Deep Research Archives

A Scientific Guide to Managing Tinnitus with Normal Hearing: An Evidence-Based Mitigation Framework

Section 1: Understanding Your Tinnitus: The Science Behind the Sound

Tinnitus is a complex issue that goes beyond simply 'ringing in the ears.' Especially for those who suffer from persistent tinnitus despite receiving a normal result on standard hearing tests, the cause requires a deeper understanding. This section explores the neurological and physiological mechanisms of tinnitus in individuals with normal hearing to establish a scientific foundation for effective management strategies.

1.1 When Hearing is 'Normal' but the Sound Persists: Uncovering the Real Causes

Your experience is by no means imaginary. The phenomenon of persistent tinnitus despite normal results on a standard pure-tone audiogram is not clinically uncommon, affecting approximately 10% of tinnitus patients.1 This suggests that standard tests do not capture all aspects of the auditory system, and the root of the problem may lie more in the brain's signal processing than in damage to the ear itself.

The Hidden Hearing Loss Hypothesis

A standard hearing test measures the 'hearing threshold,' which is the quietest sound level at which you can hear specific frequencies. A normal result on this test means there is no significant issue with your ability to detect sound. However, this does not guarantee that the auditory system is entirely intact. The key lies in a phenomenon known as 'hidden hearing loss' or 'cochlear synaptopathy.' This refers to damage to the synapses (neural junctions) between the hair cells of the inner ear (cochlea) and the auditory nerve, which is the first gateway for transmitting sound to the brain.1 Prolonged noise exposure is considered a primary cause, and this microscopic damage does not affect the hearing threshold, so it goes undetected in standard tests. However, it can degrade or distort the quality of the signal transmitted to the auditory nerve, and the brain may perceive this incomplete signal as an abnormal sound—tinnitus.1 If you have no trouble with conversations in quiet environments but struggle to distinguish sounds in noisy settings, hidden hearing loss may be a possibility.

The Brain's Compensatory Gain Theory

The auditory system is highly adaptive. When the auditory signal from the ear is subtly reduced or distorted due to factors like hidden hearing loss, the brain's auditory centers compensate by increasing their internal 'volume.' This is known as 'central gain enhancement.'2 In this process, the brain amplifies not only external sounds but also the subtle background neural noise that occurs within the auditory pathways.5 Ultimately, tinnitus can be seen not as a result of the ear damage itself, but as the brain's excessive compensatory response to a compromised signal. In other words, the brain is creating and presenting a sound that isn't actually there.2

Spontaneous Neural Activity

Even in a healthy auditory system, the auditory nerve continuously generates a low level of spontaneous electrical signals without any external stimulus.1 Normally, this signal is too weak compared to ambient sound stimuli for us to notice. However, in extremely quiet environments like an anechoic chamber, or when the brain's sound-filtering function is compromised by stress or fatigue, this normal background activity can be perceived as sound.1 This is why even healthy individuals sometimes experience a 'ringing' sound in quiet places, and it may not be a pathological condition.6

1.2 Identifying Tinnitus Types: Differentiating Somatic, Neurological, and Other Forms

Tinnitus can be classified into several types based on its cause and characteristics. Understanding which type of tinnitus you have is the first step in developing a personalized management strategy.

Subjective vs. Objective Tinnitus

Tinnitus is broadly divided into 'subjective tinnitus,' which is audible only to the individual, and 'objective tinnitus,' which can also be heard by an examiner or others.7 Most cases of tinnitus are subjective and result from abnormal neural signals within the auditory system. In contrast, objective tinnitus accounts for 10-15% of all cases and is caused by actual physical sounds within the body, such as blood flow in vessels near the ear (vascular tinnitus) or spasms of muscles around the ear and neck (muscular tinnitus).7 Objective tinnitus has a more identifiable cause and thus a higher likelihood of successful treatment.

The Rise of Somatic Tinnitus

A type of tinnitus that has recently gained attention, especially among younger individuals with normal hearing, is 'somatic tinnitus.'5 This occurs when issues in the muscles or ligaments around the ear, such as the neck, jaw, or shoulders, trigger or influence the intensity of tinnitus.11 If your tinnitus changes when you turn your head, clench your jaw, or adopt certain postures, somatic tinnitus is a strong possibility.13 Poor posture from prolonged computer and smartphone use (e.g., 'tech neck') is a primary cause.5 The mechanism involves the Dorsal Cochlear Nucleus (DCN) in the brainstem, where auditory signals and somatosensory signals from the neck and jaw converge. Chronic tension in the neck or jaw muscles generates abnormal somatosensory signals, which can interfere with the auditory pathway, causing the brain to misinterpret them as sound.14

Vascular and Muscular Tinnitus

Though less common, other types to consider include pulsatile tinnitus, which sounds like a 'whooshing' or 'thumping' in sync with your heartbeat and may indicate a problem with blood vessels near the ear.8 Causes can include high blood pressure, anemia, atherosclerosis, or vascular malformations.8 An irregular 'clicking' sound may suggest spasms of the small muscles in the middle ear.8

1.3 The Essential First Step: Comprehensive Medical and Audiological Evaluation

Tinnitus is a 'symptom,' not a disease, so it is crucial to identify the underlying cause.18 Do not rely on self-diagnosis; a comprehensive evaluation by a professional is essential.

Beyond the Standard Hearing Test

A simple pure-tone audiogram may not be sufficient. Early age-related or noise-induced hearing loss often begins in the high-frequency range, which is easily missed by standard tests.1 Therefore, a high-frequency audiometry test that measures above 8,000 Hz is necessary. Additionally, various audiological tests, such as a tympanometry to check the condition of the eardrum and an auditory brainstem response (ABR) test to assess the auditory nerve's response, should be conducted to analyze the cause from multiple angles.7

Ruling Out Underlying Conditions

A thorough examination is crucial to rule out rare but serious causes such as an acoustic neuroma (vestibular schwannoma), brain tumors, or vascular malformations.7 A contrast-enhanced Magnetic Resonance Imaging (MRI) may be performed if necessary.7 Furthermore, systemic conditions like temporomandibular joint (TMJ) disorders, cervical spine (neck) issues, hypertension, diabetes, thyroid disease, and anemia can also cause tinnitus, so a review of medical history and relevant tests should be conducted.8 This systematic approach provides a clear picture of the origin of your tinnitus, which is essential for alleviating unnecessary anxiety and developing the most effective management plan. Table 1: Tinnitus Subtypes in Individuals with Normal Hearing Subtype Somatic Tinnitus Central Gain Tinnitus Vascular Tinnitus Muscular Tinnitus

Section 2: The Physical Connection: Managing Somatic Tinnitus Through Movement and Therapy

A significant portion of tinnitus cases in individuals with normal hearing, especially the rising number among younger people, falls into the category of 'somatic tinnitus.' This means that tinnitus is no longer just an ear problem but is deeply connected to our body's structural imbalances, particularly issues with the temporomandibular joint (TMJ) and the neck. This section provides an in-depth analysis of the anatomical and neurological principles of somatic tinnitus and presents scientific, practical physical management methods based on these principles.

