What is tinnitus
What are the causes of tinnitus
How common is tinnitus
When should i see a doctor for tinnitus
Is tinnitus permanent
Can you cure tinnitus
Is it possible my tinnitus will go away
Does tinnitus get worse over time
Is tinnitus correlated with other health conditions
How can a doctor help me understand my tinnitus
Tinnitus treatment therapies and hearing aids
Are there pharmaceutical treatments available for tinnitus
What is tinnitus retraining therapy
Have any alternative therapies proven successful
What is masking
Can hearing aids help tinnitus
What are the best hearing aids for treating tinnitus
What are some experimental treatments that might prove successful
Living with tinnitus: how diet, exercise, and lifestyle changes can help
Should I make changes to my diet
Can dietary supplements help address my tinnitus
How will exercising affect my tinnitus
What practices can help me protect my mental health
Are there any day-to-day changes that might help me manage my tinnitus
Tinnitus is the technical name for a sound — usually a persistent, high-pitched ringing in the ears — that has no outside environmental source. The sensation is extremely common, and in fact, many people don’t realize they’ve experienced it after a loud concert, while operating heavy machinery, or while battling head congestion.
Tinnitus is not a disease in itself. It’s a symptom. Tinnitus symptoms can be low-pitched or high-pitched, the volume can vary, and patients can experience it in one or both ears. Usually, the quieter the environment, the louder tinnitus feels — which is why it may seem to vanish when music is playing or the television is on.
According to the American Tinnitus Association, this ringing sensation is “a sensorineural reaction in the brain to damage in the ear and auditory system.” In other words, the ringing ears is the brain’s response to any of a host of other ear problems.
>What are the Causes of Tinnitus?
There are about 200 documented causes of tinnitus. That can make it hard for people living with tinnitus to understand where the condition came from, and even harder to figure out how they can reduce its impact on their lives.
Let’s start with the most common cause: hearing loss. The majority of tinnitus cases are the result of damage to the inner ear, or cochlea. Other causes include age-related hearing loss.
There are tiny hair cells in the inner ear that sense noise. When sound waves pass through the ear canal to the middle and inner ear, these cells transmit sound waves into neural signals, which travel into the brain and are understood as sound.
As people age, they are repeatedly exposed to loud noises. These tiny cells can be damaged and lose their ability to process certain frequencies. Or, they can die, meaning they can no longer process sound at all.
Current research suggests that, as these cells lose the ability to hear certain frequencies and send signals to the brain, they change the way the brain processes sound altogether. The brain doesn’t receive the neural signals it expects, and neurons respond in unusual ways.
Tinnitus, at least in part, might be the brain’s attempt to make up for those missing frequencies.
“Primary tinnitus” is the result of hearing loss. While this sensation can be temporary or ongoing, it generally cannot be cured. This includes both temporary hearing loss caused by exposure to loud sounds, like machinery or loud music, and the long-term hearing loss that commonly comes with age.
“Secondary tinnitus” can be traced to a specific cause that may be treatable. Once these problems are addressed, the associated tinnitus usually goes away.
For example, tinnitus sometimes accompanies head and neck injuries and ear infections. It can also occur when ear wax touches the eardrum, changing the way that part of the ear vibrates.
Other ear problems that can cause tinnitus include middle ear infections, which are relatively common; or otosclerosis, which is the stiffening of the tiny bones in the middle ear. Muscle spasms can also occur in the two tiny muscles in this part of the ear, which can cause intermittent tinnitus that may be audible to people nearby.
Meniere’s disease, which affects the balance mechanism in the inner ear, can also lead to tinnitus.
Some medications have been shown to spark tinnitus or make it more severe. Large doses of aspirin can have this effect. Some antibiotics and diuretics can also cause damage to the inner ear, potentially leading to tinnitus.
Traumatic brain injuries, lesions on and near the hearing portion of the brain, and disorders like acoustic neuroma can cause tinnitus too.
Finally, the ringing sensation can accompany cardiovascular diseases, temporomandibular joint arthralgia (TMJ), diabetes, muscle stress and fatigue, anxiety, insomnia and depression.
Tinnitus is extremely common. About 50 million Americans experience tinnitus regularly. Usually it’s a temporary affliction, often following exposure to loud noise, that fades in a matter of hours.
