Extreme Hyperacusis and Tinnitus — Noises Trigger Dizziness and Panic

Hello everyone,

I am still quite new here, I have already read a lot, but have not yet spoken up myself.

I have been suffering from tinnitus and extreme hyperacusis for a few weeks. I can't really identify a specific trigger, but I have been listening to podcasts and music through headphones for many years. The tinnitus and hyperacusis then started during a time of stress and anxiety in my life. My tolerance for noise is now extremely low. I am at home 24 hours a day, and I have to do any activity with hearing protection. My own voice and typing on a keyboard is often too much. I can't even think about watching television.

I have no pain so far - but noises and conversations trigger dizziness and sometimes panic in me. In addition, I sometimes have a kind of echo directly after louder noises, especially in my right ear. It sounds like a kind of "swoosh". An audiogram shows no abnormalities up to 8 kHz.

My question: even though you can find some success stories here regarding hyperacusis, is it rather unlikely that it will disappear again, or does it get better after some time for most people? I have not been able to find any really reliable figures on this so far.

I wish every sufferer a speedy recovery!

 

I am sorry to know of the discomfort that you are going through with tinnitus and hyperacusis @Audigo. I am fairly confident the onset of these conditions was caused by the regular use of headphones. You were probably listening to your podcasts at too high a volume without realizing it.

One of the most common causes of tinnitus and hyperacusis is exposure to loud noise. Listening to audio through headphones, earbuds, headsets, noise-cancelling or bone conduction headphones are the main causes of this type of tinnitus. Please click on the links below and read my posts. Go to my started threads and read: Tinnitus, a Personal View, Will My Tinnitus Get Worse? The Habituation Process, How to Habituate to Tinnitus.

Hyperacusis can improve and it can also be cured. More is explained in the link below. I advise you to stop using any type of headphones, even at low volume.

All the best,
Michael

New to Tinnitus, What to Do? | Tinnitus Talk Support Forum
Hyperacusis, As I See It | Tinnitus Talk Support Forum

 

Hyperacusis does go away, either by itself and your ears being less sensitive as they relearn that the everyday sounds are not harmful.

But there are also meds that can improve, as hyperacusis is also a mental problem. In my case, Zinc, Paracetamol or Alprazolam had incredible effects on it, it completely removed it, but often just temporarily. All three meds do work on the nervous system, Zinc works as a protection and the other two as a way to calm down the nervous system.

I still would never advise anyone to take those besides Zinc, which is harmless, over a longer period of time, as you can become addicted or damage your stomach. These things are more for days when you need to get something done and are too worried about the pain in your ears.

 

Thank you @Michael Leigh and @SashaG for the quick response.

I think the next months will be the hardest time of my life, with LDLs arround > 30.

I am happy about every success story that is still posted here. Especially if it also started with such low LDLs

 

Well, if you’re not getting pain, that’s a damn good sign. Loudness hyperacusis can be distressing but I promise you will be ok. There’s only a couple cases of loudness hyperacusis who I know who are completely debilitated. I have severe pain hyperacusis so it’s much different. My pain hyperacusis needs silence for me to feel bette. The more sound there is around, the more deep, stabbing, burning, aching pain I get. Before my pain hyperacusis got really bad, my loudness hyperacusis was so severe I couldn’t touch a bad or flick a light switch, they sounded like explosions. I hate to admit it but sound therapy helped my loudness hyperacusis a lot. I hate anything inside my ears; it spikes my tinnitus every time. I used a fan next to me 24/7 and I improved a lot in certain frequencies. I overdid it and made my pain hyperacusis worse.

My opinion: I would take it easy and just wait and see if your loudness hyperacusis goes away first. If it doesn’t improve in 6 months to a year, I would try low-level sound and see if it helps. I do recommend to try and relax because overthinking it will definitely make it worse. The only time I would start to worry is if you start getting actual lingering nerve pain. I sound like a hypocrite for this but if you only have loudness hyperacusis, I do not recommend to sit at home and never go outdoors like some of us. The only reason I do stay home is because one noise will leave me in severe pain for days and permanently worsen me.

I think you have a very good chance at healing. You need to exercise, eat healthy, and distract yourself as much as you can.

Even when my loudness hyperacusis was really bad, I still went for walks at night, had a few friends come over, did things outside, and exercised. It’s when I started getting nasty nerve pain I realized it was serious and I needed to stay home or I would continue to worsen.

What turned my loudness hyperacusis into severe pain hyperacusis (noxacusis) was more noise damage, airbag deployment, then a brake screech gave me the deep lingering stabbing pain in my left ear.

