What Theories Support Stress Causing or Worsening Tinnitus / Hyperacusis?

When I first got tinnitus, one of the things to blame was the antimycotic fluconazole (I was taking pills), although I never managed to find sufficient data online to support ototoxicity. However for me it's quite possible, because all these sets of uncommon symptoms and the quality of my tinnitus & hyperacusis, reflects damage that I can't believe it can be just from mere sound.

Long story short, it's been more than two weeks that I have been dealing with new symptoms. Especially with my hyperacusis. Ironically after a period that my symptoms seemed more manageable (unless I just learned to cope in some way after 3 years). This unprecedented flare-up happened coincidentally after the recent loss of my father. Personally I never believed that just stress can cause tinnitus. I would appreciate if somebody could cite here studies that claim this. I have been wondering whether stress can be enough. If that was the case so many people would end up with tinnitus & hyperacusis. On the other hand I had been wondering, a few weeks ago I began to apply on my infected toenail the antimycotic tioconazole (which apparently is a compound of the same class as fluconazole), this time in the form of a topical laque. I was reading on the leaflet that absorption of the compound is negligible. However could a topical antimycotic agent on my toenail could reach the cochlea and leave me with more damage?

I am baffled. I did feel a bit better, after one week of complete isolation and a short-course of prednisone. However things have remained supersensitive. I just had to drive and get groceries and that was enough to flare up this condition again. Therefore I have ended up with more reactive tinnitus and more sound sensitivity.

It's needless to say that I am exhausted. I have been trying to survive this for 3 years. I am already sad that my situation never got better like other people here. I am also sad and scared because I have ended up with complicated symptoms. Unexpectedly the moment I started feeling that I manage, I ended up with a new wave smashing me. It's too much effort for nothing. I don't thing I can do this. Hyperacusis is death.

 

I think you will be able to find lots of theories and studies about how stress can cause tinnitus and hyperacusis. The problem is that tinnitus and hyperacusis are not defined the same for each individual so as we scour the internet for similarities or differences it just makes it that more confusing. When the body is stuck in the flight of fight response and it becomes chronic, that's when things start unraveling. I don't think it's coincidence that your father's death brought on a flare up. Many people have reported an increased sensitivity to sound and other stimulus when dealing with extreme stress. I think that certain people are predisposed at dealing with stress better than others. I am certainly one that does not deal with it well. My current situation is different but I know that if I can get my stress and anxiety under control then the recovery has a chance to begin. Constantly thinking about the tinnitus and the hyperacusis will always make it worse. Easy to say not to think about it but very hard to do, especially with the hyperacusis. It's a viscous cycle of negativity when we are surrounded by sounds that we know shouldn't aggravate us but do. A person on another site posted a reply to my post and ended with, "This journey is for the strong". It's an interesting way to look at it but very true. In my opinion if we're not strong enough then we'll never get through it, or at the least our recovery will be severely delayed.

I haven't told you anything you don't already know, but just know that there's someone else out there pulling for you to get through this.

 

Thank you. I am lost here. I really don't know what to do.

 

I'm very sorry for your loss.

I lurk here all the time and have rarely felt compelled to post or comment on something, but your post really made me think. Here's why:

I've had tinnitus for years, but about 2 months ago, I also developed terrible hyperacusis. This was following the tragic suicide of my father about 2 months earlier. I can't begin to tell people how devastating losing my father (particularly to suicide) has been.

I never had anxiety before in my life, but the whole incident and the subsequent inquest (both within the family and IRL), as well as being Executor of my father's estate, combined with complete isolation from the world due to lockdown, have given me insurmountable levels of stress. The hyperacusis seemed to come on after a loud motorbike drove passed me, but I have serious reservations as to whether this one incident was the cause - I feel like the stress caused by my father's passing may have predisposed me to it. Granted, I've not done myself any favours over the years as I've attended concerts without ear plugs and have been a life-long musician that loves loud music.

About two weeks after I developed the hyperacusis, I decided to take Magnesium citrate after reading some stories on here that it helps. Lo and behold, within hours I saw a huge difference, and over the next 4 days, I would say my hyperacusis improved about 60-70%. After doing more research, I discovered that people who have chronic stress/anxiety have depleted Magnesium levels, and taking it in its citrate form (as opposed to other forms) made a huge difference to bioavailability. I have since decreased my intake and only take it on days where my stress returns because I found that the magnesium will dehydrate you and give you a metallic taste once you've reached your normal levels.

So I'm convinced, at least in some cases, that stress can predispose or, at least, worsen hypreacusis. My hyperacusis still hasn't fully resolved and some days are still very difficult, but I've gone from wincing at the sound of my own footsteps and typing on the keyboard to being able to go outside for a walk without ear plugs. I still can't deal with anything tinny, like plates, iPhone speakers and so on, but I'm hoping that, in time, this will improve as well.

In a few weeks' time I will be living with family in a quite place and won't have to deal with my father's affairs anymore. I will also start counselling and therapy, so I'm hoping all these things combined will help. I will report back to let you know if I've improved following the subsequent stress relief.

 

Hello @vermillion ,
I'm sorry for your loss and suffering.

Meds aren't my area, but I think that that is unlikely.