Tinnitus sufferers are more commonly men than women. The problem is strongly correlated with age, meaning the older you are, the more likely you are to experience tinnitus.
Some people, especially those older than 50 or who have already experienced some hearing loss, live with chronic tinnitus — a recurring or constant ringing sensation that lasts longer than six months. At this point, most doctors recommend sufferers seek medical treatment in case tinnitus indicates a serious illness.
Even though most tinnitus is caused by hearing loss, the ringing is occasionally a symptom of rare and potentially life-threatening afflictions.
Tinnitus that sounds like a heartbeat is known as “pulsatile tinnitus.” This could indicate a tumor, an unusual connection between a vein and artery in your ear, or cardiovascular disease. Most doctors recommend contacting a physician as soon as possible in this case.
Occasionally, the ringing in one person’s ears may be audible to someone nearby, which may also suggest a more serious problem.
How to stop the ringing in your ears: Because there are so many potential causes of tinnitus, you may wish to see a doctor to understand what’s causing the ringing.
To prepare for your appointment, think about when the tinnitus began. Were you exposed to loud noise around that time? Were you dealing with an illness or injury?
Then, consider: What does your tinnitus sound like? Is there ringing in your ears? Or would you describe it as ringing, humming, whooshing, or another way? Is the sensation constant, does it pulse steadily, or does it come and go?
Finally, check in with the rest of your body. Are you having trouble hearing everyday sounds? Do you feel dizzy? Are you suffering from headaches, jaw pain, or jaw clicking?
During your examination, your doctor will likely administer an audiogram, or hearing test. He or she will also probably give you a physical examination, including your ears, head, neck and torso.
Radiologic testing, including X-rays, CT scans and MRI scans, are usually not necessary. However, if your tinnitus is pulsatile, only occurring in one ear, or potentially linked to a neurological issue, your doctor may order these additional tests.
Typically, no, tinnitus is temporary. In the majority of cases, it results from exposure to loud noise and fades within hours or days.
But repeated experiences of loud noise is linked to hearing loss, and hearing loss is strongly correlated with tinnitus — so it’s wise to wear hearing protection in loud environments and limit your exposure to loud sounds whenever you can.
There is no cure for chronic tinnitus caused by hearing loss. It is usually manageable, however — four in five people with chronic tinnitus say they’ve gotten used to the ringing and are able to live with it. But some people say tinnitus makes it hard for them to concentrate, sleep, work, study, or manage anxiety and depression.
The short answer is, no, there is no cure for tinnitus.
Because tinnitus is a symptom caused by something else, the only way to get rid of tinnitus altogether is to treat the underlying condition. If the ringing is caused by an infection or injury, or is the side effect of a medication, it should go away when you address the condition or stop taking the medication.
But in the vast majority of cases, tinnitus is caused by hearing loss, which is irreversible. The condition is often temporary — after exposure to loud noises, your ears may ring for a few hours or a day — but as you ages and hearing loss gets worse, the brain produces more and more hyperactive signals to respond to that hearing loss, which can lead to tinnitus. This kind of ringing will probably not stop.
Tinnitus is manageable, however. Work with a doctor to understand what may have caused your tinnitus, address it if possible, and find a way to adapt to it so that the condition doesn’t interfere with your daily life.
If you are living with “secondary tinnitus,” which has a specific underlying cause such as an infection or medication, then your tinnitus should go away when you treat the underlying cause. For example, if you treat an ear infection, stop taking any ototoxic medications, heal from a head or neck injury, or address temporomandibular joint problems (TMJ) — and provided that was the cause of your tinnitus — the ringing will most likely stop.
However, the majority of people who live with tinnitus are experiencing “primary tinnitus,” which is associated with damage to the inner ear and noise-induced hearing loss. There is no cure for this kind of tinnitus, because it is not possible to reverse the hearing loss that caused it.
It is possible to manage tinnitus so it doesn’t interfere with your day-to-day life. Many people learn to ignore the condition, or use sound machines to keep the ringing in check. For those who live with insomnia, anxiety or depression, seeking treatment for these conditions can help lessen the severity of tinnitus and stop ringing in your ears.
Again, this depends on the nature of the case of tinnitus. For most people afflicted with temporary tinnitus, brought on by exposure to loud noises, the condition usually improves and then vanishes altogether in a matter of days.