Wear earplugs in environments you cannot control.

If you’re getting dizzy from sound, I would get more tests done, it could definitely be some vestibular issue. Something else could be going on here.

 

You will be alright @Audigo, so try not to worry. Read my posts in the links and those on my started threads that I have mentioned. It's better to print them and take your time to read them thoroughly. This way you will absorb and retain the information. The posts are a form of counselling, by referring to them often will help to reinforce positive thinking.

Start using sound enrichment, especially at night, and keep away from headphones.

Take care,
Michael

 

Hi @Brian Newman -- Thanks for your insightful post. I was curious however; why would you hate to admit that sound therapy helped your loudness hyperacusis?

 

Because sound therapy has made some people worse. It’s kinda 50-50 chance. Sometimes it worsens people, but others it helps. Something to be careful with. Listen to you ears; if they don’t feel right, stop. That’s very important.

 

I’m wondering if it’s the digital audio aspect of it.

 

I agree with you @Brian Newman.

Sorry to know you are still in a lot of discomfort with pain hyperacusis. Sound enrichment should be used with caution. It is something I always advise, especially with noise-induced tinnitus, with or without hyperacusis, since the auditory system in many cases is hypersensitive to sound. Saying that, in the early stages of this condition, I believe sound enrichment should be implemented as soon as possible. This can be going outside for 10 or 15 minutes at first just to get used to sounds in the natural environment. If necessary, noise reducing earplugs should be worn but only on a temporary basis.

Staying in the the home in complete silence as some people do for too long a period, without the auditory system being stimulated by natural sounds in the environment, risks making the ears more sensitive to sound. It is a judgment call only the individual can make because we are all different. The longer one restricts themselves from normal everyday sounds in the environment, or chooses not to use nature sounds from a sound machine, with the belief complete silence in the home is the answer to healing, other psychological problems can develop that I have covered in my thread: The Complexities of Tinnitus and Hyperacusis.

Please understand I am not referring to you, because the severity of your hyperacusis has reached intolerable levels, brought on by further exposure to loud noise mentioned in your post.

Michael

The Complexities of Tinnitus and Hyperacusis | Tinnitus Talk Support Forum

 

This is a good post @Michael Leigh, explaining the issues of the 'natural' intrinsic urge to go for silence versus the 'logical' extrinsic option to expose the ears to natural sounds.

If you remember @Bill Bauer, he was quite an advocate of silence to promote healing, effectively the antithesis of your advice. Does anyone know what happened to Bill Bauer? Did staying in silence work for him?

Did staying in silence, and I mean really committing to it for months, work for anyone?

A sound machine in the corner of a room producing nature noises in the background does seem harmless enough. But what if the person is sensitive to digital/loudspeaker sounds?

It's such a complex problem and, as you always say, Michael, no two people react the same. It means we need to make difficult choices, knowing we could be gambling the delicate state of our auditory system, for better or worse.

 

Thank you for your comments @Jupiterman. I remember @Bill Bauer fondly, and want to say I miss reading his posts on this forum. Even through Bill and I never always agreed, I admired him because he was always respectful towards me and I told him more than once that he behaved like a true gentleman.

At times I thought Bill was being overzealous, when advising people to immerse themselves in total silence when they complained about hyperacusis and being oversensitive to sound. This seemed to work for Bill when he was in the early stages of noise-induced tinnitus with hyperacusis. With great trepidation he gradually worked towards re-engaging his auditory system to accept normal everyday sounds.

When outside he always had noise reducing earplugs and earmuffs on this person, to guard himself from any potential sound that he deemed to be harmful, especially if a police or ambulance was coming towards him with their siren blaring. I remember Bill saying supermarket trolleys could be incredibly noisy, and therefore he would wear earmuffs and he didn't give a hoot whether people looked at him strangely.

Bill often remarked about the high noise levels that electric hand driers created in washrooms, and advised people to use earmuffs when using them or give them a wide berth and use paper towels instead. I agree, those electric hand driers can be very loud. Even though I have been cured for many years of hyperacusis, If I have the option of using the paper towel, I do.

I hope Bill is doing well and nothing untoward has happened to him.

All the best,
Michael

 

@Audigo,

I am sorry that you are going through this. I went through severe hyperacusis with tinnitus about 2 1/2 years ago. Mine could have been caused by several things, but the trigger was when my son yelled as loud he could in my ear. I'm not sure why, but it affected both ears (I went to the dentist right after). It was during the start of the pandemic and I was quite stressed, my husband was yelling 24/7 with a barking dog and homeschooling my child.

