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Left to right, Karie Ryan, Michele Acito, Katelynn Blackburn and Lisbeth Votruba shared insights into the nursing profession with Fox News Digital. Two other nurses shared thoughts as well.  (iStock/Karie Ryan/Michele Acito/Katelynn Blackburn/Lisbeth Votruba)

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You’ve likely felt your heart beating in your chest after strenuous activity — or have taken your pulse by placing your fingers on your wrist or neck.

A less common — and sometimes startling — sensation is to actually hear the “whooshing” sound of your heartbeat in your ears.

Fox News Digital reached out to two doctors to learn more about what causes this and whether it’s a cause for concern.

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Hearing your heartbeat in your ears — also known by the Latin name “pulsatile tinnitus” — isn’t always a sign of a medical problem, but it could warrant a discussion with your physician, according to Frederick James Meine, M.D., an interventional cardiologist with Novant Health in Wilmington, North Carolina.

“Many people hear it at one time or another, especially when they are lying down on their side,” Meine told Fox News Digital.

What causes the condition?

Hearing your heartbeat can be related to ear issues such as wax buildup, fluid in the ear or other hearing issues, Meine said.

The most common cause is Eustachian tube dysfunction. This is usually due to allergies, according to Jesus Lizarzaburu, M.D., a family physician with TPMG Grafton Family Medicine in Yorktown, Virginia. 

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“The Eustachian tube connects the middle ear to the back of your nose, and when it is blocked or doesn’t open and close properly, it can cause the sound of your heartbeat to be heard in your ears,” he told Fox News Digital.

Another culprit could be earwax buildup, which can also cause a seal in the ear canal that makes the heartbeat easier to hear, Lizarzaburu added.

Elevated blood pressure is another cause, though less common.

Hearing your heartbeat can be related to ear issues such as wax buildup, fluid in the ear or other hearing issues, a doctor said. (iStock)

On rare occasions, medications like non-steroidal anti-inflammatories (NSAIDs), antibiotics, diuretics, chemotherapy medications, aspirin, certain antidepressants, quinine and antivirals can cause tinnitus, a ringing in the ears that is in rhythm with the heart rate, noted Lizarzaburu. 

“Extremely rare causes would be an aneurysm (a bulge in a blood vessel in the brain) or a vascular tumor, which is made up of a collection of blood vessels,” he added.

When to seek medical attention

A thorough physical exam, including a blood pressure check and an examination of the carotid arteries in the neck, is an important part of gauging overall cardiovascular health, Meine advised.

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“In addition, ruling out anemia or hyperthyroidism, both of which could cause increased blood flow and possibly contribute to pulsatile tinnitus, could be evaluated with simple lab tests,” he said.

If someone experiences the condition intermittently, it is likely less worrisome, the doctor noted. 

A thorough physical exam, including a blood pressure check and an examination of the carotid arteries in the neck, is an important part of gauging overall cardiovascular health, a doctor advised. (iStock)

“However, if it is persistent or new-onset, we would perform a complete history and physical exam,” he said. 

From a cardiovascular perspective, if someone is experiencing pulsatile tinnitus or hearing their heartbeat in their own ears, Meine said it’s important to rule out any potential cardiovascular issues.

The doctor would also make sure the patient does not have a blockage or narrowing of the neck arteries, which could contribute to louder heart sounds in the ears and head, he said.

“I do want to stress that most of us occasionally hear our heartbeats in our heads and ears, especially when our heart rate is increased during exercise,” Meine said.

For more Health articles, visit www.foxnews.com/health.

• Nicotine alternatives like 6-methyl nicotine in vapes may be more addictive than nicotine, according to the FDA.
• These synthetic substances are not regulated by U.S. tobacco and vaping laws that control traditional nicotine.
• Traditional nicotine is derived from tobacco leaves, while 6-methyl nicotine is synthesized in labs using chemicals.

Nicotine alternatives used in vapes being launched in the U.S. and abroad, such as 6-methyl nicotine, may be more potent and addictive than nicotine itself, though the scientific data remains incomplete, according to the U.S. Food and Drug Administration (FDA) and independent researchers.

The synthetic substances – which have a chemical structure similar to that of nicotine – are not subject to U.S. tobacco and vaping regulations that are designed to control traditional nicotine, a highly addictive drug.

That means manufacturers can sell vapes containing synthetic nicotine analogues such as 6-methyl nicotine in the United States without seeking authorization from the FDA – a process that can be costly, time-consuming and is often unsuccessful.

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Big tobacco firms like Altria Group and British American Tobacco have already lost substantial U.S. sales to an influx of disposable vapes containing traditional nicotine that are being illegally sold without FDA authorization.

Altria, the maker of Marlboro cigarettes in the United States, highlighted the emerging use of 6-methyl nicotine in vapes and other smoking alternatives in a May 9 letter to the FDA, according to a copy of the correspondence posted on its website.

It urged the agency to evaluate the compounds and establish what authority it had over them, warning they posed a “new threat” to regulation of the sector.

“The introduction and growth of chemicals intended to imitate the effects of nicotine, if left unchecked, could present unknown risks to U.S. consumers and undermine FDA’s authority,” the letter said.

