In the past not too audible but now it is deafening especially in quiet rooms. I have some hearing loss.
Warm welcome to the forum, Karen. Here you are not alone as we understand the challenge of handling a new or higher level of tinnitus ringing. The initial period is the toughest. Saying that, it is helpful if you can find out the reason for the increase or spike. Above poster mentioned some common ones. Below I will list a broader list of causes.
There are many causes, single or combined, which can trigger or aggravate tinnitus including by not limited to drug reaction or side-effects from ototoxic drugs, ear wax build-up, ear or Eustachian tube infection or ETD, ear drum injury, fluid build-up in ears feeling pressured or fullness, sinus infection & congestion, TMJ, TTTS, high blood pressure or blood circulation problem, loud noise exposure or acoustic trauma/shock, head trauma & injury, neck injury or muscle problems, hearing loss, Meniere's Decease, barotrauma from sudden change of air pressure such as during landing & taking off on flights especially with blocked nose causing failure to balance the pressure changes, slapping of the ears, deep grief for the loss of loved ones, untreated sleep apnea, extreme, extended stress, anxiety & panic disorder, etc., etc. T can also be caused or made worse by unhealthy diet such as too much salt, sugar, caffeine, MSG, alcohol etc. or by lacking some mineral or vitamin supplements, such as Magnesium, Zinc, B12, D3 etc.
That of course is not all that there is that can cause tinnitus but enough list to include common ones. If you have any of these prior to the spike, then see if you can get a specialist to check it out if it is a fixable problem by medical people.
TRT is only one of the many treatment alternatives offered out there. It can be expensive. If you can solve the problem if it has a medical cause, you may be able to save some money in the process. Good luck. Take care. God bless.