Making Music and Noise-Induced Hearing Loss

I know… what a goddamn unpleasant, sensitive, horrifying topic to talk about. One which begs for any kind of contemplation to be hidden away in a repressed corner of the mind.

This is true for anyone who relies on hearing for their art. Especially if they already suffer from some noise-induced hearing loss, like musicians and sound engineers.

But we have to do it, folks, we can never turn a blind-eye (or a deaf-ear?) to this subject. Otherwise, we’ll pay the price later. This article is a collection of knowledge and wisdom I’ve been gathering over the years. I’m sure it’s not complete, but there’s enough here to keep one’s hands busy for a while.

Article Content Table:

1. The Mixing Volume

Mixing loud feels awesome!

Fletcher-Munson curves tell us why that is.

If you mix at lower volumes, the ears will hear mostly the mid-frequencies.

But turning up the volume will reveal the low frequencies – which give your mix power – and the high frequencies – which give it excitement.

Listening to the mix like this is exhilarating.

Therefore, even if the song is not that great or the mix is not that good, turning up the volume will make you forget that. That’s the whole reason for the Loudness Wars, if you ask me…

Winning the Loudness Wars

Get addicted to loudness and you’ll damage your hearing permanently in a few years. If you’re really lucky, you might get some tinnitus too.

Mixing loud will also make your ears get tired very fast. And tired ears make bad decisions.

Stolen meme from Todd Poore

Ear fatigue is the result of restricted blood flow to the inner-ear, a physiological response designed to help protect your hearing.

Tired ears are therefore the precursor to hearing damage. You think your tired ears are “free lunches”? Over a long period of time, there are no free lunches, and no bad deeds go unpunished.

So change your mixing approach.

If you’ve been mixing at loud volumes all this time, your fear is that the mix won’t hold up at softer listening volumes. On the other hand, when you mix at lower volumes, the fear is that the mix might become too harsh when listening at louder volumes.

The former problem is much harder to fix than the latter 😉

So, feel free to check your mix at high volumes from time to time. But then return to regular listening levels.

If you want to monitor your studio listening levels closely, consider buying a calibrated sound meter (not those apps for your smartphone). Even a cheap sound meter from Amazon will do the trick.

2. The Loud Sounds of the World

Use the sound meter I’ve mentioned above to study the sound pressure level of the things around you, and develop a sense of what can cause hearing damage. Then avoid those things, or use hearing protection whenever in their presence.

You’d be surprised how easily things can reach sound levels capable of damaging your hearing.

Sound sourceSound Pressure Level
Firearms160 dB
Boom Box inside car150 dB
Jackhammer130 dB
Shouting into the ear112 dB
Rock and Roll band110 dB
Ear buds at maximum level105 dB
Power Lawnmower95 dB
Ear buds at medium-high level94 dB
Dyson DC12 vacuum cleaner90dB
Milling machine84 dB
Garbage disposal80 dB
Source: Engineering Noise Control

You should be careful, though, not to develop some kind of phobia to loud sounds, because this will not be beneficial neither for your brain nor for your hearing system.

Consider the case of Adam Smith, who developed hyperacusis (decreased tolerance to sound volumes) and consequently also developed a phobia to many sounds, even those whose sound pressure levels were not damaging to the ears. This prevented him from improving his condition for a long time, and it was only when he was able to overcome his fear that he was able to succeed in beating his condition.

If you are a live sound engineer or if you enjoy going to live concerts, consider getting special earplugs like the Eargasm High Fidelity Earplugs. Unlike regular earplugs, which reduce primarily the high-frequencies, leaving you with a muffled sound, Eargasm earplugs will attenuate all frequencies evenly. So, you’ll still be able to listen critically – an essential skill for a live sound engineer – while protecting your hearing at the same time!

3. Can Headphones Cause Hearing Loss?

Experts have been increasingly telling us that headphones have been prompting a significant increase of hearing loss in adolescents.

Teenagers won’t think or care much about their hearing, so they won’t care that their earbuds can easily reach 94 dB SPL or more.

I know I didn’t.

It will take them many years until they start to slowly realize how much damage their headphones have been causing their ears. Sometimes it’s too late. Hopefully, this isn’t you.

It certainly could have been me.

Even though I grew conscious of their dangers, I still used headphones heavily up until Dec. 2016.

It was only when I complained to my audiologist that I was having some trouble listening to people, that she recommended me to stop using headphones. She told me they were probably causing a temporary threshold shift on my hearing. I followed her advice and my hearing returned to normal. She was right.