2.1 The Jaw-Ear Axis: How Temporomandibular Joint (TMJ) Dysfunction Can Trigger Tinnitus

The temporomandibular joint (TMJ) is anatomically very close to the ear, so even minor problems with the TMJ can directly affect the ear.15 If an ENT examination reveals no specific abnormalities, TMJ dysfunction could be the hidden cause of your tinnitus.

Anatomical Proximity and Shared Nerves

The close relationship between the TMJ and the ear becomes even clearer in the nervous system. The trigeminal nerve, which controls the masticatory (chewing) muscles of the jaw, also extends branches to the tensor tympani muscle in the middle ear.15 Therefore, chronic tension in the jaw muscles due to habits like clenching (bruxism) or grinding teeth during sleep can transmit abnormal nerve signals to the tensor tympani, causing problems with pressure regulation inside the ear and leading to tinnitus.

Mechanical Stress

When TMJ disorders cause the lower jaw to move out of its normal range, the ligament connecting the jawbone to the malleus (a small bone in the middle ear) can be abnormally stretched.15 This can cause mechanical errors in the sound transmission process, where the vibrations of the eardrum are conveyed to the inner ear, resulting in tinnitus. This is similar to how a single mistuned string on a well-tuned instrument can create dissonance.

Self-Diagnosis

A simple self-diagnosis can help you infer the connection between your TMJ and tinnitus. Check if the loudness or pitch of your tinnitus changes when you open your mouth wide, close it, move your jaw from side to side, or clench your molars tightly.13 If you notice a change, it is highly likely that a TMJ issue is contributing to your tinnitus.

2.2 The Cervical Connection: The Impact of Neck Tension and Posture

'Tech Neck' or 'Forward Head Posture,' a common ailment of modern life, is one of the most frequent causes of somatic tinnitus.5 The posture of leaning the head forward to look at a smartphone or computer screen places an enormous strain on the muscles around the neck and shoulders.

Disruption of Neural Signals

Prolonged poor posture leads to chronic tension in the muscles around the neck, particularly the sternocleidomastoid (SCM) and trapezius muscles.12 The tension in these muscles sends continuous abnormal somatosensory signals to the Dorsal Cochlear Nucleus (DCN) in the brainstem, as mentioned earlier.14 The DCN becomes confused while integrating these signals with auditory signals, which can result in the creation of a non-existent sound or the amplification of existing tinnitus. This is clear evidence that poor posture can disrupt not just muscle comfort but the auditory perception system itself.

2.3 A Practical Guide to Physical Interventions: Evidence-Based Stretches and Exercises

The key to managing somatic tinnitus is to relieve excessive muscle tension, restore proper posture, and reduce the abnormal somatosensory signals entering the auditory brainstem. Consistent exercise and stretching can be a more fundamental solution than medication or other treatments.

Neck Stretches

Upper Trapezius Stretch: Sit in a chair and hold the bottom of the chair with one hand. Use the opposite hand to gently pull your head to the side, feeling the stretch on the side of your neck. Hold for 20-30 seconds on each side.21 Levator Scapulae Stretch: Turn your head 45 degrees, then use the hand on the same side to gently pull your head diagonally downward (as if looking toward the opposite armpit). Feel the stretch in the diagonal muscle at the back of your neck.22 Chin Tucks: Stand or sit with your back against a wall. Pull your chin in, as if trying to press the back of your head against the wall, and hold. This is highly effective for correcting forward head posture and strengthening the deep neck muscles.21

Jaw Relaxation and Massage

Masseter Massage: Locate the hard muscle below your cheekbone that bulges when you clench your molars. Gently massage this area in a circular motion with your fingers or a massage ball to release tension.25 TMJ Relaxation Exercise: Lightly place the tip of your tongue on the front of the roof of your mouth. Slowly open and close your mouth only as far as you can without your tongue moving. This helps train the TMJ to move within its normal range.27

Shoulder and Posture Exercises

Shoulder Rolls and Shrugs: Raise your shoulders as high as you can toward your ears, then let them drop completely. Also, perform large circles with your shoulders, both forward and backward, to release tension in the trapezius muscles.23 Scapular Squeezes: Pull your shoulder blades together in your back, as if trying to make them touch. This is essential for correcting rounded shoulders and maintaining good posture.

Full-Body Physical Activity

In addition to targeted stretches, regular aerobic exercise (e.g., brisk walking, jogging, swimming, cycling) improves overall blood circulation, which helps ensure adequate blood flow to the inner ear.17 Furthermore, exercise plays a crucial role in breaking the tinnitus-stress cycle by reducing stress hormones and promoting the release of endorphins.29 For tinnitus sufferers, exercise is not an option but an essential part of a management strategy. The success of these physical approaches depends on consistency. A few stretches will not resolve years of ingrained poor posture and muscle tension. The path to fundamentally managing somatic tinnitus lies in practicing these exercises daily with correct form to create new, healthy physical habits.

Section 3: Brain Retraining: Advanced Psychological and Neurological Strategies

While the onset of tinnitus may be linked to minor ear damage or physical issues, its persistence and evolution into a distressing symptom that diminishes quality of life is entirely a matter of the brain. How the brain perceives the tinnitus signal and emotionally responds to it determines the level of suffering. This section delves into two of the most powerful and evidence-based approaches to tinnitus management: Cognitive Behavioral Therapy (CBT) and Tinnitus Retraining Therapy (TRT), which focus on retraining the brain.

3.1 The Vicious Cycle: How Stress and the Nervous System Perpetuate Tinnitus

One of the most critical concepts in understanding tinnitus is the 'Neurophysiological Model' proposed by Dr. Pavel Jastreboff.31 This model explains that the core of the problem is not the tinnitus sound itself, but the brain's reaction to that sound.

The Role of the Limbic and Autonomic Nervous Systems

The tinnitus signal, transmitted through the auditory pathway, does not only reach the cerebral cortex for sound perception. It also connects to the 'limbic system,' which governs emotions, and the 'autonomic nervous system,' which regulates the body's fight-or-flight response.31 When you first notice tinnitus and have negative thoughts and anxiety like, "What is this sound?" or "Is there something seriously wrong with me?", the limbic and autonomic systems are activated.

The Tinnitus-Stress Feedback Loop

This brain reaction classifies the tinnitus as a 'threatening signal.' As a result, the brain focuses more on the tinnitus sound, and stress hormones (cortisol, adrenaline) are released, putting the body in a state of tension.33 This tension and arousal make the nervous system more sensitive, causing the tinnitus sound to be perceived as louder and clearer.36 This amplified tinnitus, in turn, causes greater anxiety and stress, which then stimulates the limbic and autonomic systems again, creating a vicious cycle.38 It is difficult to escape the distress of tinnitus without breaking this cycle.

