Recently Developed Loudness Hyperacusis After Acoustic Trauma — Worsened Tinnitus/Hyperacusis by Methylprednisolone

[delta784]

Hello everyone,

About a month ago, I developed mild loudness hyperacusis due to acoustic trauma. The first ENT doctor I consulted didn't prescribe steroids (Prednisone or Methylprednisolone) because there was no hearing loss. I then went to another ENT, who told me that since the hyperacusis had been present for less than a month, we could try Methylprednisolone. Instead of using the intratympanic route, we opted for intravenous (IV) injections through my arm.

After taking the second 60 mg dose via injection, I developed unmaskable tinnitus in one ear and Morse code-like tinnitus in the other. Following this, I stopped the injections cold turkey. I also feel like my mild hyperacusis has worsened.

My question is: could Prednisone or Methylprednisolone have caused this? Some websites suggest that these medications are ototoxic. I got tested again and still have no hearing loss up to 16,000 Hz in both ears.

I urgently need help. What are the signs of ototoxicity?

 

[Nick47]

Prednisolone does not damage the inner ear. Your symptoms may have progressed despite the treatment, but improvement will take time. In the meantime, avoid loud noises and consider arranging CBT. You can also explore treatment and research threads for additional management ideas. A combined approach is usually most effective. Additionally, it may be best to avoid Facebook groups, as they often contain unreliable advice from people promoting supplements and massages.

 

[delta784]

Prednisolone does not damage the inner ear. Your symptoms may have progressed despite the treatment, but improvement will take time. In the meantime, avoid loud noises and consider arranging CBT. You can also explore treatment and research threads for additional management ideas. A combined approach is usually most effective. Additionally, it may be best to avoid Facebook groups, as they often contain unreliable advice from people promoting supplements and massages.

If I had taken Prednisolone orally, I don't think it would have affected me as much. I took it intravenously, which I believe caused the issue. Now, I have a constant ringing in my healthy left ear and a beeping, Morse code-like tinnitus in my right ear (which doesn't bother me as much). However, the ringing in my left ear is extremely loud.

 

[pants]

Can you describe your acoustic trauma? It's possible that those tones developed independently of the Methylprednisolone. I'm almost six months out from my own acoustic trauma, and I didn't take any prednisone, yet I also have morse code-like tinnitus and other tones. Depending on how soon after the trauma you took the steroids, they may have given you a chance to reduce some of the damage.

I found loud noises unbearable for months after my acoustic trauma (a loud indoor metal concert). I keep earmuffs in most rooms so I can quickly put them on if needed, like when the dog barks or when I use the coffee grinder. I also have earplugs for driving and going out. I stopped going out altogether to avoid loud places and experienced setback after setback. Doing almost anything seemed to worsen my tinnitus.

Recently, I've started feeling much better. My sensitivity to noise has improved. It's not quite back to where it was before, but I was able to attend a wedding last weekend with musicians' earplugs. It was much louder than anything I had exposed myself to in the past few months, so I was nervous about how it would affect my tinnitus, especially since much less had worsened it in the past. Thankfully, my tinnitus is now much less bothersome than it used to be. I still need to be cautious since it hasn't been long since I reached this good place with my tinnitus, and I know improvement isn't always linear.

Right now, I'm happy with my progress and hope it continues. I'm a big believer in the TPP approach for tinnitus recovery from acoustic trauma: Time, Patience, and Protection.

 

[delta784]

Can you describe your acoustic trauma? It's possible that those tones developed independently of the Methylprednisolone. I'm almost six months out from my own acoustic trauma, and I didn't take any prednisone, yet I also have morse code-like tinnitus and other tones. Depending on how soon after the trauma you took the steroids, they may have given you a chance to reduce some of the damage.

I found loud noises unbearable for months after my acoustic trauma (a loud indoor metal concert). I keep earmuffs in most rooms so I can quickly put them on if needed, like when the dog barks or when I use the coffee grinder. I also have earplugs for driving and going out. I stopped going out altogether to avoid loud places and experienced setback after setback. Doing almost anything seemed to worsen my tinnitus.

