Struggling to Cope with Tinnitus and Hyperacusis — All Connected to My Digestive Issues

My name is Diego, a CBT psychotherapist living in London, although I have been on sick leave for many months & now in Spain, seeking the support of my family.

My story:

My tinnitus started around 5 years ago after a stomach surgery to treat my acid reflux. It was both a low level pulsatile and a low pitch tinnitus that I only could only hear at night and if I covered my ears. I did not think much of it. However after this surgery, I had many symptoms such as dizziness, sweating, fatigue and sinusitis that were related to digestion. My doctor told me that there may have been some irritation or damage to the vagus nerve in the esophagus and put me on an antidepressant (Citalopram) to calm it. And it worked! These symptoms gradually went away, including tinnitus.

Two years after, I came off the antidepressant and within a month, the tinnitus returned but then with a new high pitch ringing that would gradually become severe over time.

I thought there was link between my digestive problems and the tinnitus so I took different antidepressants: Citalopram, Sertraline and Mirtazapine, but stopped them because they would make my tinnitus more intrusive. Huge disappointment. My digestive problems gradually got better, however the tinnitus got worse.

Interestingly, in November 2020, I had another stomach operation and just after, my tinnitus improved a lot (I could not even hear it) for 2 months and I'm pretty sure it was related to the general anaesthesia. It slowly got worse. I feel my tinnitus is very connected to my digestion. It gets louder after I eat anything (while I doing my digestion), even drinking water increases it for about half an hour. I avoid eating fats, alcohol, sugars or acidic food because it increases it a lot. I follow a very clean diet, as I don't feel I have a choice. Does anyone relate to this?

I have been to an ENT who examined my ears and everything is normal. I also had an MRI that showed that everything is normal except for a slight intrasellar arachnoidocele herniation, which apparently is nothing related to tinnitus.

My tinnitus gradually became more severe, affecting my sleep. This is when it impacted on my work and my general wellbeing. I decided to take a break from my life in London and stay for a while in a Spanish village with my family, seeking their support.

There are a few things that that improve my tinnitus: sleep well, long conversations (for hours).

In September 2021, I developed hyperacusis after opening a plastic vacuum sealed container with a knife. The sound felt similar to a gun shot (but not that loud). I then felt it in my ears (like an echo). My tinnitus became louder and sounds got louder too and uncomfortable, I started having strong headaches. That is when I stopped working & have been on sick leave since.

I tried to get help, engaged with a psychotherapist as well as a TRT audiologist. They focussed on a few ideas: these sound traumas have not caused any damaged in my ears, I should not protect my ears (only in certain situations i.e. building work) and I should work on my emotional response to sounds, ignoring triggers and symptoms.

However during the TRT treatment I suffered a few traumas (dog barking, car door closing, child screaming). I had very painful headaches daily and really struggled to cope with my tinnitus. At times, I could not tolerate my mother's voice and had to leave the room. I also struggled with my sleep and started using Clonazepam daily. I had no choice. Obviously, the TRT treatment aiming to gradual expose myself to environmental sounds was not working. The idea that 'if others can cope with certain sounds, I should do too' could not apply to my experience as sometimes, listening to low volume tv could trigger a set back. The psychological interventions would not help - mindfulness. It was clear to me that I was in a difficult cycle of having more sound traumas and then more sensitive nerve systems and so on.

Next, I decided to go to a neurologist and a psychiatrist. I started a course of two antimigraines (Flunarizine 5 mg and Pregabalin 100 mg). I gradually started to get better. My tinnitus, the hyperacusis and the headaches all were improving fast. I was so happy that was planning my return to my life in London, however two months ago I had another sound trauma (my niece screaming next to me), I recovered after a week, however a few days later my sister dropped an object next to me. Since then, the hyperacusis is up and my tinnitus is again very loud and I am struggling to cope with it all again.

I am digesting that this is my situation for now, a struggle to trying to protect myself from loud sounds and coping with this level of tinnitus. I fear that new traumas makes my hyperacusis & tinnitus worse and worse. I feel that I would need to sort out my digestive issues in order to deal with me tinnitus & hyperacusis. What do others think?