3.2 Cognitive Behavioral Therapy (CBT): Breaking Negative Thought Patterns to Reduce Distress

Cognitive Behavioral Therapy (CBT) does not aim to eliminate the tinnitus sound itself. Instead, it is a highly effective psychological therapy technique that focuses on reducing the distress caused by tinnitus by breaking the cycle of negative thoughts, emotions, and behaviors associated with it.39

Core Principles

The fundamental premise of CBT is that 'our emotions and behaviors are determined not by events themselves, but by our interpretation (cognition) of those events.' In other words, it is not the 'tinnitus sound' that creates distress, but negative automatic thoughts like "This sound is driving me crazy" or "It's horrible that I have to listen to this for the rest of my life" that lead to emotions of anxiety and depression, which in turn result in avoidance behaviors in daily life.40

Key Techniques

Cognitive Restructuring: With a therapist, you identify your automatic thoughts about tinnitus (e.g., catastrophizing, overgeneralization), examine the evidence for whether these thoughts are rational, and then practice replacing them with more realistic and balanced alternative thoughts.40 For example, you practice changing the thought "I can't do anything because of this sound" to "This sound is bothersome, but I can forget about it for a while if I focus on activities I enjoy." Relaxation Training: You learn various relaxation techniques, such as deep breathing and progressive muscle relaxation, to calm the overactive autonomic nervous system and relieve physical tension caused by tinnitus.40 Attention Diversion: You learn skills to intentionally shift your attention away from the tinnitus. This goes beyond simply thinking about something else and includes focusing on specific senses (sight, touch) or finding engaging activities.40

Evidence of Effectiveness

CBT is one of the most scientifically supported treatments for reducing tinnitus-related distress, anxiety, and depression, and for improving quality of life, with numerous studies demonstrating its long-term effectiveness.41

3.3 Tinnitus Retraining Therapy (TRT): A Neurophysiological Approach Through Habituation

Tinnitus Retraining Therapy (TRT) is a systematic treatment program based on Jastreboff's neurophysiological model. The ultimate goal of TRT is 'habituation,' retraining the brain to perceive the tinnitus signal as an unimportant background noise.31

The Goal of Habituation

Habituation occurs in two stages. The first is 'habituation of reaction,' where the negative emotional and physical responses to tinnitus (irritation, anxiety, tension) disappear. The second is 'habituation of perception,' where you reach a stage where you do not perceive the tinnitus sound itself unless you consciously focus on it.32 This is similar to how our brain filters out the sound of a refrigerator, judging it as unimportant and not allowing it to surface to our conscious awareness.50

The Two Core Components of TRT

Directive Counseling: This is the most crucial part of TRT, where a professional educates the patient in detail about the mechanisms of tinnitus and the brain's response, based on the neurophysiological model.31 Through this education, the patient understands that their tinnitus is not a sign of a brain tumor or a serious illness, and they are freed from the vague fear and misconceptions about tinnitus. This cognitive shift, reclassifying the tinnitus sound from a 'threat' to a 'meaningless, neutral signal,' is the first step toward habituation. Sound Therapy: Conducted alongside counseling, sound therapy is different from simple 'masking.' The patient listens to a low-level broadband noise (such as white noise) throughout the day using a sound generator (usually worn in the ear). The key is to adjust the volume to the 'mixing point,' where the tinnitus is not completely covered, but the tinnitus and background sound are heard together.31 By continuously creating a rich and neutral sound environment, the contrast between the prominent tinnitus signal in quiet environments and the background noise is reduced, gradually stopping the brain from detecting and amplifying the tinnitus signal.

Success Rate and Treatment Duration

TRT typically requires long-term treatment of 12 to 18 months because it takes time for the brain's neural networks to reorganize.56 However, when the treatment protocol is followed consistently, it boasts a very high success rate, with over 80% of patients showing significant symptom improvement.31 These brain retraining strategies show that tinnitus management is not a passive process of taking medication or undergoing procedures, but an active learning process where the patient understands and trains their own brain. Understanding the mechanism of tinnitus and eliminating fear is the beginning of the treatment, and through this, you can regain control of your life.

Section 4: Mastering the Auditory Environment: The Strategic Use of Sound Therapy

Sound therapy is a core component of Tinnitus Retraining Therapy (TRT) and one of the most practical tools for managing tinnitus in daily life. The goal of sound therapy is not simply to 'cover up' the tinnitus, but to create an optimal auditory environment that reduces the prominence of tinnitus and promotes the brain's habituation. This section presents specific, practical strategies using various tools and methods based on the scientific principles of sound therapy.

4.1 The Fallacy of Silence: The Principle of Sound Enrichment

For people suffering from tinnitus, a quiet environment is often a space of distress rather than comfort. This is closely related to how the brain works.

Why Silence Amplifies Tinnitus

In a quiet environment, there is very little background noise, so the relatively weak tinnitus signal becomes very prominent.2 This is similar to how a small candle appears exceptionally bright in a dark room.61 Additionally, when there is a lack of external auditory stimulation, the brain tends to focus more on internal signals—namely, tinnitus—and amplifies them, a phenomenon known as 'central gain.' Therefore, deliberately seeking out quiet places to avoid tinnitus can actually worsen it.

The Goal of Sound Enrichment

The basic strategy of sound therapy is to artificially create and maintain a 'sound-rich environment' 24 hours a day.47 The goal is to reduce the contrast between the tinnitus signal and background noise by ensuring there is always a low, gentle background sound, thereby lowering the cognitive salience of the tinnitus. This reduces the burden on the brain's auditory system and encourages it to process the tinnitus signal as just one of many neutral sounds, ultimately aiding habituation.

4.2 The Sound Therapy Toolbox: From White Noise to Advanced Soundscapes

Various sounds are used in sound therapy, and it is important to choose the most comfortable and effective sound based on individual preferences and situations. Broadband Noise (White/Pink Noise): This is the most basic and widely used sound. White noise contains sounds of all frequency bands at nearly equal intensity, making it effective at neutralizing tinnitus with a specific frequency and gently stimulating the entire auditory cortex of the brain.62 Pink noise has less energy in the higher frequency bands, so it may feel softer than white noise. Nature Sounds: Sounds like rain, waves, streams, and wind can have a similar effect to white noise while being more psychologically calming and pleasant.57 Music: Calm instrumental or ambient music without lyrics can also be effective. However, music with a very distinct melody or rhythm that draws attention is less suitable than predictable, monotonous music that can fade into the background.62 Notched Sound Therapy: This is a newer technique where you listen to music or noise from which the frequency band of your tinnitus has been precisely removed. In theory, this is said to reduce tinnitus by suppressing the over-excitement of the auditory cortex responsible for that frequency, but the scientific evidence for its effectiveness is still under investigation.64