Though it may seem counterintuitive, chronic tinnitus generally does not get worse over time. In fact, patients find that they notice the ringing less as they learn to live with and manage it.
Yes — many of them, in fact.
A few associated conditions include:
- Diabetes. High blood sugar, prolonged levels of which lead to diabetes, can keep cells from properly regulating levels of certain elements in the inner ear. It can also damage cranial nerves and blood vessels that connect to the ears. A 2009 study in the Brazilian Journal of Otorhinolaryngology found that nearly 88 percent of people with tinnitus also had diabetes or other insulin- and blood sugar-related illnesses.
- High blood pressure. High blood pressure, and the elevated heart rate that often accompanies it, can make existing tinnitus more noticeable — but if the tinnitus was caused by something else, like hearing loss, lowering your blood pressure won’t make it go away. In rare cases, a buildup of cholesterol in blood vessels can cause tinnitus.
- Anxiety and stress. People who already live with anxiety or struggle to manage stress may have a harder time adapting to tinnitus if they develop it, and tinnitus can be an additional stressor, making these conditions more severe.
- High sensitivity to noise. Some people experience an extreme reaction to noise known as hyperacusis. This may be as serious as physical pain when noise, even ordinary sounds at ordinary volumes, reaches patients’ ears. The American Tinnitus Association says about 12 percent of its members have experienced hyperacusis.
- Allergies. Congestion can make tinnitus more severe, so people with allergies may find that exposure to allergens correlates with more intense tinnitus. Treating allergies can usually mitigate this.
Having any of these conditions does not mean that you will start suffering from tinnitus. Nor does hearing ringing in your ears mean you must have diabetes, high blood pressure or anxiety. But because the sensation may be related to these or other conditions, it’s wise to consult a doctor and understand your tinnitus as well as possible.
Audiologists have a diverse set of tools that can help you understand your tinnitus, treat it if possible, and find ways to live with it if not.
According to the American Tinnitus Association, if you’re seeing an audiologist for the first time, he or she will likely administer a comprehensive set of tests to better understand how healthy your hearing is.
These tests may include speech and hearing tests like the ones you had in grade school — listening and repeating words and testing the range of frequencies you can hear. Other, more sophisticated exams, may include:
- Acoustic reflex testing. Normally, when a loud sound reaches the ear, muscles in the middle ear contract. This is both a physical and a neural response. In an acoustic reflex test, a doctor plays various sounds and monitors the movement of the middle ear muscles and activity in the surrounding neural pathways.
- Tympanogram. This is another middle ear test, which focuses on the three tiny bones and the eardrum. It monitors the way the eardrum moves in response to pressure changes. These results are recorded on a graph, which doctors analyze.
- Otoacoustic emission testing. In this third middle ear test, a doctor uses tiny microphones to monitor hair cells in the middle ear. Remember, damage to these hair cells can cause hearing loss. This test can help show the extent of that kind of damage.
Since most hearing loss is linked to the middle ear, these tests can help doctors measure your middle ear activity and figure out which gaps exist in your hearing. Those gaps often reveal specific attributes of your tinnitus — for example, if you have lost hearing in high frequencies, it’s more likely that you hear high-pitched ringing.
Further tests that focus specifically on tinnitus include:
- Sound matching. Imagine the test an eye doctor administers to determine the strength of a prescription — asking, “one or two?” until they reach exactly the right combination of lens attributes. In sound matching, an audiologist does something similar with tinnitus sounds. The doctor plays ringing tones for the patient and makes adjustments to their pitches until the artificial sound matches the sound the patient hears.
- Minimum masking levels. A “minimum masking level” is the softest volume at which an external noise overpowers a patient’s sense of his tinnitus.
- Loudness discomfort levels. This is the opposite of the minimum masking level assessment. A doctor may test to determine the volume at which sound becomes painful to hear.
Understanding these levels can help doctors determine which treatments are most likely to be helpful. Many therapies use sound to treat tinnitus, and these specific assessments — the frequency and quality of the tinnitus, the quietest artificial sound that masks it — can help your doctor customize those treatments for you.
“Treating tinnitus” is a bit of a misnomer. The majority of tinnitus cases are caused by hearing loss, which cannot be undone. If tinnitus is the result of some other underlying medical condition, then treating that condition should stop the ringing sensation in a patient’s ears. But if it’s hearing loss, tinnitus patients have to learn to live with it.