Is there anyone here with a similar experience? Thanks for reading my story.

 

I'm sorry the struggle you are having with this. Only advice I can give is to keep fighting. You got better and will again. Hoping for the best.

 

Hi @Diego LR,

Sorry to read about your experiences. I have not come across tinnitus originating specifically from digestive issues but, given the number of nerve cells in the gut and the fact that most serotonin is produced there (and, perhaps your initial success with Citalopram), perhaps there is, indeed, something in this. Then there is the link to the Vagus Nerve. Any damage may affect the workings of the parasympathetic nervous system (responsible for digestion, immunity, heart rate).

Have you considered seeing a functional medicine practitioner or a gastrointestinal doctor for further tests? Do you have any issues now with your digestive system? Could any supplements to support gut health help? Probiotics? Perhaps intermittent or dry fasting might help with this? There are even faecal transplants that may help to reset the gut microbiome.

Hopefully, you can pursue one or two of these avenues if you have not tried them and understand your issues more and, hopefully, find something to help with this.

 

Welcome to the forum. Not sure about hyperacusis and digestive issue but many people suffer hyperacusis from acoustic trauma or hearing loss/damage. I had 2 runs of hyperacusis myself. The first one came over a decade ago after I developed high pitched tinnitus. It went away in a year. The 2nd run with it came about 18 months ago after my left ear were deaf overnight in an episode of unexpected SSHL. Again it went away after 8 months or so. Hope yours will fade over time too like many members do.

Best wishes. God bless your recovery.

 

Hey Diego, could you maybe tell me after how many days you started noticing improvements on these drugs?

Are you currently taking them?

 

With Flunarizine, I saw improvements just after 2 days of taking it. Pregabaline only helps with sleep, and again after just a few days. I am still taking them.

 

You don't think there could be a synergistic effect?

 

I have no idea.

 

Did the improvements reach a plateau after a few days?

By the time you started taking these drugs, did you already try to protect yourself from sounds?

If you don't mind me asking, have you ever considered increasing the Flunarizine and/or Pregabalin dosage? Or switching from Lyrica to Gabapentin?

 

Unfortunately, whoever advised you that you didn't need to protect your ears gave you very poor advice. You do. Maybe not w/ earplugs or sound protecting earmuffs all the time (but if you know you will be exposed to loud noises, you do). Both are only for protection, as they will increase your perception of the tinnitus because you won't be masking it w/ ambient sounds.

ENTs and others in the medical field, quite honestly, know very little about tinnitus. It isn't treated in the usual ways, if at all. Your inner ears were undoubtedly damaged due to a number of factors. Loud, unexpected noise, medications, etc. Now you need to manage your tinnitus. Many people are able to get good sleep using sound devices, or a simple box fan placed by the head of your head. A waterfall usually works well, you can buy small ones for home use. You just need to experiment and see what works for you. Make 100% sure that any medications you take are not related to tinnitus. If they are, I wouldn't take them unless there were absolutely no replacements available, and there usually are.

You will be the expert w/ your tinnitus. Most of us damaged our inner ears in similar ways, but our personal tinnitus is unique to each of us. The damage causes a neural brain path to form, so our brain and ears are linked in a different manner than before the tinnitus. Keep a diary and see if certain foods or meds spike it. Raised blood pressure usually will. Sleep is very important, even if it's broken up at night, just get as much as you can. Stress is an enemy, and of course tinnitus creates stress, but how that stress is handled is where you want to put your focus on. Staying busy helps, as well as exercise (but not too much). Watch out for swimming and getting water in your ears. Meditation can help w/ stress, a simple Zen meditation that is solely focused on your breath will increase your awareness and calm you down at the same time w/o increasing the tinnitus. But there are literally hundreds of different types of meditation, find the one that works best for you.

 

Gabapentin made my tinnitus much worse after only one dose so I stopped. I tried increasing Flunarizine but did not see much difference. I also tried to increase Pregabaline but higher doses makes you very very tired during the day. Now I am in the process of trying to swap Pregabaline for QUVIVIQ for sleep.