The lesson is this: even though I was consciously not listening to my headphones at loud volumes, what constitutes a safe volume may be lower than most people think… especially for those who use headphones all the time.

With this in mind, it should go unsaid that if you use non-noise-cancelling headphones in noisy environments, you’re asking for trouble, as you’ll be constantly raising the volume of the music to drown the exterior sounds out.

The discussion regarding headphones and hearing loss can go even further. There is a lot of discussion happening right now surrounding the controversial topic that headphones use, regardless of volume, may be prejudicial. Especially for people who already suffer from some kind of hearing damage like noise-induced hearing loss, noise-induced tinnitus and hyperacusis.

From the Tinnitus Talk support forum, we find a possible explanation why headphones and speakers are not the same thing:

The difference between them is diffusion. The headphone delivers the lot right to your eardrum whereas the speaker diffuses the sound over a greater distance, with more components of the sound energy being absorbed by other things in the space, thus reducing the net energy load on your eardrum, thus on your hearing mechanism beyond the drum.

My own audiologist that told me the same thing. She said “the ears don’t like hearing sound straight into them, it’s not a natural thing. Instead, they prefer hearing reflections bouncing in the environment around us.

Since her tips solved my hearing problems at the time, I’m biased to believe her theories.

The other reason I believe her theories is because whenever I use headphones again, I almost immediately start feeling the consequences, the most predictable one – but not the only one – being temporary somatic tinnitus on my right ear, with a frequency that can be modulated by voluntarily changing the ear pressure, for example.

If you search for long enough, you will also find other explanations involving our hearing system being affected by surrounding electric fields (1)(2), but I’m not so sure about that.

Regardless, I avoid using headphones as much as possible, and my hearing feels better for it. I invite you to consider trying the same.

4. “Your damaged hearing will adapt”

Okay, yes – having 40 years of mixing experience will help you out a lot, even if you have hearing loss. Dave Pensado is not a young guy anymore and he’s been mixing hundreds of songs yearly since the 70s. It’s impossible that he doesn’t have some hearing loss at this point.

Yet, this doesn’t seem to be a problem. His experience and close mental relationship with Sound has allowed his auditory system to compensate for this loss. And the proof of this is in the pudding. I mean, damn! this mix sounds good:

Also, mixing with reference tracks or using tools like iZotope’s Tonal Balance will help you stop wondering if your hearing loss is making you boost the high end too much.

Having said that, let’s not fall into the mistake of thinking that hearing is such a linear issue.

This is what Harman International (the parent company of JBL) has to say about individuals subjected to loudspeaker blind tests.

Consistency and hearing loss: Some listeners will listen to exactly the same setup in two different listening sessions and come up with radically different ratings for the same loudspeaker. Experiments have shown that the most erratic listeners are those with hearing loss. It turns out that people with good hearing tend to offer more consistent assessments over multiple listening sessions and tend to agree closely with each other.

Harman International

Let’s not think that mixing with hearing loss is just boosting unnecessarily the higher frequencies with EQ because we can’t hear them. No, what Harman International is telling us is that hearing loss affects the consistency of our hearing assessments in a broader sense. Hearing loss is not just a matter of losing the ability to hear certain frequencies. It’s more complex than that.

So, my point is this: mild hearing loss won’t end your mixing or music career… but it’s better to avoid it as much as possible, because it’s not a linear, simple problem. Just be prudent and take all the preventive steps described in this article, every single day. It is not a coincidence that it is said that “mixing is a young man’s game”. So do yourself a favor and stay young for as long as you can.

5. Remember the Mabaan

Presbycusis, or age-related hearing loss, is taken as a given among the medical community, with an expected loss of 2000 Hz per decade in the high frequencies, starting after your adolescence. If you can’t hear 16000 Hz by the time your 40, that’s normal – the doctor will tell you.

Now, I’m not saying that presbycusis is not a real condition. It certainly is. But you should at least be aware that extensive presbycusis is not an inevitable condition, if certain conditions are met.

The two main causes of presbycusis are (1) vascular disease and (2) exposure to noise.

Up to this day, it hasn’t been entirely possible to determine the degree of influence of each cause, because it’s not possible to find populations that are exposed to one cause and not the other.

It was possible, though, to find a tribe in Sudan that was exposed to neither cause.

That’s the Mabaan tribe.

