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The Relationship Between Salicylates and Tinnitus

August 27, 20236 min read

The Relationship Between Salicylates and Tinnitus: Exploring the Facts

Aspirin, a commonly used non-steroidal anti-inflammatory drug, has garnered attention for its potential effects on tinnitus. Tinnitus, characterized by the perception of ringing or buzzing in the ears, can be a distressing condition for those who experience it. It's estimated that 30 million people in the U.S. alone rely on aspirin for pain management or as part of their heart health regimen. However, there have been concerns about the connection between aspirin and tinnitus, prompting a closer examination of the facts.

Salicylates and Tinnitus

What you need to know about salicylates and tinnitus!

The Chemical Link: Salicylates and Tinnitus

To understand the potential relationship between salicylates and tinnitus, we must understand the role of salicylates. Aspirin belongs to a class of drugs known as salicylates, which can be found in various over-the-counter and prescription medications. Salicylates are also present in certain foods, such as fruits, vegetables, nuts, processed meats, red wines, and grain-based alcohols. While there is no direct evidence linking the consumption of salicylate-containing foods or medications to tinnitus, some individuals with tinnitus have reported an increase in symptoms after consuming moderate dosages of of salicylates - both from food and pharaceutical sources.

Research suggests that salicylates can be ototoxic, which means they have the potential to cause hearing loss and tinnitus at high dosages. Salicylates interfere with the function of certain cells in the inner ear, particularly hair cells in the cochlea that play a crucial role in processing external sounds. When the function of these hair cells are compromised, it can lead to a reduction in the ability to detect low to average level sounds, resulting in changes in neural pathways in the brain that may manifest as tinnitus.


The Impact on the Auditory System

Studies have examined the effects of salicylates on various parts of the auditory system, shedding light on how they may contribute to tinnitus perception. In the peripheral auditory system, which includes the cochlea and auditory nerve, salicylates have been found to suppress neural output, leading to a reduction in cochlear amplification and auditory sensitivity. This suppression can result in a threshold shift, where sounds need to be presented at higher intensities to be perceived.

Moving beyond the peripheral auditory system, salicylates have been shown to affect different subdivisions of the central auditory system. The inferior colliculus (IC), an important relay station in the auditory pathway, does not exhibit sound-evoked hyperactivity following salicylate administration. This suggests that some compensatory mechanisms may occur to restore the amplitudes of IC responses to their normal levels. In contrast, the external nucleus of the IC (eIC) has been found to show an increase in spontaneous activity after salicylate administration in guinea pigs. These findings indicate that different parts of the IC may respond differently to high doses of salicylates.

Moving further up the auditory pathway, salicylates have been found to impact the medial geniculate body (MGB), a structure that relays auditory information to the auditory cortex. Studies have shown that salicylate can alter the spontaneous firing rate of MGB neurons, with approximately half of the neurons increasing their firing rate and the other half decreasing it. Salicylate also induces an increase in c-fos expression, a protein associated with neural activity, in the MGB. These changes in the MGB can significantly impact activity in the primary auditory cortex (A1), the region responsible for processing sound.

Effects on the Auditory Cortex

The auditory cortex, including A1 and other regions, exhibits remarkable plasticity and undergoes changes in response to systemic salicylate administration. While studies have yielded mixed results, some have reported a slight decrease in spontaneous firing rates in A1 and the anterior auditory field (AAF) following salicylate administration, while the secondary auditory cortex (A2) showed an increase. These changes may be attributed to the suppression of neural output from the cochlea and classical auditory pathway in A1, while the enhanced spontaneous firing in A2 may reflect changes occurring at both auditory and non-auditory sites in the central nervous system.

