Low Frequency Hearing Loss

For purposes of this article, we are going to refer to a low-frequency sensorineural hearing loss (hearing loss caused by damaged inner ear hair cells). This type of hearing loss impacts the frequencies 2000 Hz and below. These are the deeper pitches. A low-frequency hearing loss is also known as a "reverse slope audiogram" because someone with low-frequency hearing loss may still hear sounds in the higher frequencies. Due to that, people with low-frequency hearing loss often can still understand speech well.

causes of low-frequency hearing loss
Illustration by JR Bee, Verywell


A mutation in the WFS1 gene (the Wolfram Syndrome gene) can cause low-frequency sensorineural hearing loss. The mutation is called Wolfram Syndrome 1. Other causes of low-frequency hearing loss include Mondini dysplasia (a cochlear malformation), sudden hearing loss, Meniere's disease, viral infections, renal failure, and changes in pressure that contribute to a fistula (such as intracranial hypertension) or after spinal anesthesia. 


A low-frequency hearing loss may be missed because it tends to not have any symptoms. Lower frequency sounds do not have as much information as sounds in the higher frequencies so people with hearing in the middle and high frequencies can use what they hear in those frequencies to make up for what they do not hear in the lower frequencies, thereby masking the hearing loss.

A person with low-frequency hearing loss will usually develop speech and language normally. One of the few clues to a low-frequency hearing loss is that the person has difficulty hearing in groups or in a noisy place. In most cases, this type of hearing loss will be noticed during a regular hearing screening.

If there is a family history of low-frequency hearing loss, you should see an audiologist for a comprehensive hearing evaluation and not rely only on hearing screenings.


Treatment depends on what issues the person with hearing loss is having. In some cases, treatment may not be necessary.

There are some wonderful hearing aids that can be used to give a boost to the low frequencies without amplifying the areas a person hears normally. More importantly, these hearing aids have noise reduction features and multiple microphones which may improve hearing in noisy situations.

There are also options such as remote microphones. Your audiologist will be able to guide you in choosing appropriate technology.

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  1. Bespalova IN, Van Camp G, Bom SJ, et al. Mutations in the Wolfram syndrome 1 gene (WFS1) are a common cause of low frequency sensorineural hearing lossHum Mol Genet. 2001;10(22):2501–2508. doi:10.1093/hmg/10.22.2501