Tinnitus, often described as a ringing or buzzing in the ears, is a common condition that affects around 15% to 20% of people. While the exact causes of tinnitus are not fully understood, it often occurs when delicate hairs in the inner ear are damaged or exist in an abnormal state. Some people only experience tinnitus occasionally, while for others, it is a constant disturbance. There is no universal cure for tinnitus, although treatments like sound therapy and medications can provide relief in some cases.
The Link Between Vitamins and Tinnitus
Vitamins play many important roles in the body and are vital for overall health. However, some vitamins have been associated with worsening or triggering tinnitus symptoms when consumed in excess. In particular, supplements containing high doses of vitamin A, the B vitamins, vitamin C, vitamin D, and vitamin E have been implicated in some studies. Here is an overview of the research on how certain vitamins may impact tinnitus:
Vitamin A
Vitamin A is important for vision, immune function, growth, and reproductive health. The tolerable upper intake level for vitamin A from supplements is set at 10,000 IU per day for adults. Consuming too much preformed vitamin A from animal sources like liver or supplements can lead to a condition called hypervitaminosis A. Symptoms may include dizziness, nausea, headaches, and tinnitus.
In one case study, a 60-year-old man developed debilitating tinnitus after taking cod liver oil containing very high amounts of vitamin A regularly for 6 months. His symptoms resolved after stopping the supplements. Other reports have linked excess preformed vitamin A intake from supplements to the onset or worsening of tinnitus as well.
B Vitamins
The B vitamins include B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folate), and B12 (cobalamin). These vitamins help convert food into energy and play key roles in nervous system function. While B vitamin deficiencies can sometimes cause tinnitus, high doses may also trigger or exacerbate symptoms in some cases.
One study looked at 100 patients with tinnitus who were given high doses of B1, B6, and B12. More than half reported worsening of their tinnitus, often within days after starting supplements. Niacin in particular has been linked to tinnitus at very high doses of 2-6 grams per day.
Vitamin C
Vitamin C is a powerful antioxidant that supports immune function. The recommended daily intake for adults is 75-90 mg. While vitamin C deficiency is rare, some doctors recommend supplementing with 1-3 grams per day to shorten colds or aid immunity. However, high doses of vitamin C may worsen tinnitus in some cases.
One study followed 131 patients who were given 1 gram of vitamin C daily for one week, then 3 grams daily for one week. 53% of patients reported tinnitus, with 8% indicating their symptoms began during vitamin C supplementation. Large doses of vitamin C may promote tinnitus by enhancing activity of the vagus nerve.
Vitamin D
Vitamin D plays an important role in calcium absorption and bone health. Some research indicates vitamin D deficiency may be linked to hearing loss and tinnitus. However, high doses have also been reported to trigger tinnitus in some cases.
A case study described an older man who developed tinnitus after beginning to take 8000 IU of vitamin D daily. His symptoms resolved after stopping the high-dose supplements. While moderate doses around 2000 IU per day are likely safe, excessive vitamin D supplementation may exacerbate tinnitus.
Vitamin E
Vitamin E functions as an antioxidant that protects cells from damage. The recommended intake for adults is 15 mg per day. While animal studies suggest vitamin E deficiency may cause hearing loss and tinnitus, high doses have also been linked to tinnitus in some cases.
One report described a man who developed severe tinnitus, dizziness, and gait disturbances after taking 1600 IU per day of vitamin E for only 2 days. His symptoms resolved once he was admitted to hospital and stopped taking the supplements. Excessive vitamin E intake may promote tinnitus through effects on the inner ear.
Potential Mechanisms
It’s not entirely clear why high doses of certain vitamins may worsen or trigger tinnitus in some individuals. Here are a few potential mechanisms that have been proposed based on limited research:
- Altering nerve signaling – Vitamins may act on nerve pathways, enhancing excitatory signals to the auditory cortex and worsening tinnitus.
- Inner ear cell damage – High concentrations of fat-soluble vitamins like A and E may cause oxidative damage to delicate inner ear cells.
- Changes in blood flow – High doses of niacin and vitamin C act as vasodilators, which may alter inner ear blood flow and cellular activity.
