Can Tinnitus Cause Dizziness? What Research and Experts Say

Article At a Glance

• Tinnitus usually does not directly cause dizziness or vertigo. When the symptoms occur together, they may share an underlying ear, vestibular, neurological, medication-related, or other medical cause.
• The inner ear contains separate but closely related systems for hearing and balance. Some disorders can therefore produce both auditory and vestibular symptoms.
• Ménière’s disease, vestibular migraine, labyrinthitis, vestibular schwannoma, and other conditions can sometimes involve both tinnitus and dizziness.
• BPPV commonly causes positional vertigo but does not typically require tinnitus as part of the disorder. Tinnitus occurring with BPPV may have another or additional explanation.
• Sudden hearing loss, new neurological symptoms, severe new dizziness, or other concerning symptom combinations deserve prompt medical evaluation.

Tinnitus and dizziness can be unsettling individually.

Experiencing them together can be even more concerning.

You may wonder whether the ringing, buzzing, or hissing in your ear is somehow making you dizzy.

Usually, that is not the best way to understand the relationship.

Tinnitus generally does not directly cause dizziness.

Instead, the two symptoms can occur together because some conditions affect the auditory system, vestibular system, or nearby neurological structures.

Understanding the pattern of your symptoms can help a healthcare professional determine what type of evaluation may be appropriate.

Why Can Tinnitus and Dizziness Occur Together?

The inner ear performs two major sensory functions.

The cochlea is involved in hearing.

The vestibular organs provide information about head movement and position that helps the brain maintain balance and spatial orientation.

Because these structures are located close together and communicate with the brain through related neural pathways, some inner-ear disorders can affect both hearing and balance.

That can produce combinations of symptoms such as:

• Tinnitus
• Hearing loss
• Vertigo
• Unsteadiness
• Ear fullness
• Motion sensitivity

However, the presence of both symptoms does not prove that the inner ear is responsible.

Dizziness can also have neurological, cardiovascular, medication-related, metabolic, visual, psychological, and other causes.

What Does Dizziness Mean?

“Dizziness” can describe several different sensations.

People may use the word to mean:

• Spinning
• Lightheadedness
• Unsteadiness
• Rocking or swaying
• A floating sensation
• Feeling faint
• Motion sensitivity
• Difficulty maintaining balance

These sensations do not necessarily have the same cause.

Vertigo more specifically refers to an illusion of movement, often described as spinning or tilting.

Distinguishing vertigo from lightheadedness or general imbalance can provide important diagnostic information.

Does Tinnitus Cause Vertigo?

Tinnitus itself is not generally considered a direct cause of vertigo.

If you experience ringing in the ears and spinning at the same time, clinicians usually consider whether another condition could explain both symptoms.

Examples can include:

• Ménière’s disease
• Labyrinthitis
• Vestibular migraine
• Selected inner-ear disorders
• Vestibular schwannoma
• Medication effects
• Head injury
• Other neurological or medical conditions

The timing of the symptoms can be especially useful.

For example, a clinician may ask whether tinnitus changes during the dizzy episode, whether hearing fluctuates, how long the dizziness lasts, and what triggers it.

How Hearing and Balance Work Together

The cochlea and vestibular organs are different structures, but both are located within the inner ear.

The vestibular system includes:

• Three semicircular canals
• The utricle
• The saccule

These structures detect different forms of head movement and orientation.

The brain combines vestibular information with information from:

• Vision
• Muscles
• Joints
• Other sensory systems

This integrated information helps maintain balance and stable vision during movement.

A problem affecting one component can sometimes produce dizziness or imbalance even when hearing remains normal.

Likewise, a cochlear problem can cause hearing loss or tinnitus without producing dizziness.

Can Hearing Loss Occur With Tinnitus and Dizziness?

Yes.

Some inner-ear disorders can produce all three symptoms.

The pattern of hearing loss can provide useful information.

Clinicians may want to know whether the hearing change is:

• Sudden or gradual
• Stable or fluctuating
• In one ear or both
• Associated with ear fullness
• Present only during attacks

A hearing test can help determine whether measurable hearing loss is present.

Learn more about hearing loss and tinnitus.

Ménière’s Disease

Ménière’s disease is an inner-ear disorder that can produce a characteristic combination of auditory and vestibular symptoms.