Electrophysiological studies have provided further insights into the effects of salicylates on the auditory cortex. Sound-evoked local field potentials (LFPs) and multiunit spike discharges in the auditory cortex have been evaluated after systemic salicylate administration. Salicylate has been found to induce a threshold shift and decreased LFP amplitudes at low stimulus levels, consistent with its suppressive effects on the cochlea. However, at high stimulus levels, the amplitudes of the LFPs in the auditory cortex are enhanced compared to control levels. This enhancement may be attributed to a loss of GABA-mediated inhibition, a key inhibitory mechanism in the brain. Studies have shown that substances that increase GABA-mediated inhibition can suppress salicylate-induced hyperactivity in the auditory cortex, supporting the hypothesis that the reduction in GABA-mediated inhibition contributes to the hyperactivity observed in the auditory cortex and MGB.

Alterations in the auditory cortex caused by salicylates can also impact frequency tuning and receptive fields. Salicylate has been found to induce frequency-dependent shifts and widening of frequency receptive fields in A1. This results in an over-representation of mid-frequencies (10-20 kHz), which has been associated with salicylate-induced tinnitus perception. The shift in frequency tuning may be influenced by the reduction in cochlear amplification at very high and low frequencies and the salicylate-induced reduction of cortical inhibition.

Understanding the Risk: Dosage and Considerations

The risk of experiencing the effects of salicylates on hearing, including tinnitus, is dependent on dosage. Consuming more than 4 grams (or 4000 mg) of salicylates puts individuals at risk of experiencing the effects on hearing. However, for individuals using aspirin as part of their cardiovascular health regimen, the typical daily dosage is less than 100 mg, which has been shown to have no impact on tinnitus. For pain management, a regular strength aspirin pill is about 325 mg. To reach dangerous levels, an individual would need to consume an excessive amount of aspirin, which not only poses risks to ear health but also increases the likelihood of other side effects associated with overuse.

It's important to note that the effect of aspirin on tinnitus may be temporary and reversible. Normal doses of aspirin for low-level pain management are relatively low risk and unlikely to cause significant increases in tinnitus symptoms. However, if aspirin does cause auditory discomfort, individuals are advised to consult their healthcare provider to explore alternative pain management options or consider non-aspirin pain relievers. Additionally, meditation or other alternative pain management techniques can be explored as complementary approaches to chronic pain relief.

For those who may require higher doses of aspirin for short-term medical procedures or under the guidance of a physician, it's reassuring to know that any resulting increases in tinnitus symptoms are temporary and will only last as long as the medication is in the system. As always, it's crucial to consult a healthcare professional for personalized advice and guidance regarding medication usage.


The relationship between aspirin and tinnitus is complex, influenced by factors such as dosage, individual sensitivity, and the intricate workings of the auditory system. While salicylates, including aspirin, have the potential to affect hearing and contribute to tinnitus perception, the risk is primarily associated with high dosages. Regular doses of aspirin for pain management or cardiovascular health are generally considered safe and unlikely to cause significant increases in tinnitus symptoms.

As with any medication, it's important to be mindful of individual reactions and consult healthcare professionals for personalized advice. By staying informed and discussing concerns with healthcare providers, individuals can make informed decisions about their pain management and overall health while minimizing the potential impact on tinnitus. needs is a link to the product or service which he wants to promote.

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Dr. Alexi Silance is an integrative and functional medicine practitioner. Having healed herself from lupus, fibromyalgia, chronic fatigue, and breast implant illness, she is determine to help "heal the world". Dr. Silance specializes in using "normal" labs you already have to find answers so that you can achieve health and healing. A firm believer that our body's innately know how to heal, she wants to empower others to reclaim their life and vitality. You may reach Dr. Silance at:

Dr. Alexi Silance

Dr. Alexi Silance is an integrative and functional medicine practitioner. Having healed herself from lupus, fibromyalgia, chronic fatigue, and breast implant illness, she is determine to help "heal the world". Dr. Silance specializes in using "normal" labs you already have to find answers so that you can achieve health and healing. A firm believer that our body's innately know how to heal, she wants to empower others to reclaim their life and vitality. You may reach Dr. Silance at:

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