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.

 

[trevl]

@Cloudious, you have measured seven data points in a spectrum of 8000 Hz. It is extremely likely that you have hearing loss, but it is also extremely unlikely that seven data points provide an adequate measure of your true hearing. Too much data is missing from your audiogram to make a reasonable conclusion, such as "my hearing is good."

Decrease the measurement increment to 250 Hz across the frequency range you have shown. You can ask for it, but no audiologist I know of can do this.

 

[Cloudious]

Alright, I have a bit of an update after taking a couple of weeks off. I've noticed that the burning pain in my ears has been less frequent over the past 14 days. My ability to understand musical lyrics also seems to have improved slightly, although it is still not where I would like it to be.

At the same time, I have started experiencing some unusual balance issues that developed over the past couple of weeks. I generally have very good balance, but I recently noticed brief moments of dizziness that last for just a second, particularly when I lift my head upward or bend downward.

To get more insight into my condition, I recently underwent balance testing. This included ABR, ECOG, and VNG testing. (For the record, the VNG test was pretty nauseating.) The ABR and ECOG results came back clean, with no abnormalities. However, the VNG results showed upbeat nystagmus, as well as abnormal findings during caloric fixation and optokinetic testing.

I tried to ask the ENT what these results meant, especially since he told me everything came back fine, but I haven't received a response for clarification yet. If these findings are related to my current hearing concerns, then addressing the balance issues might also help improve my hearing.

I will be speaking with a neurologist soon to explore what can be done next.

@Cloudious, you have measured seven data points in a spectrum of 8000 Hz. It is extremely likely that you have hearing loss, but it is also extremely unlikely that seven data points provide an adequate measure of your true hearing. Too much data is missing from your audiogram to make a reasonable conclusion, such as "my hearing is good."

Decrease the measurement increment to 250 Hz across the frequency range you have shown. You can ask for it, but no audiologist I know of can do this.

If measurements spaced 250 Hz apart across the entire frequency range are not performed, then how would you or anyone else know if hearing loss has occurred between those testing points?

Even if some loss did occur, would it be significant enough to cause any real or noticeable challenges?

I did have a previous hearing test that measured ten different frequency points, and everything still came back within normal limits. I can still hear different frequencies at a sufficient volume. The main difficulty I experience is hearing in environments with competing sounds, which is a different kind of issue.

I will attach that audio test as well.

 

[trevl]

If measurements spaced 250 Hz apart across the entire frequency range are not performed, then how would you or anyone else know if hearing loss has occurred between those testing points?

Even if some loss did occur, would it be significant enough to cause any real or noticeable challenges?

When you have ear damage caused by environmental sounds at excessive volumes, whether from a rifle range, working in a kitchen, playing in a band, or any similar setting, you are not exposed to just one frequency. There are always many frequencies involved in the damage, but the one with the highest volume in that sound is usually responsible for most of the ear damage.

You should not expect a single frequency to stand out on an audiometry graph as the one where you have hearing loss. Instead, the graph will likely show something like a bell curve, or a slightly altered version of one, representing the range of hearing loss. For example, an audiometry test that records a single point at 3000 Hz might fall somewhere within that curve, but it is unlikely to reflect the point of greatest loss. A more detailed audiogram that uses 250 Hz intervals can provide a clearer idea of where the most significant loss occurs.

If you begin to notice a pattern, you might consider narrowing the interval range of testing to 200 Hz or even 100 Hz, if time permits. This could result in a more clearly defined bell curve. However, it may also introduce data noise, which would appear as a sharp zigzag pattern. You might find that you have extremely severe hearing loss in a narrow frequency band, for example, across a 10 Hz range. That kind of narrow loss may be insignificant when it comes to everyday hearing, since nearly all environmental sounds include many frequencies at varying volumes, as mentioned earlier.

On the other hand, if the frequency range where you measured that severe hearing loss also matches the frequency of your tinnitus, then you have discovered something useful. This can help you identify which frequencies, and therefore which types of environmental sounds, you may want to avoid. Doing so could help prevent your tinnitus from spreading to other frequencies or becoming louder.