I started holding my ears when my husband would talk loudly and he made fun of me. He said you are holding your ears like a child. What a jerk. I have tried to move on and forgive, but that's another conversation.

I could not tolerate any sound. Footsteps were too loud for me. Crumpling trash bags, slamming of car doors, closing the door to the refrigerator (which my family does all day long), slamming doors in and out of the house and closing the door to the microwave were all too loud for me. I had several hearing tests and went to several ENTs (useless) and one otologist (next to useless). I think the lack of empathy and treating this as if it were a psychological illness rather than an injury to the auditory system was one of the most difficult aspects to this condition.

I cried every day and I concluded that I was going to have to move on. I also stopped taking a medicine for an autoimmune, in case it had caused the injury (Hydroxychloroquine) and started a strict diet protocol called AIP-Paleo. I had all the usual symptoms, headaches, jaw pain, tooth pain, ear pain, feeling of ear fullness, muffled hearing and a warm sensation in my ear.

I started to leave the house more with earplugs. I ordered musicians earplugs and would wear them anytime I left the house. I started to drive again. It was quite freeing to be able to drive a car again and take my son to school. I started to experiment with different environments to see what I could tolerate.

I was feeling much better, until I received the vaccines. After the vaccines, I experienced vertigo and dizziness with a double ear infection. I also had severe neck pain. This was the first time I had experienced vertigo or daily dizziness.

I decided to apply for a doctoral program and apply to teach at the college level. I was not quite ready to do either one of these things, but I felt I needed to focus on goals rather than obsess about hyperacusis and tinnitus. I had to attend orientation and classes on campus about 4 hours from my house. We were also required to stay on campus. I wore my headphones and earplugs and made it through, even when the fire alarm went off in the dorms.

I am half way through my doctoral program and will start writing my dissertation this summer. This is also my 4th semester to teach college It has not been an easy road, but it is much better. I attend most activities and school functions for my child. I avoid places with loud environments, but I do not panic if I encounter one. I can watch TV at a lower volume and I listen to podcasts in the car. I still wear earplugs outside the house, but my life is relatively normal with a few modifications.

Best to you,
twa

 

I tried early on with sound therapy and over time just got more reactivity. My sound tolerance improved but I struggle with continuous noise and digital sounds. I protected only when I needed to, I was positive, I worked with an audiologist who follows Jastreboff protocol and unfortunately my reactivity never improved. I never preach only silence but it seems silence usually calms it for a bit.

 

Again, this is a judgement call that only the affected person can make. All I will say, whilst silence gives you temporary relief from your reactivity to sound, this is not a long term solution. There is also the risk of lowering the loudness threshold of the auditory system which can make it more sensitive to sound.

Please read @David S's recent posts. He once had immense difficulty listening to sound enrichment and using white noise generators. He followed my advice and didn't give up and decided to take things very slow. He has improved a lot and his oversensitivity to sound has reduced considerably. Two years ago @Eleanor89 was having a lot of difficulty with hyperacusis. Talking on the telephone required placing a piece of cloth over the earpiece during conversation, otherwise her tinnitus and hyperacusis would spike and reach very painful levels.

She was also under the care of an audiologist but was unable to wear the white noise generators. She followed my suggestions, to get used to using a sound machine first at night, then slowly introduce the white noise generators. At first she could only wear them for a few minutes but her patience and resilience has enabled her to get her life back.

We are all different so I encourage you to keep on trying. It doesn't matter how many times you fall, keep trying and eventually you will succeed. It took me 4 years to habituate for the second time. My ENT consultant said I was the second worst tinnitus patient she had met in all her years as an Audiovestibular physician.

I wish you well,
Michael

 

Thanks man. I’ve been trying. Even putting on sound in another room with high quality speakers. It’s tough because the piercing can be painful when it reacts. I’ve tried to associate a positive response to sounds, but my subconscious knows I’m pushing through and I feel it makes it worse? My brain pushes my tinnitus pretty loud in silence anyways.

 

I know you have been trying @Wrfortiscue and I realize what you're going through is very difficult. Can you please tell me your daily routine if you have one? Do you leave your home and go to work, or work from home? If you're at home all the time, are you able to leave the house and go for a walk? You mentioned being under the care of an audiologist, is this online or do you have face-to-face consultations? Are you taking any medications? I realize some of these questions are personal.