4.3 Implementing Sound Therapy: Practical Application of Devices, Apps, and Environmental Sounds

Sound therapy can be easily practiced in daily life without special equipment. During Sleep: Nighttime is when tinnitus can be most distressing, so sound therapy is particularly important. Place a sound generator, fan, or humidifier next to your bed, or use a smartphone app to play a soft sound all night.65 Volume control is key here: the sound should not completely mask the tinnitus, but be set at a level (the mixing point) where the tinnitus sound is slightly masked by or mixed with the background noise.31 During the Day: Utilizing Environmental Sounds: In a quiet office or home, simply opening a window slightly, playing quiet music, or using a small tabletop fountain can provide effective sound enrichment. Using Smartphone Apps: Specialized tinnitus management apps like 'ReSound Relief' allow you to create your own soundscape by combining various types of sounds (white noise, nature sounds, etc.) and offer useful features like timers and relaxation exercise guides.62 Wearable Sound Generators: For those with severe symptoms or who live in very quiet environments, using a wearable sound generator, similar in form to a hearing aid, can be effective. It provides a stable sound directly to the ear throughout the day, promoting habituation.31 For Cases with Mild Hearing Loss: 80-90% of tinnitus patients have some degree of mild hearing loss that they may not be aware of.61 In such cases, wearing a hearing aid prescribed by a professional can be the most effective form of sound therapy. Hearing aids amplify ambient sounds (speech, environmental noises), naturally creating a sound-rich environment that reduces the perception of tinnitus. At the same time, they fundamentally address the auditory stress and the brain's compensatory gain caused by hearing loss.2 The success of sound therapy begins with understanding the concept of 'management' rather than 'masking.' The true goal of sound therapy is not to fight and eliminate the tinnitus, but to use sound as a tool to help the brain learn to coexist peacefully with it. Finding the most comfortable sound for you and practicing consistently is crucial.

Section 5: Building a Foundation of Health: Lifestyle, Diet, and Nutritional Science

Tinnitus is not an isolated symptom; it interacts closely with your overall physical and mental health. Therefore, to manage tinnitus effectively, it is essential to build a solid foundation of healthy lifestyle habits in addition to evidence-based treatments. This section critically examines lifestyle factors that can influence tinnitus management—such as exercise, sleep, diet, and nutritional supplements—based on scientific evidence and provides practical guidelines.

5.1 The Pillars of Health: The Critical Impact of Exercise and Sleep Hygiene

The most powerful and side-effect-free 'prescriptions' for tinnitus management are regular exercise and quality sleep. While these two do not directly cure tinnitus, they effectively regulate the key factors that amplify it: stress and nervous system hypersensitivity. Exercise: Regular physical activity offers multiple benefits for tinnitus management. Stress Reduction: Aerobic exercise directly contributes to breaking the tinnitus-stress cycle by lowering levels of the stress hormone cortisol and promoting the release of mood-enhancing endorphins.17 Improved Blood Circulation: Regular exercise enhances cardiovascular health, promoting smooth blood flow throughout the body, including the microvessels of the inner ear.17 Enhanced Sleep Quality: Adequate physical activity during the day helps you achieve deeper, more stable sleep at night. Sleep Hygiene: Sleep deprivation is one of the most common factors that worsen tinnitus.18 The following is a detailed sleep hygiene protocol for tinnitus patients. Consistent Sleep Schedule: Going to bed and waking up at the same time every day, even on weekends, is crucial for stabilizing your body's circadian rhythm.67 Optimal Bedroom Environment: The bedroom should be kept cool, dark, and quiet. However, complete silence can make tinnitus more prominent, so it is essential to use sound therapy, as previously described, to maintain a soft background noise throughout the night.65 Pre-Sleep 'Relaxation Ritual': Avoid using electronic devices that emit blue light, such as smartphones and TVs, for at least an hour before bed. Instead, engage in relaxing activities like a warm bath, light stretching, meditation, listening to calm music, or reading.65 Sound Therapy for Sleep: To prevent tinnitus from becoming louder in the quiet of the bedroom, make it a habit to turn on a sound generator or app before you go to sleep.65

5.2 The Tinnitus Diet: Separating Scientific Evidence from Popular Myths

While many claims suggest that certain foods can cause or cure tinnitus, the scientific evidence is mostly weak. The most important principle is to maintain a balanced diet that is good for overall health, especially cardiovascular health.63 Sodium: Excessive sodium intake is well-known to worsen symptoms in patients with Meniere's disease. Although its direct link to other types of tinnitus is not clear, it can raise blood pressure and affect blood flow, so avoiding salty foods and practicing a low-sodium diet is recommended.7 Caffeine: The relationship between caffeine and tinnitus is controversial. Some argue that caffeine can excite the nervous system and worsen tinnitus 2, but large-scale studies have shown no correlation or even a contradictory result that high intake may lower the risk of tinnitus.33 The most reasonable approach is 'self-observation.' If you clearly feel that your tinnitus worsens after drinking coffee or tea, it is best to reduce your intake. Otherwise, there is no need to prohibit it entirely, and moderate consumption is acceptable.73 Alcohol and Nicotine: These two should be clearly avoided. Nicotine is a potent vasoconstrictor that interferes with blood supply to the inner ear.33 Alcohol can degrade sleep quality, cause dehydration, and temporarily dilate blood vessels, making tinnitus seem louder.7 Quitting smoking and moderating alcohol consumption are very important lifestyle habits for tinnitus management.

5.3 A Critical Review of Nutritional Supplements: Ginkgo Biloba, Magnesium, Zinc, and B Vitamins

Numerous nutritional supplements claim to alleviate tinnitus, but the scientific evidence for their effectiveness is mostly lacking or inconsistent. It is not recommended to take supplements indiscriminately without a confirmed nutrient deficiency.77 Ginkgo Biloba: Although widely known for its blood circulation-improving effects, multiple high-quality studies (including a Cochrane review) on patients with tinnitus as their primary symptom have repeatedly shown no significant effect compared to a placebo.79 While some positive studies on a specific standardized extract (EGb 761®) exist, the overall evidence is very weak.81 Zinc: Zinc plays an important role in inner ear function, so it is theoretically plausible. However, clinical trial results are mixed, and a Cochrane review concluded that there is no evidence that zinc supplementation helps improve tinnitus, except in patients with a confirmed zinc deficiency through blood tests.86 Magnesium: Some studies suggest that magnesium may be helpful in preventing noise-induced hearing loss or alleviating somatic tinnitus due to its effects on regulating neurotransmitters (glutamate) and relaxing muscles.94 However, large-scale clinical studies on tinnitus itself are still lacking. Vitamin B12: Studies have shown a link between vitamin B12 deficiency and tinnitus, especially in the elderly and patients with noise-induced hearing loss.100 However, supplementation therapy has only been shown to be effective in patients with a confirmed vitamin B12 deficiency through blood tests, with no effect in non-deficient patients.102 In conclusion, there is no 'magic pill' for tinnitus management. Rather than relying on unverified supplements, it is a much wiser and more effective strategy to build on a nutrient-rich diet and establish the pillars of health: exercise and sleep. Table 2: Evidence Summary for Common Tinnitus Supplements Supplement Ginkgo Biloba Zinc Magnesium Vitamin B12

Section 6: A Blueprint for Relief: Creating Your Personalized Tinnitus Management Plan

So far, we have explored a vast amount of information, from the scientific causes of tinnitus to physical, psychological, environmental, and lifestyle approaches. The final step is to integrate all this knowledge into a practical and sustainable personalized management plan. This section provides a concrete blueprint for combining various strategies to create synergy and incorporate them into your daily life.

