Six Months Ago My Hearing Was Normal — Now I Have Significant Hearing Loss

Hi Guys,

I just went to Boots to get fitted for ACS Custom earplugs. They said due to the pressure in my right ear that they couldn’t fit them. However, since I was there, they said that they would do a hearing test.

I had my hearing tested in July 2021 and my hearing was within normal ranges but now I have significant hearing loss. I have no idea how this happened. What do you think? Was my tinnitus just a precursor to the hearing loss?

This is my audiogram now. I’m in complete shock. Only just turned 30.

 

I would not say that's "significant" hearing loss, but I bet sometimes you have trouble with speech in noise or the "cocktail party" effect. It's enough loss to make your ears and brain work more, and work harden when decoding sound; that sort of work will get you tired at the end of a long day.

If you have sensorineural hearing loss, the perceived quality of your hearing may depend on whether the hair cells for the damaged frequencies (those after 2 kHz, where your audiogram drops) are amplifying sound or not. This is a bit hard to explain, but basically if you are in an empty and silent room and can hear sharply a clock ticking, or there is sharpness in the sound of an aircon machine, you should be fine.

On the contrary if there is like a void of sound in those situations, or the sound is perceived dimmed, flat or devoid of richness, then things are not going well...

The drop at 4 kHz may be related to noise trauma. Do you remember any episode with loud noise that could have produced that?

My audiogram is similar to yours in the high frequencies. These are some considerations:

- The decibel scale is logarithmic, so the first 10 dB of loss are not the same in terms of volume than the next 10 dB, 20 dB, 50 dB. The lower it gets, a larger chunk of "volume" is lost. It is a logarithmic curve.

- In my case I can feel very different from one day to another, having a similar audiogram. So let's say your audiogram at 6 kHz (input of sound) is more or less the same than last month but somehow the perceived quality of sound is much worse... so similar audiograms, very different perceived quality of sound.

- Speech is at the medium range of the frequency range, so you should be ok with it for now. The more background noise there is, the more complicated it will be to understand what it is said.

- High frequencies are key to discriminating sounds or speech in noise. So with an audiogram that drops at high frequencies it should be harder to make out the different instruments of a song, or a classical music piece, or to appreciate the different layers of sound.

 

Hi, thanks for the reply.

There was no significant noise trauma at the onset of my tinnitus. I hammered a few nails into a raised bed in an open outdoor area. However, I was taking Doxycycline at the time and was diagnosed with Shingles a few days later.

Should have clarified, I do not mean significant in terms of the severity of my hearing loss. Just that there has been a significant drop - I started at 0 dB in July and am now near enough -40 dB 6 months later. I’m scared this trend will continue.

I would describe the hearing in my right ear as ‘flat’ and there is such an intense pressure. My left ear does not bother me at all, even the tinnitus is lighter. I could live happily with 2 left ears but the right is so uncomfortable.

 

Did Shingles affect your eyes or face?

"Shingles oticus, also known as Ramsay Hunt syndrome type II, involves the ear. It is thought to result from the virus spreading from the facial nerve to the vestibulocochlear nerve. Symptoms include hearing loss and vertigo (rotational dizziness)."

Shingles - Wikipedia

Can you notice clearly the direction sounds are coming from?

I mean, if a cellphone rang in a crowded room and everyone was using the same ringtone, could you tell where the cellphone is ringing.

Did you notice any sudden drop of hearing at any time? This has happened to me as an instant reaction to loud noise, and sometimes it happened by itself, out of the blue, without any known reason. In my particular case there is a light-headed feeling, tinnitus and then a sudden drop of hearing. Normally my hearing comes back to baseline after these episodes but in one or two occasions it did not come back to baseline and my perceived quality of hearing worsened.

 

Around the time of my Shingles all my teeth were sore on one side - resolved around the same time as the rash (was prescribed an antiviral). There was nothing wrong with my eyes though and the rash appeared on my torso.

