Dr. Konstantina Stankovic: Medical doctor, researcher, and chair of the Department of Otolaryngology, Head and Neck Surgery at Stanford School of Medicine. A leading expert on the inner ear, hearing loss, and tinnitus.
What this episode covers
Andrew Huberman and Dr. Konstantina Stankovic explore how the auditory system works, from the fetal ear in the second trimester through aging. They cover the mechanics of the cochlea, the two main types of hearing loss, and the mounting evidence linking hearing loss to dementia and cognitive decline. The conversation gives practical, science-backed protection strategies: earplugs, safe decibel limits, magnesium, and avoiding ototoxic drugs. They also dig into tinnitus, cochlear implants, sound pollution's effect on wildlife, micro/nanoplastics in hair cells, and the deep connection between sound, emotion, and the vestibular system.
Recommended on this episode
Magnesium Threonate
various
“I've been taking magnesium threonate for, gosh, well over a decade because I learned that it was the form that most readily crosses the blood-brain barrier”— Andrew Huberman
The guest's own work
Protocols: An Operating Manual for the Human Body
Andrew Huberman
“I have a new book coming out... It's entitled "Protocols: An Operating Manual for the Human Body."”— Andrew Huberman
Also referenced (named, not recommended)
Magnesium Bisglycinate
various
“I know a lot of people take magnesium bisglycinate as an alternative. As far as I know, those are interchangeable.”— Andrew Huberman
Why We Sleep
Matthew Walker
“the great sleep scientist, Matt Walker, author of "Why We Sleep," et cetera, has cited experiments where they look at bottles of melatonin”— Andrew Huberman
Big reveals from this episode
- Hearing loss affects 1.5 billion people, disables half a billion, and another billion will be affected by 2050 (WHO).
- Some 'temporary' ringing in the ears after a concert is actually permanent synaptic damage ('hidden hearing loss').
- Taking magnesium before loud noise exposure reduced hearing loss in military studies; magnesium threonate is the leading candidate.
- The best current treatment for tinnitus is a cochlear implant; 75% of recipients improve and it vanishes entirely in 10%.
- Unaddressed hearing loss costs nearly a trillion dollars annually and is strongly linked to social isolation and dementia.
- Regular ibuprofen/NSAID use (twice a week or more) raises the likelihood of hearing loss at all ages.
- Micro and nanoplastics were preferentially taken up by hair cells in the inner ear in her lab's studies.
- There is no primary cancer of the inner ear, a phenomenon that could inform new cancer therapies.
Worth remembering
- The human cochlea in cross-section is about the size of Lincoln's upper face on a penny, filled with only ~140 microliters of fluid (three raindrops).
- The ear can detect displacements smaller than the diameter of a hydrogen atom (sub-angstrom level).
- For every 3-decibel increase in sound, safe exposure time halves; 80 dB is safe for ~8 hours.
- A simple rule: if someone nearby can hear what's in your headphones, it's too loud.
- Melatonin bottles can be off by up to 85% in either direction from their labeled dose.
- The brain can recalibrate: improving peripheral hearing input lets it 'take care of itself' and quiet tinnitus.
- The fetus can hear in the second trimester, and the organ of hearing is fully formed in utero.
- In superior semicircular canal dehiscence, people develop 'superhuman hearing' and can hear their own eyeballs move.
- Women hear better than men pre-menopause but catch down to men's levels post-menopause, implicating estrogen.
- Birds fully regenerate inner-ear hair cells within about a month; mammals cannot.