Prednisone for Hyperacusis: Any Experiences? Natural Alternatives?

Hi everyone I'm new here. I developed hyperacusis after a loud event in early March. I left with tinnitus and my hyperacusis set in about 10 days later. I have all the symptoms, ear pain and burning, TTTS, high frequency sensitivity. Due to the lockdown I wasn't able to get into my ENT until last week. Audiogram showed no change in hearing from my last test in 2015. I asked my ENT about prednisone as I've heard some have had success with it after a similar event. Ideally this would be administered sooner but different Dr's have different theories. He wrote me a script and said it was a crap shoot for success at 9 weeks out. Another Dr I consulted said he wouldn't administer it past 30 days.

Has anyone with hyperacusis from a noise event tried prednisone with any success? If so how soon after the event did you take it? What was the mg and for how long? Has anyone had success with any natural anti-inflammatory options like Turmeric, etc?

Im not a huge fan of prednisone and it's side effects so I haven't taken it yet.

Any insight from fellow sufferers would be appreciated. Thanks!

 

Can’t comment on prednisone because I only found out about it several months into my hyperacusis. I did try Turmeric, ginger tea, and other anti inflammatory foods with no noticeable effect on my hyperacusis.

Sorry you have to deal with this too

 

While I did not benefit from a prednisone course when my tinnitus initially appeared (no clear cause) I did benefit recently from a course after a severe spike following an acoustic event. However, my first dose was less than 72 hours after said event, and while the tinnitus was permanently reduced my noise sensitivity was terrible while on the drug due to the anxiety increase. Even the most optimistic specialists I’ve spoken with say that a month or so afterwards max is the time when prednisone is useful. Personally I would explore options with less terrible side effects. I’ve never had any success with supplements though to be frank.

 

If your dose is between 40 and 60 mg per day for at least 10 days + tapering, then that is about right. Sometimes doctors prescribe something like 5 mg per day to get the patient asking for Prednisone out of their office.

Have you experienced any fading/improvement compared to how it was 6 weeks ago? If you have, then you will likely continue to heal, and you don't need Prednisone...

 

No real improvement compared to 6 weeks ago. If anything it's probably a little worse as phonophobia is starting to settle in. The vicious cycle of perceived loudness mixed with anxiety hasn't helped. My startle response is really exaggerated now too and it wasn't like that 6 weeks ago.

Not having much luck with finding any dedicated tinnitus and hyperacusis clinics in my area. I'm doing sound therapy on my own and am hoping with time things will normalize.

Thanks for your replies!

 

It's ok to be scared and try to avoid the things that have the potential of hurting you (e.g., give you a serious tinnitus spike). It seems to me that it is good that you are now taking into account that you aren't healthy any longer and acting accordingly. What you wrote above is the equivalent of a person who broke his leg complaining that he feels bad about his fear of playing soccer, like he used to do before he broke his leg.

Make sure that this therapy isn't the reason your tinnitus isn't improving. Are any of the sounds loud or very high pitched? Do you feel any ear fullness right after the sound therapy?

 

I have been on prednisone three times (my problem is unknown, but most likely believed to be autoimmune related), and have had inconclusive results. Note that I started prednisone months after my problem started.

My belief -- and this is purely speculation -- is that the prednisone is good for my ear and disease, but really bad for my brain's response. Every time I go on prednisone during a downswing, the hyperacusis and tinnitus gets worse, but right after I stop taking it, I have an upswing.

Prednisone is known to increase blood pressure and cause anxiety and other psychiatric problems. One of the reasons why it's hard to assess its efficacy is because hyperacusis patients have two problems. The first, and foremost, is inner ear damage. The second is a brain that responds very poorly to the faulty signal. Hence, it's hard to find a drug that one can say helps while on it.

For example, antidepressants calmed my brain way down, but my tinnitus/hyperacusis got worse. I am trying really hard to be patient with supplements, as I sometimes wonder if there's a "one step back, two steps forward" effect.

Ultimately though, I have no proof of my conjecture.

 

@goodfella032 -- Because of my own health history of adrenal insufficiency, I've done extensive research on the body's cortisol levels, and how they're impacted by various steroid medications. Here's a quick review of some of my baseline understanding:

The body normally makes ~40 mg of cortisol/day. Most steroid medications such as Prednisone are altered and revved up versions of the body's own cortisol molecular structure. Every mg. of those medications is roughly equivalent to about 4x the body's natural cortisol. So if you're given a dose of lets say 50 mg. prednisone, that would be equivalent to 200 mg. of natural cortisol. That's a lot, roughly 5x more than your body produces in a day.

