Reactive Tinnitus — Removal of Reactivity. Is It Possible?

Very sorry to hear that, @GBB.

How's your loudness hyperacusis?

And is your reactivity unchanged, both in terms of spikes and distortions?

 

Hey @GBB, I read somewhere across these forums that you had a good experience with Nortriptyline. Just curious if you tapered off and why?

 

Yes it can improve.

The underlying cause of reactive tinnitus is usually noise induced tinnitus and having some oversensitivity to sound or hyperacusis. It can improve over time using self help by gradually being exposed to sound, or using white noise generators under the guidance of an audiologist as counselling maybe required.

Michael.

 

@GBB, I may have asked already but does your reactivity spike for a period of time or does it go back down once the external sound is lowered/removed?

 

White noise and any raining sounds or crickets I used to play at night on my small Marshall Kilburn amp (and had good success before tinnitus became reactive), now even at very low volume seems to make the tinnitus spike and it almost feels painful. The sounds compete with the tinnitus.

So what do you do in this case?

 

@Travis Henry, I have reactive plus bad tinnitus. I think you slowly have to introduce sounds again. I use sound generators with pink noise (very low volume). Sometimes for some hours and sometimes for a full day depending on how I feel. If I feel sore in my ears the next morning, I rest. Then I try again. And again. I do not know what else to do. I let my ears have a break from sounds during night/sleeping. At least until I can tolerate the sound generators all waking hours. I also use medication for sleep and to control my anxiety.

If you want good guidance how to reintroduce sound, read posts by @Coffeebean and @MindOverMatter.

They both suffered from bad reactive tinnitus.

 

For the time being, just use natural sounds. White noise can be very irritating for the auditory system. Are you able to sleep without earplugs?

Wish you well,
Stacken

 

@Stacken77, what natural sounds do you typically use? From Spotify? Did you try pink noise?

 

I'm not able to sleep on general sadly. My tinnitus has gotten really bad and is so high pitched and piercing.

 

Hope you’re doing better from your last big spike.

 

I'm not quite there yet, but by "natural sound" I mean anything but artificial audio, from speakers. It could be sleeping without earplugs, or opening a window and letting in the high frequency sound from the outside nature. I've always been especially sensitive to colored continuous noise, and I believe there are studies showing that it can be counterproductive for tinnitus. But if anyone tolerates it, then it's probably fine and will do its job of desensitization.

Wishing you well, David.
~Stacken

 

Please just let my reactive tinnitus go awayyyyyyyyyyyyy! Omg so tired of wearing hearing protection 24/7 and all sounds amping my tinnitus up.

 

Why wear hearing protection all the time? That will only make you more sensitive to sounds. I can understand wearing them when exposed to loud noise/sounds but other than those times it's not advisable to wear them. It's important to find a way over time to make your ears less sensitive to noise.

 

I try this in my home, not wearing earplugs or earmuffs and it makes my tinnitus roar so loud by end of day.

 

Mine amps up daily but yea I let sound in and you may have to.

 

Yeah I let sound in daily. Yesterday I just said fuk it and took off all protection in my room. Tinnitus burned up to a banshee howling by end of day. Took 2 mg of Clonazepam to put me down & even that didn't quiet the tinnitus at all. I just finally fell asleep to it. I dunno how to survive this, but I am battling everyday. Everyday is pure hell.

 

I understand. You may just have to let bits and pieces at a time. Tinnitus is always gonna spike until the tolerance goes up. If it starts causing any pain, back off.

 

I would like to ask you for some advice. I'm very much new to tinnitus (after middle ear infection) and it became now what I think is reactive tinnitus. In the silence I have "almost" silence, my tinnitus is mild, high frequency hiss/squeak. But every little sound (every click on my desktop, every breath of my boyfriend sleeping beside me, every move of bedsheet, voice of friend... everything) make it louder and more intrusive. Like a broken speaker. It keeps me awake in the nights (I tried to sleep with earplugs and earmuffs, unsuccessfully so far).

I try to protect my ears in a loud car, but I don't wear earplugs outside or at home as I don't want to became too sensitive to everyday sounds and spend rest of my life in a soundproof box.

Do you have any advice for me on what to do? Should I try sound therapy? (I tried nature sound, white and pink noise and shower noise, but it all made my tinnitus louder and didn't provide any relief).

Can this improve over time? Can someone please share their experience?

The only place where I can't hear it is in my shower right below the shower head.

 

Since you are new to tinnitus Eliska, my advice is to be careful taking any treatment for it. In the early stages it's usually best to allow the ears to naturally heal. If the tinnitus is caused by an ear infection, see your doctor and take any medication that is prescribed to treat it and that is all, providing you do not have acute pain in your ears, dizziness, balance problems or experience deafness.

An ear infection can cause tinnitus and it's notorious for taking time to go away so patience is required. When it does go away, the tinnitus should subside too. Using low level sound enrichment can help to stop you focusing on the tinnitus especially at night. Please click on the links below and read my posts: New to Tinnitus, What to Do? Tinnitus, A Personal View.

Before the onset of your tinnitus, if you regularly listened to audio through headphones, earbuds, AirPods, headsets, noise cancelling or bone conduction headphones, then the tinnitus might also be noise induced which is one of the most common causes of tinnitus. It is possible to have an ear infection that causes tinnitus but you have mentioned it is reactive to sound.

Reactive tinnitus is not a medical condition. A lot of people that complain of reactive tinnitus the underlying cause to this oversensitivity to sound is hyperacusis which can vary immensely between people. Tinnitus usually accompanies it and both conditions are brought on by exposure to loud noise or the person has been a regular user of the type of headphones mentioned above.

