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Can Hypothyroidism Cause Ringing In The Ears?

Learn how low thyroid hormone levels may cause ringing in your ears.
Can Hypothyroidism Cause Ringing In The Ears?
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Do you ever find yourself lying in bed, trying to sleep, but all you can hear is a persistent ringing or buzzing in your ears? It’s a frustrating experience, to say the least. You probably wonder what’s causing this annoying sensation. Was it exposure to loud noises or perhaps an ear infection? 

Have you considered that hypothyroidism could be the culprit? Yes, that’s right – there’s a possibility that your thyroid function and those phantom noises in your ears are connected!

What is hypothyroidism?

Your thyroid is a small, butterfly-shaped gland located in your neck. Although small, the thyroid gland regulates your body’s metabolism, growth, and development. More specifically, the thyroid produces hormones that control the rate at which your body utilizes energy and influences protein synthesis. When your thyroid doesn’t produce enough thyroid hormones, it leads to a condition called hypothyroidism. Hypothyroidism is characterized by a general slowdown of many body functions.

So, what is the connection to your hearing? Thyroid hormones play a significant role in maintaining the health of your nerves, including those in your ears. When your thyroid isn’t functioning properly, it can disrupt the delicate balance of chemicals and signals in your body. This can lead to symptoms like ringing in the ears.

What is tinnitus?

Tinnitus is the medical term for “ringing in the ears.” Although it is not considered a serious medical condition, it can significantly impact your quality of life. People can experience tinnitus at any point, especially after exposure to loud noises. Sometimes, tinnitus occurs in healthy people for no apparent reason. In other cases, tinnitus may relate to an underlying medical condition or head injury.

Along with damage caused by frequent exposure to loud noises, other causes of tinnitus include:

  • Medications such as certain antibiotics, antidepressants, or non-steroidal anti-inflammatory drugs (NSAIDs)
  • Blockage in the ear canal from earwax or fluid from an ear infection
  • Jaw problems
  • Meniere’s disease, an inner ear disorder
  • Autoimmune disorders like multiple sclerosis or lupus
  • Head, neck, or brain tumor
  • High blood pressure
  • Heart disease

Tinnitus can also be associated with hearing loss. Hearing loss can be due to natural aging or repetitive exposure to loud noises, but not all people with hearing loss experience tinnitus.

How tinnitus is produced is not well understood. This frustrating condition may result from dysfunction in or damage to the nerves that send information between the ears and the brain. These nerves are responsible for delivering sound and providing information about balance to the body.

As you will see below, the ear is a highly complex organ. Damage can occur in several places, leading to trouble hearing and persistent ringing and buzzing. 

Brief overview of how the ear works

The ear is part of your sensorineural system. It delivers sound waves and transforms them into electrical signals. These signals travel from your ears to your brain along nerves. Once in the brain, the signals are interpreted. Your brain interprets these sounds as loud or quiet and identifies them as music, someone talking, or a dog barking, for example. And in some cases, as “ringing in the ears.”

Your ear has three key areas that help perform these functions: the external ear, middle ear, and inner ear.

The external ear -- also known as the “outer ear” -- is the outer part of your ear that you can see or feel with a Q-tip. This part of the ear amplifies and transmits sounds to the tympanic membrane (eardrum), which is highly sensitive to sound waves and pressure changes.

The middle ear is on the inside of the tympanic membrane. It contains the oval window, eustachian tube, and three tiny bones: the hammer (malleus), anvil (incus), and stirrup (stapes). Vibrations from the eardrum are transmitted by these small bones in the middle ear to the oval window to amplify sound waves. Meanwhile, the inner ear is also responsible for equalizing pressure. It is where you feel pressure changes when you change elevation rapidly, like when ascending or descending in an airplane.

The inner ear consists of the cochlea, semicircular canals, and vestibular system. The cochlea helps turn sound waves into sounds. The semicircular canals react to body movements and are mainly responsible for rotary motion. The vestibular system, in particular, is responsible for maintaining balance.

Heads up: Most providers warn against using a Q-tip to clean out the outer ear. Q-tips can irritate your ear and push earwax against the eardrum. This can cause damage to the eardrum or block the ear canal. As we learned earlier, a blockage in the ear canal can lead to tinnitus.

How does hypothyroidism cause ringing in the ears?

Tinnitus is a relatively common symptom seen in the general population. Yet the exact prevalence is unknown. It can range anywhere from 5% to over 40%. Why the wide range? There isn’t a universal definition for tinnitus, making it hard to report the exact prevalence.

Likewise, there is no consensus on what causes tinnitus in people with hypothyroidism. But, the theory is that thyroid hormones affect the sympathetic nervous system.

Your sympathetic nervous system helps control many bodily functions, such as heart rate, blood pressure, and sweating, amongst many others. But it may be best known for its role in your “fight-or-flight response” to get you out of high-stress situations.

