Living with Tinnitus
In this brief presentation, Dr. David Perlmutter explains that tinnitus—ringing in one or both ears—is increasingly common. He identifies two primary categories of causes: acoustic trauma from loud noise exposure and idiopathic tinnitus, which often appears in older adults without a clear origin. Perlmutter highlights a recurring clinical observation that many idiopathic cases involve markedly low vitamin B12 levels, especially in patients who use acid‑blocking medications. He describes how proton‑pump inhibitors and similar drugs reduce stomach acidity, impairing B12 absorption, and notes that B12 is essential for nerve health, including auditory nerves. Clinical improvement is frequently seen when patients receive high‑dose B12 supplementation, and he advises avoiding unnecessary acid‑blocking drugs to prevent B12 deficiency and its potential contribution to tinnitus.
