Well in my case, I'm pretty certain I have both noxacusis and loudness hyperacusis.
I think if you had active ATP leakage (i.e. especially acutely), more ATP produced would mean more available. However, there is nerve sensitization after the acute period. If you were really good at protecting yourself from sound, you'd have a much lower amount released (since it is part of normal hearing anyway) and it would probably make less of a difference. Release depends on loudness of sound (louder sounds need use energy in transmission).
I also started CoQ10. I now take CoQ10, CBD, Theracurmin, Nicotinamide Riboside, and Fish Oil. I haven't noticed any obvious improvements. By the way, the following study showed that CoQ10 only helped tinnitus for those low on it -- otherwise, no effect.
I always struggle to answer this question because I find the current terminology (loudness v. pain) to be quite troubling. I've recently been toying with the idea of starting a thread about this, and your question has now prompted me to do it. In that thread I will also attempt to answer your question as best as I can. As always, I would be grateful for your feedback.
I wonder what her hyperacusis type was, how long she had it, how severe it was, and how long it took to improve. In the interest of being consistent, I think TRT "working" is almost always just time. It's fair to wonder the same thing here.
When I think about noxacusis, I picture noises causing like a burning or stabbing sensation. Technically speaking, I have such severe loudness hyperacusis that if I were to (for example) talk in a normal voice for a few seconds, my head would start hurting. I've also gotten facial pain in my cheeks. I don't consider this to be noxacusis though. I think noxacusis is primarily something where it's reasonable to believe that the issue is type II afferent sensitization.
The interesting question is whether the stabbing and the burning are two different mechanisms. The burning in my case also radiates to the direction of my cheeks, suggesting irritation of the trigeminal nerve (this seems to be common in pain hyperacusis). Interestingly some noises actually slightly trigger the nerves atop my upper teeth (like when you eat something extremely cold), not my ears. But once again, it's an area innervated by the trigeminal nerve. Also when I fiddle with my ears, which I have been doing essentially my whole life (it's a bad habit), there is a sensation of warmness that lingers for some time. So to summarise, the nerves around my ears, mainly the trigeminal nerve is sensitized.
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