If you continue taking that for too long, the body's adrenal glands will quit producing cortisol altogether. However, if you take less than 40 mg., (called low-dose hydrocortisone therapy), the adrenal glands will not shutdown down, but will reduce cortisol output depending on the needs of the body. I myself have been doing low-dose hydrocortisone (10-20 mg/day) for many years, with no problems.

The body normally responds to any kind of injury by increasing its normal levels of cortisol to facilitate the healing process. My best guess is it's rarely the equivalent of 200 mg, but I could be wrong. The point I'm getting to however, is that I believe it's safer to do relatively low-dose bioidentical cortisol than to do the artificially created revved up versions. BTW, each of those steroidal medications have a different molecular structure, not because they're superior, but because it allows pharma companies to have their own particular patent.

How much bioidentical cortisol to take? Based on my experiences, if I feel my body needs some extra oomph, I will increase my normal low-dose hydrocortisone. I've experimented a lot, and can easily take a total of 30-40 mg with good results. On a few occasions, I've taken 70-80 mg. for 3-5 days, again with good results (and no ill effects). It's a fair amount, but it appears to be less than normal prednisone prescriptions, and almost assuredly much safer. It also feels like it's in line with what the body might do naturally to help a healing process.

I have my own prescription of hydrocortisone (called Cortef). However, it's a relatively benign "drug" that can be purchased from online pharmacies without a prescription (at least it used to be available). If I was in a position where I was seriously contemplating temporarily increasing my cortisol levels, I would opt for the bioidentical cortisol over the souped up pharmaceutical versions. It would give me a lot more control, and the risks of side effects would be much less.

High dose Vit. C may be a possible alternative. I read this past week of people taking high doses shortly after acoustic trauma, and getting good results. I can see where it could quickly reduce inflammation, perhaps scavenge free radicals, and perhaps other things as well. I think other things could also be helpful, such as turmeric, curcumin, gingko biloba, etc. But as far as something that may have steroidal type properties, high dose Vit. C is probably the most potent.

@Michael Leigh @Hazel @Jack Straw @FGG @linearb @Greg Sacramento @Markku @Autumnly @Star64

 

Hi Bill,

Just to clarify my number one issue is the hyperacusis. Tinnitus was the immediate symptom upon my noise exposure and Hyperacusis started about 7-10 days later followed by the TTTS symptoms. The sound therapy I'm doing on my own is low level pink noise. I'm not pushing it too much until I get into an audiologist with experience treating this. My tinnitus is annoying, but the hyperacusis is debilitating.

 

@Lane I appreciate your succinct response and sharing your personal research, you've given me a lot to chew on regarding the steroid topic. As for natural alternatives, the high dose vitamin C is something I haven't heard about, I am definitely going to look into that.

I may have some more questions for you in the future as I move forward.

 

In that case, chances are that you will end up being ok. Hyperacusis (and TTTS) goes away for the vast majority of people. It goes away naturally, you don't need to expose yourself to noises in an attempt to get rid of it. In fact, many of us here (myself included) found that after we began listening to our bodies and began avoiding the noises that caused hyperacusis or tinnitus or other discomfort, that's when our hyperacusis (and tinnitus) began getting better.

The bottom line is that (unless you keep shocking your ears with the noises that it has trouble handling) you will feel better in about 6 months, a Lot better in 12 months, and hyperacusis should be gone after 18-24 months.

Be careful:
https://www.tinnitustalk.com/thread...orum-more-useful-than-your-ents-advice.28006/

 

@Zugzug thank you for your insight and personal story regarding the prednisone.

I took this as a kid up to around 20 as I dealt with asthma growing up( I'm in my mid 40s now) and hated being on it. I'm a pretty anxious person anyway and hyper vigilant on what meds I put in my body so my mind is already against it. With so many different angles one can take its hard to justify it's use in my case. If there were better evidence that it may help, and not just temporarily, I would be willing to try it and manage the side effects. It's just not one of those drugs that I would try at my age and at the stage past my incident based on a crap shoot, and so far most of the feedback I've gotten back or researched has showed a slight chance it would help.

One of the main reasons I started looking into anti-inflammatory meds was due to an incident i had about 3 weeks ago. I was about to go bed and out of nowhere I felt my left ear plug up. My tinnitus spiked on the left, my hearing on the left was muffled, and it felt like my sinuses and nose on the left side became immediately stuffed up. Not knowing what to do I took a small dose of Ibuprofen (400mg) and within an hour it was back to normal. (Normal being the regular aural fullness and baseline tinnitus I've been dealing with regularly on the left side. My hearing also returned to baseline. This got me thinking about the anti-inflammatory route and possibly something stronger. My thinking was that a possible steroid course may just knock this thing out permanently. Or a natural anti-inflammatory long term regimen may also help. Or this could just be the TTTS acting up and I had a major flare up and thats it.

