Mild Tinnitus with Reactivity, Central Gain, and Possible Synaptopathy

[thinkingmind]

Hello, after a few weeks of reading threads, I finally decided to make a post (and a new account).

Disclaimer: I know I have mild tinnitus, but since I have always been hypersensitive to sound, heat, light, and other stimuli, it is already extremely disturbing. It is especially difficult because it is also reactive to low-level white noise. To all the severe tinnitus sufferers out there, you are true warriors. I wish you nothing but the best, whether that means healing or a reduction in symptoms.

Background: I had experienced slight, transient tinnitus a few times after exposure to loud music. The longest episode lasted about two weeks. After that, I always wore earplugs at loud music events. For the past eight years, I stopped going to such events entirely. Unfortunately, I forgot my earplugs at an event in January. I think I already had very mild tinnitus before the January event, but it was so faint I could barely hear it even when focusing with earplugs in.

Event(s) and Story: I am a 26-year-old male. I developed tinnitus about two and a half months ago after being exposed to approximately 45 minutes of loud music (I estimate around 100 dB) in a relatively small room, without earplugs. During the event, both my ears made a popping sound. It was not loud, and I suspect it was the stapedius or tensor tympani reflex.

When I got home and was in a quiet environment, I heard the tinnitus. Something in me knew this time was different. It was a tonal sound, around 4 kHz in both ears. It was not very loud, maybe 2 out of 10. I waited 48 hours and then went to see an ENT. He performed an audiogram up to 20 kHz and found only a slight 20 dB dip at 12 to 13 kHz. Since this is still considered normal hearing, I did not receive Prednisolone. I was prescribed Betahistine instead.

In the first week, the tinnitus did not improve much. In the second week, it became quieter. The tonal sound shifted to more of a hissing or static noise, which was less loud (about 1 out of 10), but still disturbing.

I then went on a previously planned holiday. Before leaving, I visited the barber, who used an electric shaver near my ear. That was the first time I noticed my tinnitus was reactive. At the holiday destination, I went to a relatively loud restaurant with friends. Not dangerously loud, but loud enough that I immediately put in earplugs. It was still too much, so I left after a few minutes. Back at the hotel, the tinnitus was a bit louder again. When it flares up, it tends to settle after a few days and return to baseline.

Back home, the tinnitus gradually faded again over a few weeks, but the baseline never fully disappeared. The reactivity seemed to worsen, possibly because I was overprotecting. I tried a course of cortisone at week five and another at week seven. Both times, the tinnitus decreased significantly during treatment. However, after finishing the cortisone, it came back louder than before, then eventually returned to baseline. At its worst, it was an awful electrical hissing, which later settled into a more typical hissing or slightly piercing sound.

The cortisone therapy was the first time I experienced what I call "cochlear tinnitus"—a sound more like the original 4 kilohertz tone I heard in the beginning. On top of that, I experience what I call "central gain tinnitus," which is more of a hissing and fluctuates significantly over time. The reactive form of this central gain tinnitus can reach about 3 to 4 out of 10 in intensity.

TMJ Complications: I have always had bruxism and tend to clench my teeth when stressed. The tinnitus made me clench even harder, to the point that I developed jaw clicking and sore muscles. That said, I believe TMJ contributes only a small part to my current tinnitus. In the past, I only had slight tinnitus when yawning.

Current Situation: The cochlear tinnitus is still noticeable in the middle of the night and early morning. This type is quiet and has clearly improved since the onset. When I am more awake, the central gain tinnitus becomes louder and more prominent. This is also the form that reacts to external sounds, such as laptop fans or car engines, making it worse and sharper.

What I Am Doing to Manage Tinnitus:

• Melatonin
• Lutein (for NT-3)
• Taurine
• B Vitamins
• Vitamin C and D
• Zinc
• Betahistine
• Ginkgo
• Magnesium
• NAC
• Turmeric
• Ginger
• HBOT (twice a week, as I am not in good enough health to do more)
• Ashwagandha
• Night guard
• Reading tinnitus forums (treatments and success stories)
• Wearing double protection when outside
• Avoiding social events since loud voices trigger reactivity

In the past few weeks, I have had mornings where the tinnitus is barely noticeable. I can hardly hear it in a silent room. In the afternoon, it gets stronger, and in the evening it can remain strong, although it sometimes fades again. When I wake up during the night or early morning, I only hear the cochlear tinnitus. It is not very loud, around 0.5 out of 10. However, the central gain tinnitus returns after a few minutes.

Doctor's Opinion (Two ENTs): They think it will likely go away, given that the tinnitus is not very severe. However, I felt that they did not really care or may lack experience. The consultations lasted only about five minutes.

What Seems to Help:

• Melatonin
• Sleep (mornings are better)
• Quiet environments (reduces reactivity)
• Possibly some supplements, though it is not clear which ones

What Makes It Worse:

• Sounds
• Biting or yawning (but only briefly)

So, my current theory is that I have ongoing inflammation that has not fully resolved, or possibly synaptopathy, also known as hidden hearing loss.

What do you all think? Is there a chance for full remission (not just habituation)? Will the reactivity at least go away? What else can I or should I do?

Thank you very much.

Kind regards, and all the best.