Maybe I've Had Hyperacusis This Whole Time?

[Cloudious]

Hello everyone!

After experiencing acoustic trauma from a concert over three months ago, I've been dealing with various symptoms. I wasn't sure exactly what to call it, but it might be a mild form of hyperacusis. Here are my current symptoms:

• Slight burning in my ears, sometimes triggered by constant background noise. In the first month, laughter near my ear would cause instant pain, but that's no longer the case.
  
  
• Difficulty hearing voices in the presence of background noise like running water, air conditioning, or appliance humming. Interestingly, I don't struggle as much when the background noise is crowd chatter. At first, I thought voices had become quieter, but it might actually be that other sounds have gotten louder. When I walk into grocery stores or restaurants, commercial refrigerators and drink dispensers definitely sound louder than normal. However, I don't have trouble hearing people in quiet environments.
  
  
• Issues distinguishing sounds of similar frequencies. For example, I used to hear my hands rubbing together with soap while running water from the sink, but now it's much harder to detect that sound when the water is on.
  
  
• Instrumentals in music overpowering vocals and making consonants sound muted. This issue is especially noticeable with high-frequency or "swishy"-sounding instruments like cymbals. It also seems more pronounced when listening through phone speakers compared to other audio sources. Here's an example of a song where I've noticed this issue:
  
  
  
  
• Bass in music sounding lower in volume than before.

From what I understand, hyperacusis can cause certain sounds to become imbalanced or louder in general, even if there's no pain from everyday noises. Has anyone else experienced symptoms similar to mine? If so, did they improve over time?

Thankfully, my hearing test with an audiologist last week showed no measurable hearing loss. I'll share my results below for context. The QuickSIN test results (which assess speech-in-noise perception) also came out normal, though they aren't shown here.

 

[HighleyTall]

Outer hair cells (OHCs) are more prone to damage than inner hair cells (IHCs). Since OHCs function as amplifiers and help filter sound, this may be why you're experiencing these issues.

I firmly believe that anyone with tinnitus also has some form of hyperacusis, though many people don't notice it, especially when it's mild. To me, it also seems that both tinnitus and hyperacusis might be caused primarily by OHC damage. This could explain why patients with severe IHC damage (as seen in very poor audiograms) sometimes don't experience tinnitus or hyperacusis. Similarly, it might explain why someone with a very good audiogram can still experience both. The painful sensation may be due to the nociceptors on OHCs (see Megan Beer Woods' work on this).

NAC helps combat oxidative stress, a key factor in OHC damage, while magnesium reduces excitotoxicity. These supplements are safe to take. Also, try to avoid stress—it can make both tinnitus and hyperacusis permanently worse (speaking from personal experience).

 

[Cloudious]

Outer hair cells (OHCs) are more prone to damage than inner hair cells (IHCs). Since OHCs function as amplifiers and help filter sound, this may be why you're experiencing these issues.

I firmly believe that anyone with tinnitus also has some form of hyperacusis, though many people don't notice it, especially when it's mild. To me, it also seems that both tinnitus and hyperacusis might be caused primarily by OHC damage. This could explain why patients with severe IHC damage (as seen in very poor audiograms) sometimes don't experience tinnitus or hyperacusis. Similarly, it might explain why someone with a very good audiogram can still experience both. The painful sensation may be due to the nociceptors on OHCs (see Megan Beer Woods' work on this).

NAC helps combat oxidative stress, a key factor in OHC damage, while magnesium reduces excitotoxicity. These supplements are safe to take. Also, try to avoid stress—it can make both tinnitus and hyperacusis permanently worse (speaking from personal experience).

Thanks for the insight! When it comes to Magnesium, is there a specific type that may be more beneficial for recovery? I've heard that Magnesium glycinate is good for ear-related issues, so I was wondering if it might help with this particular issue.

 

[HighleyTall]

GROK (not a doctor, and neither am I):

Best Choice for Tinnitus?

Magnesium L-threonate is likely the best candidate among BBB-passing forms for improving tinnitus. Its ability to elevate brain magnesium levels aligns with emerging theories about tinnitus as a neurological condition tied to plasticity and signal misfiring. Studies like those from Cevette et al. (2011) and anecdotal practitioner insights (e.g., NeuroMed Tinnitus Clinic) suggest magnesium's neuroprotective role could reduce symptom severity, especially in noise-induced or chronic cases. However, the evidence is not definitive—tinnitus varies widely in cause and response, and no large-scale trials confirm L-threonate as a cure.
Practical Considerations

• Dosage: Studies have used 500+ mg/day, but start lower (e.g., 144-200 mg elemental magnesium) and consult a doctor, as excess magnesium can cause side effects (diarrhea, low blood pressure).
• Caveat: The American Tinnitus Association and others caution that supplements aren't a proven cure. Benefits may be subtle or placebo-driven for some.
• Combination: Pairing with a holistic approach (e.g., sound therapy, stress reduction) might amplify results.

In short, magnesium L-threonate stands out for its BBB-crossing ability and potential to target tinnitus's neural roots. If cost or availability is an issue, magnesium glycinate is a solid secondary option, though its effects may be less brain-specific. Always check with a healthcare provider, especially since tinnitus could signal underlying issues needing separate attention.