Recently, I've started feeling much better. My sensitivity to noise has improved. It's not quite back to where it was before, but I was able to attend a wedding last weekend with musicians' earplugs. It was much louder than anything I had exposed myself to in the past few months, so I was nervous about how it would affect my tinnitus, especially since much less had worsened it in the past. Thankfully, my tinnitus is now much less bothersome than it used to be. I still need to be cautious since it hasn't been long since I reached this good place with my tinnitus, and I know improvement isn't always linear.

Right now, I'm happy with my progress and hope it continues. I'm a big believer in the TPP approach for tinnitus recovery from acoustic trauma: Time, Patience, and Protection.

Sorry for the late reply. It was a different situation—a hair dryer was too close to my ear canal, blasting at full speed without me noticing. However, my tinnitus wasn't caused by that. It was caused by methylprednisolone injections in my arm, which I received two weeks after my acoustic trauma.

I know this response is late, but I was scared of permanent damage. Here I am now, having given myself tinnitus. I'm not sure if I should take NAC after 25 days of drug-induced tinnitus.

 

[Nick47]

The Prednisolone did NOT CAUSE your tinnitus. Noise exposure did. It can be a one-time event or, more commonly, accumulate over time.

Let it go...

 

[delta784]

The Prednisolone did NOT CAUSE your tinnitus. Noise exposure did. It can be a one-time event or, more commonly, accumulate over time.

Let it go...

The noise exposure was caused by a hair dryer that was held too close to my right ear canal without my noticing. The tinnitus subsided after two weeks. However, Methylprednisolone gave me new bilateral tinnitus tones, including in my previously healthy left ear. I swear on everything I love in my life—I can't let it go because I know what caused my tinnitus. Either they gave me something else by mistake, or it was caused by the Methylprednisolone steroid injections.

 

[Nick47]

I can't let it go because I know what caused my tinnitus. Either they gave me something else by mistake, or it was caused by the Methylprednisolone steroid injections

@delta784, you have to let it go. There can be a delay after noise exposure; it's common for it to get worse before it gets better. Plus, if you believe the steroids caused it, what difference does it make? You have tinnitus, I have tinnitus, and CBT is currently the gold-standard treatment

 

[delta784]

@delta784, you have to let it go. There can be a delay after noise exposure; it's common for it to get worse before it gets better. Plus, if you believe the steroids caused it, what difference does it make? You have tinnitus, I have tinnitus, and CBT is currently the gold-standard treatment

But Nick, I'm only 29, and I want to enjoy the things I used to before—traveling, eating, seeing new places, talking to my girlfriend over the phone, making jokes, and more. Now, I can't find any joy in these things. I feel like I'm finished inside. How can I overcome this? My previously healthy left ear seems to have worsened; it doesn't feel healthy anymore.

 

[Nick47]

@delta784, you could try the NeuromedCare approach under treatments or simply give it time (6–24 months) for improvement. CBT may also be helpful.

No one, at any age, wishes for a chronic disease!

 

[HighleyTall]

I have a young family member in their late 20s who developed severe tinnitus and hyperacusis after being exposed to loud noise at a Rammstein concert. Initially, he thought his life was over, but he eventually recovered almost completely. Now, he attends concerts again, using hearing protection, although I don't recommend this as it can give a false sense of security. I, too, continued playing music with custom-molded earplugs.

It's important to understand that it's not just the loudness that matters but also the duration of sound exposure. For example, playing shooting games with headphones for hours every day can seriously damage your hearing.

Give your ears time to heal. This process can take months, but improvement is possible, especially since you're still young. Moving forward, try to avoid exposure to loud noise as much as possible. Our ears are not designed to withstand extreme loudness from speakers, woofers, and tweeters.

 

[delta784]

I have a young family member in their late 20s who developed severe tinnitus and hyperacusis after being exposed to loud noise at a Rammstein concert. Initially, he thought his life was over, but he eventually recovered almost completely. Now, he attends concerts again, using hearing protection, although I don't recommend this as it can give a false sense of security. I, too, continued playing music with custom-molded earplugs.

It's important to understand that it's not just the loudness that matters but also the duration of sound exposure. For example, playing shooting games with headphones for hours every day can seriously damage your hearing.

Give your ears time to heal. This process can take months, but improvement is possible, especially since you're still young. Moving forward, try to avoid exposure to loud noise as much as possible. Our ears are not designed to withstand extreme loudness from speakers, woofers, and tweeters.