 

@Bill Bauer I appreciate the optimism I'm hopeful this goes this way for me too.

My event was being at a loud night club. I wasn't there that long and was taking breaks from the loudness, but right before I left the DJ did this air horn thing over the music (air horn sound not a real air horn) and that's what did it.

I'm avoiding distressing sounds as much as possible at least in the outside world. I have a wife and 4 kids so quiet time in the house is hard to come by.

So you think sound therapy is a waste of time?

 

I remember reading a small number of posts where people said that it has helped. I also remember reading some posts where people said they got worse. You will want to play it by ear.

Personally I have had two serious (but temporary) tinnitus spikes after playing a sound of the wrong frequency too loud when watching YouTube (clips that allow one to test one's hearing as well as a clip about the high pitch sound made by old TV that had amplified the sound).

It is my understanding that hyperacusis and TTTS seldom stick around longer than two years.

 

HI @goodfella032

I am unable to advise you on prednisone because I've never taken it. However, since you have noise induced tinnitus with hyperacusis, I might be able to help you. This type of tinnitus will usually improves with time and lots of it. In order to make this process easier on yourself, I advise you to follow the recommendations in my posts in the links below. I advise you not to use headphones or earbuds including a headset to listen to any type of audio even at low volume, as you risk making the tinnitus and hyperacusis worse. It is also a good idea to keep away from overly loud sounds. Try to avoid quiet rooms and surroundings particularly at night, by using sound enrichment by the bedside at low level. More about this is explained in the links below.

All the best
Michael

https://www.tinnitustalk.com/threads/new-to-tinnitus-what-to-do.12558/
https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/
https://www.tinnitustalk.com/threads/the-habituation-process.20767/

 

I have had prednisone immediately after accidental loud sound exposure. I have tried it several times (didn't learn from my errors), both for a short course (about 10 days) and a long course of one month (this I did only once, reluctantly, on my ENT's advice).

I do not recommend it. It did nothing to help really and on a long course and a high dose it is normal not to be able to sleep well and being pretty nervous, frantic. It can also have apparently some side effects in the long run. I regret having had this medication.

Hope that helps.

 

Thanks @Bill Bauer for sharing your story and your insight. I really appreciate it.

@Michael Leigh thank you for sharing the links and for the information. I definitely won't be using anything on my ears as far as headphones, ear buds, etc. I've realized in the time I've been dealing with this that it's a slippery slope of not avoiding sounds completely, always having some type of sound around, but avoiding painful or loud sounds. It's a tight rope to walk for sure! You mention in your post about hyperacusis the following : "However, it was completely cured in two years with TRT and having counselling with a hearing therapist". Is a hearing therapist the same as an audiologist? Did you wear in ear sound generators during the day for your white noise? What type of sounds did you use at night?

@Juan thank you for sharing your story about your experience with Prednisone. Your post most certainly helps!!

 

HI @goodfella032

Thank you for your question and for taking the time to read my posts. I think they will be of help to you and suggest, you read them periodically and those that I am going to paste below as they will help reinforce positive thinking.

I live in the UK. A patient that has tinnitus that wasn't caused by an underlying medical condition within the auditory system, as in Noise induced tinnitus, is usually referred to Audiology after tests have been carried out at ENT. Here they will see either an Audiologist or Hearing Therapist depending on the way that particular NHS hospital operates. I have corresponded with many people from other countries with tinnitus and often asked, what is a Hearing Therapist? From this I have gathered Hearing Therapists are not so common abroad.

Hearing Therapy is part of an Audiology department. My Hearing Therapist practices: TRT, CBT, counselling, relaxation and Mindfullness classes with tinnitus patients. She also sees patients with impaired hearing who may not necessarily have tinnitus. An Audiologist carries hearing tests which most of us are familiar with. They issue hearing aids and white noise generators to patients. I have seen my Audiologist for hearing tests and on occasions when I need new white noise generators. Some Audiologists also practice TRT and CBT with tinnitus patients and some (not all) were either born with tinnitus or acquired it as some time in their life. My Hearing Therapist was born with tinnitus.

