The 2025 State of Tinnitus: What Causes It, What Treats It, and
Where Herbal Medicine Fits
By Willie Crawford, Herbalist And Medical Researcher

Introduction

Tinnitus—the perception of sound without an external source—
is a condition affecting millions worldwide. It can sound
like ringing, buzzing, hissing, or roaring, and while not
life-threatening, it can be deeply disruptive. In the U.S.
alone, roughly 25 million adults experience it each year.

There’s no single cause and no single cure. Instead, tinnitus
represents a mix of auditory system changes, brain reactivity,
somatosensory influences (like jaw or neck issues), medication
effects, and psychological factors such as stress and sleep.
The good news? While we don’t have a magic pill, 2025 brings
forward a clearer roadmap of what works, what doesn’t, and
where herbal medicine may have a role.

AUTHOR'S NOTE: This helped me: https://themodernmidas.com/quietum

My damage was caused by 20 years of flying military aircraft,
30 years of firing loud weapons, and a 40+ year martial arts
career where I sustaine numerous blows to the head!

The Causes of Tinnitus
Hearing Loss and Noise Exposure

The most common contributors are age-related hearing loss and
noise-induced damage. Even subtle changes at very high
frequencies—beyond what standard audiograms measure—can
trigger tinnitus. Protecting ears from excessive sound is
crucial, though complete silence can actually make tinnitus
worse by heightening the brain’s sensitivity.

Medications and Chemicals

Certain drugs can worsen or trigger tinnitus. These include
some chemotherapy agents, antibiotics, high-dose aspirin or
NSAIDs, and loop diuretics. Industrial solvents and chemicals
can also contribute. Medication review with a doctor is often
an early step in evaluation.

Jaw and Neck Disorders

Conditions like temporomandibular joint disorder (TMD) or
cervical spine dysfunction can “feed into” the auditory system.
Treating these mechanical issues has been shown to reduce
tinnitus in some cases.

Stress, Sleep, and Brain Reactivity

Stress, anxiety, and sleep disruption can all amplify tinnitus
perception. Research increasingly shows the brain’s limbic
system (which governs emotion) is tightly linked to tinnitus
distress. This explains why two people with the same sound
perception may have very different quality-of-life impacts.

Vascular and Neurologic Causes

Pulsatile tinnitus—sounds in rhythm with the heartbeat—can
indicate vascular abnormalities and always requires medical
workup. Unilateral tinnitus with sudden hearing loss,
imbalance, or neurological signs also demands urgent
attention.

How Tinnitus is Evaluated

Medical history and red-flag screening (onset, one-sided vs
both, pulsatile vs constant).

Audiology testing, often extending to ultra-high frequencies.

Imaging when vascular or neurological concerns exist.

Questionnaires like the Tinnitus Handicap Inventory to measure
distress.

Emerging biomarkers, such as pupil responses or subtle facial
muscle reactions to sound, are under active study and may
revolutionize diagnosis.

Current Best Treatments
Education and Reassurance

First-line care includes explaining the condition, reducing
fear, and promoting healthy sound environments. Avoiding
silence, practicing good sleep hygiene, and reducing stress
form the foundation.

Hearing Aids and Sound Therapy

For people with hearing loss, hearing aids can improve overall
sound input and reduce tinnitus perception. Many devices now
include built-in sound generators. Combining amplification with
individualized counseling is proving especially effective.

Cognitive and Behavioral Approaches

Cognitive Behavioral Therapy (CBT) and Acceptance and
Commitment Therapy (ACT) consistently reduce tinnitus-related
distress, even if the sound itself remains. Internet-delivered
CBT/ACT programs are expanding access worldwide and are
increasingly seen as core therapies.

Cochlear Implants

For those with severe or single-sided deafness, cochlear
implants can significantly reduce tinnitus impact. Studies show
sustained benefits up to two years post-implant.