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It cited SPREE BAR, a vape launched in October by Charlie’s Holdings Inc that uses 6-methyl nicotine.

The FDA does not comment on its correspondence with individual firms.

In response to Reuters’ questions about 6-methyl nicotine and other nicotine alternatives, the FDA said in a statement: “Although more research is needed, some emerging data show these nicotine analogs may be more potent than nicotine – which is already highly addictive, can alter adolescent brain development and have long-term effects on youth’s attention, learning and memory.”

Traditional nicotine found in many vapes and pouches is extracted from tobacco leaves. 6-methyl nicotine, in contrast, is made entirely in the lab using chemicals.

The FDA said it was considering the use of such synthetic compounds from an “agency-wide perspective” and would use all of its resources to protect youth from products that may harm their health. As well as tobacco products, the FDA also regulates drugs, foods, cosmetics and more to ensure safety and efficacy.

“The FDA is a data-driven agency, and we’re in the process of reviewing the available data to inform potential actions in this space,” it said in response to Reuters’ questions.

Three academic researchers told the news agency that current studies of 6-methyl nicotine are too limited to draw definite conclusions on the health impact or to what degree it is addictive.

Imad Damaj, a professor in the Department of Pharmacology and Toxicology at Virginia Commonwealth University, said his research showed 6-methyl nicotine may be more potent than nicotine, but more extensive tests were needed to say what impact it has on humans.

The limitations of existing research included that some papers were industry funded, while others focused on the short-term impact on animals or cells and were insufficient to understand 6-methyl nicotine’s effects on human bodies, the researchers said.

Charlie’s Holdings calls the 6-methyl nicotine solution used in SPREE BAR Metatine. SPREE BAR’s website says Metatine “may have a toxicity profile similar to nicotine”.

SPREE BAR promises users 6,000 puffs from each device and offers fruity flavors including “blue razz ice” and “creamy melon”, according to its website.

The FDA has yet to approve any flavored vape using traditional nicotine for sale in the United States, saying companies have not been able to show that the health benefits they offer to smokers outweigh the known risks to young people, who may be more attracted by the flavors.

Charlie’s Holdings co-founder Ryan Stump told Reuters that the company only targets adults, adding that flavors played an important role in its mission to help smokers quit cigarettes.

Stump said Charlie’s Holdings respects and abides by laws in every market where it operates. He acknowledged that more research is needed on 6-methyl nicotine, adding that the company dilutes it in its products.

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Anes Saleh sells SPREE BAR in his vape shop in Denver, Colorado, called Sultan Smoke. He said he has some customers who only buy Spree Bar instead of a nicotine vape and he hasn’t had any negative feedback on the product.

“The only… protest I would hear about people not wanting to try this is that they don’t know what Metatine is or does,” he said.

Stump said that Charlie’s Holdings is working on new varieties of SPREE BAR and new products using 6-methyl nicotine. It will launch SPREE BAR internationally this year. He declined to say where.

The company buys the 6-methyl nicotine solution used in SPREE BAR from another U.S. firm, Novel Compounds, according to Novel Compounds’ founder Samuel Benaim.

Novel Compounds imports 6-methyl nicotine from overseas and alters it to make it easier for manufacturers like Charlie’s Holdings to use in their products. It sells this solution under the trade name imotine.

Tests commissioned by Novel Compounds have found 6-methyl nicotine to be no more harmful than nicotine, Benaim said. But he also said that more research was needed into the chemical.

Benaim added that Novel Compounds had received legal advice that its product is not classified as a tobacco product or drug in the United States. The company is committed to legal compliance, he said.

MORE POTENT THAN NICOTINE?

Sven Jordt, a professor at Duke University, who has authored papers on products like SPREE BAR, said 6-methyl nicotine could me more addictive and toxic than its traditional cousin.

“Do we want to have such a chemical as a recreational product, available to anyone?,” he asked. “That’s really questionable.”

Neither Jordt nor Damaj – the professor at Virginia Commonwealth University – have received funding from tobacco or vape makers.

As well as the United States, Novel Compounds also sells its 6-methyl nicotine solution around the world, including in the United Kingdom, Indonesia, India and Japan.

Another company, Aroma King, sells 6-methyl nicotine in the United Kingdom in pouches, which users insert under the lip to get a buzz. The pouches are sold in cans emblazoned with graphics of gorillas in suits and sunglasses.

It said in a February blog post that its 6-methyl nicotine products were “less toxic”, “less harmful”, and “less addictive” than regular nicotine products.

In a statement to Reuters, Aroma King cited existing research, its own toxicology and other tests and its supplier, which classifies 6-methyl nicotine as less toxic under the European Union’s Classification, Labelling and Packaging of Substances and Mixtures (CLP) Regulation.

Aroma King said 6-methyl nicotine was self-classified by its supplier. It declined to say who supplies it with the chemical.

Four Chinese companies hold patents in China related to the production of 6-methyl nicotine, including Zinwi Biotech, a company that makes the liquid used in vapes.

Zinwi Biotech confirmed it is researching 6-methyl nicotine but did not answer further questions, including on whether it has sold any 6-methyl nicotine so far. Reuters was unable to find contact details for the other firms.