There is no pharmaceutical treatment for tinnitus. But several therapies can help reduce the volume or intensity of the ringing sounds, helping patients to live the most normal lives possible.
Currently, there is no FDA-approved drug treatment for tinnitus. Remember, the root cause of most cases of tinnitus is an abnormal neural response to abnormal signals from the inner ear. An effective drug treatment would have to “reverse the neural hyperactivity at the root of tinnitus,” according to the American Tinnitus Association.
Some patients who experience anxiety or depression related to their tinnitus may use drug therapies to treat those conditions. If you think tinnitus is affecting your mental health, consider cognitive behavioral therapy to help you adapt to the condition, or contact a psychiatrist or psychologist to discuss other treatments.
While antidepressants and antianxiety medications may help relieve those conditions, there’s little evidence that they actually reduce the ringing in patients’ ears.
Tinnitus retraining therapy, or TRT, is a technique developed in the 1980s for tinnitus treatment. In TRT, a doctor uses a device inserted into the patient’s ear to generate sounds that match the sounds of his or her tinnitus.
TRT’s goal is to get a patient’s auditory system used to tinnitus signals in controlled treatment, so when they develop out in the world, they will feel less noticeable.
TRT treatments typically continue for one to two years.
While this method cannot treat the underlying causes of tinnitus — it cannot restore lost hearing, which is the most common reason people experience tinnitus, nor can it address other medical disorders — it has been successful in helping patients live with tinnitus. In certain studies, as many as 80 percent of patients have reported improvement after TRT.
Many studies have shown that hypnotherapy reduces anxiety and helps patients relax, and there’s some evidence that prolonged treatment can alter neural connections within the brain. However, there’s little scientific research specifically exploring the impact of this treatment on tinnitus.
Some studies suggest acupuncture might be an effective treatment for tinnitus, though more research is needed. For example, a 2006 study in the Brazilian Journal of Otorhinolaryngology found that, after acupuncture treatments on the right part of the head, tinnitus patients said the intensity of the ringing was reduced.
A “tinnitus masker” is a device worn in the ear, similar to a hearing aid. It produces quiet white-noise-style sounds that have effects similar to ambient noise or sound machines — they distract, or “mask,” the sound of the ringing. The masking sound is designed to be more manageable, or less annoying, than the sound tinnitus produces.
Masking can help tinnitus patients perceive the condition less, and there is some evidence that tinnitus remains less impactful after patients turn maskers off.
There has not yet been robust scientific research on maskers themselves, but keeping ambient white noise in the background of one’s home is a widely recognized strategy for adapting to tinnitus. Masking devices are based on the same principle.
Some hearing aids include maskers. These are especially useful for patients who suffer from both hearing loss and tinnitus.
Because tinnitus is so often connected to hearing loss, doctors frequently try to help patients adapt to both conditions together.
Remember how tinnitus linked to hearing loss works. First, sensitive hair cells that process sound waves become damaged. Damaged cells can no longer send their normal neural signals to the brain, so the brain cannot fully process the sound. In response, the brain may generate abnormal signals, which become a ringing or buzzing sound in patients’ ears.
Hearing aids can’t undo these neuroplastic changes in the brain. Instead, they use microphones, amplifiers and speakers to increase the volume of environmental noise. That helps more sound reach the inner ear, which means more sound can be processed by the auditory system. If the brain is processing sound signals more normally, it may produce fewer tinnitus signals.
And the louder hearing aids make environmental noises seem, the more those noises mask tinnitus, which in turn makes it easier for patients to focus on hearing environmental noises. This positive feedback loop is most significant for people whose hearing loss affects the same range of frequencies as their tinnitus. A doctor can help you determine which frequencies are most impacted by your condition and whether a specific hearing aid could help.
In a 2007 survey of 230 health professionals, about 60 percent told the Better Hearing Institute that their patients felt that wearing hearing aids reduced their tinnitus problem at least a little. Just over 22 percent described “major relief.” About 39 percent of respondents said hearing aids had no effect on their patients’ tinnitus.
I recommend two brands: Miracle Ear and Starkey.
Miracle Ear sells three different hearing aid options for reducing the severity of tinnitus. These devices can generate five different static noise sounds and four different ocean wave sounds, so patients can either play the one that best corresponds to the frequency of their tinnitus or the one that feels most soothing. Either way, the sound is meant to distract from the ringing noise.