All the best,
Michael

 

Hi @Wrfortiscue -- Are you saying you're experiencing a piercing sensation while doing some sound therapy? It doesn't seem to me that would be good, and should never be the case.

 

A real discussion has developed here, very nice!

I wanted to give a quick update: my "good" right ear is 5-10% better today than yesterday. I was able to watch 30 minutes of TV at the lowest volume. Left ear still terrible.

Tinnitus screams very loudly.

Bad news: it could be Lyme disease, I hadn't considered that at the beginning. I was bitten by a tick in October. Blood has now been taken.

Have a good start to the week!


Thank you @twa you for your encouraging words!

I appreciate it very much and hope that you will continue to be successful on your way at university!

 

I had an audiologist from Treble Health. She has over 15 years of experience treating hyperacusis. She was one of the speakers in the Tinnitus Relief Summit and they follow Jastreboff's teachings. Her name is Tracy Holcomb.

https://tinnitusreliefsummit.com

I can go for walks and drive with earplugs. I do spike. Digital audio causes bad reactivity and it never used to. I can tolerate some louder sounds, just specific frequencies do me in. Phone audio blasted me yesterday by accident and my left ear got burning pain and tinnitus went haywire.

I do work from home. I speak in meetings and use a higher quality speaker.

If I push digital audio too much, the reactivity just gets higher in frequency until it feels like a piercing sensation.

 

Hi @Audigo -- There's a lot of political and financial interests involved in Lyme testing. I hope you're not getting the conventional test done by most doctors and health care facilities, which is notoriously unreliable. I would encourage you to research Lyme testing, and which ones are the most accurate.

You also might want to research Lyme Literate Medical Doctors (LLMDs). Even they, however, often have differing advice on how best to test and treat it. The Lyme picture is very complex, and I haven't kept up with it all. What I do know is a person really has to do their homework to keep up with things, and learn to separate the wheat from the chaff.

BTW, I had two different Lyme tests about 5-10 years apart that came up negative. Then without any additional tick bites, I, a few years later, tested positive for Lyme when using a different test. In the meantime, the Lyme bacteria continued to wreak havoc on my body. HBOT eventually seemed to turn a significant corner for me.

 

I have above the ear pink/white noise generators (I listen to pink noise). One of my audiologists recommended setting the volume to just below the tinnitus while another one said to set it at “whatever volume is comfortable for you.” They are both trained in TRT. Do you have any thoughts on the volume? My generators go up to 20 dB (which is like a whisper), but they are playing sound very close to my eardrum/auditory system so it seems much louder. I have been setting them so that they are barely audible in a very quiet room (like an interior closet), but I would not say that this is “just below the tinnitus.” I would have to turn it up much louder to get it just below it (almost to the point of masking the tinnitus).

 

Hello @Lane, thank you so much for your reply.

What they did was an IGM/IGG antibody test and now I have the results: both are negative.

I don't know what that means...

 

I realize that you are having a lot of difficulty at the moment. The fact that you are under the care of an esteemed audiologist, that specialises in treating tinnitus and hyperacusis is concerning, because it appears you are not making any improvement. Unfortunately, the information in your post is not enough for me to advise you in the way that I would like. This not your fault but can be a problem when corresponding in writing. You are not a newbie having had tinnitus since 1999.

I will assume that you suffered a second noise trauma at some time that caused your tinnitus and hyperacusis to increase. Whilst you seem to be able to manage the tinnitus, it is the hyperacusis that is causing you most of the problems in terms of spiking, when your auditory system is subjected to certain sounds, which some people refer to as reactive tinnitus.

If I am correct, I believe you have a form of variable tinnitus with severe hyperacusis. This is my interpretation of what is affecting you although it's not a known medical condition. I refer to it in my thread: Can I Habituate to Variable Tinnitus? It usually affects people that have habituated to noise-induced tinnitus, for a year or more then suffered a second noise trauma. This condition varies between people and isn't easy to treat but it is possible, because I habituated after my second noise trauma even though it took 4 years.

Sound therapy, counselling and possibly medication is the solution for this condition. You have mentioned being under the care of an audiologist and I suspect, you have had online meetings. Online tinnitus counselling might benefit some people but it's not something I recommend for you, as I don't believe it can ever be as good as face-to-face counselling, especially as your condition is acute.