These can include:

• Episodes of vertigo
• Fluctuating sensorineural hearing loss
• Tinnitus
• A feeling of pressure or fullness in the affected ear

Vertigo episodes associated with Ménière’s disease typically occur in distinct attacks rather than as a few seconds of dizziness caused solely by changing head position.

Tinnitus alone does not establish Ménière’s disease.

Neither does dizziness alone.

Diagnosis depends on the overall symptom pattern, hearing findings, and appropriate clinical evaluation.

Vestibular Migraine

Vestibular migraine is a neurological disorder in which migraine-related processes are associated with vestibular symptoms.

Possible symptoms include:

• Vertigo
• Motion sensitivity
• Unsteadiness
• Sensitivity to visual movement
• Headache in some episodes
• Light or sound sensitivity
• Nausea

A headache does not have to occur during every vestibular migraine episode.

Some people with vestibular migraine also report tinnitus or other auditory symptoms.

However, tinnitus is not specific to vestibular migraine and should not be used by itself to make the diagnosis.

The exact biological mechanisms underlying vestibular migraine continue to be studied.

Labyrinthitis

Labyrinthitis refers to inflammation affecting structures of the inner ear.

It can produce vestibular symptoms together with hearing symptoms.

Possible features include:

• Vertigo
• Imbalance
• Nausea
• Hearing loss
• Tinnitus

The term should not be used for every sudden episode of dizziness.

A related condition, vestibular neuritis, primarily affects vestibular function and typically does not produce the same hearing-loss pattern.

Sudden significant vertigo with hearing change deserves medical evaluation because several conditions can produce that combination.

What About BPPV?

Benign paroxysmal positional vertigo, or BPPV, is one of the most common causes of positional vertigo.

It occurs when tiny calcium-carbonate particles called otoconia become displaced into a semicircular canal.

Typical BPPV produces brief episodes of vertigo triggered by movements such as:

• Rolling over in bed
• Looking upward
• Bending down
• Getting into or out of bed
• Turning the head in certain directions

The vertigo usually lasts for a relatively short period after the triggering movement.

Tinnitus is not a defining feature of BPPV.

A person can certainly have BPPV and tinnitus at the same time, but the tinnitus may have a separate cause or reflect another accompanying auditory condition.

Clinicians should therefore avoid assuming that BPPV explains new tinnitus or hearing loss.

How Is BPPV Treated?

When BPPV is correctly diagnosed, specific canalith-repositioning maneuvers can often move the displaced particles out of the affected semicircular canal.

The maneuver selected depends on which canal and side are involved.

The commonly known Epley maneuver is used for certain forms of posterior-canal BPPV.

Not every positional dizziness problem is BPPV, and not every BPPV variant is treated with the same maneuver.

Persistent or uncertain symptoms should be evaluated rather than repeatedly self-treated without a clear diagnosis.

Vestibular Schwannoma

A vestibular schwannoma, historically called an acoustic neuroma, is a usually benign tumor arising from Schwann cells associated with the vestibular portion of the vestibulocochlear nerve.

Possible symptoms can include:

• Progressive asymmetrical hearing loss
• Unilateral tinnitus
• Unsteadiness
• Balance difficulty
• Other neurological findings in selected cases

Classic spinning vertigo is not necessarily the dominant symptom.

Most people with unilateral tinnitus or dizziness do not have a vestibular schwannoma.

However, persistent one-sided tinnitus accompanied by asymmetrical hearing loss or neurological findings may lead a clinician to consider additional testing.

Superior Semicircular Canal Dehiscence

Superior semicircular canal dehiscence involves abnormal thinning or an opening in the bone overlying part of the superior semicircular canal.

Possible symptoms can include:

• Sound-induced dizziness
• Pressure-induced dizziness
• Autophony
• Unusual awareness of internal body sounds
• Hearing abnormalities
• Sometimes tinnitus or pulse-synchronous sounds

Diagnosis requires more than symptoms alone.

Specialized hearing or vestibular testing and high-resolution imaging may be used when the condition is suspected.

Treatment depends on symptom severity and diagnostic findings.

Not everyone with the anatomical finding requires surgery.

Can Ear Infections Cause Tinnitus and Dizziness?

Some ear conditions can cause combinations of hearing and balance symptoms.

Middle-ear infections or fluid can alter hearing and produce ear pressure or discomfort.

