Healthnotes Newswire (January 18, 2001)—According to a large clinical trial published in this week’s British Medical Journal (BMJ), the popular herbal supplement Ginkgo biloba is not an effective treatment for people suffering from tinnitus (ringing in the ears).¹

Completed by researchers at the University of Birmingham in Great Britain, the 12-week placebo-controlled trial recruited 1,121 people suffering from tinnitus for at least one year but for less than five years. Participants were given either a standardized Ginkgo biloba extract (50 mg three times per day) or an identical looking placebo pill.

The researchers found that there were no significant changes in either the ginkgo or the placebo group at the end of the 12-week trial. Side effects were rare and primarily consisted of mild stomach upset that was reported equally in both groups.

Previous Trials Yield Mixed Results

Sold as an herbal supplement in the United States, the standardized extract of the leaves of the Ginkgo biloba tree has been reported by some to be a promising treatment for tinnitus.² Although approved in Germany as a potential treatment for tinnitus,³ the clinical research support for the herbal extract has been mixed.⁴ Critics of ginkgo as a treatment for tinnitus have pointed to the small number of patients and occasional lack of a placebo comparison group in European trials.

On the positive side, the herbal extract has shown some promise in treating elderly people whose tinnitus is associated with changes in blood flow to the brain due to cardiovascular disease (sometimes called "cerebral insufficiency").⁵ In these people, tinnitus is only one of a constellation of symptoms that often includes a decrease in mental sharpness and memory. While the current clinical trial suggests ginkgo may hold little promise as a general approach to tinnitus, the researchers add “…it may be effective in treating tinnitus in patients who also have other symptoms of cerebral insufficiency.”

Further studies are needed before ginkgo is completely crossed off the list of potential treatments for tinnitus. These studies should be more closely monitored in a clinical setting and should include more in-office measurements of symptoms. In addition, future trials should extend the treatment period beyond three months and should compare higher doses of the extract to determine whether they may be effective.

What is Tinnitus?

Tinnitus, or “ringing in the ears,” is the medical term for the perception of sound when no external sound is present. Although it is often described as a ringing sound, tinnitus is sometimes described as hissing, roaring, whistling, chirping, or clicking. Tinnitus may be sporadic or constant.

Over 50 million Americans experience tinnitus to some degree, with approximately 12 million seeking medical attention. The condition is estimated to affect 10% of the world’s population; about 0.5% consider it to severely interfere with their quality of life.⁶

The potential causes of tinnitus are numerous and include exposure to loud noises, certain medications, ear or sinus infections, jaw misalignment, high blood pressure, head or neck trauma, and thyroid disease. Of these, the most common cause is exposure to loud noises leading to noise-induced tinnitus and hearing loss.

Due to the diversity of underlying causes, the search for an effective treatment for tinnitus has largely been fruitless. Treatment often aims at the underlying medical condition. Doctors may suggest a hearing device that produces sound that is more tolerable than tinnitus, as well as earplugs to block loud noises that could cause further damage.

Other Options for People with Tinnitus

Because of the lack of effective drug therapies, many tinnitus sufferers seek alternative treatments, such as acupuncture, biofeedback, and nutritional supplements (vitamin B12 and zinc). As has been the case with other prospective treatments, each has had mixed results in clinical trials and may prove useful in only a small segment of tinnitus sufferers.

Tinnitus sufferers interested in learning more about the condition, including potential treatments and resources, should contact the American Tinnitus Association (www.ata.org or 800-634-8978).