Schubert, Nick M A, Rosmalen, Judith G M, van Dijk, Pim et al. · Hearing research · 2021 · DOI
This study looked at how common tinnitus (ringing in the ears) is in a large group of Dutch adults and found that about one-third experience it at some point. The researchers discovered that tinnitus is linked to various conditions including hearing problems, heart issues, depression, and notably, chronic fatigue syndrome (ME/CFS). Understanding these connections may help doctors better treat tinnitus and related conditions.
This large population study identifies chronic fatigue syndrome as a novel disease associate with tinnitus, suggesting shared biological mechanisms between ME/CFS and this common auditory symptom. For ME/CFS patients experiencing tinnitus, this work provides epidemiological evidence that their symptom cluster is recognizable in the general population and warrants investigation of common underlying pathways. The identification of inflammatory and autoimmune disease associations strengthens the biological rationale for investigating immune mechanisms in both conditions.
This cross-sectional study cannot establish causality or determine whether ME/CFS causes tinnitus, tinnitus causes ME/CFS, or whether a third factor causes both. The study relies on self-reported tinnitus and historical disease data rather than objective audiological testing or prospective follow-up, limiting confidence in temporal relationships. The associations identified do not explain the mechanisms linking these conditions or whether interventions targeting one condition would benefit the other.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Schubert, Nick M A, Rosmalen, Judith G M, van Dijk, Pim, & Pyott, Sonja J (2021). A retrospective cross-sectional study on tinnitus prevalence and disease associations in the Dutch population-based cohort Lifelines.. Hearing research. https://doi.org/10.1016/j.heares.2021.108355
BibTeX
@article{mecfsatlas-schubert-2021-retrospective-cross,
author = {Schubert, Nick M A and Rosmalen, Judith G M and van Dijk, Pim and Pyott, Sonja J},
title = {A retrospective cross-sectional study on tinnitus prevalence and disease associations in the Dutch population-based cohort Lifelines.},
journal = {Hearing research},
year = {2021},
doi = {10.1016/j.heares.2021.108355},
note = {PubMed: 34607212},
url = {https://www.mecfsatlas.com/evidence/schubert-2021-retrospective-cross},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/schubert-2021-retrospective-cross
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