Hearing Loss and Noise Exposure Regarding Tinnitus

[Lisa88]

Hi Dr. Nagler,
Does having tinnitus make us more susceptible to hearing loss from loud noise exposure?
I have always thought the answer was no.
But in the first year or two of tinnitus, our system can be on red alert, which may or may not have an effect on the tissues and cells surrounding the auditory nerve and hair cells of the cochlea. Possibly the glutamate caused by this stressed state can also create a more vulnerable system.
Or, for chronic patients, a vulnerability has already been created in the peripheral/central auditory system. Would this not leave it therefore more exposed to loud noises?
To clarify my question above - maybe a person with tinnitus would be more vulnerable to hearing loss from loud noise exposure than a person without tinnitus?
What are your thoughts?
Thanks, Dr. Nagler.
Lisa

 

[Dr. Nagler]

Hi @Lisa88 -

You ask:

"Does having tinnitus make us more susceptible to hearing loss from loud noise exposure?"

...............

Well, the truth is that nobody knows the answer for sure. My strong suspicion is NO - especially because in a completely silent environment most everybody will detect tinnitus! So what we are really talking about here is a matter of degree. Still and all, nobody really knows. It may be that having tinnitus does indeed make folks more susceptible to noise-induced auditory damage. Or not.

But as I see it, there is a very important takeaway for you and for every other tinnitus sufferer who wonders about the same thing. And that takeaway is: What difference does it make? I mean, regardless of where the truth lies, the fact is that you are not going to change your behavior one bit, nor should you. Whatever the answer is, you are going to continue taking reasonable precautions to protect your auditory system from noise-induced auditory damage, right? You are not going to do more if the answer is YES, and you are not going to do less if the answer is NO.

So, since the answer is irrelevant, why even ask the question! Indeed, pondering such things is an example of unnecessarily devoting time to your tinnitus. You necessarily devote enough time as it is, right?

I am nonetheless very glad you asked - because it is precisely the kind of thing I will be talking about in a piece I will be posting on this Doctors' Corner forum in the next day or two in response to a question about obstacles to habituation. So please stay tuned.

All the best -

Dr. Stephen Nagler