I did have issues 2 months after the infection - dizziness with a sensation that I was about to faint, my vision would black out during these times. This has resolved for the most part, however, I have noticed that I can no longer tolerate going on a swing (I have a young daughter), it makes me feel lightheaded and gives a spinning sensation.

If a noise is on my right side, I have a harder time placing it, but I do ok. Impossible to answer your question though, due to COVID-19/my onset of tinnitus, I haven’t really been in any crowded places.

I haven’t noticed a sudden loss of hearing but a while back (2 months), I remember that I couldn’t hear the radio at my normal volume and had to turn it up 2 notches.

My main worry is AIED as I already have two autoimmune conditions.

Out of interest, have you tried hearing aids? The audiologist I saw today mentioned they could be helpful for masking the tinnitus.

 

Ok, just had that temporary change in tinnitus, where the noise disappears and then comes back. This time my tinnitus (typically a high pitched eeeeee) went away and has come back as a very loud hiss in my right ear. This has never happened before. Should I be worried? Did the pure tone audiogram cause damage?

 

This is me. When my tinnitus started in 2017, the loss was around 30/50 dB.

 

What caused the loss?

 

No, I have not tried them, as all my hearing problems stem from severe hyperacusis.

Hearing aids are also not recommended when hearing is very good at lower frequencies and worse (mild - moderate hearing loss) at high frequencies. The brain would have a hard time adjusting to the hearing aids, and it could produce worse hyperacusis. That's what my ENT said, and also my personal guess as a hyperacusis sufferer (although I have not tried hearing aids myself).

 

No, an audiometric test cannot cause damage.

Tinnitus is very unpredictable, and it may change in pitch and volume. That happens all the time...

 

Can you hear without hearing aids?

I mean, how do you cope with hearing loss? What are your strategies to adapt?

 

Weird, this is the first time it has ever happened to me. Same tone going strong for 7 months.

 

Tinnitus is very individual. In my particular case it changes all the time, and sometimes I do not hear it. It is not my main problem. For me it is like the flip side of hearing loss. Tinnitus is linked to hearing loss.

Baseline tones may stay the same for some time, with small daily differences, and they can change due to a number of reasons, like noise exposure, inflammation, etc They may react even to what you eat... tinnitus is very individual.

 

Firecracker explosion when I was child.

But I had no tinnitus at that time. Tinnitus appeared 26 years later

 

Ah man, I feel for you, this shit really sucks.

Out of interest, has your tinnitus increased in line with your hearing loss?

Do you wear a hearing aid?

 

You struggle more with the hearing loss? Or something else? Do you have a feeling of pressure/fullness? For me the pressure is the worst part of this whole ordeal.

I woke up this morning and my tinnitus is back to normal. Very scary experience since it’s the first time my tinnitus has ever changed.

Makes you wonder, if it’s damage to the inner ear, how can that tone that I’ve heard for 7 months just disappear?

 

I used to have an extreme feeling of pressure and fullness due to my hyperacusis reacting to loud noise.

In the last few months I have permanent fullness, but it is not as extreme as before, it's like a dull feeling of pressure that is constantly there.

Now hearing loss is my main issue as trying to understand what others are saying, TV, phone conversations etc makes me feel very tired every day.

My personal guess is that maybe there are a couple of different elements malfunctioning. Haircell damage, which impacts on brain processing of sound, and maybe on other ear and brain structures. This is subtle at the beginning and becomes more obvious when hearing problems get worse.

 

Sorry to hear you are also struggling with this pressure sensation. I have dull pressure around 60% of the time but sometimes it gets intense for a few days then dies back down. Out of interest, have you noticed a pattern to your fullness? I find mine is much better In the morning, makes me wonder about whether it’s caused by hearing loss.

I’m sorry to hear you are struggling so much with your hearing loss. I take it you have had a recent setback the past few months? Was it caused by noise? I hope doctors can at least do something to help you.

