Rescue Protocol After Noise Exposure?

[withintention]

I'm wondering what people recommend as a "rescue" protocol after noise exposure to reduce hearing loss and tinnitus.

I currently use NAC. Do people recommend steroids, and if so, which ones? Is there anything else that might help?

I've had severe unilateral tinnitus for over a year and usually use a headset on my "good" ear. Four days ago, the volume was way too high when I put the headset on, and I got about half a second of what seemed like more than 100 decibels. Now I'm starting to hear ringing in my good ear.

 

[Pseudonymmed]

NAC, NAD, Resveratrol, and Magnesium have all shown some promise in studies on noise exposure. Antioxidants in general are not a bad idea. It is important to avoid any further noise exposure.

Corticosteroids like Prednisone can potentially help, but they must be taken as soon as possible. After a few days, the likelihood of them helping is greatly reduced. They also carry a number of potential side effects and may temporarily worsen tinnitus for some people.

 

[PeteJ]

How long should NAC and Magnesium be taken, and at what dosage?

 

[RattleKat]

I see this a lot. Steroids are absolutely brutal on the body and should not be taken lightly. They can help reduce inflammation in the inner ear to reverse hearing loss and improve thresholds after severe acoustic trauma, such as an explosion or standing in front of 130 dB speakers at a gig for hours, because those situations can cause damage to the stereocilia.

A 100 dB sound for half a second, however, isn't going to cause damage. There's no mechanism for the steroids to act on. If the hearing system were that fragile, the entire world would already be deaf. There would be no drummers, no rock musicians, and no construction workers.

In my opinion, it's more likely to be a spike caused by an overactive nervous system that has come to associate sound with danger. Not all spikes mean physical damage has occurred. I think the best approach is to try to stay calm, exercise, stay hydrated, and prioritize sleep. NAC has shown promise in preventing noise-induced hearing loss, but it won't reverse damage that has already been done.

 

[PeteJ]

I see this a lot. Steroids are absolutely brutal on the body and should not be taken lightly. They can help reduce inflammation in the inner ear to reverse hearing loss and improve thresholds after severe acoustic trauma, such as an explosion or standing in front of 130 dB speakers at a gig for hours, because those situations can cause damage to the stereocilia.

A 100 dB sound for half a second, however, isn't going to cause damage. There's no mechanism for the steroids to act on. If the hearing system were that fragile, the entire world would already be deaf. There would be no drummers, no rock musicians, and no construction workers.

In my opinion, it's more likely to be a spike caused by an overactive nervous system that has come to associate sound with danger. Not all spikes mean physical damage has occurred. I think the best approach is to try to stay calm, exercise, stay hydrated, and prioritize sleep. NAC has shown promise in preventing noise-induced hearing loss, but it won't reverse damage that has already been done.

I think the potential problem is when the hearing or ear condition has already been compromised by damage. If there's been injury in the auditory system, that's when the risk grows. Still, your evaluation makes sense, and it's my hope that it applies in my case, especially.

I'm worried because I don't recall having a spike like this for quite some time. I know I've had one similar to my latest, but it was a long time ago, and I don't remember whether it went back to baseline or if I just adapted. There wasn't much I could do about it then. What I don't want is to get worse now, because I was already struggling with how things were.

With the current spike, I'm waiting for it to settle down. Most of my recent spikes have settled relatively quickly, but I don't think I'll be that lucky this time. I really hope you're right that a loud sound around 100 dB, like a truck dumping salt in a garage, for just half a second (twice) won't cause damage. I believe it's mostly damage that shifts a baseline, although my overactive nervous system might prolong the spike. But in the end, it should still return to baseline. I hope so. :-/

 

[racedy]

Hi, this is my protocol:

1. If noise exposure is over 120 dB, or if it has caused significant pain, muffled hearing, or much louder or new-onset tinnitus, contact your ENT or doctor. In some cases, it may be best to go to the ER or urgent care to discuss the use of steroids. Peer-reviewed literature shows that oral steroids can be useful if started within 24 hours of acoustic trauma.

2. Magnesium has also been proven in scientific and medical literature to help. One study used around 168 mg, but the recommended daily allowance is 300–400 mg. I usually take 400 mg. I primarily take glycinate, though my multivitamin contains oxide. I am not sure if the form matters. You can also get enough magnesium from your diet, as it is found in avocados, beans, and other foods.

3. Eat anti-inflammatory foods such as turmeric, fruits, and vegetables, and avoid foods and drinks that cause inflammation or disturb sleep.

4. Get enough sleep.

5. Xanax or another benzodiazepine can help if you are panicked. I once had a tinnitus spike that lasted six months because I panicked after a loud noise. I wish I had taken Xanax right away so I could have calmed down. I believe the spike was caused by my stress, because the sound was a louder buzzing in my head, not in my affected ear. After six months the spike finally eased, and the head buzz became barely noticeable.

6. Exercise, exercise, exercise. This is not talked about much, but a cardio workout really helps me after loud noise exposure. Exercise improves blood flow to injured tissues and reduces inflammation. It has also helped with other mental health issues. Endorphins make a difference. Work out long enough that you are sweating and out of breath, if possible.

7. Avoid loud noises. This is obvious for us. I wear earplugs or noise-cancelling headphones if I know I will be in any situation where there is even a slight chance of loudness, for example when walking my large dog who barks passionately at UPS trucks.

8. Avoid ototoxic medications if possible.

9. Distract yourself and get your mind off it. Watch a funny movie, talk to friends, or focus on other projects. Do not ruminate or stress. Before I had tinnitus, if I heard loud noises like jets flying overhead or power tools, I never gave it a second thought.

10. I also avoid caffeine initially, since it can make me more anxious and even cause heart palpitations. It can also disrupt circadian rhythm. However, it has never affected my tinnitus.

Good luck, and I hope this helps someone in the future.