Managing Tinnitus in POTS Patients - Causes, Treatments, and Relief

Finding Relief from Tinnitus for People with POTS

Tinnitus and POTS often go hand in hand. POTS stands for Postural Orthostatic Tachycardia Syndrome, a disorder of the autonomic nervous system. POTS can cause an array of symptoms, including chronic fatigue, dizziness, fainting, and fast heart rate. Tinnitus - a constant ringing, buzzing, or roaring in the ears - is also common in people with POTS.

Tinnitus can greatly diminish quality of life for POTS patients who are already struggling with a complex chronic illness. The unrelenting noise makes it difficult to focus, sleep, and hold conversations. Fortunately, there are ways to manage tinnitus to lessen its impact.

Causes of Tinnitus in POTS

While the root cause is not always clear, there are several theories about the link between POTS and tinnitus:

• Impaired blood flow - POTS affects circulation, which may deprive the ears of oxygen.
• Inner ear dysfunction - Balance issues in POTS may damage hair cells in the inner ear.
• Abnormal brain signals - Faulty neurotransmission in POTS could cause tinnitus.
• Anxiety and stress - POTS often leads to anxiety that can worsen tinnitus.
• Medications - Some drugs used to treat POTS like antidepressants are ototoxic.

Tinnitus Management Tips for POTS Patients

While there is no cure for tinnitus, there are ways those with POTS can manage it more effectively. Strategies include:

• Increase salt and hydration - Improving blood volume in POTS may help circulation to the ears.
• Try supplements - Lipoflavonoids, ginkgo biloba, and zinc supplements may provide relief for some.
• Mask the noise - Soothing background sounds and white noise machines help distract from tinnitus.
• Use hearing aids - They amplify external sounds to make tinnitus less noticeable.
• Practice stress reduction - Yoga, meditation, deep breathing lower anxiety that exacerbates tinnitus.
• Get enough sleep - Fatigue seems to worsen tinnitus, improved sleep hygiene helps.

Experiment to find the remedies that offer the most relief. Keeping a tinnitus journal can help identify triggers and track treatment effectiveness.

When to See a Doctor for POTS and Tinnitus

Consult your doctor if tinnitus:

• Occurs suddenly or without apparent cause
• Happens in only one ear
• Is accompanied by hearing loss
• Prevents you from sleeping or working
• Causes great emotional distress

A doctor can check for underlying conditions and provide appropriate treatment options. See an otolaryngologist to examine your ears and evaluate the cause of tinnitus.

Tinnitus Treatment Options for POTS Patients

A multi-disciplinary approach combining lifestyle remedies, medical treatments, and coping techniques often works best for minimizing tinnitus in POTS patients. Available options include:

Medications

There are no FDA-approved drugs specifically for tinnitus, but some medications may help reduce symptoms:

• Tricyclic antidepressants - Amitriptyline and nortriptyline can suppress tinnitus noise.
• Anticonvulsants - Drugs like gabapentin may calm abnormal nerve signals.
• Anxiolytics - Alprazolam and other anti-anxiety drugs can minimize distress.

Discuss risks versus benefits of medications with your doctor. Lower doses and shorter treatment periods can help avoid side effects.

Sound Therapy

Soothing sounds can mask tinnitus perception and divert attention from it. Options include:

• White noise machines - Provide steady, unobtrusive background noise.
• Hearing aids - Fitted devices enhance external sounds.
• Custom sound therapy - Pleasurable, personalized sounds are embedded in hearing aids or standalone devices.
• Phone apps - Convenient apps like White Noise allow mixing different background sounds.

Use sound therapies judiciously at volumes that don't damage hearing. They can be used alongside other tinnitus treatments for POTS patients.

Electrical and Magnetic Stimulation

Stimulating the ears and brain may reduce tinnitus by altering nerve impulses. Approaches include:

• Transcranial magnetic stimulation (TMS) - Magnetic pulses target involved brain areas.
• Transcutaneous electrical stimulation (TES) - Mild electrical current stimulates the ears.
• Vagus nerve stimulation (VNS) - Implanted device intermittently stimulates the vagus nerve.

These techniques show some promise but require further research to confirm effectiveness. The procedures are noninvasive except for VNS which requires surgical implantation.

Tinnitus Retraining Therapy (TRT)

TRT involves counseling and sound therapy to promote habituation - getting accustomed to tinnitus so you notice it less. Key components include:

• Cognitive behavioral therapy (CBT) - CBT helps identify and modify negative thought patterns that exacerbate tinnitus.
• Education - Learning about tinnitus facilitates habituation.
• Sound therapy - Using external sounds trains the brain to focus less on the tinnitus.
• Relaxation techniques - Strategies like deep breathing and mindfulness meditation reduce tinnitus-related distress.

TRT requires commitment over 18-24 months but can significantly improve ability to cope with tinnitus.

Lifestyle Changes to Lessen Tinnitus for POTS

Certain daily habits can dial down the impact of tinnitus. Patients with POTS may find it helpful to:

• Avoid ototoxic substances - Caffeine, alcohol, smoking, and some medications can exacerbate tinnitus.
• Reduce sodium intake - For some patients, excess salt seems to worsen tinnitus.
• Exercise regularly - Aerobic activity increases blood flow which may reduce tinnitus.
• Get plenty of rest - Fatigue often amplifies tinnitus, so get adequate good quality sleep.
• Manage stress - Anxiety, depression, and stress tend to aggravate tinnitus.
• Use ear protection - Prevent further ear damage and tinnitus worsening from loud noise exposure.

Be patient and consistent with lifestyle remedies, as their benefits often accumulate over time. Keep notes on what helps or hurts tinnitus symptoms.

The Outlook for Tinnitus in POTS Patients

Living with constant tinnitus poses many challenges, especially for those already dealing with POTS symptoms. While tinnitus generally cannot be cured, treatment can make it much more manageable.

Using a combination of sound therapy, medications, counseling, and lifestyle changes, many patients achieve noticeable relief. Work closely with your doctors to find the best individualized treatment plan.

Strategies that help promote habituation allow you to focus less on the tinnitus so you can live your life

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.