6.1 The Synergy of Strategies: Why a Multifaceted Approach is Key

Tinnitus rarely arises from a single cause; it is a multifactorial symptom resulting from a combination of factors. Therefore, relying on just one method lowers the chances of success. The most effective tinnitus management is achieved when multiple strategies are organically combined. For example, a patient with somatic tinnitus due to severe neck and jaw tension would need a multifaceted plan that includes physical stretching to reduce the source of the abnormal signals (physical approach), Cognitive Behavioral Therapy (CBT) to manage negative emotional responses to tinnitus (psychological approach), and sound therapy during sleep to promote the brain's habituation (environmental approach). These strategies are not mutually exclusive; they work together to tackle the complex problem of tinnitus from different angles, creating a synergistic effect.

6.2 Designing Your Daily and Weekly Routine: A Template for Action

To translate theory into action, a concrete plan is needed. The following is a sample schedule that integrates the key strategies discussed earlier into daily life. This is a starting point and should be modified to fit your personal lifestyle and needs to create your own routine. Morning (After Waking Up): Perform 10 minutes of neck, shoulder, and jaw stretches (Somatic Tinnitus Management) Play background music or the radio at a low volume while getting ready to create a sound-rich environment (Sound Therapy) Start the day calmly with 5 minutes of deep breathing or meditation (Stress Management) Daytime (During Work or Activities): Get up every hour for light stretching to correct posture (Posture Management) In a quiet environment, use a smartphone app or a small sound generator to maintain background noise (Sound Therapy) When stress levels rise, practice CBT by taking 2 minutes for deep breathing, identifying, and challenging negative automatic thoughts about tinnitus (Cognitive Behavioral Therapy) Evening: Engage in 30-40 minutes of moderate-intensity aerobic exercise like brisk walking or jogging (Exercise and Stress Management) Have a healthy, low-sodium dinner, finishing at least 3 hours before bedtime (Diet Management) Begin your 'relaxation ritual' 1 hour before bed: turn off smartphones/TV, take a warm bath, read, or listen to calm music (Sleep Hygiene) At Bedtime: Turn on a sound generator or app in the bedroom (set the volume to the 'mixing point') Create a completely dark and cool environment Go to bed at a regular time

6.3 Tracking Progress and Sustaining Long-Term Improvement

Tinnitus management is a marathon, not a sprint. Consistency is key, and objectively tracking your progress can be a great source of motivation and help you adjust your strategies. It is recommended to keep a simple journal and record the following items daily: Tinnitus loudness (on a scale of 1-10) Degree of tinnitus-related distress (on a scale of 1-10) Stress level (on a scale of 1-10) Sleep quality (hours and satisfaction) Management strategies practiced that day (e.g., 10 minutes of stretching, 30 minutes of aerobic exercise) Notable observations (specific situations, foods, etc., that worsened or alleviated tinnitus) This record will help you identify which strategies are effective for you and what factors (personal triggers) exacerbate your tinnitus. In conclusion, the ultimate goal of tinnitus management is to move the tinnitus sound from the 'foreground' of your consciousness to the 'background.' This is not achieved by fighting the sound, but by systematically dismantling the brain's connections that give the sound its importance (stress, fear, silence, muscle tension). The tinnitus itself may remain, but it can become a neutral signal that you can ignore, rather than a distressing presence that dominates your life. By consistently practicing the scientific and multifaceted approaches presented in this report, significantly improving your quality of life and breaking free from the distress of tinnitus is a very realistic goal. Table 3: Sample Integrated Tinnitus Management Schedule Time of Day Immediately After Waking Morning Afternoon Evening 1 Hour Before Bed At Bedtime