The sympathetic nervous system is made up of many different types of nerves and uses specific neurotransmitters to communicate. Neurotransmitters are chemicals that your body makes to communicate. As with thyroid hormone, having too much or too little of these neurotransmitters can disrupt bodilyy functions.

An overstimulated sympathetic nervous system can throw off the balance of neurotransmitters. One type of neurotransmitter -- norepinephrine -- tends to be higher in those with an underactive thyroid and low thyroid hormone levels.

Your sympathetic nervous system also influences the blood supply to the inner ear. When the inner ear doesn’t get enough blood, tinnitus can develop. Interestingly, animal studies show that altering the sympathetic nervous system can affect the inner ear’s blood supply. And what helps regulate your sympathetic nervous system? Thyroid hormone levels! In general, the sympathetic nervous system and thyroid hormone regulate body processes in similar ways, often complementing each other. When the balance of neurotransmitters and thyroid hormone levels is thrown off, auditory hearing symptoms may ensue, and hearing may be affected.

There are other pathways as well. Hypothyroidism can indirectly contribute to tinnitus by causing other health issues that may cause ringing in the ears. For example, people with thyroid issues often experience changes in their blood pressure and blood flow. Both factors can affect the blood vessels in the inner ear and contribute to tinnitus. Additionally, hypothyroidism can lead to a build-up of fluid in the middle ear or excess wax development, further worsening the problem.

Finally, low thyroid hormone levels during neonatal and infantile periods of development may result in an underdeveloped cochlea.

Are there risk factors for developing tinnitus?

Exposure to loud noises is the top risk factor for developing tinnitus. But there are others.

A 2022 study showed that the rate of tinnitus associated with hypothyroidism is increased with age as well as by other medical conditions, including:

Some of these risk factors you can’t change, like your age, but you can change others, such as your sleep habits and anxiety level.

How is tinnitus treated in people with hypothyroidism?

Treating the cause of tinnitus is the key when there is an underlying medical condition. In this case, it means managing hypothyroidism.

Hypothyroidism requires life-long therapy with thyroid hormone replacement medication. There are several different medication options. The most common one prescribed is levothyroxine.

Before starting a thyroid replacement medication, your healthcare provider will perform a thyroid blood test panel. These tests measure how low your thyroid hormone levels are and can confirm that you have hypothyroidism. The process of dose titration -- finding the right thyroid medication and dosage that best supports your health -- can involve different doses over weeks to months. But once you are on the correct dosage, you will likely experience a significant improvement in your hypothyroid symptoms, including tinnitus. Animal studies did report, however, that when thyroid hormone deficiencies occur before the onset of hearing loss, changes to the auditory system are usually not reversible.

As mentioned, some lifestyle habits can contribute to tinnitus. So, making simple adjustments may go a long way to help manage your symptoms. These include:

Keep in mind that tinnitus is a vague symptom with several different causes. Treating hypothyroidism is an excellent start to improving ringing in your ears. But if this frustrating symptom persists, meet with a healthcare provider specializing in tinnitus.

A note from Paloma Health

If you’ve been experiencing ringing in your ears and suspect it might be related to hypothyroidism, what should you do?

Well, the first step is to talk to your healthcare provider. They can perform simple blood tests to check your thyroid hormone levels. These tests help determine whether hypothyroidism is the culprit behind your symptoms. If thyroid dysfunction is the cause, there are treatment options available. If you need comprehensive hypothyroidism care, consider becoming a Paloma Health member. Our end-to-end thyroid care provides a personalized plan to optimize your thyroid health. Schedule a free consultation today.


National Institute on Deafness and Other Communication Disorders. Tinnitus. NIDCD. Published June 15, 2018. Last updated May 1, 2023. Accessed April 7, 2023. [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the ear work? 2011 Oct 13 [Updated 2019 May 9]. Accessed April 7, 2023. Available from:

Hsu A, Tsou YA, Wang TC, Chang WD, Lin CL, Tyler RS. Hypothyroidism and related comorbidities on the risks of developing tinnitus. Sci Rep. 2022 Mar 1;12(1):3401. doi:

Cleveland Clinic. Sympathetic Nervous System (SNS). Cleveland Clinic. Published June 6, 2022. Accessed April 7, 2024.

Mullur R, Liu YY, Brent GA. Thyroid hormone regulation of metabolism. Physiol Rev. 2014 Apr;94(2):355-82. doi:

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Emilie White, PharmD

Clinical Pharmacist and Medical Blogger

Emilie White, PharmD is a clinical pharmacist with over a decade of providing direct patient care to those hospitalized. She received her Doctor of Pharmacy degree from Massachusetts College of Pharmacy and Health Sciences. After graduation, Emilie completed a postgraduate pharmacy residency at Bon Secours Memorial Regional Medical Center in Virginia. Her background includes caring for critical care, internal medicine, and surgical patients.

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