Pulsatile tinnitus - You Are Not My Doctor

January 31, 2023 1:06 PM

I will see my doctor about this but it's so bizarre that I was wondering if anyone had experienced anything similar.

I've been experiencing pulsatile tinnitus (rare, not necessarily a great sign) intermittently over the past year, but have only read enough to start worrying about it recently.

It only happens when I get stressed at work.

I thought this might be the case but wasn't sure until today, when I got done with a short, intense workout that raised my blood pressure while listening carefully for the ear pulsing - nothing. I'd never noticed it during intense exercise and today was no exception. Sat back down at my desk, got an email from someone who never, ever, ever does the due diligence that they are supposed to do despite being a long-time staffer and there it went, pulse beating in one ear.

Every time I hear it, it's when something frustrating (not even worrying, almost always just frustrating/annoying) happens at work. I cannot believe that my blood pressure is spiking so much while sitting quietly at my desk that it exceeds the blood pressure rise from a HIIT workout. Since I started reading about it, I've been listening out for it, too, so I don't think that it's constant and I notice it only when I'm stressed.

Have you ever experienced anything like this? Is there anything that could be causing it that would be present for stress/irritation and not for exercise?

posted by Frowner to Health & Fitness (10 answers total)

I cannot believe that my blood pressure is spiking so much while sitting quietly at my desk that it exceeds the blood pressure rise from a HIIT workout

You don't have to "believe" one way or the other, check the data. You could get a blood pressure cuff and check your blood pressure both when this sort of work event happens and after exercise.
posted by yohko at 1:29 PM on January 31, 2023 [3 favorites]

I had this and it was caused by anemia. Not one doctor figured that out, and doctors I've since mentioned it to have been surprised. It was intermittent - I can't remember if stress made it worse. At any rate, do get your hemoglobin checked just in case.
posted by FencingGal at 1:29 PM on January 31, 2023 [3 favorites]

I have had pulsatile tinnitus when I had cholesteatomas. These are benign tumors that grow in one's middle ear and the pulsatile tinnitus was prettty diagnostic for it for me. You should go see an ENT - first step to diagnose will be a tympanogram looking for negative pressure in your ear. For me it had nothing to do with stress or high BP. Good luck.
posted by leslies at 1:30 PM on January 31, 2023 [3 favorites]

My understanding of pulsatile tinnitus is that there is a noise you're hearing (unlike regular tinnitus) but either the sound is different or your brain is noticing it more.

Regular tinnitus is often affected by stress and anxiety and that's due to stress influencing how you perceive the sound. It would make sense to me that rather than your blood pressure spiking due to stress, it could possibly be your brain paying more attention to the sound input due to stress.

As for whether it is pulsatile tinnitus or not, measure your pulse while you're hearing it and see if the two synchronise. Either way, go and see a doctor - I don't think you're supposed to ignore any rhythmic tinnitus.
posted by plonkee at 1:33 PM on January 31, 2023 [2 favorites]

I have patulous eustachian tube, a harmless annoying condition that occasionally causes a bit of pulsatile tinnitus; mostly I get the typical "hearing your voice in your ear while speaking" symptom. I have talked to an ENT doctor, read some papers on it, measured my blood pressure with a cuff at home and tracked the results, and I still don't know why it tends to happen when I'm hungry and/or dehydrated. Harmless disorders tend not to get a lot of attention in medical research. But I don't mind, because I know I'm ok. I hope you are able to see a doctor soon.
posted by dreamyshade at 1:56 PM on January 31, 2023

Yup, I had pulsatile tinnitus due to idiopathic intracranial hypertension. My intracranial pressure was high due to CSF not draining properly and venous stenosis. I always found a correlation to it being worse in periods of high stress even though I don’t have high blood pressure.
posted by msladygrey at 6:55 PM on January 31, 2023

This week I'll be making an appointment with an ENT thanks to that suggestion. I've had tinnitus for years, but it's worse in my right ear and that's also the side where it pulses. I've only been able to distract myself with background noises.
posted by emelenjr at 7:21 PM on January 31, 2023

Get the data for sure. I didn’t realize I was hypertensive after exercise until I did a stress test. It may be that the endorphin rush / good cardio vibes after a workout are distracting you from awareness of the tinnitus. If you’ve had Covid, as I’m sure you know, that’s been implicated in all kinds of cardiac issues in people of all ages.
posted by cotton dress sock at 7:58 PM on January 31, 2023

I don’t have the scientific reason, but I have pulsatile tinnitus when I am on Lexapro, and not when I am off it. I’ve been on and off enough times to be sure this is true. I cannot find anything in the literature describing why the PT could be related to neurotransmitters, but there it is.
posted by Knowyournuts at 10:38 PM on January 31, 2023

I’ve had pulsatile tinnitus the last few years. Sometimes noticeable because of some kind of blood pressure spike, sometimes because of the angle of my head, sometimes just because. I got it checked out by my GP, an audiologist, and an ENT, and in my case they all just shrugged - no harmful root cause, just the blood vessels and/or bits of my ear moving or changing shape with age.
posted by threecheesetrees at 4:06 AM on February 1, 2023