Mabaan man – Source

This tribe is remarkable when it comes to hearing abilities and their preservation. Not only are they not exposed to noise, their philosophy and lifestyle is intermeshed with the ability to hear.

Research Samuel Rosen described them like this:

  • They live in a dramatically quiet, almost silent atmosphere;
  • They don’t use rifles to hunt;
  • They don’t use drums in their music;
  • They speak in soft voices;
  • They can hear a conversation, spoken in a normal voice, 90 meters away!

Simply put, they have the most acute hearing ever tested on a human population.

More important for this article, though, is that they show only mild signs of presbycusis:

53% of Mabaan elders in their 70s were capable of hearing 14000 Hz. In New York, that percentage is 2%.

Unfortunately – for Science, not for the Mabaans – they also have a low saturated fat diet, which results in them having no vascular diseases.

So we end up not knowing how much each cause (vascular disease and exposure to noise) contributes to presbycusis. We can only make educated guesses.

But we can still learn a lot from the Mabaan tribe: a good diet and a philosophy of silence goes a long way to preserving your hearing well into your old years.

6. Protective Medicine

As of December 2020, a new drug called ISRIB (Integrated Stress Response Inhibitor) has made headlines, and has been shown to:

  • 1. Restore memory function months after traumatic brain injury;
  • 2. Reverse cognitive impairments in Down Syndrome,
  • 3. Prevent noise-related hearing loss;
  • 4. Fight certain types of prostate cancer;
  • 5. Enhance cognition in healthy animals.

ISRIB is not a regenerative drug, but it “might one day be used as a hearing-protection regimen before working in a noisy environment or going to a loud concert.”

For the Sound Engineer that knows he will have to be around (loud) music all day, this hearing-protection regimen should prove itself to be very useful to him as well.

7. Maximizing Health

Never dispense with a healthy lifestyle.

All the components that comprise your hearing system, and your brain, they all need to be maintained to avoid physical decay over time. So follow this steps:

Drink lots of water.

The physiological power of water is a well known scientific fact. Among many other benefits, it contributes to optimal brain function and connectivity.

Since the brain is an extremely important organ for the hearing process, it should go unsaid that you should take good care of it.

Drinking water becomes even more relevant when we take in consideration the scientific study that shows that drinking water attenuates noise-induced hearing loss in guinea pigs.

Eat healthy food.

As we’ve seen before with the Mabaan tribe, nutrition plays an important role in keeping you and your hearing healthy. Besides the known correlation between vascular disease and hearing loss, some specific minerals and vitamins have been shown to promote hearing health.

1. Folic Acid: having a folic acid deficiency has been shown to induce premature hearing loss.

FoodFolic Acid per 100 g
Liver738 µg
Lentils479 µg
Black beans444 µg

You can also try folic acid supplementation.

Folic Acid Supplement

2. Magnesium: preventive administration of this mineral has been shown to be effective in reducing susceptability to noise-related hearing loss.

FoodMagnesium per 100 g
Pumpkin seeds550 mg
Flax seeds392 mg
Brazilnuts376 mg

You can also try magnesium supplementation.

Magnesium Supplement

3. Zinc: deficiency in this mineral is associated with worsening of existing hearing condictions such as tinnitus and sensorineural hearing loss in about 1/3 of eldery patients. It is also believed that this deficiency contributes to an acceleration of presbycusis (age-related hearing loss).

FoodZinc per 100 g
Oyster91 mg
Beef12 mg
Pumpkin seeds10 mg

You can also try zinc supplementation.

Zinc Supplement

4. Omega-3: these fatty acids have been shown to help prevent progressive hearing loss. They are also fabulous for your brain, memory and eyes.

FoodOmega-3 per 100 g
Flaxseed oil53 304 mg
Chia seeds17 552 mg 
Mackerel5 134 mg

Be aware of one thing: our body is not very efficient in converting vegetable sources of omega-3 into DHA and EPA. These two fatty acids are the responsible for most of the benefits of omega-3.

So don’t let yourself be fooled by the high amount of Omega-3 present in Flaxseed oil or Chia seeds. They’re still beneficial, but to get the most bang for the buck, you should focus on getting the Omega-3 from animal sources such as mackerel, salmon, sardines, etc.

Or get it from supplements.

Most Omega-3 supplements have a higher quantity of EPA fatty acids, which have anti-inflammatory proprieties.
Fewer Omega-3 supplements focus on having higher quantity of DHA fatty acids instead, which are very beneficial to the brain. For this reason, these are typically are marketed towards pregnant woman.