I don't have studies to quote for you that give a direct connection, but I will share the connection that does have studies we can pull up if needed.
There are 2 paths, one implied by @Aaron91 that is systemic biochemical deficiency and another that is neuromuscular toxicity.

1. Systemic biochemical deficiency: Stress, be t emotional, physical, or chemical, requires more function of the body's machinery and biochemical processes. That requires more supplies (like magnesium). If the body is chronically stressed, already deficient (perhaps diet), and/or has a unique need (different people have different genetically-determined unique needs), an additional stress (of any sort and sufficient magnitude or duration) will cause the body machinery to make priority decisions that may compromise function in vulnerable organs or systems. It's clear that there is much variability in that scenario. That's why some people say, "Wow! [B vits, magnesium, Zn, or whatever] is a miracle!", but it doesn't work at all for another person.
   
2. Neuromuscular toxicity: Emotional stress or Physical stress cause waste products to build up in the muscles. This is most obvious with hard exercise and sore muscles. Waste products are normal, but if the muscles is tense, blood flow into and out of the muscles is restricted. If the muscle stays tense, this causes waste products to build up in the muscle and irritate the muscle and nerve endings. We call this a trigger point. The muscle is usually tight from a sustained body posture (like the computer mouse too far out or screen too low or high, etc) or, as may be more relevant to your situation @vermillion , from emotions causing reactive, expressive muscle tension. Our shoulder and jaw muscles are expressive; they help us communicate. When we are emotionally stressed, they tighten up and stabilize the jaw ans neck. Maybe that's useful for something, but long-term, it just causes more problems, aka Trigger Points.

If you want to know how trigger points relate to tinnitus, check out some of my other comments in older threads...or you can ask.

 

@Aaron91

I am really sorry to hear about your loss. I can't imagine the emotional turmoil you and your family are going through. I am lost for words.

Glad your hyperacusis is improving. I still would be careful with cars and motor bikes while walking they trigger my hyperacusis big time and main symptom is ear burn.

I wish you all the best.

 

@Sash thank you for your condolences. I am touched by how supportive everyone is on these forums.

I am still very careful when I go outside and I know that I am not out of the woods by any means as I'm still struggling with a lot of frequencies at normal volumes. Thank you for your concern, and I really hope your hyperacusis improves as well.

I just wanted to add something to my previous post.

In researching hyperacusis more, I discovered that there have been anecdotal cases of people coming off anti-depressants who then developed terrible hyperacusis. So assuming that these anti-depressants are responsible for controlling, to some extent, stress/anxiety/serotonin levels, perhaps there is a correlation (dare I say, causation) between hyperacusis and anxiety/stress/serotonin. Again, perhaps it doesn't cause the hyperacusis, but maybe it can be the trigger if you already have hearing damage, or vice versa. I expect my stress levels to drop considerably from August onwards, so I'll be curious to see how my hyperacusis improves (or not) thereafter.

 

I'm so sorry to hear about your loss. I can truly imagine that was a very difficult time for you. I know this is an old thread but I was reading somewhere that hyperacusis can actually be a symptom of PTSD. I have PTSD and quite a classic case as well. I'm incredibly anxious, stressed, and hypervigilant and suffer from panic attacks and flashbacks. It wouldn't surprise me if anxiety/stress has a role to play in tinnitus and hyperacusis.

 

Thank you, @shelbynn.

I think it's certainly possible that there could be a link between hyperacusis, or at least some forms of it, and PTSD. I remember reading about another member on here who also developed hyperacusis after losing their father.

The thing is, it's still not entirely clear to me what the link is, if at all, and I avoid giving too much credence to this thesis because I'm mindful that these anecdotal stories can be hijacked by TRT shills to strengthen their own narratives. It's evident to me that there doesn't need to be some traumatic event to predispose one to this condition.

Having said this, I watched a web presentation by Paul Fuchs today, who said something I wasn't previously aware of.

Apparently, the efferent fibres running from the brainstem, which innervate the cochlea, play a role in acoustic trauma. In fact, they have even genetically engineered mice to have an efferent system that works better than normal, and they discovered that these mice didn't experience hearing loss after noise exposure. It would seem to me then that whatever molecular or physiological processes lead to hearing loss and associated conditions, such as hyperacusis, are not necessarily always caused by some objective threshold/volume of sound, but by whatever threshold the efferents determine must be reached for those hearing loss mechanisms to begin in the cochlea. If true, I must wonder then whether some kind of environmental stressor, such as a traumatic event, could have an effect on the behaviour of these efferents. We know for a fact that PTSD/trauma causes an increase and decrease in the volumes of the amygdala and hippocampus respectively, so I don't think it would be a stretch to say that other parts of the brain/brainstem could be affected by trauma as well.

 

Paul Fuchs' discussion about the efferent connections in the webinar also made me wonder: do some people have an efferent system that is genetically predisposed to be more susceptible to acoustic trauma? Might some of us have a genetically 'weaker' efferent system? Given that we now know that there is a massive individual variation with regards to how much noise people can tolerate, it would sort of make sense.

 

I actually work with other trauma survivors and have done a lot of research on how trauma affects the brain. Trauma actually does change the structure of your brain, including the frontal lobe.

 

Don't knock hormones. Your body responds very strongly and may not recover from a new state.