I mean no disrespect to your audiologist, but does she live with tinnitus and has experience of it being severe? In my opinion, unless the tinnitus therapist lives with tinnitus and has experience of it being mild, moderate and severe, the counselling will not be of the highest quality. This is important because tinnitus can affect a person's mental and emotional well-being considerably. Therefore, the only way one can understand tinnitus and to be able to empathise and counsel someone affected by it is to live with it themselves. Tinnitus cannot be learnt from a book or taught at medical school in any great depth. This is the reason so many people with tinnitus complain about ENT doctors, not being able to understand what they are going through. ENT doctors treat underlying medical conditions that cause tinnitus in the auditory system, but they do not treat tinnitus.

After my second noise trauma, I was unable to listen to my Hi-Fi system for over 2 years even at low volume. I felt so down about this I boxed up all the equipment and placed it in my loft so I wouldn't be tempted to use it. I bought a small Bose Wave radio with CD player. This unit replayed music in very high quality and didn't irritate my tinnitus. I wasn't suffering from hyperacusis after my second noise trauma.

As you work from home, try taking some breaks from work to go outside for walks. Use your noise reducing earplugs to help you get used to normal everyday sounds. Gradually work towards using the earplugs less but do this slowly. In addition to this, I suggest you return to basics by using a small sound machine, the type sold by Sound Oasis. Model S-680-2 is good, their top model is S-5000. Use it while working at your computer during the day and at night by the bedside. Once you get used to using low-level sound enrichment and your tinnitus and hyperacusis don't spike, then I suggest to slowly introduce the white noise generators.

Please print the posts in the links below and take your time and read them. They explain variable tinnitus and how to use sound therapy using a sound machine and white noise generators.

All the best,
Michael

Can I Habituate to Variable Tinnitus? | Tinnitus Talk Support Forum
Sound Enrichment and White Noise Generators | Tinnitus Talk Support Forum

 

Does this help?

Could you give the model of your speaker?

 

Hey man,

Sorry to hear things are still awry. Everything you describe in terms of how your ears are behaving I'm having exactly the same experience. So rest assured; you're not alone with this.

To give a bit more perspective to the online consultation thing; I've had two face-to-face meetings with senior audiologists in the NHS whose professional titles pitch them as being expert in tinnitus and hyperacusis management. When I've described my symptoms (same as the ones you're having) to them, however, I've unfortunately been met with glazed expressions on both occasions. It's soul-destroying but I think absent any objective measure for tinnitus or physiological imaging for hyperacusis, it's just not possible for a clinician to really get a handle on what we're dealing with.

At NHS point of care we have a modicum of choice when it comes to who treats us, however, applying tight criteria in public healthcare when finding a specialist may not be realistic, especially as the NHS (in my area at least where audiology is concerned) is essentially broken.

The obvious alternative therefore, is online.

It's taken quite a bit of fishing around but I've finally made contact with a tinnitus/hyperacusis management audiologist who's suffered with loud tinnitus for a long time. This person also worked for many years in the NHS. I'm definitely going to take that next step in private treatment at some point but I must absolutely satisfy myself first that the person on the other end of the Internet is best placed to help me get the most out of it.

I remember when you started with Treble Health. I don't want to denigrate them but I have misgivings about the operation because I get a sense that their approach is a bit cookie-cutter. Nuanced cases like yours and mine need a more creative and experiential approach - and dare I say it - perhaps an older audiologist who's been round the block a few times with this. At least that's my take on it.

 

Your experience @UKBloke, @Wrfortiscue's, mine and others' that I have corresponded with is not unusual after habituation has been reached, then suffered a second noise trauma and developed what I call: Variable tinnitus. This condition is unusual and quite unique because it has many variables. I became aware of it over a period of time after counselling people with noise-induced tinnitus who had suffered a second noise trauma.

My audiologist was born with tinnitus and I have a lot of respect for her because she understands this condition. However, she openly admitted to me, when I suffered a second noise trauma and my tinnitus changed dramatically to what I now refer to as variable tinnitus, that she rarely sees patients with my type of tinnitus.

Michael

 

I think what I did wrong was just keep pushing through reactivity and piercing pain and it made me worse. That's the only thing I could think of. It would fatigue my ears, and then I would be clumsy and drop things further messing me up.

New strategy for now is:

1. Avoid digital audio.
2. Walking will be my sound therapy for now.
3. Try to slowly introduce pink noise or whatever from another room when I feel I'm ready to.

Yeah man, I don’t really know what to do lol, let me know how they treat you.

 

Try not to worry about what you did in past. Wipe the slate clean and return to basics. Start using a sound machine for low-level sound enrichment. When you are comfortable with this, slowly introduce the white noise generators.

 

Will do.