Tinnitus Since November 2020 — Initial Root Cause EBV Infection?

[Prongs13]

Hi everyone, I live in London and wanted to introduce myself and ask for some advice please.

I had my tinnitus onset in early November, when the following things happened:

1. I contracted COVID-19 in April 2020 and was sick for nearly 2.5 months. While I was really sick, I developed pulsatile tinnitus which did go away. However, I was left with fleeting tinnitus (it would show up a few times a week mainly at night and would not last long).
2. In early November, I had a diagnosed external ear infection in both ears (much worse on my left) by 2 ENTs.
3. I took a short 5 day course of Neomycin ear drops. My eardrums were confirmed intact before and after the course by ENTs.
4. The second ENT ran a hearing test and I had no hearing loss.
5. I had my proper tinnitus onset the morning of November 6th. It started on my left ear and did not stop. This was 2 days after the most painful day of the ear infection and 1 day after I started the Neomycin drops. 1 week later, it started on my right ear as well.
6. I had a latent Epstein Barr Virus infection reactivate (confirmed by a blood test). EBV can cause tinnitus and ear issues, there are many many complaints about this on EBV online communities.
7. I did not have any noise exposure prior to onset, and although I somewhat frequently went to noisy clubs/concerts for a few years in 2013-2015, the frequency of that had gone down a lot and especially very little in the last couple of years. I never had any ringing or hearing issues after going to clubs or concerts.

My tinnitus and hyperacusis journey:

1. Although tinnitus has been my primary problem, hyperacusis has showed up on n off.
2. November and most of December were not great. Although I had a few good days where I thought it was fading away, it always came back. My tinnitus was generally much worse during the night, and I frequently had a lot of problems sleeping.
3. Also during this phase, I noticed that tinnitus and hyperacusis corresponded to days when my overall health wasn't great. My theory for this was this had to do with my EBV activation (EBV can take a month or so to get back into dormant state). I would also be sensitive to inflammatory foods during this period.
4. I threw the kitchen sink at the problem. I was already taking a lot of anti virals since November, but in mid-December I switched to a very anti inflammatory diet and this really turned the tide. I was also taking supplements (NAC, Magnesium, Ginkgo etc) and started red light therapy in late December (I bought the Konftec laser).
5. I had tinnitus in both ears (typically worse on my left ear). The hyperacusis was almost entirely in my left ear only. Both tinnitus and hyperacusis fluctuated a lot. I also had a lot crackling and discomfort in my Eustachian Tubes, and this typically worse when tinnitus and hyperacusis were worse. I had trouble getting the left ET to open up for about a month even when doing a valsalva.
6. My tinnitus always spikes right around bedtime, and also in the morning when I start to wake up. However, it usually calms down within 30-60 minutes after waking up and mornings are usually the quietest part of the day with sometimes volume at 0.
7. In November and December, an ENT and an audiologist mentioned that I have positive ear pressure, worse on my left.
8. On December 13th, a siren passed me by while I was on a walk, and which prompted me to really stress about potential noise exposure. I had a bad tinnitus and hyperacusis spike that evening which calmed down over a couple of days.
9. Steadily, my health started to improve, and along with that tinnitus and hyperacusis also slowly started to improve. The bad days were less frequent and not as intense.
10. By late January, I was doing way better. I was 90% healthy. Hyperacusis was 95% gone. Tinnitus was still there but fading. It would be really really quiet during 80% of the day, and the nights were improving a lot too. I was confident at this point of continuing my improvement, but also pretty satisfied with where I was.

If you're still reading at this point, thank you! I am about to get to the most interesting part.

On February 7th I was in a friend's place and she ran a very loud blender and I didn't have ear protection (I did use fingers to block my ears after a second), and that really got me stressed out. Over that evening tinnitus and hyperacusis gradually came back and increased over that week and I lost all my confidence and got back to very high stress levels.

5 days after that I was hanging out in my friends place, and this was the worst my hyperacusis had ever been. People speaking at normal volumes was causing intense pain. I wanted to leave but they insisted I eat dinner. And then the strangest thing happened, as soon as I ate dinner, the hyperacusis went away 80%. I had noticed this a little bit before but this time the difference was stark. I got a hunch then and started to chew gum and hyperacusis stayed gone and I was able to comfortably hang out with no pain.

According to my research, this feels like it must have TTTS. In hindsight, I think it was my stress after the blender incident that caused me freak out and started to clench my jaw like crazy. I noticed the next couple of days that I would be clenching my when handling noisy cutlery.

5 days after this incident, both tinnitus and hyperacusis have improved a lot but not yet back to my late January peak. I have confirmed that the eating correlation still holds true. My hyperacusis tends to pick up a bit in the evenings, but then gets relieved as soon as I eat dinner. Another thing I noticed during these days is that while I am eating, my tinnitus frequently goes away. I mean goes away entirely, down to 0 volume.

I started to do some TMJ exercises, and have a lot of soreness on the left side of my face. Although I never had any TMJ issues prior to this, but it's possible that the stress of this time have amplified a smaller issue. I do have an overbite.

So here it is. I have spent a ton of time lurking on these forums since onset, probably read 100s of posts and deeply feel for all the people here going through such pain. I was never a religious person but I have to admit I have prayed a lot during the past 3 months.

My main theory of what happened to me is that the EBV infection was my initial root cause, compounded by a lot of stress. I don't think the Neomycin ear drops in the quantity that I took could have caused this. My ear drums were intact and the onset on my left side was happened after I applied the ear drops just 3 times. Based on the scientific studies about this I have read about this, quantity and dosage matters a lot.

However, I feel like at this point it's continuing due to a combination of stress, TTTS, middle ear fluid, possible ETD and possible TMJ.

I wanted to share my story and see if anyone here had any advice! Thank you!