I like to alternate between them

Omega-3 Supplement (High EPA)

Omega-3 Supplement (High DHA)

5. Potassium: this mineral has been shown to increase the production aldosterone, the hormone responsible for, among other things, maintaining the health of your inner ear fluid.

FoodPotassium per 100 g
Sun-dried tomatoes3427 mg
White beans1795 mg
Spirulina1363 mg

Potassium Supplement

Aldosterone Hormone

Some websites cite potassium as a mineral that “regulates the fluid in your inner ear” and therefore you should focus on potassium-rich foods to maintain or improve inner ear health. This is not entirely correct.

Yes, it’s true that potassium is important in the inner ear, where it plays a central role in converting sounds into electric signals. But if at any time you detect low levels of potassium in you inner ear, that probably doesn’t necessarily mean you haven’t been eating enough bananas lately.

The most likely explanation is that you have low levels of the hormone aldosterone, which is the real responsible for regulating levels of potassium and sodium in the nervous system.

In other words, potassium regulation, not potassium levels (that doesn’t mean you should skip eating your bananas) is the culprit for some forms of hearing loss.

“We found a direct link between blood levels of aldosterone and the ability of people to hear normally as they age. Depressed hormone levels may hurt hearing both in the inner ear and the part of the brain used for hearing.”

International Center for Hearing and Speech Research

The researchers themselves admit that more research is needed to understand if there is a direct causation between aldosterone and hearing loss, or if it’s simply a matter of correlation and there’s actually a third underlying cause yet to be discovered.

These are some factors that may cause low aldosterone levels (hypoaldosteronism):

Some things that may increase your aldosterone levels are:

It would be smart to regularly control your levels of aldosterone through blood tests, and keep your doctor informed about it.


Multiple studies such as this one by Miami University, this one by University of Florida and this one by the Indian Institute of Ear Diseases show that cardiovascular exercise, stretching and Yoga show benefits for maintaining hearing health, delaying or halting presbycusis (age-related hearing loss).


Improper or insufficient sleeping is associated with poorer blood circulation, which, in turn, is an important part to guarantee the maintenance and survival of the hair cells in the inner ear.

Sleeping improperly will also atrophy your brain’s temporal lobe, which coincidentally is the part of your brain that processes sound.

Stress Relief

Chronic stress is known to cause a list of health problems. One of the reasons is the reduced blood flow that results from it. And, as seen previously, reduced blood circulation in not good for your brain’s hearing processing, nor for the inner-ear hair cells.

Stress has also been linked to Sudden Hearing Loss (a completely different condition than regular hearing loss, and often worse), and also linked to tinnitus.

Another study refers a possible association between hypertension and hearing loss.

To get some stress relief, you can do many things:

  • Dedicate time to your hobbies;
  • Dedicate time to your friends and family;
  • Be in Nature;
  • Exercise (as mentioned before);
  • Meditate;
  • Practice Yoga;
  • Sleep well (as mentioned before);
  • Go to the Sauna (as mentioned before);
  • Laugh;


Research has established that smokers are at a much higher risk of developing noise-induced hearing loss than non-smokers, as it irritates the lining of the inner hear and blocks the neurotransmitters responsible for sending auditory information to the brain.


Studies have shown a link between hearing loss and diabetes.

This means that not only should you make sure that you’re ingesting the right minerals and vitamins to promote good hearing health, but that you should also remove foods that increase the risk of developing type-2 diabetes.

For type-1 diabetes, you should talk to your doctor to receive personalized recommendations.

Bhramari Pranayama and Stretching of Neck and Shoulders

The same Indian Institute of Ear Diseases mentioned before, has also conducted an investigation on the effects of certain breathing techniques, stretches and meditation have on tinnitus and hearing loss.

The results of that study make it worth considering:

  • 3 out of 12 participants reported major improvements on their tinnitus and hearing loss conditions;
  • 10 out of 12 participants reported significant improvement on their quality of life.

