Can CBD oil treat tinnitus?
'The biggest challenge with CBD is that everyone reacts differently'
Medical science has yet to find a cure for tinnitus, an audiological and neurological condition that affects more than 50 million Americans. As a result, tinnitus sufferers are left to seek out whatever relief they can find. For some, this may mean trying cannabidiol, also known as CBD.
What is CBD?
Cannabidiol is one of many chemical compounds that can be extracted from the flowers, leaves and buds of Cannabis plants known as marijuana or hemp, depending on the strain. Hemp plants are very similar to marijuana plants, but contain much lower levels of tetrahydrocannabinol (THC), the active chemical that causes a psychoactive high in marijuana users.
CBD is distinct from THC. CBD users do not experience a high.
CBD can be made into a variety of products, such as oils, tinctures, gels, and sprays.
Why has CBD become popular?
In 2018, Congress passed the Agriculture Improvement Act, officially removing hemp from the Controlled Substances Act. This opened the door for researching and marketing the non-narcotic aspects of the plant.
Today many companies sell the chemical compound, claiming its medicinal virtues include alleviating pain and treating a wide variety of conditions including anxiety, depression, insomnia, acne and tinnitus. Rigorous medical research, so far, is limited for most of these conditions. Exceptions include certain rare types of epilepsy and tumors that can be treated with an FDA-approved drug containing CBD called Epidiolex.
Note that the FDA does not regulate the commercial market for CBD supplements, and products vary widely in quality and strength. For example, products made with hemp seed oil do not actually contain any CBD. Medical-grade CBD is still largely restricted to states in dispensaries where marijuana has been legalized, either for THC or CBD or both. Consumer Reports has put together a useful primer on how to shop for CBD.
Research on tinnitus and CBD
Two types of cannabinoid receptors in the brain, CB1 and CB2, respond to the presence of cannabis components, including CBD. Emerging research suggests that these receptors may play a role in balance and hearing. This has led some to wonder if taking CBD might help with hearing disorders, such as tinnitus. But there's not a lot of information to date.
A 2015 study using CBD to treat lab rats, for example, showed it didn’t help, and in some instances even seemed to worsen tinnitus (in rats, at least). A 2020 literature review stated that human research is needed before any conclusions can be drawn.
Some evidence suggests that tinnitus could be a side effect of CBD, but more research is needed to confirm this. In a 2022 study of medical cannabis use in 201 older adults, 9.1% of participants reported tinnitus as a side effect of products containing CBD and THC. Regarding this finding, the study authors wrote: “Tinnitus stood out as a unique adverse event in this sample and should be further investigated to determine the generalizability of this observation.”
However, there's some evidence that CBD might help with stress, which can be a problem for people with chronic tinnitus. One study published in the 2015 issue of Neurotherapeutics suggests CBD is effective in reducing anxiety behaviors related to disorders such as post-traumatic stress disorder (PTSD), seasonal affect disorder (SAD) and (obsessive-compulsive disorder) OCD. Other studies have produced mixed results, according to VeryWell.com.
This lack of data also exists for side effects. The Mayo Clinic notes they may include "dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. CBD can also interact with other medications you're taking, such as blood thinners."
Trying CBD: One person's perspective
Because tinnitus patients often have high levels of mental distress from the constant ringing in their ears, anything that helps with stress relief is appealing, explains Glenn Schweitzer, a Healthy Hearing contributor who documented his methods for managing his condition in his book Rewiring Tinnitus and also writes about his experiences on his website. He has recently started using CBD.
“It’s funny because I had this idea going in that CBD was just some silly health craze that wouldn’t really amount to anything,” he said. “I honestly thought it was going to be like the antioxidant fad a few years back, when supplements with 'super food' ingredients like acai berries were all the rage but ended up being all hype and no substance.”
Although his expectations were low, the results he felt after his first dose made him a believer.
“Most people take CBD oil sublingually, letting it absorb under the tongue, but I didn’t know that at the time. I just swallowed the oil and 30 minutes later, my anxiety disappeared entirely. It blew my mind. I’ve struggled with anxiety for most of my life, and it was just gone. That tight feeling in my chest and stomach just melted away. But I wasn’t sedated, high, or impaired in any way."
'Everyone reacts differently'
That was several years ago. Today Schweitzer said he uses CBD on an “as-needed basis.”
“When I’m dealing with stressful and challenging circumstances, I take CBD every day, usually 30 minutes before I go to bed,” he explained. “I find it helps me fall asleep, and I experienced a cumulative benefit in taking it every day. The best way I can describe it is that it greatly increases my ability to deal with stress.”
While Schweitzer is a proponent of CBD, he admits there are challenges. His advice to others who are interested in using it to treat their tinnitus is to do some research before they talk to their doctor and then start with a small dose if they decide to proceed.
“The biggest challenge with CBD is that everyone reacts differently,” he said. “The dose that works for me could be too much or too little for you. And not everyone experiences the same thing. Some people, like me, notice an immediate effect. Others have to take it every day for a week or two before they notice anything. And some experience nothing at all. You have to be comfortable experimenting a bit to find what works best for you, and that’s kind of unfortunate. But for me, it was worth all the effort.”
Meanwhile, it's important to keep in mind that one person's experience isn't the same as a randomized controlled clinical trial on a large group of patients. That kind of data is needed, noted Timothy Caulfield, a University of Alberta-Canada health law expert, health trend tracker and host of the Netflix series A User's Guide to Cheating Death.
"Testimonials and anecdotal reports may suggest research, but it's never good evidence," he said in a news release. "The scientific process is specifically designed to overcome the biases inherent in anecdotal evidence."
Finally, use caution. Products marketed as the "best CBD" don't have to pass any tests to make that claim. State laws vary widely regarding the use of cannabis products of any kind, and the FDA doesn't regulate the compound, meaning the quality of supplements containing CBD aren't proven. Please determine if CBD is legal where you live before purchasing or consuming products which claim to contain the compound, and discuss any concerns with your doctor.
Make sure you're eating a hearing-friendly diet. Certain vitamins, minerals and supplements may help, too. For tinnitus, it also may help to see a hearing care professional who specializes in the disorder. They can suggest solutions, including possibly recommending hearing aids with tinnitus masking features, to help you find some relief. Our directory can help you find a hearing instrument specialist or audiologist near you.
Note: This piece originally published in March 2019. It was updated and medically reviewed in July 2023 by Dr. Patricia Weiser, a licensed pharmacist and medical writer. She obtained her Doctor of Pharmacy degree at the University of Pittsburgh.