 

At the beginning, pressure was linked to the hyperacusic "cycles". In pain hyperacusis this means that after being exposed to a very loud sound, even if brief, the ear "closes" and one gets pressure, pain etc for different lengths of time depending of the severity of the exposure, the pitch and vibration to the sound etc etc... This can last for a few weeks in the worst cases, only after a brief sound as I say, like being exposed to a power tool, a car honking nearby, a siren going off unexpectedly and sounds like that, loud sounds.

In the last months, what's worrying me is that there's pressure but this is not linked to any objective loud sound, as I have been very careful and in general have been ok with sound. I have been around medium sound for many hours a day, though, conversation (in Spain many people talk quite loud), radio etc... so I could put my symptoms down to hearing fatigue. That could be a reason. Still, it is shocking to me, as I (sadly) have a lot of experience with hyperacusis.

No, that's the weird thing... no obvious setback, and still pressure all the time.

My ENT said that hearing aids are not an option since my low frequencies are very good, although there is a drop in my high frequencies. My feeling is my hair cells for the high frequencies are not amplifying and modulating sound anymore.

My guess is even damaged hair cells can amplify sound, maybe producing a worse balance and pitch than healthy hair cells, but still driving a lot of input to the brain. It's like hearing a certain sound but distorted, or at a different pitch, so one can hear maybe 8 kHz but the quality of sound seems lower, of a lower sound...

Amplification and modulation is important. This means in a silent room sounds are enhanced, and also there are mechanisms (mechanical, in the middle ear, plus some help from hair cells) that make us perceive sound a bit lower (to protect the ear) when the volume is loud. So when this system is altered due to hair cell damage the brain gets a bit crazy...

 

Yes, the pressure is what worries me the most. I feel the longer it stays, the more damage is done. I am having such an uphill struggle trying to be seen by anyone on the NHS. After 7 months I have just given up and am now loaning money for a private ENT. In the time I’ve waited I have dropped 40 dB of hearing, will be one of my biggest regrets in life.

Have you repeated your audiogram since the worsening began? My hearing loss did not show in the first month. I also had no obvious noise exposure.

Obviously I don’t know your full circumstances, and your ENT is no doubt the best person to decide what you need specifically, but I’ve been reading that open fit hearing aids are used for people with only high frequency hearing loss. Did he mention any reason why these would not be suitable? Is it the hyperacusis?

I am a little confused about whether you still suffering from hyperacusis? You mentioned you used to get ear fullness related to this which makes me think it has improved/gone away. However, you also mentioned that hearing aids could make it worse. Is your ENT worried that hearing aids will bring your hyperacusis back?

Sorry if you have explained this already, I am not the best reader and sometimes struggle to follow.

 

Yes, I have audiograms very often. However, slight differences in audiograms may mean big differences in perceived quality of sound. This has to do with the processing of sound, and I don't think it can be assessed objectively by any test other than the speech in noise test... but that test still has its limitations. No test will be able to explain the changes in the perception of music for instance...

Yes, I am still suffering from hyperacusis, but it seems less severe because now there is hearing loss.

Yes, my ENT is worried that hearing aids mess up with my hyperacusis and tinnitus, and are not so beneficial for my high frequency hearing loss.

One thing I am very thankful for... are subtitles. Now everything has subtitles, so it is easier to follow TV programs. My brain does not have to struggle with sound and with volume setting. I just read the subtitles, hear the speech, and the brain fills the gaps.

A piece of advice: listen to music and try to remember the tunes. I think it is a good exercise for the brain, and this will also help to appreciate music if your hearing deteriorates further. If you know a piece of music, if you have heard it a few times before when you had good hearing, your brain will fill the gaps even if you no longer hear all the instruments, layers or sounds in the future.

 

Terrible combo hearing loss and sound sensitivity. Worst of both worlds. I have sensitivity, but only to my daughter’s voice (of all things).