Inner-ear inflammation can produce more substantial vestibular symptoms.

The presence of tinnitus and dizziness during an ear infection does not identify which part of the ear is involved.

Persistent hearing loss, severe vertigo, significant pain, drainage, or worsening symptoms deserve appropriate evaluation.

Can Medications Cause Both Tinnitus and Dizziness?

Yes, some medications can be associated with tinnitus, dizziness, hearing changes, or vestibular effects.

However, these effects differ substantially among medications.

Some drugs can directly affect cochlear or vestibular structures.

Others may cause dizziness through effects unrelated to the inner ear, such as:

• Blood-pressure changes
• Sedation
• Changes in alertness
• Dehydration
• Neurological effects

This distinction matters because a medication that lists both tinnitus and dizziness as possible adverse effects is not necessarily damaging the inner ear.

Which Medications Can Affect Hearing or Balance?

Certain medications and treatments are known to have clinically important auditory or vestibular effects in selected circumstances.

Examples can include some:

• Aminoglycoside antibiotics
• Platinum-based chemotherapy agents
• Loop diuretics
• Salicylates at particular doses
• Other medications depending on dose and clinical circumstances

Risk varies according to:

• The specific drug
• Dose
• Treatment duration
• Route of administration
• Kidney function
• Other medications
• Existing auditory conditions
• Individual susceptibility

Do not assume that every medication associated with dizziness or tinnitus is ototoxic.

What Should You Do if Symptoms Begin After Starting a Medication?

If tinnitus, dizziness, or hearing changes begin after starting or changing a medication, contact the healthcare professional managing the treatment.

Useful information includes:

• When the medication was started
• When the symptoms began
• Whether the dose recently changed
• Whether symptoms occur after each dose
• Whether hearing has changed
• Whether other medications or supplements are being used

Do not stop a prescribed medication solely because tinnitus or dizziness develops unless a healthcare professional instructs you to do so.

Some medications require careful tapering or are being used to treat serious conditions.

Can Anxiety Make Tinnitus and Dizziness Feel Worse?

Yes.

Anxiety and stress can influence both symptoms.

With tinnitus, increased attention and emotional distress can make the sound more intrusive.

Anxiety can also contribute to sensations such as:

• Lightheadedness
• Unsteadiness
• Hyperventilation-related symptoms
• Increased awareness of movement
• Muscle tension

This does not mean tinnitus and dizziness are imaginary.

Nor should anxiety automatically be assumed to explain new vestibular or auditory symptoms.

When a medical or vestibular disorder is present, anxiety can coexist with it and amplify the burden of the symptoms.

Can Cognitive Behavioral Therapy Help?

Cognitive behavioral therapy, or CBT, has evidence supporting its use for reducing tinnitus-related distress.

CBT may also be useful for anxiety or maladaptive responses associated with persistent dizziness in selected individuals.

The purpose is not necessarily to eliminate the underlying auditory or vestibular signal.

Instead, therapy may help with:

• Fear associated with symptoms
• Catastrophic thinking
• Avoidance
• Attention to tinnitus
• Sleep problems
• Coping strategies

Specific success percentages should not be promised.

Benefit varies according to the individual and the underlying condition.

Does Diet Affect Tinnitus and Dizziness?

There is no universal diet for people with tinnitus and dizziness.

Dietary recommendations depend on the diagnosis and the person’s overall health.

Generic advice to eliminate:

• Caffeine
• Alcohol
• Artificial sweeteners
• MSG
• Aged cheese
• Processed meat
• Other specific foods

is not appropriate for every person with these symptoms.

Some people with migraine disorders identify individual dietary triggers.

Some people with specific medical conditions receive sodium or other dietary recommendations.

These should be individualized rather than applied universally to everyone with tinnitus or dizziness.

Should You Keep a Symptom Journal?

A simple symptom record can sometimes help identify useful patterns.

Consider recording:

• When dizziness begins
• How long it lasts
• Whether it feels like spinning, lightheadedness, rocking, or imbalance
• Whether head movement triggers it
• Whether tinnitus changes during the episode
• Whether hearing changes
• Whether one ear feels full
• Headache or migraine symptoms
• Medication changes
• Recent illness

The goal is not to obsessively monitor every sensation.

A concise record can simply make it easier to describe recurring episodes accurately during a medical appointment.

