The role of vitamin D in subjective tinnitus—A case-control study

Abstract

Regarding the high prevalence of vitamin D (25(OH)D) deficiency in the population and its possible association with ear diseases, we aimed to investigate the 25(OH)Dserum level in patients with subjective, nonpulsating tinnitus and its effect on tinnitus severity. The study included 201 tinnitus patients and 99 controls. Patient clinical information, including tinnitus characteristics and severity according to Tinnitus Handicap Inventory (THI), loudness assessed by Visual Analogue Scale (VAS), audiometry, and the blood level of vitamin D, was recorded. The level of 25(OH)D in tinnitus patients was significantly decreased compared with the controls (19.86 ± 7.53 and 27.43 ± 8.85 ng/ml, respectively; P value < 0.0001). More patients in the tinnitus group were deficient in vitamin D, compared with the controls (50.7% vs. 22.2% respectively, p < 0.0001). Tinnitus patients with a lower serum level of 25(OH)D (≤15 ng/dl) were significantly younger, had a higher degree of tinnitus severity measured with THI and VAS scales, had higher triglyceride and TSH levels, and a lower HDL level compared with individuals who had higher 25(OH)D level (>15 ng/dl). There was a strong correlation between the 25(OH)D level and THI. Our findings suggest that a large proportion of tinnitus patients suffers from vitamin D deficiency and that the vitamin D level correlates with tinnitus impact. We recommend a vitamin D assessment for all tinnitus patients.

The Role of Diet in Tinnitus Onset: A Hospital-Based Case-Control Study from Italy

“…Diet, specifically the Mediterranean one, could have a role in prevention of tinnitus onset and partly explain the relatively limited prevalence of tinnitus in areas of the Mediterranean basin [ 7 ]. This is confirmed by various researchers who postulated a potential protective influence of certain foods on tinnitus onset or annoyance [ 8 , 9 , 10 , 11 , 12 ], either Mediterranean food items (fresh fruit and vegetable intakes [ 10 ]) or other nutrients (reduced intake of vitamin B 2 and B 3 [ 8 ], chocolate intake [ 9 ], and improved intake of vitamin D [ 11 ] and manganese [ 12 ]), leading to preventive recommendations and, in some circumstances, even treatment recommendations, through dietary supplements. However, to date, there is no conclusive evidence to support the latter recommendations.…”

Serum Vitamin D Concentration Is Lower in Patients with Tinnitus: A Meta-Analysis of Observational Studies

“…In all three studies and four cohorts, the serum value of Vit D was found to be lower in patients with tinnitus than in those without, with WMDs ranging between −1.45 to −7.57 ng/mL. The pooled analysis performed using the quality effects models confirmed a significantly negative WMD of Vit D concentration in patients with tinnitus compared to those without, with a WMD of −6.2 ng/mL (95% CI, −10.3 to −2.1 ng/mL; I 2 , 56%), though such difference was largely determined by the study of Nowaczewska et al [ 18 ], expressing the largest sample size ( n = 300) ( Figure 1 ).…”

“…After excluding replicate publications among the three scientific search platforms, a total of 72 articles were originally detected using the predefined criteria and by hand-searching the reference lists, 69 of which ought to be eliminated because they did not present a comparison of serum Vit D levels in patients with or without tinnitus ( n = 29), did not assessed tinnitus ( n = 16) or Vit D status ( n = 5), lacked a control group of subjects without tinnitus ( n = 3), were review articles ( n = 11), editorial material ( n = 3) or case reports ( n = 2). A final number of 3 studies (all observational, case-control), with four cohorts and totaling 468 patients with ( n = 268) or without tinnitus ( n = 200) were finally included in our meta-analysis [ 16 , 17 , 18 ]. The main characteristics of these studies are summarized in Table 1 .…”

Serum vitamin D concentration is lower in patients with tinnitus: a meta-analysis of observational studies

“…In all three studies and four cohorts, the serum value of Vit D was found to be lower in patients with tinnitus than in those without. The pooled analysis performed using the quality effects models confirmed a significantly negative WMD of Vit D concentration in patients with tinnitus compared to those without (WMD, -6.2 ng/mL; 95%CI, -10.3 to -2.1 ng/mL; I 2 , 56%)m, though such difference was largely determined by the study of Nowaczewska et al [18], expressing the largest sample size (n=300).…”

“…After excluding replicate publications among the three scientific search platforms, a total of 72 articles were originally detected using the predefined criteria and by handsearching the reference lists, 69 of which ought to be eliminated because they did not present a comparison of serum Vit D levels in patients with or without tinnitus (n=29), did not assessed tinnitus (n=16) or Vit D status (n=5), lacked a control group of subjects without tinnitus (n=3), were review articles (n=11), editorial material (n=3) or case reports (n=2). A final number of 3 studies (all observational, case-control), with four cohorts and totaling 468 patients with (n=268) or without tinnitus (n=200) were finally included in our meta-analysis [16][17][18]. The main characteristics of these studies are summarized in Table 1.…”