Those X's, O's, and dB numbers aren't as complicated as they look. Here's what they actually mean.
An audiogram is a graph that maps your hearing ability. It shows the softest sounds you can hear at different pitches in each ear. Think of it as a report card for your ears — not pass or fail, but a precise picture of where your hearing is strong and where it drops off.
An audiogram can diagnose your hearing loss and indicate what type of hearing loss you have. It can distinguish your hearing in each ear and whether you have hearing loss on one or both sides.
During the test, you wear headphones and press a button every time you hear a tone. The audiologist plays sounds at different volumes and pitches and plots the results on the graph. The pattern those marks form tells the whole story.
Example audiogram showing mild-to-moderate sloping hearing loss — common with age-related loss. Red circles = right ear. Blue X's = left ear.
The horizontal axis shows frequency measured in Hertz (Hz). Think of this as pitch — from low sounds like a bass drum on the left (250 Hz) to high sounds like a bird chirping on the right (8000 Hz). The numbers typically go: 250, 500, 1000, 2000, 4000, 8000.
The vertical axis shows intensity measured in decibels (dB). This represents how loud a sound needs to be for you to hear it. Here's the counterintuitive part: the numbers start at 0 at the top and go down to 120 at the bottom. The lower down the mark on the chart, the louder the sound needed to be for you to hear it.
Each mark on your audiogram represents the softest sound you could hear at a specific pitch in a specific ear. Here's what the standard symbols mean:
For adults, an audiogram reading between -10 and 25 dB is considered within normal limits. Beyond that, loss is categorized by degree. Your audiologist calculates your "pure tone average" (PTA) — typically the average of your thresholds at 500, 1000, and 2000 Hz — to assign a degree:
| Degree | dB Range | What you might notice | OTC suitable? |
|---|---|---|---|
| Normal | –10 to 25 dB | No significant difficulty | No aid needed |
| Mild | 26–40 dB | Trouble in noise, soft speech, groups | ✅ Yes — OTC works well |
| Moderate | 41–55 dB | Difficulty with normal conversation | ✅ Yes — OTC may work |
| Mod-Severe | 56–70 dB | Need loud speech; TV very high | ⚠️ Borderline — get evaluated |
| Severe | 71–90 dB | Loud speech barely audible | ❌ Prescription needed |
| Profound | 91+ dB | Very little hearing without aids | ❌ Specialist required |
The shape of your audiogram matters as much as the degree. Two people with the same average dB loss can hear very differently depending on which frequencies are affected. Here are the most common patterns:
Many audiograms include a banana-shaped region plotted on the chart. This represents where the sounds of normal conversation fall. When your hearing thresholds fall below the speech banana, those are the sounds you're likely missing in conversation. This explains why two people with the same "degree" of hearing loss can have very different experiences — it depends on which parts of speech they can still access.
Vowel sounds (a, e, i, o, u) cluster at low to mid frequencies. Consonants — the sounds that give speech its clarity — live in the high frequencies. A sloping loss that spares the low frequencies but hits the highs will leave you hearing the volume of speech but missing its clarity. That's why so many people say "I can hear fine — I just can't understand what people are saying." That's not a paradox. That's a high-frequency sloping audiogram.
Once you understand your audiogram, the path forward becomes clearer:
If your loss falls in the OTC range, your next step is figuring out which device matches your audiogram pattern. A sloping high-frequency loss — the most common — benefits most from a device with strong high-frequency amplification and speech clarity processing. That's exactly what the ELEHEAR Beyond Pro's AI system is designed for.
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Normal hearing is a threshold of 25 dB HL or better across the tested frequencies (roughly 250 Hz to 8,000 Hz). On the chart, that means your marks sit near the top, within the 0–25 dB band. The lower your marks drop on the graph, the more hearing loss you have at that pitch.
The O (often shown in blue) marks your right ear’s thresholds and the X (often in red) marks your left ear. Each symbol shows the quietest sound you could hear at that frequency. Audiologists also use brackets, triangles, and arrows for bone-conduction and “no response” results, but the X and O for air conduction are the two you’ll see most.
Hearing aids are typically recommended once your average threshold falls into the mild range (about 26–40 dB) or worse, especially if you struggle with speech. Moderate loss (41–55 dB) and beyond almost always benefits from amplification. Even mild high-frequency loss often warrants a device, because that’s where much of speech clarity lives.
OTC hearing aids are designed for adults with perceived mild to moderate loss — roughly a 26–55 dB average. If your audiogram is in that range, OTC devices are a legitimate, lower-cost option. If it shows moderate-to-severe or severe loss, or a steeply sloping pattern, you’ll get better results from a professionally fitted prescription device.
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