The SIK Axis and Cochlear Mitochondrial Vulnerability: A Proposed Unified Mechanism for Nutritionally-Mediated Tinnitus and Sensorineural Hearing Loss

Tinnitus affects approximately 15% of adults globally — roughly 1.5 billion people — and is among the most common and least effectively managed symptoms in clinical medicine. This paper proposes that the Selenium-Iodine-Kidney (SIK) axis framework applies with equal mechanistic validity to cochlear mitochondrial vulnerability. The cochlea and the kidney share four critical structural characteristics: extreme metabolic demand, exclusive reliance on oxidative phosphorylation, end-artery blood supply with no collateral circulation, and dependence on local selenoprotein-mediated antioxidant defense. This paper identifies a clinically actionable, nutritionally addressable upstream mechanism and proposes the first cross-specialty biomarker panel connecting otolaryngology, endocrinology, and nutritional medicine for tinnitus evaluation. All claims are hypothesis-level.