If you haven't been exposed to loud noise and you're not a regular user of any type of headphones, then it's unlikely the tinnitus is noise induced.

All the best,
Michael

New to Tinnitus, What to Do? | Tinnitus Talk Support Forum
Tinnitus, A Personal View | Tinnitus Talk Support Forum

 

This is just so not true Michael, I read you saying this all of the time but reactive tinnitus is not always hyperacusis. It can be separate, and often is. I don't have hyperacusis, I had my LDLs tested and they were within normal range. Nothing sounds too loud to me. How would you explain that?

People have tinnitus that rides over everything. My tinnitus is quieter in a quiet room. AC sets it off, as well as riding in cars, etc.

It can come from many different things, not just hyperacusis.

 

Although I find Michael very helpful and knowledgeable, I can sympathise somewhat with you @BrysonKingMe. I've spoken with a few people who have not (or at least told me) been exposed to prolonged loud sound. In particular A LOT of them developed tinnitus that is reactive after a COVID-19 infection or one of the COVID-19 vaccines. They have been told by audiologists it's hyperacusis, however in many cases this has occurred without exposure to loud noise. So what is the mechanism at play here? Is it hearing loss/damage to the auditory system that has ramped up central gain? It seems that the source of damage may be irrelevant to the development of reactive tinnitus/hyperacusis.

I suppose if you break your leg, it doesn't make much difference whether it's a car accident or football tackle; the end damage is a broken leg.

 

In my opinion there is no such thing as reactive tinnitus. It was a terminology made-up in tinnitus forums many years ago and has now become common place. I have no qualms with anyone that chooses to use this term, I just think they are making living with tinnitus more difficult for themselves.

I have read your first post to this forum and you say: When you first got tinnitus it was from gunshots. This proves my point, the underlying cause of this so called reactive tinnitus, is a result of exposure to loud noise, or using headphones at too high a volume which usually causes noise induced tinnitus

I wish you well,
Michael

 

I will say this. Hyperacusis takes many forms. Whether it be loudness, pain, or reactive. Doing a lot of reading and just gathering data from a lot of folks this is what I have seen so far for TRT in treating it.

Loudness hyperacusis: TRT usually benefits this group the most from what I’ve seen. Others just recovered with time.

Reactive hyperacusis: TRT worsens sometimes because reactivity does not like the digital audio and rides on top (my experience). I have seen some benefit from TRT and others got worse. I think a small methodical approach to protecting and allowing sounds when hyperacusis is lower may be beneficial in this category. Just imo.

Pain hyperacusis: almost all TRT I’ve seen for this category does not help. Almost all need silence until healed, then gradual introduction to sound.

Also true nature sounds > digital sounds for recovery. However, most of us have to get to a point where our brains can allow sounds for long periods of time in order for TRT to really have any effect, like you say with in-ear generators.

 

I mean no disrespect, but believe the main reason you are having so much difficulty with your tinnitus and hyperacusis, is because you spend too much time reading about these conditions instead of directing your thoughts to more positive things and getting on with your life.

I have explained many times that tinnitus is an integral part of our mental and emotional wellbeing and so is hyperacusis, until it is treated and cured. The more time you devote to reading up on these conditions, the more you reinforce negative thinking which is no help to you at all.

As you think, so shall you become.

Michael.

 

Yeah maybe, and yeah it is a problem to obsess. Not going to argue you there, it’s a bad habit I need to stop.

 

I had non-reactive tinnitus for 10 years and had no idea that there was such a thing. Now, just a few minutes of music from my high quality phone will make my tinnitus louder.

The nerves are very weak. You have to make the hearing nerves stronger.

 

I’m starting to align myself with this take as time goes by too. It’s been slightly over a year and while my loudness hyperacusis has downgraded to mild, almost cured at times, the reactivity can still be ever so prevalent however.

I think your reactive tinnitus is similar to mine where the reactivity will instantly get triggered by a continuous sound source. Let’s use your AC as an example because the same applies to me too. When the AC is on and running, the tinnitus will compete with the AC noise. The higher the fan speed, the more louder your tinnitus will get instantly. But once you turn the AC off, your tinnitus will instantly go back down to a lower baseline. There’s no lingering spikes. Sometimes there could be a spike, but more of less that’s not the case (for me at least).

This kind of reactivity is instantaneous and depends on certain types of noise in your surroundings.

 

No, I got tinnitus in 2016 and it faded to 0.1%. Never noticed it, ever. Even if I tried to hear it, I wouldn't be able to hear it. Nothing would spike it, ever.

I got reactive tinnitus from benzos. And this woman got reactive tinnitus from an ear infection.

You do not know everything sir, and you need to respect that it is a real condition that people suffer badly from, or else you are doing everyone a disservice.

 

How?

 

I have never said I know everything but will say, I have a lot of experience with noise induced tinnitus and hyperacusis. I have counselled and corresponded with many people affected by these conditions.

With respect, I want to advise you that tinnitus never completely goes away, particularly when it is noise induced, even though it may appear to do so, it is still there in the background operating at a very low level. Therefore, your original tinnitus which was caused by gunshots in 2016, was still present but because it was at a very low level made its perception difficult.

Your so called reactive tinnitus which is an oversensitivity to sound (hyperacusis) is a result of further noise exposure which doesn't necessarily have to be loud. If you have been using any type of headphones since 2016 or attended places where loud music is present or worked in a noisy environment, it would have been only a matter of time before your noise induced tinnitus would have returned.

Your underlying problem is noise induced tinnitus with hyperacusis or having over sensitivity to sound. The solution is treatment. I suggest you see an audiologist that practices tinnitus and hyperacusis management.

I wish you well,
Michael