Struggling with Tinnitus and Hyperacusis: Why Are Audiologists So Misinformed?

[Landman]

So I am just like many of you here, living with tinnitus and hyperacusis for more than three years, and it keeps getting worse. It started with an initial noise trauma, then about a year later, COVID and the COVID vaccine (which caused SSNHL and required injections) triggered the hyperacusis and made the tinnitus much worse.

I have been to multiple ENTs, audiologists, a neurotologist, and two different teaching hospitals that specialize in hearing disorders and tinnitus. They have all told me contradictory things, even though they are supposedly trained in the same field.

The one thing they all agreed on was that I should not have any issues with "normal loud noises," especially if I was wearing hearing protection. They all equate no ear damage with no tinnitus spike, which is nonsense in my experience.

So my question is: do you think that exposure to 75 to 85 decibel noise (or that level after protection) is really causing new nerve damage, or is it, as they claim, just my limbic system overreacting? In other words, is this all psychological, or is the noise that spikes me to new levels every week or two, levels that never return to baseline, actually causing physical damage in my ears? Are overexcited nerves a physical problem or a mental one?

I feel like I am going downhill fast because of normal everyday sounds, and the professionals basically all tell me I am crazy.

 

[Sydnears]

I think every single case is different—the cause, the presentation of the tinnitus, what it reacts to, and what the right thing to do is going forward.

When I developed mine after an infection, an audiologist at a specialized tinnitus clinic did a hearing test and an LDL test. My tinnitus spiked for two weeks. When I went back again, she was completely dismissive and said there was no way 100 dB could cause my tinnitus to increase. She also claimed she had never heard of Morse code tinnitus and didn't believe me that tinnitus could be reactive.

It made me completely lose hope. I think the only training they really have is for slow, degenerative, age-related tinnitus that develops gradually, is not reactive, and can be helped with hearing aids. They then try to apply that limited understanding to the entire spectrum of tinnitus cases.

For me, the experience was damaging, expensive, and borderline traumatic. The whole industry needs to move forward and get with the times. It's just not good enough.

 

[Varda]

do you think that exposure to 75 to 85 decibel noise (or that level after protection) is really causing new nerve damage

What sort of noises are you talking about?

 

[Jupiterman]

If you have a severe case of tinnitus, you are wasting your time speaking to so-called "experts." Severe cases are rare, and an audiologist or ENT may not even encounter one in their entire career.

If you have multiple noises and your tinnitus easily worsens from further noise exposure, then continuing to expose yourself to loud sounds, whatever that means in your case, will likely make your condition worse.

The main goal of ENTs and audiologists is to get you to "live your life as if you don't have tinnitus," to return to work, and to carry on with daily activities regardless of the consequences to your ear health. While the harm caused to a patient's ears is not intentional, it is a byproduct of their ignorance about the effects that even so-called normal noise exposure can have on severe cases.

And you are right, they treat it as a psychological problem. Why? Because there is no cure. Any incurable disease that compromises quality of life will inevitably affect mental health. Tell me one that doesn't.

There is debate about whether hearing damage and tinnitus damage are separate. I believe a tinnitus spike is caused by already damaged hair cells and nerve fibers being further aggravated by loud noise exposure. After such exposure, the exacerbation or over-excitation may settle back to its previous state (the spike calming), or, if the noise was loud enough, further damage may occur, causing the spike to remain and the tinnitus to worsen permanently. This could also affect your hearing.

The choice is simple: continue exposing yourself to loud sounds and risk worsening your tinnitus and possibly your hearing, or take clear measures to use ear protection.

 

[NormySan]

I definitely think that 75 to 85 dB after reduction can cause a spike or problems. I went to a concert the other day, and I'm having an awful spike right now, even after using ear protection that should have reduced the sound to about those levels. I've done that before without issues, but this time it didn't work.

 

[kingsfan]

When I developed mine after an infection, an audiologist at a specialized tinnitus clinic did a hearing test and an LDL test. My tinnitus spiked for two weeks. When I went back again, she was completely dismissive and said there was no way 100 dB could cause my tinnitus to increase. She also claimed she had never heard of Morse code tinnitus and didn't believe me that tinnitus could be reactive.

An audiologist I visited several years ago told me that the tests another audiologist had performed on me, which made my condition worse, should never have been given to someone with tinnitus. So there are at least some who have an idea of what they're talking about.

So my question is: do you think that exposure to 75 to 85 decibel noise (or that level after protection) is really causing new nerve damage, or is it, as they claim, just my limbic system overreacting? In other words, is this all psychological, or is the noise that spikes me to new levels every week or two, levels that never return to baseline, actually causing physical damage in my ears? Are overexcited nerves a physical problem or a mental one?

I don't think it's only sound pressure that can worsen tinnitus, but also the frequency of the sound itself. I'll get a spike just from listening to a drum kit cymbal crash at the very lowest possible volume on a stereo. I wonder if it has something to do with neurons in the tinnitus brain being more easily susceptible to excitotoxicity or something similar.

There have been sounds at the same decibel level that devastated my tinnitus, while others didn't affect it at all. For example, my cat screaming at 85 dBA in the car on the way to the vet had no effect on me, but spending just a couple of seconds in a restroom while a hand dryer was running at a slightly lower dBA level left me spiked for a couple of months and possibly caused lasting effects on my tinnitus.