I really appreciate you taking the time to chat to me about this, I feel completely in the dark about what’s happening to me right now. Good to speak to someone who’s been there.

I’ll have to get back into music, I’ve almost completely stopped listening to it since my tinnitus onset. Hearing tinnitus over the top of my favourite tunes makes me so frustrated. I’d love to get some enjoyment out of it again.

I hope you don’t mind a last couple of questions. Has your ENT mentioned the likelihood of the pressure/fullness sensation getting better over time? Also, how long did it take for your hearing to deteriorate? and at what age did it start? I’m very nervous about the rapid decline in my hearing, especially since I’m relatively young.

 

No, because ENTs don't have a clue about what causes this. For instance, if one is exposed to very loud noise and this triggers hyperacusis for the first time, then the pressure one gets afterwards is obviously derived from the noise. However, it is harder to explain why it stays over the years, and why it sometimes disappeared, or why lately it got permanent... because here there is not always an obvious trigger...

But I guess it is the same for tinnitus fluctuations in pitch, tone, and volume: ENTs do not know why that happens. And you will see through the forum stories of people who, after suffering tinnitus for a long time, suddenly experience a big change in pitch, tone, or volume, for no known reason.

It took many years. I was very careful when my ears after getting severe hyperacusis. However, my hearing started getting worse when I was around 37, so quite young in this sense...

The drop in high frequencies your audiogram shows would correspond normally to someone in his late fifties, I think. I mean, if there were no previous history or noise exposure at work or recreational (concerts or loud venues etc).

Nowadays ENTs look at the "new normal" and they say "there's not much hearing loss" or "it's a bit worse than normal for you age but not too bad"... the thing is ENTs have had to review their own book, and their own standards, because there is an epidemic of people with serious hearing problems at a young age, due to noise being everywhere from the supermarket to any seemingly quiet street where are very loud motorbike goes by...

So a drop in high frequencies, or a drop in all frequencies to -25 dB and even -30 dB is discarded as the new normal. ENTs will tell you it is not a great audiogram, but maybe it's the average audiogram of our times, saturated by noise.

 

Ah, I won’t get my hopes up then! I would be happy if the ENT could at least rule a few things out, AIED in particular. As I said, I had no noise exposure, and my audiogram was fine 3 weeks after the shingles and tinnitus onset. The loss and fullness happened at a time where other rheumatoid symptoms were rearing their ugly head.

I can deal with worsening pain, but my hearing, that’s different. I am a 30-year-old female so I hope this loss is not defined as ‘normal’.

 

No, your audiogram is not normal for your age...

 

Thanks for all your help. I really hope things improve for you going forward.

 

Hi @Juan,

I got another audiogram done to measure conductive loss. My audiologist said I do not have any conductive loss, just SNHL. I’m a bit confused about why the triangles are higher up. I take it this gap is within normal ranges?

Anyway, you seem to know your way around an audiogram, what do you think?

 

Sorry to butt in here! But out of interest, does the latest audiogram frequency/dB loss correspond with the one back from late January?

 

I suppose it would help if I uploaded the image lol! Would appreciate your input.

 

Not at all. The more the merrier!

I got an audiogram done in July 2021. At this point I had ‘normal’ hearing (I will see if I can find the audiogram). Basically, there were no large dips, with all frequencies between 0 & 10 dB in my right ear. My left ear was my ‘bad ear’ it had the same dip of 25 kHz at 8 kHz, but 4 & 6 kHz were at 10-15 dB.

It seems on paper like noise damage, but hammering nails outside is hardly an acoustic trauma that warrants such a noticeable shift in hearing. Maybe cumulative noise exposure? Or maybe being on Doxycycline made me more susceptible to noise damage? An ENT ruled out shingles. He also said it could be autoimmune. Anyone’s guess really...

I hope this answers your question? Don’t really know what you meant by correlation lol.