Dr. Konstantina Stankovic on Huberman Lab: Why Noise Hurts

What used to be called “temporary threshold shift” is now known to sometimes leave lasting synaptic damage between hair cells and auditory nerve fibers (“hidden hearing loss”), even when the audiogram later looks normal. Symptoms can include tinnitus and difficulty hearing in noisy environments. If you leave a concert or loud setting with ringing ears or a clogged sensation, that’s a sign you’ve pushed your system too far and need to avoid a second insult for a while.

Rough guide: 80 dB is safe for ~8 hours. Every +3 dB halves safe exposure time (83 dB → 4 hours; 86 → 2 hours; 89 → 1 hour; 92 → 30 minutes). Concerts often hit 110–120 dB; jet engines ~140 dB. At those levels, unprotected exposure can be literally deafening. Use a dB-meter app on your phone, wear earplugs that provide enough attenuation (20–30 dB for loud shows), and insert them correctly. If someone standing next to you can hear what’s coming out of your headphones, it’s too loud.

Hearing loss affects 1.5 billion people and disables ~500 million. It drives withdrawal from social situations, depression, and increased cognitive effort just to decode speech. Standard audiograms can miss early and ‘hidden’ damage—up to 90% of neurons can be gone while thresholds test “normal.” Emerging tests (e.g., speech-in-noise) may better predict who’s at cognitive risk. Treating hearing loss early (e.g., with hearing aids or cochlear implants) helps maintain social engagement and may help protect cognition.

Controlled studies in conscripted military populations showed those given magnesium before loud artillery exposure had less hearing loss. Animal data indicate magnesium levels in the cochlea change more than any other ion after noise trauma. Population work suggests higher magnesium intake/serum levels correlate with better hearing. Magnesium threonate likely crosses the blood–brain barrier best and is a promising candidate for hearing protection, but optimal dose, timing, and formulation remain unproven. Priority remains a magnesium-rich diet (nuts, seeds, fish, leafy greens).

Tinnitus is a brain-generated phantom sound, often triggered by reduced input from the ear, akin to phantom limb pain. Systematic reviews and meta-analyses show no consistent benefit of common supplements (including magnesium or melatonin) across the broad tinnitus category—likely because multiple biological subtypes are being lumped together. Current guidelines emphasize two interventions with decent evidence: amplification (hearing aids) when hearing loss is present, and cognitive behavioral therapy to reduce distress and de-couple tinnitus from emotional circuits.