White noise generators are often used while having tinnitus counselling with an Audiologist/Hearing Therapist for best results. They are normally used as part of TRT. Some people may not need counselling and obtain good results using the devices to help with habituating to tinnitus and treating hyperacusis, by desensitizing the auditory system with white noise at low level. I wore white noise generators for 8 to 10hrs a day as part of TRT. At night I used an Oasis sound machine by the bedside at low level. Please click on the links below and read my posts on TRT.

All the best
Michael

https://www.tinnitustalk.com/threads/what-is-trt-and-when-should-it-be-started.19024/
https://www.tinnitustalk.com/threads/what-happens-in-trt-sessions.18195/
https://www.tinnitustalk.com/threads/acquiring-a-positive-mindset.23969/
https://www.tinnitustalk.com/threads/tinnitus-and-the-negative-mindset.23705/

 

Hi @Michael Leigh

Thank you for sharing your story and your continued insight! Also thank you for the helpful links.

Lately I've been having trouble keeping my anxiety levels low and I know this is having an impact on my lack of progress. I wake up in the morning with extreme exaggerated startle response that usually gets better as the day progresses. I'm thinking since cortisol levels are supposedly highest upon waking that this annoying high startle response is correlated. If I can get a handle on my anxiety I know I'll be able to move forward.

The problem is that once I get somewhat calm as the day progresses, my ears are usually fatigued by then and I deal with the increase in my TTTS symptoms. All the while dealing with sound sensitivity day and night.

@Michael Leigh based on your post about starting TRT after 6 months for tinnitus, do you think this is a good time frame for my situation dealing with hyperacusis, tinnitus, and TTTS? Should I wait? Just do sound enrichment on my own as you mentioned above? Thank you for your continued insight

 

@goodfella032 -- I've experienced an exaggerated startle response for many years, with it at times becoming quite severe, so I can relate to your situation. I think mine was at least partially a result of having a concussion as a teenager. Later on I contracted Lyme Disease and had other health issues that literally wracked my brain and neurological system. As such, I've explored just about every possible solution I could think of to calm my system(s) down on a daily basis. This included doing benzodiazapines for many years, which I finally was able to withdraw from over a period of 15 months. But I still needed some kind of solution, so I turned toward more natural, non-drug solutions.

I discovered many natural remedies that worked quite well for me for many years. But they were not up to the task of calming my system once it went into overdrive with the onset of my tinnitus in Feb. 2018. At that time, I doubled down on what I knew had worked for me in the past. I was also literally forced to discover whole new ways in which I might be able to better deal with the crisis of tinnitus (and a badly shaken brain) from a very bad reaction to a prescription anti-nausea medication whose modus operendi is to work on how the brain works--yikes!.

Some of my remedies have included various supplements, various physical exercises and techniques, energy and polarity balancing, etc. It's an approach that few people take, as it's not in line with the way most people think about health, healing, and relaxation. Most people are far more oriented toward going to their doctors, and taking the drugs they recommend, even though they often have very serious "side effects". I've occasionally posted some of my more natural orientations on some threads that discuss some of the problems with these drugs, but there's generally not much interest.

I've thought about starting a whole separate thread with a title of something like, "Natural Ways to Calm an Agitated Brain and Nervous System" (which is surely what tinnitus causes). But I never seem to get around to it, as it would entail putting a fair amount of effort into sharing things I've learned over many years of trial and error, and for which there may be very little interest -- I have no idea if you would be interested in some of the things I've learned, but maybe I'll just leave you with a couple of links to videos I discovered, and which have been especially helpful for me. I actually do the two techniques in videos simultaneously before I even get out of bed in the morning. -- Let me know if you'd like to hear more.

The energy exercise [for lungs] I most recommend for coronavirus health -- 7 min.

The Simplest and Most Effective Exercise For Thoracic Extension -- 5 min.

 

HI @goodfella032

Thank you for your kind comments. I would like to ask who told you that you have TTTS? are you referring to: Tonic tensor tympani syndrome? You have had Noise induced tinnitus for just over 2 months. I think you should take things easy and do not rush into starting any tinnitus treatment, especially with what's going at the moment with Covid 19. If you are feeling stressed and anxious which is understandable, then have talk with your doctor who may prescribe something to help relax you.

I think you should give yourself more time and use low level sound enrichment whenever possible and particularly at night.