Third, Miracle Ear offers something called Notch Therapy, which is designed to train the brain to ignore tinnitus sounds. A specialist tunes the hearing aid to match the frequency of the wearer’s tinnitus, and after several weeks to several months, users may find they no longer notice their tinnitus ringing.
Starkey, another leading producer of hearing aids, offers a whole line of tinnitus products that use masking techniques to help patients adjust to tinnitus.
Like Miracle Ear, the frequency and quality of Starkey’s masking tone can be adjusted to match the ringing in patients’ ears. Users can adjust the volume of these masking sounds depending on their environment.
Several other hearing aid manufacturers offer tinnitus treatment options. Widex’s Zen product uses wind-chime-style sounds to mask tinnitus. ReSound’s tinnitus-focused hearing aid offers straightforward white noise and volume amplification. Siemens offers four different tones, including white noise, “pink noise,” inaudible speech, and quiet, high-pitched tones.
Your doctor can help you decide if any of these hearing aids, or other brands, are right for you.
The American Tinnitus Association describes the following as “promising prospective treatments” for tinnitus. That means that in early studies, they have produced data that shows they can be successful.
All of these treatments need a lot more testing and evaluation before they’ll be available to ordinary tinnitus patients. However, if some of them make it out of carefully controlled clinical trials, they may offer powerful treatment options.
- Repetitive Transcranial Magnetic Stimulation, or rTMS. In this treatment, a doctor positions a powerful magnetic coil against a patient’s head and sends electromagnetic pulses into the brain tissue.
Remember, after a patient suffers hearing loss, the brain cannot properly process sounds. So it responds with neural hyperactivity to make up for the lost frequencies. This hyperactivity manifests as tinnitus. Strong electromagnetic stimulation, like the kind administered in rTMS, can reduce neural activity, and thereby the intensity of tinnitus.
So far, rTMS has produced mixed results when compared to placebo treatments.
- Transcranial Direct Current Stimulation (tDCS). Like rTMS, the goal of this treatment is to send electromagnetic pulses into the brain, which reduce neural hyperactivity. But instead of a magnetic coil, a patient wears electrodes on his or her scalp, and a doctor sends different pulses through each electrode depending on the neurons beneath.
Some tDCS studies have shown as many as 40 percent of patients responding to this treatment, but it still needs to undergo large clinical trials.
- Deep Brain Stimulation (DBS). DBS is a surgical procedure, in which a doctor places electrodes directly into the brain. It is currently used to treat Parkinson’s Disease and similar disorders that involve tremors, and some of those patients have said the surgery also reduced the intensity of their tinnitus.
DBS is still far from treating tinnitus directly, however, since doctors don’t yet know which areas of the brain need to be stimulated to produce the right effects.
- Vagus Nerve Stimulation (VNS). Doctors treating epilepsy and depression have used VNS — the surgical placement of an electrode on the vagus nerve, which runs from the brain to the heart and digestive system via the neck — to manage those conditions, with some success.
While some research suggests that VNS may help tinnitus patients, the American Tinnitus Association warns that “much of the scientific output (comes) from private companies attempting to develop commercial VNS products.”
Again, these treatments are still experimental. Scientists agree that much more research is necessary to understand if they can help tinnitus, and if so, how much. Surgical procedures, in particular, can be dangerous and expensive, and it’s unlikely DBS or VNS will be available as tinnitus treatment in the foreseeable future.
Some patients use hearing aids to cope with tinnitus. Other doctors suggest that tinnitus patients use background music or noise to lower the perceived volume of the ringing. Some people sleep with their heads elevated, seeking to reduce head congestion.
Stimulants, including nicotine and caffeine, can make tinnitus’ ringing feel louder. Smoking in particular can make tinnitus more intense — it reduces the ease with which blood flows throughout the body, including to the nerve cells that control hearing.
Tinnitus patients should monitor their mental health. The condition is profoundly annoying, and it can affect quality of life, especially for people who already live with depression and anxiety. Cognitive behavioral therapy or treatment by a psychiatrist or psychologist may help sufferers cope with tinnitus — but doctors generally do not recommend antidepressants or anticonvulsants for people with tinnitus unless they have an underlying mental health condition that requires such treatment.