참고 자료 이명 치료 백과사전 ④ 청력이 정상인데도 이명이 발생할 수 있나요 ..., 8월 5, 2025에 액세스, http://www.healtip.co.kr/news/articleView.html?idxno=2761 "이명, 더 이상 불치병 아냐… 대부분 호전됩니다" [헬스조선 명의], 8월 5, 2025에 액세스, https://m.health.chosun.com/svc/news_view.html?contid=2022111102161 이명의 원인과 치료 / 스페셜이비인후과 박치열 - YouTube, 8월 5, 2025에 액세스, https://www.youtube.com/watch?v=ZzDR1PxvDTI [랜선건강교실] 귀에서 들리는 삐- 소리의 정체? 이명과 난청의 원인부터 귀 건강 관리법까지! I 이비인후과 문일준 교수 - YouTube, 8월 5, 2025에 액세스, https://www.youtube.com/watch?v=aWv6mLwH-UQ '이명'이 불치병?…개인별 맞춤 한방치료로 개선 가능 - 헬스케어N ..., 8월 5, 2025에 액세스, https://m.healthcaren.com/news/news_article_yong.jsp?mn_idx=395942 귀에서 삐 소리, 윙 소리, 알수없는 소리의 원인 | 이명 병원 안가고 낫는법! - YouTube, 8월 5, 2025에 액세스, https://www.youtube.com/watch?v=N8jCO6R79BI 이명 - 국가건강정보포털 - 질병관리청, 8월 5, 2025에 액세스, https://health.kdca.go.kr/healthinfo/biz/health/gnrlzHealthInfo/gnrlzHealthInfo/gnrlzHealthInfoView.do?cntnts_sn=5706 귀 울림 및 윙윙거림 - 이비인후과 장애 - MSD 매뉴얼 - 일반인용, 8월 5, 2025에 액세스, https://www.msdmanuals.com/ko/home/%EC%9D%B4%EB%B9%84%EC%9D%B8%ED%9B%84%EA%B3%BC-%EC%9E%A5%EC%95%A0/%EA%B7%80-%EC%9E%A5%EC%95%A0%EC%9D%98-%EC%A6%9D%EC%83%81%EB%93%A4/%EA%B7%80-%EC%9A%B8%EB%A6%BC-%EB%B0%8F-%EC%9C%99%EC%9C%99%EA%B1%B0%EB%A6%BC 이명, 스트레스와 관련 깊어 - 보도자료 배포 | 건국대학교병원, 8월 5, 2025에 액세스, https://www.kuh.ac.kr/intro/newdata/view.do?bbs_no=2807 '이명'이 불치병? 개인별 맞춤 한방치료로 개선 가능, 8월 5, 2025에 액세스, https://www.medipharmhealth.co.kr/mobile/article.html?no=68565 이명 - 대치서울이비인후과, 8월 5, 2025에 액세스, https://dseoul.kr/55 체성이명, 전기침 및 부항, 텐스 등 한의치료 '효과', 8월 5, 2025에 액세스, https://www.akomnews.com/bbs/board.php?bo_table=news&wr_id=15408 턱관절 장애로 이명과 두통이 생길 수 있나요? - 닥터나우, 8월 5, 2025에 액세스, https://doctornow.co.kr/content/qna/636929a8938e4f7c8036c80db920e1aa www.hasung.co.kr, 8월 5, 2025에 액세스, http://www.hasung.co.kr/index.php?midName=data&right=right11#:~:text=%ED%84%B1%EA%B4%80%EC%A0%88%20%EC%9E%A5%EC%95%A0%EB%8A%94%20%EA%B2%BD%EC%B6%94,%EC%A4%91%EC%B6%94%EC%99%80%20%EC%97%B0%EA%B4%80%EC%9D%B4%20%EC%9E%88%EC%8A%B5%EB%8B%88%EB%8B%A4. 이명, 돌발성난청, 황반변성, 녹내장 치료 하성한의원, 8월 5, 2025에 액세스, http://www.hasung.co.kr/index.php?midName=data&right=right11 [#EBS평생학교] 4강 내 몸의 소리가 들린다, 체성 이명 이효정의 우리를 괴롭히는 귀 질환, 8월 5, 2025에 액세스, https://www.youtube.com/watch?v=TkqgnTe2Iss 이명 - 대한이비인후과학회, 8월 5, 2025에 액세스, https://www.korl.or.kr/info/sub01_15.php 이명(Tinnitus) | 질환백과 | 의료정보 - 서울아산병원, 8월 5, 2025에 액세스, https://www.amc.seoul.kr/asan/healthinfo/disease/diseaseDetail.do?contentId=32441 대한이비인후과학회 창립 60 주년 제13차 이비인후과 종합학술대회, 8월 5, 2025에 액세스, https://www.korl.or.kr/workshop/abstract/schedule/view_abstract.php?code=13&number=130486 시끄러운 이명소리, 턱관절부터 체크해보세요. | Signia, 8월 5, 2025에 액세스, https://www.signia.net/ko-kr/blog/local/ko-kr/is-the-ringing-in-my-ears-tinnitus-or-tmj/ Head and Neck Exercises for Tinnitus Wake Forest | PhysioFit of NC, 8월 5, 2025에 액세스, https://www.physiofitnc.com/head-and-neck-exercises-for-tinnitus-wake-forest/ How to Stop Tinnitus in 30 SECONDS - YouTube, 8월 5, 2025에 액세스, https://www.youtube.com/watch?v=4QPOK2uYNrM 5 Exercises to Help your Tinnitus - Oto, 8월 5, 2025에 액세스, https://www.joinoto.com/articles/5-exercises-to-help-your-tinnitus Cervical Tinnitus Relief Stretches - YouTube, 8월 5, 2025에 액세스, https://www.youtube.com/watch?v=lwWDbZrGDPg&pp=0gcJCfwAo7VqN5tD 목덜미-턱관절 마사지로 '이명' 잠재운다 - 동아일보, 8월 5, 2025에 액세스, https://www.donga.com/news/It/article/all/20191210/98734687/1 How to Relieve Tinnitus Quickly - EastWest Physiotherapy Burnaby, 8월 5, 2025에 액세스, https://www.eastwestphysiotherapy.com/how-to-relieve-tinnitus-quickly-practical-tips-and-strategies-from-a-physiotherapist/ hpwellness.aimmed.com, 8월 5, 2025에 액세스, https://hpwellness.aimmed.com/03_healthinfo/menu03_05_01_view.asp?cate1_cd=A004&cate2_cd=B004&cate3_cd=C004&cate4_cd=&pageNo=5&CONTENT_SEQ=21022 Exercises for Tinnitus: Ringing in Ears Relief - Miracle Ear, 8월 5, 2025에 액세스, https://www.miracle-ear.com/hearing-diseases/tinnitus-ringing-ears/exercises-for-tinnitus [이명] 이명이 있는 분들에게 절대 해서는 안되는 말, "참고 사세요", "친구처럼 지내세요" | 질병백과 - YouTube, 8월 5, 2025에 액세스, https://m.youtube.com/watch?v=BcIFjlRUxmk&pp=ygUKI-q3gOydtOy5vA%3D%3D 이명이 들리는데...운동해도 되는지 고민이신가요? - YouTube, 8월 5, 2025에 액세스, https://www.youtube.com/watch?v=tn_0nVNGdcQ 이명 재훈련 치료 - 임상이비인후과, 8월 5, 2025에 액세스, https://www.jcohns.org/download/download_pdf?pid=jcohns-22-1-50 Tinnitus Retraining Therapy - KoreaMed Synapse, 8월 5, 2025에 액세스, https://synapse.koreamed.org/upload/synapsedata/pdfdata/0130hmr/hmr-36-120.pdf 귓속 낯선 소리 '이명', 생활습관부터 점검해야 - 헬스경향, 8월 5, 2025에 액세스, https://www.k-health.com/news/articleView.html?idxno=51185 이명 환자에서 스트레스, 불안, 우울 정도의 측정 및 임상적 의의, 8월 5, 2025에 액세스, https://www.ejao.org/upload/pdf/0202007004.pdf 이명, 우울과 불안 등 스트레스와도 연관 - 데이터솜, 8월 5, 2025에 액세스, https://www.datasom.co.kr/news/articleView.html?idxno=108100 스트레스와 이명 관계있나? | 스트레스 관리 | 이명 대처법 이거 보시면 됩니다 - YouTube, 8월 5, 2025에 액세스, https://www.youtube.com/watch?v=GGJw9kr_QMA 이명은 귀 문제와 신경계 문제가 함께 작용 - YouTube, 8월 5, 2025에 액세스, https://m.youtube.com/watch?v=FgT5bq_Buqw&pp=ygUKI-ydtOuqheyZnA%3D%3D 나만 들리는 '삐~' 소리, 이명 | 건강정보 - 세브란스병원, 8월 5, 2025에 액세스, https://sev.severance.healthcare/health/media/card.do?mode=view&articleNo=65755&title=%EB%82%98%EB%A7%8C+%EB%93%A4%EB%A6%AC%EB%8A%94+%E2%80%98%EC%82%90%7E%E2%80%99+%EC%86%8C%EB%A6%AC%2C+%EC%9D%B4%EB%AA%85 www.inha.com, 8월 5, 2025에 액세스, https://www.inha.com/page/health/medicine/161690#:~:text=%EC%9D%B8%EC%A7%80%20%ED%96%89%EB%8F%99%20%EC%B9%98%EB%A3%8C(CBT)%3A,%ED%95%98%EA%B3%A0%20%EC%A0%81%EC%9D%91%ED%95%A0%20%EC%88%98%20%EC%9E%88%EB%8F%84%EB%A1%9D%20%EB%8F%95%EB%8A%94%EB%8B%A4. 