What the research says about caffeine, hearing loss and tinnitus

Wondering how caffeine intake might affect your hearing, especially when it comes to hearing loss and tinnitus (ringing in the ears)? What about Meniere's disease? 

This isn't a heavily studied topic of research, and for the most part, it does not seem that caffeine intake plays a big role in hearing health overall. 

What is caffeine?

Caffeine is a natural stimulant found in coffee, tea, chocolate and many energy drinks as well as some non-prescription cold and allergy medications and pain relievers. It stimulates the central nervous system, improving circulation and focus and keeps us from feeling tired after a late night on the town. Studies indicate caffeine may reduce the risk of certain cancers, such as liver, mouth and throat as well as type 2 diabetes, Parkinson’s disease and stroke.

How does caffeine affect hearing loss?

For the most part, it does not appear that normal caffeine intake (around 2 cups of coffee day, or less) will have much of an impact on your hearing in the long-term. Caffeine does restrict blood vessels and alter blood pressure, and blood flow is an important part of healthy hearing, so researchers have wondered if there is a relationship. A large Korean observational study found no connection. In fact, it found that people who drank coffee had lower rates of hearing loss than non-coffee drinkers. 

Caffeine may worsen temporary hearing loss after noise exposure

Ever left a really noisy event and your hearing felt funny and muffled? You likely experienced temporary threshold shift (TTS), a sign that your the delicate hair cells of your inner ear are overworked and fatigued. Under normal conditions, your hearing should recover in a few days, if not sooner. It might help to skip any large doses of caffeine until your hearing is back to normal: Daily consumption of caffeine may prolong recovery from TTS, a 2016 study showed. However, the study was conducted on a small group of guinea pigs, so it likely does not translate to the same effect in people. 

And some cancer patients should be cautious, too

Cancer patients who take the drug cisplatin should be careful combining the drug with caffeine intake. Cisplatin is well-known to cause hearing loss and tinnitus in chemotherapy patients, a phenomenon known as cisplatin-induced hearing loss. A 2019 study on lab rats showed that adding caffeine increased the risk of hearing loss. The study authors concluded that "these findings highlight a possible drug-drug interaction between caffeine and cisplatin for ototoxicity and suggest that caffeine consumption should be cautioned in cancer patients treated with a chemotherapeutic regimen containing cisplatin."

What about tinnitus and caffeine?

No need to abstain, according to research

Some tinnitus patients report an improvement in symptoms when they cut back on caffeine. If you also find it useful, then by all means, cut back. Just keep in mind that so far, research hasn't shown that cutting back will reduce tinnitus. In fact, one study on women actually found lower rates of tinnitus among women who reported heavy coffee use. 

This is similar to a previous study finding that indicated "caffeine abstinence" was an ineffective treatment for tinnitus, and in fact, the withdrawal from caffeine might actually be distressing. 

No evidence was found to justify caffeine abstinence as a therapy to alleviate tinnitus, and acute effects of caffeine withdrawal might even add to the burden of tinnitus, the study authors said.

Meniere's disease and caffeine

Patients who have Meniere's disease are sometimes told to cut back on alcohol, salt and caffeine to help alleviate symptoms. Anecdotally, diet changes can be very helpful for some people, especially low-salt diets. But there's scant evidence on the topic, especially when it comes to caffeine and alcohol.

Theoretically, "caffeine and alcohol intake can result in constriction of blood vessels (vasoconstriction) and could result in a reduction in the blood supply to the inner ear, which may make patients' symptoms worse," state the authors of an evidence review on Meniere's and dietary changes. "Many doctors advise dietary changes as a first‐line treatment as it is thought to be a relatively simple and inexpensive option," they added.

But frustratingly, the review authors found no high-quality studies on the topic at all. "This intervention is widely recommended to patients without any proven benefit or clear understanding of any potential harms. This may delay the use of more effective treatment options resulting in disease progression and patient suffering or adverse effects," the authors state.

Bottom line: The relationship between caffeine and hearing health has not been studied enough to know what, if any, impact caffeine has on Meniere's disease, hearing loss or tinnitus.

If you enjoy coffee, soda or energy drinks and are otherwise healthy, there is no research indicating you should stop. That said, if you want to see if cutting back on caffeine helps you, then by all means give it a try.