My problem is not loudness hyperacusis. I protect my ears from sounds over 80 dB. I'm glad to hear your family member is doing better. My issue is tinnitus, which developed after receiving intravenous steroid medication. It's been a month with no improvement whatsoever. Noise-induced tinnitus tends to get better over time, but with drug-induced tinnitus, I don't think so—the damage is done. I just can't cope with it at all. At the end of the day, I know I'm the only one who can help myself, but I am extremely sad.

 

[Nick47]

Noise-induced tinnitus tends to get better over time, but with drug-induced tinnitus, I don't think so—the damage is done. I just can't cope with it at all. At the end of the day, I know I'm the only one who can help myself, but I am extremely sad.

Both noise-induced and drug-induced hearing damage affects the inner ear in the same way; damage is damage. Millions of people take steroids every day. Currently, CBT, time, and habituation are the most effective treatments available. If you don't have hyperacusis, continue living your life as usual, while avoiding loud environments.

 

[delta784]

Both noise-induced and drug-induced hearing damage affects the inner ear in the same way; damage is damage. Millions of people take steroids every day. Currently, CBT, time, and habituation are the most effective treatments available. If you don't have hyperacusis, continue living your life as usual, while avoiding loud environments.

My tinnitus worsened overnight after October 25th for no apparent reason. I was never exposed to loud sounds. I was sleeping when fleeting tinnitus occurred, and I went deaf for a moment; this happened twice, also on October 27th. Now my right ear has severe tinnitus and moderate dysacusis.

 

[Nick47]

My tinnitus worsened overnight after October 25th for no apparent reason. I was never exposed to loud sounds. I was sleeping when fleeting tinnitus occurred, and I went deaf for a moment; this happened twice, also on October 27th. Now my right ear has severe tinnitus and moderate dysacusis

Symptoms of noise exposure often appear with a delay and can change over the following six months. Hyperacusis may initially worsen, then lessen, and possibly worsen again as the brain adjusts to a temporary or permanent change in hearing thresholds.

Tinnitus, while often perceived as sounds in the ears, is actually processed in the brain, specifically in the auditory cortex. In my case, I experienced fleeting tinnitus, where the tinnitus would come and go multiple times over the first year. This transient form of tinnitus is a common occurrence following noise-induced tinnitus.

 

[J96]

@delta784, I wouldn't take @Nick47's advice. I developed a new tinnitus tone from a single dose of prednisone. Eleven months later, that tone is much quieter, but it's still there. I'm 100% sure it's from the steroid, as I was in noise isolation, dealing with a trauma that, like in your case, was in the other ear.

Personally, I believe it's due to damage. Once tinnitus involves more than one tone in each ear, there's a level of inhibition in the auditory system that weakens, which can lead to issues like dysacusis, hyperacusis, noxacusis, and reactive tinnitus. The vast majority of people seem to develop these after acquiring multi-tonal tinnitus at some point.

 

[delta784]

@delta784, I wouldn't take @Nick47's advice. I developed a new tinnitus tone from a single dose of prednisone. Eleven months later, that tone is much quieter, but it's still there. I'm 100% sure it's from the steroid, as I was in noise isolation, dealing with a trauma that, like in your case, was in the other ear.

Personally, I believe it's due to damage. Once tinnitus involves more than one tone in each ear, there's a level of inhibition in the auditory system that weakens, which can lead to issues like dysacusis, hyperacusis, noxacusis, and reactive tinnitus. The vast majority of people seem to develop these after acquiring multi-tonal tinnitus at some point.

Yes, I am absolutely certain that Methylprednisolone caused and worsened my dysacusis and tinnitus. I promise everyone I care about that I never had tinnitus in my left ear before, and my right ear only had borderline symptoms. Now, I experience dysacusis and constant Morse code beeps in my right ear, along with moderate tinnitus in my left ear.

The most bothersome issue is the tinnitus and dysacusis in my right ear. Is there any chance they could improve over time if I protect my ears? At least the dysacusis? How can I forgive myself? If I could go back to September 22, I would do everything differently. I feel like I'll probably need to wear earplugs whenever I'm outside for the rest of my life.