Confused About Reactive Tinnitus: Where's the Expert Advice?

[Raven Nevermore]

Hi everyone, I'm new to the group.

My tinnitus started after radiation to my throat seven years ago. It impaired my healing from the treatment, so I sought help within six months. I began TRT with an audiologist trained in the Jastreboff method and started using sound generators, increasing the volume by one notch for 30 minutes a day. I also did sound therapy for hyperacusis by listening to pleasant music for 30 minutes and increasing the volume by one notch each week. At night, I used sound enrichment.

I followed this routine for two years and improved, but I still had difficulty with certain noises causing pain—running water, car travel, motors, air conditioners, and even my own voice. My tinnitus would get louder when exposed to these sounds.

I then switched to another audiologist, this time online. They diagnosed me with reactive tinnitus and dysacusis. I bought their sound generators and followed their program, but I still struggle.

There are so many conflicting opinions on reactive tinnitus. Wear earplugs. Don't wear earplugs. Use sound therapy. Don't use sound therapy, just rest your ears. Be social, but only in quiet places. Be social and train your brain to understand the sounds are not harmful. Avoid irritating noises. Expose yourself to irritating noises and get used to them. I could go on, but I think you get my point.

Is there anyone who provides consistent expert advice on reactive tinnitus? A book or article? I have read Hyperacusis by Baguley, but I did not find it helpful.

Thanks for your help!

 

[Arnaudswiss]

Hi everyone, I'm new to the group.

My tinnitus started after radiation to my throat seven years ago. It impaired my healing from the treatment, so I sought help within six months. I began TRT with an audiologist trained in the Jastreboff method and started using sound generators, increasing the volume by one notch for 30 minutes a day. I also did sound therapy for hyperacusis by listening to pleasant music for 30 minutes and increasing the volume by one notch each week. At night, I used sound enrichment.

I followed this routine for two years and improved, but I still had difficulty with certain noises causing pain—running water, car travel, motors, air conditioners, and even my own voice. My tinnitus would get louder when exposed to these sounds.

I then switched to another audiologist, this time online. They diagnosed me with reactive tinnitus and dysacusis. I bought their sound generators and followed their program, but I still struggle.

There are so many conflicting opinions on reactive tinnitus. Wear earplugs. Don't wear earplugs. Use sound therapy. Don't use sound therapy, just rest your ears. Be social, but only in quiet places. Be social and train your brain to understand the sounds are not harmful. Avoid irritating noises. Expose yourself to irritating noises and get used to them. I could go on, but I think you get my point.

Is there anyone who provides consistent expert advice on reactive tinnitus? A book or article? I have read Hyperacusis by Baguley, but I did not find it helpful.

Thanks for your help!

Hello,

I've been struggling with reactive tinnitus for a year now. At first, I listened to all kinds of so-called therapeutic sounds, including white, pink, and red noise. My tinnitus gradually worsened, becoming louder and more intrusive, with new sounds appearing.

Eventually, I did the complete opposite—I protected my ears, stopped listening to any kind of white noise, and started wearing earplugs (Loop). From that moment, my tinnitus began to improve. It became more regular, no new tones developed, and it was slightly less intrusive.

I'm not an expert, but in retrospect, I believe the wisest approach in my case would have been to rest my ears from the start rather than exposing them to more sound. I would say, follow your ears' reactions and adjust your routines accordingly, no matter what the theories suggest.

 

[Jupiterman]

I am amazed your audiologist acknowledged your reactive tinnitus condition.

Reactive tinnitus essentially means that you are allergic to sound.

By not exposing to sound, you are giving your tinnitus nothing to react to.

 

[BuzzyBee]

I am amazed your audiologist acknowledged your reactive tinnitus condition.

Reactive tinnitus essentially means that you are allergic to sound.

By not exposing to sound, you are giving your tinnitus nothing to react to.

So true! Up until about two years ago, audiologists dismissed it as if it did not exist, assuming we just had regular maskable tinnitus.

Now, at least, there is information available online.

Whether to rest your ears or expose them to sound depends on the individual. You have to experiment and figure out what kind of sound, if any, helps relax your central nervous system. It could be certain types of voices, a podcast, music, or even silence. When mine spikes, I need complete quiet. Sound therapy is different for everyone.

Tinnitus is supposedly linked to hyperacusis, but they are not exactly the same. You could drop a pile of dinner plates next to me, and I would not flinch, but if a heater turns on, my tinnitus will spike and last all day. There is a connection, but also distinct differences, which means different treatments are needed.

The supposed cure is radical acceptance—once you stop caring about it, the sound is said to fade away. Maskers and certain antidepressants like Nortriptyline, Clomipramine, and even Zoloft for some people are believed to activate the "I do not care" part of the brain. Over time, this disconnects the brain from the pain or tinnitus response triggered by noise.

The problem is that some drugs make the response worse. Cannabis, for example, is supposed to relax people, yet it makes some feel paranoid. Alcohol turns off hyperacusis for some but makes tinnitus worse for others. There is no single answer, but we are making progress thanks to doctors who take an interest in how the entire body functions, not just the one area they specialize in.