- Hypersensitivity – Megadoses of vitamins may trigger hypersensitivity reactions, inflammation, and tinnitus in susceptible individuals.
However, our understanding of these mechanisms is limited. More research is needed to clarify how vitamins may contribute to tinnitus at the cellular level.
Assessing the Evidence
Most of the evidence linking high-dose vitamin supplementation to tinnitus comes from case reports and observational studies. Here are some important considerations when assessing this evidence:
- Limited sample sizes – Most reports describing vitamin-induced tinnitus are based on single patients or very small groups. Larger controlled studies are needed.
- Lack of control groups – There is often no placebo or control group for comparison in reports. This makes it difficult to establish causality.
- Self-reporting – Symptoms like tinnitus worsening are usually self-reported. More objective measures would strengthen evidence.
- Individual susceptibility – Vitamins may only exacerbate tinnitus in certain predisposed individuals, not the general population.
- High doses used – Vitamin doses linked to tinnitus are often well above recommended daily intakes.
Overall, while concerning patterns have emerged, the quality of the evidence is limited. More rigorous controlled studies are needed to clarify how vitamins may impact tinnitus.
Recommended Intakes for Tinnitus
Due to the potential risks, health authorities generally recommend avoiding high-dose vitamin supplements for tinnitus treatment unless a deficiency is confirmed. For people with tinnitus, the following daily vitamin intake ranges are considered safe and adequate:
- Vitamin A: 700-900 mcg
- B vitamins: 1.1-1.5 mg
- Vitamin C: 75-90 mg
- Vitamin D: 600-800 IU
- Vitamin E: 15 mg
Higher doses may be recommended in some cases under medical supervision, but megadoses of vitamins should be avoided. Always talk to your doctor before starting any new supplements, especially when dealing with conditions like tinnitus.
The Bottom Line
In summary, high doses of certain vitamins like A, B3, C, D, and E have been linked to tinnitus onset and worsening in some reports. However, the current evidence base has limitations and controlled studies are still needed. For people with tinnitus, it’s best to stick to recommended daily intakes of vitamins rather than megadoses unless instructed by a doctor. Supplements are never a substitute for proper medical treatment of tinnitus.
Frequently Asked Questions
Can taking vitamins make tinnitus louder?
In some cases, yes. High doses of vitamins A, B3, C, D, and E have been linked to louder or more disruptive tinnitus symptoms in certain individuals, based on some reports. However, more research is needed.
Why would vitamins make tinnitus worse?
Potential mechanisms include altering nerve signals to the brain, damaging inner ear structures and cells, changing blood flow to the ears, and triggering hypersensitivity reactions. However, exactly why vitamins exacerbate tinnitus in some people remains unclear.
Which vitamin is most likely to worsen tinnitus?
According to limited reports, vitamins A, B3 (niacin), C, D, and E have been most frequently linked to worsening of tinnitus symptoms when taken in very high doses. However, some research also suggests B vitamin deficiency could potentially worsen tinnitus.
Can vitamin B12 cause tinnitus?
There are a few anecdotal reports of B12 worsening tinnitus symptoms at very high doses of 1000 mcg per day or more. However, B12 deficiency may also potentially worsen tinnitus. For those with tinnitus, a moderate dose around the daily recommended intake is considered safe.
Can CoQ10 cause tinnitus?
Coenzyme Q10 (CoQ10) has not been linked conclusively to tinnitus. Small studies suggest CoQ10 may even modestly improve tinnitus symptoms in some cases. However, very high doses theoretically could exacerbate tinnitus, so moderation is advised.
Should I take vitamins if I have tinnitus?
Routine vitamin supplementation within the recommended daily intakes is considered safe for most people with tinnitus. However, high doses of vitamins A, B3, C, D and E should be avoided unless prescribed by a doctor. Correcting any vitamin deficiencies may sometimes improve tinnitus.
The Takeaway
Some vitamins like A, B3, C, D, and E have been associated with worsening or triggering tinnitus in a subset of people when consumed in excess. However, current evidence has limitations and controlled studies are still needed. For those with tinnitus, avoiding megadoses of vitamins is generally recommended. Speak to a doctor about appropriate vitamin intakes and whether supplements may help or worsen your tinnitus.