How Are Tinnitus and Dizziness Evaluated?

Evaluation begins with the history and physical examination.

Depending on the symptom pattern, clinicians may consider:

• Ear examination
• Hearing testing
• Neurological examination
• Vestibular testing
• Blood-pressure assessment
• Selected laboratory testing
• Imaging when clinically indicated

Not everyone needs every test.

Hearing Testing

Audiological testing can help identify:

• Sensorineural hearing loss
• Conductive hearing loss
• Differences between the ears
• Speech-understanding difficulties
• Middle-ear abnormalities

Hearing results can be particularly important when dizziness occurs with unilateral tinnitus or a perceived change in hearing.

Learn more in our complete guide to hearing health.

Vestibular Testing

Vestibular testing may be appropriate when symptoms suggest a balance-system disorder.

Depending on the clinical question, testing can include:

• Videonystagmography or electronystagmography
• Video head impulse testing
• Vestibular evoked myogenic potentials
• Rotary-chair testing
• Positional testing
• Other specialized assessments

These tests evaluate different parts of the vestibular system.

A clinician selects testing according to the suspected disorder rather than automatically ordering the entire group.

When Is MRI Used?

MRI can be useful when symptoms or hearing-test findings raise concern for certain neurological or structural conditions.

Examples can include selected cases involving:

• Asymmetrical sensorineural hearing loss
• Persistent unilateral tinnitus
• Neurological findings
• Other concerning clinical patterns

MRI is not automatically required for every person with tinnitus and dizziness.

When Is CT Used?

CT provides detailed information about bone and can be particularly useful when clinicians suspect selected structural abnormalities of the temporal bone.

For example, high-resolution CT may be part of the evaluation for suspected superior semicircular canal dehiscence.

The choice between MRI, CT, and other testing depends on what condition is being investigated.

Are Blood Tests Necessary?

Sometimes.

Laboratory testing may be useful when the history suggests systemic conditions that could contribute to dizziness or other symptoms.

There is no universal tinnitus-and-dizziness blood panel.

Testing for thyroid disease, anemia, nutritional deficiency, autoimmune disease, or other conditions should be guided by the person’s symptoms, history, examination, and clinical judgment.

When Should You Seek Medical Evaluation?

Consider medical evaluation when tinnitus and dizziness are:

• New and persistent
• Recurring without a known explanation
• Associated with hearing loss
• Mostly or entirely on one side
• Progressively worsening
• Interfering substantially with walking or everyday activities
• Associated with ear pain or drainage
• Associated with significant headache or neurological symptoms

The appropriate urgency depends on how the symptoms began and what other symptoms are present.

Sudden Hearing Loss With Tinnitus or Dizziness

A sudden unexplained decrease in hearing deserves prompt medical evaluation.

Sudden sensorineural hearing loss can occur with:

• New tinnitus
• Ear fullness
• Dizziness or vertigo
• A sudden difference between the ears

It may initially feel like a blocked or congested ear.

Do not assume sudden unexplained hearing loss is simply wax, allergies, or congestion.

Learn more about hearing symptoms that may require prompt medical attention.

When Dizziness May Be an Emergency

Seek emergency medical care when sudden dizziness or vertigo occurs with symptoms such as:

• Facial drooping
• New weakness or numbness
• Difficulty speaking or understanding language
• New severe vision changes
• Severe difficulty walking
• Loss of consciousness
• A sudden severe or unusual headache
• Chest pain or severe shortness of breath
• Other new serious neurological symptoms

Stroke and other neurological emergencies can sometimes present with dizziness.

The presence or absence of tinnitus does not reliably distinguish a benign vestibular disorder from an emergency.

What About Symptoms After a Head Injury?

Head trauma can cause tinnitus, dizziness, hearing changes, headache, and other neurological symptoms.

Seek appropriate medical care after significant head injury, particularly when symptoms include:

• Loss of consciousness
• Repeated vomiting
• Worsening headache
• Confusion
• New neurological symptoms
• Clear fluid or blood from the ear or nose
• Significant hearing changes
• Severe or worsening dizziness

The appropriate level of urgency depends on the injury and symptoms.

Frequently Asked Questions

Can Tinnitus Make You Dizzy?

Tinnitus itself generally does not directly cause dizziness.

