How Common Is Tinnitus Caused By Aspirin?

Regular use of aspirin to manage pain or as part of a heart health regimen is common. In fact, it’s estimated that 30 million people in the U.S. use this non-steroidal anti-inflammatory drug every day for a host of reasons. Aspirin – as well as naproxen (Aleve) and ibuprofen (Motrin or Advil) – may offer short-term benefits for relief of pain, but if you experience tinnitus, you may find your hearing issues exacerbated by high or prolonged reliance on any of these drugs. 

Before you abandon aspirin, however, it’s important to know the facts.

The Chemical Relationship Between Aspirin and Tinnitus 

Aspirin is part of a class of drugs known as salicylates, which are found in many over-the-counter and prescription medicines. Salicylates are also in a variety of fruits and vegetables, as well as many nuts, processed meats, red wines, and grain-based alcohols. While there’s no evidence suggesting consumption of either foods or medications containing salicylates causes tinnitus, people who struggle with tinnitus may report an uptick in occurrences of ringing in their ears if they’ve consumed unusually large amounts.

That’s because salicylates are known to be ototoxic, and can cause hearing loss and tinnitus in very high dosages. 

The reasons are twofold. 

First, salicylates interfere with the way certain cells in the inner ear (like hair cells) function. While it may seem minor, hair cells in the cochlea are responsible for helping us process external sounds. When their function is reduced, it causes a corresponding reduction in the ability of our cochlea to detect low to average level sounds. In turn, this reduces stimulation of the auditory nerve, which is thought to lead to changes in the way the neural pathways in the brain act. The outcome is that the increased neural activity can be perceived as tinnitus. 

The other challenge is that high levels of salicylates reduce inhibitory actions in the brain, which can further facilitate neural stimulation, again leading to the perception of ringing or humming in the ears.

Understanding The Risk

So what exactly is high dosage?

Depending on your size and weight, more than 4 grams (or 4000 mg) puts you at risk of feeling the effects of salicylates on your hearing. If you’re using aspirin as part of cardiovascular health, the typical daily dosage is less than 100 mg daily, which has been shown to have no impact on tinnitus. For pain management, a regular strength aspirin pill is about 325 mg. While you may require more than one or two pills to dull a headache or physical pain, you’d have to be consuming somewhere between 14-18 pills a day to hit the dangerous zone, which would not only have negative consequences on ear health, but put you in a risk category for other side effects of overuse.  

Should I Stop Using Aspirin? 

Fortunately, the effect of aspirin on tinnitus is temporary and reversible – it also doesn’t necessarily mean you should avoid aspirin altogether. 

Normal doses of over-the-counter medications to treat low-level aches and pains are relatively low risk. Taken in moderation, aspirin is unlikely to cause any spikes in tinnitus or general hearing loss. That said, if you find that the aspirin is causing auditory discomfort, consult your doctor to see if a non-aspirin pain reliever may be an option. You may also consider meditation or alternative pain management instead of aspirin or other non-steroidal anti-inflammatory drugs as part of chronic pain relief. 

Lastly, if you do find yourself in a short-term circumstance of needing higher than usual amounts of aspirin due to a medical procedure or as directed by your physician, know that any resulting upticks in tinnitus are temporary and will only last while the medication is in your system. 

If you are not sure about what to do in regards to your medication, please consult a physician.