Can You Have Tinnitus Without Having Hearing Loss?
January 28, 2022

Tinnitus is a condition that causes a ringing in the ears that is not audible by others. These phantom sounds can range in how they sound. But, tinnitus of all severities can have a negative implication on your overall well-being. From getting in the way of concentrating all the way to impacting your mood, tinnitus can have a profound effect on how you feel in your day-to-day life. 

Tinnitus and hearing loss are two conditions that frequently occur together but are the hearing impaired the only ones that experience tinnitus? This article explores if you can just have tinnitus without hearing loss and other information pertaining to tinnitus.

Equipped with this knowledge, you will be able to be more informed about tinnitus, some of its potential causes, as well as steps you could take to help you manage your tinnitus. 

The Connection Between Hearing Loss and Tinnitus

When you look at the concepts of hearing loss and tinnitus, you may think of them as opposites. Some assume that hearing loss is when you cannot hear sounds in your environment, and tinnitus is hearing sounds when they are not there. While counterintuitive, in many cases, they occur together. 

Below is a closer look at the theories as to why this may be the case. 

Damaged Hair Cells

The first possible explanation as to why tinnitus occurs alongside hearing loss has to do with how sound is perceived in the first place. The ear has many different components. The part that is responsible for converting vibrational energy into a neural impulse for the brain to perceive is the cochlea.

The cochlea is a hollow snail-like structure that has many tiny sensory hairs that are tuned to different frequencies of sound. When the right frequency hits the corresponding hair in the cochlea, it bends. The bend initiates a nerve impulse that is then sent to the brain.

A form of hearing loss known as sensorineural hearing loss can occur when the hairs of the cochlea are damaged. Damage can occur simply as a result of age, or it can occur earlier due to exposure to loud noise. The theory as to why tinnitus accompanies some forms of hearing loss may have something to do with the sensory hair damage.

Changes Within the Brain

The auditory cortex theory has more to do with how the brain responds to hearing loss than the actual sensation of sounds. With this theory, it is thought that the brain changes associated with a decline in hearing are responsible for the formation of tinnitus alongside hearing loss. 

What is thought to happen with the brain during hearing loss is that it essentially turns up the sensitivity to the signals coming from the ear because it is expecting to hear more than what it is able to hear. This slight bit of adaptation on the part of the brain is helpful. Yet, the increase in sensitivity could result in the lack of any signal being interpreted as white noise. 

The best way to imagine it is to think about trying to find a radio station. By turning up the volume while searching for a channel to tune into, you will begin to hear white noise. This white noise is not being broadcast and simply comes as a consequence of increasing the sensitivity of the radio. 

Tinnitus Without Hearing Loss

While hearing loss and tinnitus frequently occur together, there are people that just suffer from tinnitus alone and have no loss of hearing acuity.

Below is a closer look at tinnitus without hearing loss and what causes them. 

Pulsatile Tinnitus

The previous examples of tinnitus actually fall into a category of tinnitus known as subjective tinnitus. Essentially subjective tinnitus is tinnitus that has no obvious cause. Another form of tinnitus known as objective tinnitus does have an identifiable source. 

The ear is a highly sensitive organ. There are a number of different blood vessels that flow in and around the different components of the ear. Under normal conditions, these blood vessels allow blood to flow smoothly and without disturbing the ear. However, with pulsatile tinnitus, they become a source of internal noise. 

Things such as atherosclerosis, high blood pressure, and even an increase in intracranial pressure can cause internal noises near the components of the ear, which are perceivable and lead to tinnitus. 

If you have pulsatile tinnitus, you should consult with your doctor to rule out any problems or allow them to help you find a treatment option for your specific circumstance.

Those with high blood pressure may be prescribed blood pressure medications. On the other hand, those with atherosclerosis may need to make healthier lifestyle choices. 

Drug Side Effects

Another potential cause of tinnitus that is not related to hearing loss is unintentional drug side effects. There are a number of drugs that have tinnitus as a potential side effect, including some over-the-counter pain relievers, antidepressants, and even acne medications. 

In most cases, tinnitus caused by medication will resolve when the medication is ceased. This can be great news for those that experience these effects. 

How Is Tinnitus Treated?

Whether you have tinnitus with or without hearing loss, it can be difficult. Constantly having a tone in your ear is no one’s idea of a good time. It can be incredibly difficult for you to go about your day without getting bothered or agitated by tinnitus. 

The unfortunate part of many forms of tinnitus is that there is no cure. While this can be disheartening, there are options available to help you effectively manage your tinnitus and overcome it. Below is a closer look at some of the options you have when it comes to tinnitus. 

Sound Masking

The most basic method for obtaining temporary relief from tinnitus is the use of competing sounds to drown out the sound of your tinnitus. Also referred to as sound masking or white noise, this method works in the same manner as turning up the volume on your TV to not hear your rowdy neighbors. 

Sound masking is by no means an effective long-term solution, but it can be a great tool to have under your belt to manage and live with tinnitus. One of the best use cases for sound masking is when you are trying to go to sleep. When you are lying in bed in a dark, quiet room, tinnitus can become more apparent and bothersome.

Utilizing a white noise machine can allow you to fall asleep easier without having to listen to your tinnitus by drowning it out. As an added bonus, a white noise machine can help to drown out other sounds throughout the night that would have otherwise disturbed your sleep

Ear Cleaning

Another source of tinnitus that hasn’t been discussed is ear wax build-up. A buildup of earwax, known as an earwax impaction, occurs when the ear is unable to effectively expel wax. It causes a complete blockage of the ear canal. With the ear canal blocked, it can result in both hearing loss and tinnitus. 

Luckily by removing the blockage, the associated tinnitus and hearing loss can be reversed. In the case of ear wax impaction, the best way to remove it is to seek professional assistance. The ears are incredibly delicate; a small misstep could result in you damaging your ears. A licensed medical professional can help to remove the wax. It may be possible to completely reverse your tinnitus (if it is caused by the ear wax obstruction). 

Hearing Aids

If you happen to have tinnitus alongside hearing loss, utilizing hearing aids will not only allow you to hear more but could also help your tinnitus. Hearing aids give you the ability to increase the volume of incoming sounds.

This allows the sounds to be perceived by those with hearing loss. This can increase the sounds of people talking to you but can also increase the background noise. Essentially, this can act to mask tinnitus. 

If you are having a troubling time with tinnitus throughout your day and you also happen to have hearing loss, hearing aids are a great way to kill two birds with one stone. While any hearing aid could work in theory, the best option available is the one that you will be able to wear all day long.

Audien hearing aids provide a design perfect for all-day comfort, and with a shockingly small profile and weight, you may even forget you have them in. 

Managing Different Conditions

Tinnitus is a condition that is not exclusive to those with hearing difficulties. Drug-induced tinnitus and pulsatile tinnitus represent two forms of tinnitus that are unrelated to hearing loss. No matter the cause of your specific tinnitus, it can be a hassle to deal with.

Taking steps such as utilizing sound masking, hearing aids, having a wax cleaning, or getting tinnitus therapy can help to improve your standard of wellbeing and allow you to get back to you before tinnitus. 


Patients with pulse-synchronous tinnitus should be suspected to have elevated cerebrospinal fluid pressure | NCBI

How Noise Can Affect Your Sleep Satisfaction | Sleep Foundation

Tinnitus - Diagnosis and treatment | Mayo Clinic

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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