Caffeine and Tinnitus: Should You Really Give Up Coffee?
Cutting out coffee is one of the most common pieces of advice for ringing ears. It turns out to rest on surprisingly little evidence, and the best long-term data point the other way.
Where the advice came from
Caffeine is a stimulant. It raises alertness, can raise blood pressure for a while, and in some people causes jitters. It seemed logical that a stimulant would make an overactive hearing system worse, and for years patient leaflets told people with tinnitus to avoid coffee, tea, cola and chocolate. What was missing was a study that followed people over time to see whether it was true.
The 18-year Harvard study
That study arrived in 2014. Researchers at Brigham and Women's Hospital used the Nurses' Health Study II to follow 65,085 women for 18 years. None had tinnitus at the start, and all reported their diet, including coffee, tea and soda, every few years.
Over the 18 years, 5,289 women developed tinnitus. Those who took in the most caffeine were the least likely to be among them. Compared with women who had under 150 mg a day (roughly one 8-ounce cup of coffee), those at 450 to 599 mg a day had a 15% lower risk, and those at 600 mg or more had a 21% lower risk.
The authors were careful not to claim caffeine prevents tinnitus. This was an observational study of women aged 30 to 44 at the start, and coffee drinkers may differ from non-drinkers in other ways. But it made the idea that caffeine causes tinnitus very hard to defend.
The systematic review
A 2021 systematic review gathered everything published on the question. For new cases of tinnitus, the population studies again pointed to lower risk with higher caffeine intake. For people who already have tinnitus, the picture was more mixed: in one group of moderate coffee drinkers, cutting back helped a little, while heavy drinkers saw less benefit. The authors called the overall evidence inconclusive.
Why caffeine might not be the problem
Some researchers think caffeine could even help a little, since it stimulates the central nervous system and may affect how the brain processes sound. A more practical point is withdrawal. People who suddenly quit caffeine often get headaches, poor sleep and irritability, all of which can make tinnitus feel louder for a while. Advising a heavy coffee drinker to stop cold may cause more trouble than it solves.
What this means for you
If you enjoy coffee and your ringing doesn't change with it, there is no strong reason to quit. If you suspect it does affect you, test it properly: cut back slowly over two weeks, keep a simple daily log of how loud the tinnitus is on a 1 to 10 scale, then add your usual amount back and compare. Your own log is better evidence for you than any general rule. MedlinePlus has a guide to how much caffeine common drinks contain, and the 400 mg a day level most adults can handle safely.
Watch the timing too. Caffeine late in the day hurts sleep, and poor sleep is one of the most reliable ways to make tinnitus worse.
Who should still be careful
Some people do need to limit caffeine for other reasons: anyone with heart rhythm problems, poorly controlled high blood pressure, anxiety that caffeine makes worse, or trouble sleeping. Pregnant women are usually advised to stay under 200 mg a day. And if your tinnitus came with Meniere's disease, your doctor may still suggest cutting caffeine and salt, since that advice is aimed at the condition rather than the ringing itself.
Caffeine in hearing supplements
Some hearing supplements contain natural caffeine sources. Audifort, for example, includes guarana and green tea in its 22-ingredient blend. At one dropper a day, and with those two sharing a 200 mg blend with 20 other ingredients, the amount is well below a cup of coffee. Based on the research above, it is not a reason to avoid the product, though it is a reason to take it in the morning. The full label is on our Audifort ingredients page, and our verdict is in the Audifort review.
For other approaches to managing ringing ears, the American Tinnitus Association has practical guides on sound therapy and coping strategies.
Questions readers ask
Is decaf better for tinnitus?
There is no evidence that switching to decaf helps. If you want to cut back, do it gradually to avoid withdrawal headaches and poor sleep, which can make tinnitus feel louder.
Does tea count the same as coffee?
Tea has less caffeine per cup, roughly a third to a half of brewed coffee, but the same principle applies. The Harvard study counted caffeine from all sources.
What about energy drinks?
Energy drinks can pack a lot of caffeine into one can along with sugar. The research above doesn't single them out, but large single doses are more likely to cause jitters and poor sleep.