When the two occur together, clinicians consider whether another condition affects hearing, balance, or both.

Stress and anxiety associated with tinnitus can also contribute to lightheadedness or unsteadiness in some people, but new dizziness should not automatically be attributed to tinnitus or anxiety.

Why Do I Have Ringing in My Ears and Feel Off Balance?

There are many possible explanations.

Inner-ear disorders, vestibular migraine, medications, neurological conditions, hearing disorders, and other medical issues can produce combinations of tinnitus and imbalance.

The duration, triggers, hearing symptoms, and other accompanying features help narrow the possibilities.

Can You Have Tinnitus Without Hearing Loss?

Yes.

Some people with tinnitus have hearing thresholds within conventional limits on a standard audiogram.

That does not prove the auditory system is completely unaffected, but it also does not justify automatically diagnosing “hidden hearing loss” or cochlear synaptopathy.

A comprehensive hearing evaluation can determine what measurable auditory findings are present.

Does Tinnitus With Normal Hearing Mean I Will Develop Hearing Loss?

No.

Tinnitus with a normal conventional audiogram does not guarantee that future hearing loss will develop.

Protecting your hearing from hazardous noise remains sensible for everyone.

Follow-up hearing testing can be considered according to symptoms, noise exposure, age, and other risk factors.

Can BPPV Cause Tinnitus?

Tinnitus is not a defining symptom of BPPV.

A person can experience both conditions, but clinicians should consider whether another auditory problem explains the tinnitus, particularly when hearing loss or ear fullness is also present.

How Long Does Dizziness Associated With Tinnitus Last?

There is no single duration because tinnitus itself is usually not causing the dizziness.

The duration depends on the underlying condition.

BPPV may produce brief positional attacks, while other vestibular disorders can cause episodes lasting much longer.

Recording the duration and triggers can help with diagnosis.

Can Ménière’s Disease Cause Tinnitus and Vertigo?

Yes.

Ménière’s disease can involve episodic vertigo, fluctuating sensorineural hearing loss, tinnitus, and ear fullness.

Those symptoms require appropriate evaluation because several other conditions can produce overlapping features.

Can Vestibular Migraine Cause Tinnitus?

Some people with vestibular migraine report tinnitus or other auditory symptoms.

Tinnitus is not required for the diagnosis and does not by itself prove vestibular migraine is present.

Can Anxiety Cause Tinnitus and Dizziness?

Anxiety can increase tinnitus distress and can produce or worsen some forms of dizziness or lightheadedness.

However, anxiety should not automatically be used to explain new hearing or balance symptoms without considering other causes.

Should I Change My Diet?

Not simply because you have tinnitus and dizziness.

Dietary recommendations should depend on the underlying diagnosis and your overall health.

Avoid broad elimination diets unless there is a clear reason for them.

Who Should I See for Tinnitus and Dizziness?

The appropriate clinician depends on the symptom pattern.

A primary-care clinician can evaluate general medical causes.

An audiologist can assess hearing and selected vestibular functions.

An otolaryngologist or neurotologist may evaluate inner-ear and related disorders.

A neurologist may be involved when migraine or neurological causes are suspected.

Other specialists may be appropriate depending on the findings.

The Bottom Line

Tinnitus usually does not directly cause dizziness.

When ringing, buzzing, hissing, or another tinnitus sound occurs together with vertigo or imbalance, the symptoms may share an underlying cause.

The inner ear contains both hearing and balance structures, which is why disorders such as Ménière’s disease and labyrinthitis can affect both systems.

Vestibular migraine, medication effects, vestibular schwannoma, structural inner-ear conditions, head injury, and other medical problems can also produce overlapping symptoms.

BPPV is an important distinction: it commonly causes positional vertigo, but tinnitus is not a defining feature and should not automatically be attributed to BPPV.

There is also no universal tinnitus-and-dizziness diet, supplement, medication, or treatment.

The appropriate approach depends on identifying the underlying condition.

Seek prompt medical evaluation for sudden unexplained hearing loss. Seek emergency care when sudden severe dizziness occurs with neurological symptoms, severe difficulty walking, loss of consciousness, a sudden severe headache, or other signs of a possible medical emergency.

For persistent or recurring tinnitus and dizziness without emergency symptoms, a hearing and medical evaluation can help determine whether the auditory system, vestibular system, or another condition is contributing.