정신과 치료가 이명 완화에 도움이 될까요? - 힐팁, 8월 5, 2025에 액세스, http://www.healtip.co.kr/news/articleView.html?idxno=3221 Behavioral Therapies | American Tinnitus Association, 8월 5, 2025에 액세스, https://www.ata.org/about-tinnitus/therapy-and-treatment-options/behavioral-therapies/ Cognitive Behavioral Therapy for Tinnitus - American Academy of Audiology, 8월 5, 2025에 액세스, https://www.audiology.org/news-and-publications/audiology-today/articles/cognitive-behavioral-therapy-for-tinnitus/ 한국인 이명 환자의 인지행동치료, 8월 5, 2025에 액세스, https://www.kjorl.org/journal/view.php?viewtype=pubreader&number=8423 Cognitive Behavioral Therapy for Tinnitus: Evidence and Efficacy - PMC - PubMed Central, 8월 5, 2025에 액세스, https://pmc.ncbi.nlm.nih.gov/articles/PMC3936550/ 3 easy home exercises for tinnitus - Free step-by-step guides - Widex, 8월 5, 2025에 액세스, https://www.widex.com/en/tinnitus/relief/tinnitus-exercises/ 이명, 귀 질환의 원인과 치료법은? - 검단탑병원, 8월 5, 2025에 액세스, https://www.tophospital.co.kr/m/health_info/health-plus.html?bmain=view&uid=28&department_uid= Cognitive Behavioral Therapy Versus Tinnitus Retraining Therapy: Similarities and Differences - American Tinnitus Association, 8월 5, 2025에 액세스, https://www.ata.org/cognitive-behavioral-therapy-versus-tinnitus-retraining-therapy/ Research trends and hotspots of cognitive behavioral therapy for tinnitus: a bibliometric analysis - Frontiers, 8월 5, 2025에 액세스, https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2025.1536224/full Cognitive Behavioural Therapy (CBT) for Managing Tinnitus, Hyperacusis, and Misophonia: The 2025 Tonndorf Lecture - MDPI, 8월 5, 2025에 액세스, https://www.mdpi.com/2076-3425/15/5/526 새로운 개념 '이명 재활치료'의 모든 것 - 힐팁, 8월 5, 2025에 액세스, http://www.healtip.co.kr/news/articleView.html?idxno=7494 Tinnitus Retraining and Therapy - Englewood, CO, 8월 5, 2025에 액세스, https://tinnitusandhearing.com/hearing-care-services/tinnitus-retraining-and-therapy/ 이명의 최신 치료, 8월 5, 2025에 액세스, https://www.e-rvs.org/upload/pdf/0901108.pdf Tinnitus Retraining Therapy: An Update - Article 1286 - Audiology Online, 8월 5, 2025에 액세스, https://www.audiologyonline.com/articles/tinnitus-retraining-therapy-an-update-1286 Clinical Application of Tinnitus Retraining Therapy on Subjective Tinnitus, 8월 5, 2025에 액세스, https://jsms.sch.ac.kr/journal/view.php?number=165 Tinnitus retraining therapy: a different view on tinnitus - PubMed, 8월 5, 2025에 액세스, https://pubmed.ncbi.nlm.nih.gov/16514259/ 이명 재훈련 치료, 8월 5, 2025에 액세스, https://www.ejao.org/upload/pdf/0202002012.pdf 주관적 이명 환자에서 이명 재훈련 치료의 임상적 적용, 8월 5, 2025에 액세스, https://jsms.sch.ac.kr/upload/pdf/SMS_17_2_100_104.pdf Tinnitus retraining therapy: Procedure, effectiveness, and risks - Medical News Today, 8월 5, 2025에 액세스, https://www.medicalnewstoday.com/articles/tinnitus-retraining-therapy 이명 재훈련 치료 - 임상이비인후과, 8월 5, 2025에 액세스, https://www.jcohns.org/download/download_pdf?pid=jcohns-14-2-181 원인 따라 소리 다양… 이명의 종류와 치료법 - 국민건강지식센터, 8월 5, 2025에 액세스, https://hqcenter.snu.ac.kr/archives/30966 리사운드 - 이명과 귀울림 증상과 개선법 | ReSound Korea, 8월 5, 2025에 액세스, https://www.resound.com/ko-kr/hearing-loss/tinnitus 이명 완화를 위한 지원 | ReSound Korea, 8월 5, 2025에 액세스, https://www.resound.com/ko-kr/hearing-loss/tinnitus/treatment 이명 '집에서' 치료하는 2가지 방법 / 스페셜이비인후과 박치열 - YouTube, 8월 5, 2025에 액세스, https://m.youtube.com/watch?v=40bYX3Gq91g&pp=ygUQI-qwhO2YuO2Yke2ajOu5hA%3D%3D Your Guide to Sound Therapy for Tinnitus - Healthline, 8월 5, 2025에 액세스, https://www.healthline.com/health/sound-therapy-for-tinnitus 이명 때문에 잠들기 힘든 날들이여 안녕, 8월 5, 2025에 액세스, https://www.signia.net/ko-kr/blog/local/ko-kr/avoiding-insomnia-and-fatigue/ 이명에 의한 장애 정도와 삶의 질에 미치는 영향, 8월 5, 2025에 액세스, https://www.jcohns.org/download/download_pdf?pid=jcohns-13-1-50 Better Sleep with Tinnitus Tips - Hearing Australia, 8월 5, 2025에 액세스, https://www.hearing.com.au/news-and-articles/how-to-sleep-easier-with-tinnitus/ www.cnchealthplan.com, 8월 5, 2025에 액세스, https://www.cnchealthplan.com/wp-content/uploads/2021-0004_Q3_TruHearing-Tinnitus_Digital_v1.pdf How To Sleep with Tinnitus | Sleep Foundation, 8월 5, 2025에 액세스, https://www.sleepfoundation.org/physical-health/how-to-sleep-with-tinnitus