concentration and communication disorders, boredom, irritability, depression, anxiety, sleep disorders and insomnia, to the development of suicidal thoughts that require urgent psychiatric interventions. But why can tinnitus be associated with low vitamin D?
Numerous factors associated with ringing in the ear
The pathogenesis of tinnitus is complex and often multifactorial. It may come from pathologies of the external ear (such as excess wax, lesions or tympanic membrane infections), middle ear (i.e., acute or chronic infections, otosclerosis, injuries due to exposure to intense noise, use of ototoxic drugs, middle ear tumors such as tympanic glomus, muscle spasms, Eustachian tube dysfunction), inner ear (Meniere’s disease, cochlear lesions, age-related hearing loss or presbycusis), acoustic nerve pathologies (vestibular schwannoma, acoustic neuroma, conflict with itracranial arteries),
It may also arise from other causal factors, such as blood vessel disorders or malformations, ostemalacia, Paget’s disease, pointcerebellar angle tumors, temporomandibular joint disorder, others relatively distant from the hearing aid, such as hyperactivity of auditory brain neurons, multiple sclerosis, idiopathic intracranial hypertension, dural blood vessel abnormalities, head and/or neck injuries, cervical musculoskeletal imbalance, anemia, hyperthyroidism, and hypertension, along with somatoform or phobic disorders.
Association with Vitamin D
Notably, while it is important to remember that tinnitus is always a symptom of a pathology and not a disease itself, the clinical cause(s) or triggering factor(s) often remain uncertain or even completely unidentifiable. Reliable epidemiological evidence has recently been provided that lower serum vitamin D levels may be associated with hearing loss and/or sensorineural hearing loss and balance disorders.
One of the first studies that supported a possible association between Vit D deficiency and impairment of the sensorineural auditory system was published in 1983. Two years later, the same author continued to report other patients affected by bilateral and concomitant deafness with Vit D deficiency.
Notably, one study showed that demineralization of the cochlea results in severe morphological changes and impaired sensorineural auditory transmission, Thus, Vit D replacement therapy resulted in auditory improvement in 50% of patients in whom the response to treatment became available.
Thus, research on this subject continued to associate and prove vitamin D deficiency with other auditory changes that generate tinnitus, such as otitis, deafness in the elderly, benign paroxysmal positional vertigo.
Clinical Practice on Ringing in the Ear and Lack of Vitamin D
Tinnitus is a often disabling condition, characterized by the appearance of tinnitus/noises in the ears, which are usually not generated by an external sound. Vitamin D is an essential nutrient, which plays an important role in a variety of bodily functions, some of them directly related to hearing function. Therefore, it is not surprising that the results emerged from the literature and meta-analysis indicate that lower serum levels of Vit D may be associated with tinnitus. In this way, Vit D supplementation may help prevent and/or reduce tinnitus-related impairment.
Vitamin D – Science Play
Watch the video on Science Play with Fabio dos Santos
: Vitamin D: far beyond a vitamin
Article: Nocini R, Henry BM, Mattiuzzi C, Lippi G. Serum vitamin D concentration is lower in tinnitus patients: a meta-analysis of observational studies. Diagnostics. 2023; 13(6):1037. https:// doi.org/10.3390/diagnostics13061037