All the best
Michael

 

@Michael Leigh

Yes I am referring to tonic tensor Tympani syndrome. I have all the symptoms of it. Aural fullness especially in the left, intermittent ear fluttering, the feeling of a clogged eustacian tube whereas I swallow of hear ears crackle /pop but no relief, muffled hearing throughout the day that comes and goes. I also mentioned the sinus drainage I get when my ear gets really plugged. I've had a prominent audiologist in Canada and also another doctor I've consulted with online with experience tell me this is TTTS. I've been told what I really have is Aucostic Shock Disorder. I've been to an ENT and my physical exam of my ears and pressure test were normal but he had no opinion about TTTS but said that it seemed my auditory system has been shocked and that the nerves would need time to heal.

I found a local audiologist who says he's treated hyperacusis with sound therapy but didn't mention TRT. He believes that the hyperacusis is treated separately from the tinnitus. I'm reluctant to go see him as I know from my past life experiences and others that sometimes the treatment of an ailment can sometimes make it worse, or in this case permanent. There are no dedicated Hypercusis Clinics anywhere near me unfortunately.

Thank you again for your time!

 

@goodfella032

I understand that you have already been seen at ENT and had hearing tests is this correct? If yes then I advise you not to go any further at this time. If I were you I wouldn't consult with any doctors online or see an Audiologist. Stay with the doctor that first saw you for consultation and has the results of your hearing tests. The things that you have described that are TTTS this may indeed be the case. However, when I first developed tinnitus 24 years ago with severe hyperacusis I experienced similar things to you and a lot more. My whole head was completely numb for 6 months. I could hear but everything sounded as if my head was under water, it was an awful experience.

I saw a herbalist that new about Noise induced tinnitus. She said I had suffered an acute noise trauma caused by headphones. She advised that I start taking magnesium tablets and gingko biloba. As I said the numbness lasted 6 months. When I was seen at ENT for the first time, my ENT doctor said my hearing was well above normal and asked if I was taking anything. I told him about the magnesium and GB I was taking on the advice of a herbalist. He said this was good advice and something he tells all his tinnitus patients to take.

I say again that I think you should give yourself plenty of time. If you are feeling that things are getting a little too much then have a talk with your GP/family doctor and your ENT doctor. I don't advise you starting any treatment at the moment as it's possible you could make your symptoms worse.

Best of luck
Michael

 

@Lane thank you for taking the time to share your insight I appreciate it. I am always up for and looking for natural remedies. I too have been down the benzo road and although my experience wasn't years on it, it was still hell to come off of. I know that short term it would help right now but I don't wish that withdrawal and taper process on anyone. Thank you for the links and any other insight or information you are willing to take the time to offer I appreciate it.

 

Yes I've been to ent and had hearing tests. Audiogram was the same as it was 5 years ago for my last test.

What kind or form of magnesium did you take. Was it citrate?

I appreciate you taking the time to offer your advice. Most advice I've gotten is not to wait to get professional help. Obviously as humans in pain we want a quick fix so this doesn't surprise me. There's the camp that says that if one waits, it delays the recovery process as the "natural" wait and see method can only take you so far. I am under the impression that you feel one should wait for many reasons, one being that by 6 months it could very well be resolved by then through our own at home methods? Is it just that the brain isn't ready yet to start TRT healing process?

Thank you for sharing your personal story as well. It's good to get advice from the real experts in this field, as in the ones who've been through it.

 

@goodfella032

I know how you are feeling trust me I have been there. You need to try and relax and see your doctor as I've previously mentioned if things are getting too much for you. I am impressing this upon you for a good reason. Someone I know had developed Noise induced tinnitus and it was mild to moderate. I advised this person to give himself time for the tinnitus to settle down as he was in the very early stages as you are. He wouldn't listen and kept going to ENT doctors and Audiologists until one decided to try and treat him by carrying out a specific hearing test that I cannot remember the name of. The procedure was noisy and ended up making his tinnitus a lot worse with severe hyperacusis.

Even after a year had elapsed his tinnitus did not return to mild to moderate and now he is plagued with oversensitivity to sound. This is the reason I am telling you to be careful and give yourself time for the tinnitus to settle down on it's own, so you feel better mentally and emotionally.

Michael

 

I took Magnesium citrate and followed the instructions on the bottle. The advice that people are telling you not to wait is wrong. The ear and auditory system are very delicate and the best thing you can do is leave them alone for now.

I have given you my advice and wish you well.
Take care

Michael

 

@Michael Leigh

Again I'd like to thank you for your insight and help. Taking time out of your day to help a stranger in need says alot about your character. I won't forgot those that have lent their time to help me navigate this.

Take care as well

 

You are welcome @goodfella032 You will be fine with time just take things slowly.....

 

@goodfella032 -- Check out this post: -- Before and After Pictures After Atlas Realignment