Hearing Health
What is Tinnitus?
(noun): a sensation of noise (such as a ringing or roaring) that is typically caused by a bodily condition (such as a disturbance of the auditory nerve or wax in the ear) and usually is of the subjective form which can only be heard by the one affected
Ringing in your ears. You likely have some ringing already. How bad is it? It depends. If you don’t think about it often, and it’s not diminishing your ability to hear, then you’re doing fine. Take a hearing test and get a baseline. Future you will want that data.
The thing nobody tells you early enough: tinnitus that shows up after a loud night and fades within a day or two is a warning shot, not a life sentence. Tinnitus that sticks around means the damage stuck around. That’s the whole reason the Safe Limits page exists.
What is Hyperacusis?
Reduced tolerance to everyday sound. Volumes that are fine for everyone else (dishes clattering, a car door, a normal restaurant) feel uncomfortably loud or even painful. It often travels with tinnitus, and it can follow acoustic trauma.
The counterintuitive part: the instinct is to protect your ears from everything, all the time. That usually makes it worse. Overprotection in quiet environments makes your auditory system even more sensitive. Save the plugs for actually-loud situations, and let your ears live in normal sound the rest of the time. If sound is genuinely painful at ordinary volumes, that’s a case for an audiologist experienced with sound therapy, not for permanent earplugs.
Audiologist / ENT / General practitioners?
You’ll need all of these at different times imo. They’re each useful and completely useless in their own regard. You won’t find anyone to coordinate all this research for you if you need help. If only it was that easy. It’s all on you, but don’t worry.
My experience: Go to a general practitioner, especially if you have insurance, and make sure you don’t have an ear infection/fluid in your middle ear. Middle/inner ear problems are tricky to troubleshoot and there’s not much the medical community can do to help imo. The ENT and Audiologist won’t help you hear.
Audiologist: Go here for hearing aids and hearing tests. Everything for them points to hearing aids. Tinnitus Retraining Therapy uses expensive hearing aids and is legitimate science.
For the specific local providers I’ve actually had good experiences with, see Doctors.
The one true emergency: sudden hearing loss in one ear (over hours or a day or two, not years) needs steroids within days to have the best shot at recovery. Skip the referral chain: urgent care or ER, and use the phrase “sudden sensorineural hearing loss.”
What if I’m having problems? What might help?
For me:
- Medical professionals where they are helpful
- Steroids
- Maybe antibiotics
- Maybe you have something specific going on that can be addressed with a specific therapy
- Reduce your exposure
- This is where it can suck. I don’t go out as much as I’d like to, headphones aren’t an option, I limit studio time in the home. It is what it is. I’m grateful it’s not worse.
Managing hearing health long-term
The stuff that actually moves the needle, in rough order of importance:
Get a baseline hearing test, then retest yearly. Hearing loss is gradual and your brain compensates, so you will not notice 10db of loss at 4kHz. A yearly audiogram catches the trend while you can still change your behavior. Some audiologists do this cheap or free; there are also decent calibrated online/app tests for tracking between visits.
Know your numbers. Measure the rooms you’re actually in (see Equipment for meter apps). Once you know your gym is 92db and your favorite bar is 89db, the Safe Limits math stops being abstract.
Protect at the source when you can. Stand away from the speakers: a few meters can be 5-10db, which per the 3db rule is 2-4x more safe time for free. Pick venues that aren’t stupidly loud. Complain when they are; sound engineers do sometimes listen.
Give your ears recovery days. The research on temporary threshold shift says ears need quiet time after loud exposure. Back-to-back loud nights are much worse than the same nights spread across two weeks. Treat it like training load.
Watch the headphones. For most people headphones are the biggest lifetime dose, not concerts. Volume-limit your devices, use ANC in transit so you’re not cranking over engine noise, and take an ear break every hour.
Sleep, stress, and cardio. Tinnitus gets louder when you’re stressed and exhausted. Everyone who has it will tell you the same. Cardio, decent sleep, and less stimulant load won’t cure anything but they turn the volume knob down on how much you suffer from it.
Don’t doomscroll tinnitus forums at 2am. The people doing fine aren’t posting. If the ringing is spiking your anxiety, CBT for tinnitus has real evidence behind it. The goal is making your brain file the sound under “ignore,” which is what habituation actually is.
Not medical advice. See the disclaimer.