@Juan Thanks for the advice. 18 months is very new? Feels like it's been eternity at this point. I'm sorry that you've had such a bad case of hyperacusis as well. You mentioned your LDLs were worse than mine at some point, so I am assuming you have made some improvements since then? If so, what have you felt have been the most effective treatment(s) in your case?
Hyperacusis can improve but very slowly, and setbacks may make a lot of damage. In my case, I have always tried to carry on living as normally as possible. This means I work a full time and very demanding job that also means being exposed to noise. For a couple of years I was able to redesign my life to adjust to hyperacusis, moved to a quieter place and to a less demanding position at work. However, there was a point when occassional and accidental exposures to very loud noise (by any standards), at decibels of 100 +, made a lot of damage and I thought that I would try to go back to a tougher position at work.
The lessons I have learnt from all this journey is that no matter how hard you try to adjust everything to avoid noise, you are going to find some very loud noise sometimes. Examples of noise that made me worsen is driving near construction and someone using power tools near my car, or being stuck in a traffic jam and suddently facing a protest by taxi drivers who are all honking. This kind of things happened even if I seldom go to cities.
Ridiculous things have happened too, and the perfect example is going to the countryside just to walk and being around nature. I was on a dirt track with very dense trees and plants on both sides, on a working day, maybe it was like March or April, and there was total silence, and suddently a super loud enduro bike appears and heads straight towards me, with no possibility to go anywhere, so I just cover my ears. Very bad setback.
I have lost hearing due to episodes like those above, plus the daily noise at work.
Now I can tell you too things that helped: healthy diet, a bit of exercise, just walking or swimming a little, or biking can help, gyms are complicated as there will be loud sounds or loud music, so I dont go to the gym. You have to find a way of being around sound and listening to music at a volume you are ok and comfortable with. And the most important thing is to avoid the really loud sounds, like a Harley bike roaring past you, or someone using a jackhammer nearby, power tools, firecrackers and fireworks at Christmas, demonstrations and protests, loud amplifies noise, noisy venues or noisy restaurants etc As you can see, this is not going to be possible, there will be times when accidental exposure happens.
If you are exposed to noise try to spend time recovering. The times of recovery are a very good indicator of improving from hyperacusis or worsening. At my best I would recover in around 2 days, and for the worst setbacks, and more often these days, it takes me 2 or 3 weeks to recover from exposure to a bad sound.
It is hard to be rational with and come to terms with something so strange and hard to understand as hyperacusis. Do not try to understand it, just try to live the better life you can with it, and to make the best choices you can. I hope this helps and being only 18 months into hyperacusis you still have a chance to be ok. I would say that after 2,5-3 years with hyperacusis the chances of feeling ok again and having pretty normal hearing back diminish significantly.