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Understanding and Managing Tinnitus: A Guide for Veterans

soldier firing gun through a lens

“I have tinnitus in both ears, especially the left. It was horrible at first,” says Sgt. Nathan Heltzel, who served in the military for 11 years, first in the Army and then in the Air National Guard. He was deployed to Saudi Arabia in May of 2005 and did one tour there. “The hearing problems are a direct result of gunfire and loud jet engines on flight line duty. Common sources of noise are gunfire in both training exercises and on deployment as well as the sound of jet engines on the flight line that Security Forces troops secure. I left the service because of my hearing problems. I was afraid to ever fire a gun again or to be in a situation where I would be exposed to small arms fire or explosions that would make the ringing worse.”1 
 
Sgt. Heltzel’s story, while unfortunate, is not uncommon. Tinnitus, often experienced as persistent ringing or buzzing in the ears, affects over 25 million Americans2 with 30% of military veterans suffering from this condition.3  

Young woman suffering from ear pain on light blue background.

What is Tinnitus?

Tinnitus involves hearing noises without any external source. It can manifest as ringing, buzzing, clicking or whooshing sounds. There are two main types4: 

  • Subjective Tinnitus: Only the patient can hear these sounds, which may be temporary or chronic. 
  • Objective Tinnitus: Rare and rhythmic, this type can sometimes be heard by a doctor during an examination. 

Common Symptoms and Causes 

Tinnitus symptoms include a variety of phantom noises in one or both ears. Primary causes can include5: 

  • Damage to cochlear hair cells due to noise exposure 
  • Blood flow changes in nearby vessels 
  • Temporomandibular joint issues 

Other contributing factors include hearing loss, ear infections, head or neck injuries, certain medications, and chronic conditions like diabetes and Meniere’s Disease. 

Tinnitus in Veterans 

Veterans face a higher risk of tinnitus, often due to noise exposure during service. It is the most common service-connected disability, with over 1.6 million veterans affected.6  

An Airman from the 423d Security Forces Squadron adjusts his ear protection during a proficiency course at RAF Molesworth, England, Aug. 19, 2022. During the course instructors from the 820th Base Defense Group and 435th Contingency Response Group provided oversight and guidance to help critique and advance the combat arms skills of the defenders from the 423d SFS. (U.S. Air Force photo by Staff Sgt. Eugene Oliver)

Prevention Tips 

To lower the risk of tinnitus7: 

  • Use Hearing Protection: Avoid prolonged exposure to loud noises. 
  • Improve Cardiovascular Health: Maintain healthy blood vessels through diet and exercise. 
  • Limit Alcohol, Caffeine, and Nicotine: These substances can affect blood flow and exacerbate tinnitus. 

Debunking Myths 

Common myths about tinnitus include misconceptions that it’s a disease, it inevitably leads to deafness, or nothing can be done about it. In reality, tinnitus is a symptom of various underlying conditions, and there are many management strategies available. Despite the lack of objective tests, tinnitus is a real condition affecting millions, and it can signal serious health issues. 

Management Strategies 

A studio photo of a portable electric fan

Effective tinnitus management strategies can include8: 

  • Sound Therapy: Using white noise, hearing aids or specialized masking devices. 
  • Lifestyle Adjustments: Reducing alcohol, caffeine, stress and unhealthy foods. 
  • Pharmacologic Therapy: Melatonin supplements, antidepressants and consulting a physician about medications that might cause tinnitus. 
  • Rehabilitation Therapy: Incorporating techniques like tinnitus retraining therapy, cognitive-behavioral therapy and transcranial magnetic stimulation (TMS). 

New treatments, such as Lenire®, which uses bimodal neuromodulation (tongue and sound stimulation), show promise in clinical trials. 

Tinnitus isn’t the end of the world 

Tinnitus can significantly impact quality of life, especially for veterans. However, many evidence-based treatments can help manage its effects. It’s crucial for veterans to seek advice from qualified healthcare professionals to find the most effective management strategies. Together, we can better manage tinnitus and enhance the well-being of those who have served our country. 

At Heroes With Hearing Loss®, supporting veterans in navigating their journey with hearing loss and associated conditions is our mission. We created this infographic, Understanding and Managing Tinnitus, which includes valuable information about tinnitus, its causes, effects, and treatments, as well as some common myths. We invite you to download and share it with anyone you think might find it useful.  

1 Sgt. Nathan Heltzel, “Veterans Stories,” Hearing Health Foundation https://hearinghealthfoundation.org/veteran-stories 

2 “Why Are My Ears Ringing?” American Tinnitus Association, 2015 ata.org/about-tinnitus/why-are-my-ears-ringing 

3 Caroline J. Schmidt, Ph.D., et al., “Cognitive Behavioral Therapy for Veterans With Tinnitus,” Federal Practitioner, 2018 ncbi.nlm.nih.gov/pmc/articles/PMC6263445

4 Why Are My Ears Ringing?” American Tinnitus Association, 2015 ata.org/about-tinnitus/why-are-my-ears-ringing

5 “Tinnitus,” MayoClinic.org, 2022 mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156

6 Caroline J. Schmidt, Ph.D., et al., “Cognitive Behavioral Therapy for Veterans With Tinnitus,” Federal Practitioner, 2018 ncbi.nlm.nih.gov/pmc/articles/PMC6263445

7 “Tinnitus,” MayoClinic.org, 2022 mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156

8 Vincent Wu, MD, et al., “Approach to tinnitus management,” Canadian Family Physician, 2018 ncbi.nlm.nih.gov/pmc/articles/PMC6042678/pdf/0640491.pdf