Tips for a good night's sleep - Tinnitus UK, 8월 5, 2025에 액세스, https://tinnitus.org.uk/understanding-tinnitus/living-with-tinnitus/sleeping/tips-for-a-good-nights-sleep/ Foods that trigger tinnitus: Can diet make it worse? - Medical News Today, 8월 5, 2025에 액세스, https://www.medicalnewstoday.com/articles/foods-that-trigger-tinnitus Relationship Between Diet, Tinnitus, and Hearing Difficulties - PMC, 8월 5, 2025에 액세스, https://pmc.ncbi.nlm.nih.gov/articles/PMC7664714/ Lifestyle Choices | American Tinnitus Association, 8월 5, 2025에 액세스, https://www.ata.org/about-tinnitus/lifestyle-choices/ Tinnitus, food and drink, 8월 5, 2025에 액세스, https://tinnitus.org.uk/understanding-tinnitus/living-with-tinnitus/tinnitus-food-and-drink/ 치료되는 이명과, 이명일 때 먹지말야 할 음식 5가지!(귀울림, 귀에서 삐소리) - YouTube, 8월 5, 2025에 액세스, https://m.youtube.com/watch?v=KAR43fDkUmM&pp=ygUKI-ydtOuqheyZnA%3D%3D 이명소리 들린다면 이런 음식 절대 먹지 마세요! - YouTube, 8월 5, 2025에 액세스, https://www.youtube.com/shorts/-vR-RRqTASI Do dietary factors significantly influence tinnitus - RACGP, 8월 5, 2025에 액세스, https://www1.racgp.org.au/ajgp/2019/march/do-dietary-factors-significantly-influence-tinnitu The Allure of the Magic Pill | American Tinnitus Association, 8월 5, 2025에 액세스, https://www.ata.org/the-allure-of-the-magic-pill/ Ginkgo biloba for tinnitus - PubMed, 8월 5, 2025에 액세스, https://pubmed.ncbi.nlm.nih.gov/23543524/ Ginkgo biloba for the treatment of tinnitus - PubMed, 8월 5, 2025에 액세스, https://pubmed.ncbi.nlm.nih.gov/30339143/ Ginkgo biloba extract in the treatment of tinnitus: a systematic review - PMC, 8월 5, 2025에 액세스, https://pmc.ncbi.nlm.nih.gov/articles/PMC3157487/ 이명(Tinnitus) - 약학정보원, 8월 5, 2025에 액세스, https://common.health.kr/shared/healthkr/pharmreview/%EC%9D%B4%EB%AA%85(Tinnitus).pdf 은행잎 추출물의 이명 치료, 결정적 근거 필요 - 메디칼업저버, 8월 5, 2025에 액세스, https://www.monews.co.kr/news/articleView.html?idxno=33255 은행잎 제제 "耳鳴에 효과 없다" - 약업신문, 8월 5, 2025에 액세스, http://m.yakup.com/news/index.html?mode=view&nid=9469 The Effect of Ginkgo Biloba on the Survival of Spiral Ganglion Neurons in Rats., 8월 5, 2025에 액세스, https://www.kjorl.org/journal/view.php?number=833 Can zinc supplementation help alleviate tinnitus symptoms in individuals with suspected zinc deficiency? - Dr.Oracle, 8월 5, 2025에 액세스, https://www.droracle.ai/articles/198036/zinc-and-tinnitus Zinc for tinnitus: Potential benefits, risks, and other treatments - Medical News Today, 8월 5, 2025에 액세스, https://www.medicalnewstoday.com/articles/zinc-for-tinnitus Zinc supplementation for tinnitus - Person, OC - 2016 | Cochrane Library, 8월 5, 2025에 액세스, https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009832.pub2/abstract Tinnitus is on the rise and some patients are turning to zinc supplements for relief | MDLinx, 8월 5, 2025에 액세스, https://www.mdlinx.com/article/tinnitus-is-on-the-rise-and-some-patients-are-turning-to-zinc-supplements-for-relief/369vYWtMamomoh4aIuSPGe Zinc - Tinnitus UK, 8월 5, 2025에 액세스, https://tinnitus.org.uk/tinnitus-treatments/zinc/ 이명의 약물치료 - 임상이비인후과, 8월 5, 2025에 액세스, https://www.jcohns.org/download/download_pdf?pid=jcohns-22-1-28 이명과 난청에 좋은 음식이 있을까? - 매경헬스, 8월 5, 2025에 액세스, https://www.mkhealth.co.kr/news/articleView.html?idxno=74140 이명 증상에 도움 주는 자연적 요법 | 웰니스 허브 - iHerb, 8월 5, 2025에 액세스, https://kr.iherb.com/blog/tinnitus-how-to-stop-the-ringing-with-natural-medicine/209 Magnesium and hearing loss - NCBI, 8월 5, 2025에 액세스, https://www.ncbi.nlm.nih.gov/books/NBK507266/ Study Details | A Trial of Magnesium Dependent Tinnitus | ClinicalTrials.gov, 8월 5, 2025에 액세스, https://clinicaltrials.gov/study/NCT01273883 hoonet.co.kr, 8월 5, 2025에 액세스, http://hoonet.co.kr/Module/News/News.asp?MODE=V&SRNO=31093#:~:text=%EB%A7%88%EA%B7%B8%EB%84%A4%EC%8A%98%EB%A7%88%EA%B7%B8%EB%84%A4%EC%8A%98%EC%9D%80%20%EC%84%B8%ED%8F%AC%EB%A5%BC,%EC%8A%A4%ED%8A%B8%EB%A0%88%EC%8A%A4%20%EC%99%84%ED%99%94%EC%97%90%EB%8F%84%20%ED%9A%A8%EA%B3%BC%EC%A0%81%EC%9D%B4%EB%8B%A4. 귀에서 삐~ 소리가 나시나요? 이 영양소 섭취 후 이명 증상이 완화된 케이스를 소개해드립니다!, 8월 5, 2025에 액세스, https://www.youtube.com/watch?v=Mp34F1ZOPm4 시금치·녹색잎 채소, 이명에 효과 있다? - KBS 뉴스, 8월 5, 2025에 액세스, https://news.kbs.co.kr/news/view.do?ncd=2247477 [기획] 영양치료의 이론과 실제 - 23 - 청년의사, 8월 5, 2025에 액세스, http://www.docdocdoc.co.kr/news/articleView.html?idxno=34013 Tinnitus Linked to Vitamin B12 Deficiency | Louisiana Ear Nose Throat & Sinus, 8월 5, 2025에 액세스, https://www.lents.com/blog/tinnitus-linked-to-vitamin-b12-deficiency/ B12 for tinnitus: Research, recommended intake, and more - Medical News Today, 8월 5, 2025에 액세스, https://www.medicalnewstoday.com/articles/b12-for-tinnitus Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study - PMC, 8월 5, 2025에 액세스, https://pmc.ncbi.nlm.nih.gov/articles/PMC4918681/ The effect of vitamin B12 on idiopathic tinnitus - PubMed, 8월 5, 2025에 액세스, https://pubmed.ncbi.nlm.nih.gov/37647778/