Emerging Therapies
Bimodal Neuromodulation

The most exciting newcomer is bimodal stimulation, where sound
therapy is paired with gentle electrical stimulation of the
tongue. The Lenire device has shown promising results in
controlled trials, reducing distress beyond sound therapy
alone.

Brain Stimulation

Non-invasive brain stimulation, like repetitive transcranial
magnetic stimulation (rTMS) and transcranial direct current
stimulation (tDCS), shows modest benefits in some studies,
though results vary. These remain mostly within research or
specialist clinics.

Biomarkers

For the first time, researchers are developing objective ways
to measure tinnitus distress. Tools like pupillometry and
micro-movement detection could make future clinical trials more
reliable and personalized.

The Role of Herbal Medicine and Supplements
Ginkgo Biloba

Despite decades of use, the strongest research evidence shows
ginkgo offers little to no meaningful benefit compared to
placebo. It is not recommended as a reliable treatment.

Melatonin

Melatonin stands out as a promising adjunct—not as a cure, but
as a way to improve sleep and slightly reduce tinnitus
distress. Its safety profile is generally good, making it a
reasonable option under medical guidance.

Zinc, Magnesium, and Vitamin B12

Evidence is inconsistent. Supplementing these nutrients only
makes sense if a deficiency is confirmed. Correcting
deficiencies may help, but routine supplementation for all
tinnitus patients is not supported.

Antioxidants and N-Acetylcysteine (NAC)

Some research suggests potential for prevention of noise-
induced hearing damage, but there is little evidence of benefit
once tinnitus is established.

NOTE: This helped me: https://themodernmidas.com/quietum

My damage was caused by 20 years of flying military aircraft,
30 years of firing loud weapons, and a 40+ year martial arts
career where I sustaine numerous blows to the head!

Traditional Chinese Medicine

Acupuncture and herbal blends are widely used in some regions.
However, the evidence base remains low quality, with
inconsistent results across studies.

A Practical Care Pathway

Rule out red flags (pulsatile tinnitus, sudden hearing loss,
neurologic symptoms).

Do a full audiogram and set baseline measures.

Provide education and reassurance, emphasizing sound
enrichment, sleep hygiene, and stress management.

Fit hearing aids if there’s hearing loss.

Offer CBT or ACT, ideally with online access for broader reach.

Address jaw/neck problems if present.

Consider advanced therapies like bimodal neuromodulation or
rTMS in specialist settings.

Use supplements cautiously, focusing only on melatonin for
sleep or correcting proven deficiencies.

Conclusion

Tinnitus remains a challenging condition without a one-size-
fits-all cure. But progress is real. In 2025, the strongest
path forward is a layered approach: hearing correction,
psychological support, lifestyle changes, and—when
appropriate—advanced neuromodulation. Herbal and nutritional
therapies may play a minor role, with melatonin showing the
most practical benefit.

The future is hopeful: objective biomarkers, personalized
therapies, and digital CBT platforms are all moving from
research labs to real-world clinics. Patients who stay
informed, proactive, and open to evidence-based strategies can
expect better management than ever before.

About the author:

Willie Crawford’s passion for natural health began as a teen,
learning folk and herbal medicine directly from his elders.
Over the years, that foundation grew into a lifelong journey of
research into the world’s healing traditions. He completed Dr.
Josh Axe’s Essential Oil Institute training, where he became
certified as an Essential Oil Coach through the American
Association of Drugless Practitioners (AADP). The program
deepened his study of ancient systems like Ayurveda and
Traditional Chinese Medicine while emphasizing safe, practical
applications in modern life. Today, Willie shares insights that
balance traditional wisdom with contemporary research, helping
readers make well-informed choices about their health.

AUTHOR'S NOTE: This helped me: https://themodernmidas.com/quietum

My damage was caused by 20 years of flying military aircraft,
30 years of firing loud weapons, and a 40+ year martial arts
career where I sustaine numerous blows to the head!