These results were achieved by following a series of yogic-based procedures:

Bhramari Pranayama

  • Slow, deep abdominal inhale through the nose;
  • Tongue pressed on the hard palate;
  • Bring your chest up and lower your chin to it without curving your neck, also known as the jalandhara bandha;
  • Perform Shanmukhi mudra: index fingers gently close the eyes, middle fingers rest on the nose, ring fingers rest on the upper-lips, little fingers rest on the lower-lips, thumbs close the ears.
  • Eyes are focused on the Ajna Chakra, the third-eye;
  • Be completely relaxed, with a smile on your face;
  • Exhale making a high-pitched humming sound (OM) with the mouth closed;
  • Spiritual concentration on Krishna, the god of compassion, tenderness and love;
  • Hold the breath out for as long as you comfortably can;
  • During this part, spiritual concentration should be on Lord Shiva, the Destroyer, who’ll pave the way to a new beginning;
  • Do this 21 times;

Neck Flexion

  • Slow, deep abdominal inhale through the nose;
  • Bring your chest up and lower your chin to it without curving your neck (jalandhara bandha);
  • Hold the breath in;
  • Physical awareness on the back of the neck;
  • Spiritual awareness on the vishuddha chakra, on the throat;
  • Command your body to relax your neck while staying in its current position;
  • Release jalandhara bandha and exhale;

Neck Extension

  • Slow, deep abdominal inhale through the nose;
  • Gently bring your head upward and backward;
  • Hold the breath in;
  • Physical awareness on the back of the neck;
  • Spiritual awareness on the vishuddha chakra, on the throat;
  • Command your body to relax your neck while staying in its current position;
  • Enjoy the increased blood flow to your ears and brain;
  • Return to neutral position while exhaling;

Lateral Neck Flexion

  • Slow, deep abdominal inhale through the nose;
  • Stabilize and immobilize your shoulder at all times;
  • Tilt your head to the right, gently stretching it;
  • Hold the breath in;
  • Physical awareness on the back of the neck;
  • Spiritual awareness on the vishuddha chakra, on the throat;
  • Command your body to relax your neck while staying in its current position;
  • Enjoy the increased blood flow to your ears and brain;
  • Return to neutral position while exhaling;
  • Repeat, tilting your head to the left.

Head Rotation

  • Slow, deep abdominal inhale through the nose;
  • Rotate your head to the right, gently stretching it;
  • Hold the breath in;
  • Physical awareness on the back of the neck;
  • Spiritual awareness on the vishuddha chakra, on the throat;
  • Command your body to relax your neck while staying in its current position;
  • Enjoy the increased blood flow to your ears and brain;
  • Return to neutral position while exhaling;
  • Repeat, rotating your head to the left.

360º Head Rotation

  • Slow, deep abdominal inhale through the nose;
  • Hold the breath in;
  • Start by performing jalandhara bandha (1);
  • From that position, swing your head to your left shoulder (2);
  • Then swing it to your right shoulder (3) while passing on position (1);
  • Rotate the head as to look forward (4);
  • Return to original position (1);
  • These movements should be done slowly but fluidly.
  • Exhale;
  • Repeat this 3x;
  • Then repeat the same rotation movements in the opposite direction 3x as well.

Skandh Chalan

  • Put hands on knees;
  • Slow, deep abdominal inhale through the nose;
  • Hold the breath in;
  • Physical awareness on back, between the shoulder blades;
  • Spiritual awareness on Manipura Chakra, located on the solar plexus;
  • Rotate shoulders forward and upward;
  • Rotate shoulders backward and downward;
  • This is 1 cycle. Repeat it 21 times, if possible all in a single breath;
  • Command your neck, shoulders, ears and brain to heal and be revitalized while you’re doing it;
  • Exhale.

Alternate Shoulder Rotation

  • Put hands on knees;
  • Slow, deep abdominal inhale through the nose;
  • Hold the breath in;
  • Right shoulder goes upward and left shoulder goes downward;
  • Right shoulder goes forward and left shoulder goes backward;
  • Left shoulder goes upward and right shoulder goes downward;
  • Left shoulder goes forward and right shoulder goes backward;
  • This circular motion is 1 cycle. Repeat it 21 times, if possible all in a single breath;
  • Command your neck, shoulders, ears and brain to heal and be revitalized while you’re doing it;
  • Exhale;
  • Repeat the exercise in the opposite direction.


Caring for one’s hearing is much more complex than it may seem at first. It’s not just about following the tips mentioned above. It’s also important to apply them consistently.

This may require a broader change in lifestyle or mindset entirely, and that’s not always easy to do.

But if you truly care about your hearing, then I’m sure that either suddenly or gradually, you’ll find a way to implement all these science-backed tips I’ve provided in this article.

Best of luck!