Possibly. There’s not much evidence directly linking tinnitus to specific foods, or reduced tinnitus sensations to the elimination of specific foods. However, the links between healthy diets, reduced blood pressure and better blood flow are well-established. It’s wise to avoid foods that restrict blood pressure or increase the heart rate, which can cause tinnitus to feel more severe.
I recommend that tinnitus patients consider reducing their consumption of five key foods:
- Salt. Salt restricts blood vessels and increases blood pressure, restricting blood flow to the ears, eyes and brain. Most of the salt Americans consume comes from processed foods, not sprinkling as seasoning, so it can be difficult to remove completely. Start by reading food labels to get a sense of how much salt you consume.
Also, salt consumption is strongly correlated with symptoms of Meniere’s Disease. If you know your tinnitus is linked to Meniere’s, reducing your salt consumption may be more likely to help your tinnitus.
- Caffeine. Like salt, caffeine restricts blood flow and can contribute to high blood pressure. Academic research on caffeine’s relationship to tinnitus is mixed: Some studies show it exacerbates tinnitus, while others suggest it’s a beneficial treatment. Cutting back on caffeine may help, but like most lifestyle changes, it’s not a guaranteed fix.
- Sugar. Excess sugar in the blood has the potential to disrupt the workings of the inner ear, because the inner ear gets all its energy from the oxygen and glucose stored in the bloodstream. A 2004 study found that more than 84% of tinnitus patients had elevated insulin levels, which are usually a result of the pancreas producing more insulin to lower blood sugar levels. The good news about this link is, if hyperinsulinemia is causing your tinnitus, getting your blood-glucose level under control may reduce the severity.
- MSG. Monosodium Glutamate is a flavor enhancer, most often recognized in Chinese food but found in a variety of cuisines. It also increases levels of electrical activity in the brain and auditory cortex, where the loud noise caused by tinnitus is perceived.
- Saturated and trans fats. Like sugar, these substances constrict the blood vessels and reduce blood flow to many parts of the body, including the brain and ears.
The answer is probably not. It is quite unlikely that people with tinnitus are going to find a dietary supplement once and have their symptoms go away immediately. With this being said, some individuals do experience some relief taking a supplementation along with dietary changes. It is important to beware of false advertising for tinnitus treatments. Dietary supplements containing ginkgo biloba, zinc, lipoflavenoids and specific vitamins are frequently advertised online and on television but currently, there is no scientific evidence to support the claims that these supplements can help reduce, much less cure, your tinnitus.
Like reducing your intake of sugar, salt and fat, cardiovascular exercise helps open up restricted blood vessels, which allows more blood to reach the brain and ears. This may help tinnitus feel less severe.
More immediately, perhaps, exercise often helps reduce stress and anxiety. If you find your tinnitus makes you anxious, a relaxing, stimulating exercise routine may help you manage impact of the condition on your mental health.
Some doctors recommend tinnitus remedies such as simple meditation and mindfulness practices to help tinnitus patients reduce feelings of stress and anxiety. Exercise can have similar effects.
Also, tinnitus and the discomfort it creates can keep tinnitus patients from socializing as much as they used to, which can contribute to feelings of depression and isolation. If tinnitus causes you to remove yourself from your friends and family, consider asking them to make whatever household changes work for you — playing background sounds in their homes when you visit, for example — so you can maintain relationships without too much pain.
Finally, tinnitus can exacerbate anxiety and depression. If you live with mental illness, talk about your tinnitus with your doctor, psychologist, psychiatrist or therapist to see if lifestyle changes, hearing therapies or medication could help.
Many doctors suggest that tinnitus patients leave noise on at home to minimize the ringing sensation. Whether that’s music, television, a white noise machine, or some other ambient source, environmental noise can overpower the sounds created by tinnitus and help patients ignore it.
Masking devices and hearing aids, often used in conjunction, can offer similar relief everywhere patients go.
While it’s not exactly a tinnitus remedy, avoiding loud sounds can stop tinnitus from getting worse. Keep a pair of earplugs on hand to protect yourself when you unexpectedly enter loud environments.
Millions of Americans live with tinnitus, and the vast majority — about 80 percent — say the condition is manageable. With the help of a doctor, you may be able to treat an underlying cause and stop the ringing.
And even if you can’t stop the ringing, small household and lifestyle changes, ever-evolving treatments and therapies, and self-care can almost certainly help you live a full life with it.