From the Guidelines
Dietary supplements such as Ginkgo biloba, melatonin, zinc, and other supplements should not be recommended for treating tinnitus due to a lack of evidence supporting their effectiveness and potential harm [1@]. When considering the potential causes of tinnitus, several dietary supplements can exacerbate or trigger the condition.
- High doses of certain vitamins and minerals, such as vitamin A, vitamin B12, zinc, and magnesium, may contribute to tinnitus symptoms.
- Quinine-containing supplements, found in some herbal preparations or tonic water, are known to cause tinnitus.
- Ginkgo biloba, sometimes used to treat tinnitus, can ironically worsen the condition in some individuals.
- Caffeine-containing supplements, like guarana or green tea extract, may exacerbate symptoms in sensitive people.
- Niacin (vitamin B3), particularly in doses above 100mg, can cause flushing and tinnitus. These supplements typically cause temporary tinnitus that resolves when the supplement is discontinued, often due to changes in blood flow to the inner ear, direct effects on auditory nerve function, or interactions with neurotransmitters involved in hearing [@1@]. If you experience tinnitus after starting a new supplement, consider stopping it to see if symptoms improve, and consult a healthcare provider before resuming, as individual sensitivity varies considerably. It is essential to prioritize the lack of evidence supporting the use of dietary supplements for treating tinnitus, as stated in the clinical practice guideline: tinnitus executive summary [1@].
From the FDA Drug Label
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. The FDA drug label does not answer the question.
From the Research
Dietary Supplements and Tinnitus
- The use of dietary supplements to treat tinnitus is common, with supplements such as Ginkgo biloba, lipoflavonoids, magnesium, melatonin, vitamin B12, and zinc being frequently used 1.
- However, research suggests that dietary supplements are generally not effective in reducing tinnitus symptoms and may even produce adverse effects, such as bleeding, diarrhea, headache, and others 1, 2, 3.
- Some studies have reported that certain supplements, such as Ginkgo biloba, may have a positive effect on tinnitus symptoms, particularly when combined with antioxidants 4.
- It is also important to note that some herbal supplements, such as St. John's wort and goldenseal, can cause clinically important drug interactions and should be avoided by patients receiving pharmacologic therapy 5.
Potential Risks and Interactions
- The use of dietary supplements can pose potential risks, including adverse effects and interactions with prescription medications 1, 3, 5.
- Clinicians should be aware of the potential interactions between herbal supplements and medications and consult reliable resources to assess the safety of specific combinations 5.
- Patients should be encouraged to disclose their dietary supplement use to clinicians to minimize the risk of adverse interactions 5.
Specific Supplements and Tinnitus
- Ginkgo biloba has been studied as a potential treatment for tinnitus, with some studies suggesting that it may be effective in reducing symptoms, particularly when combined with antioxidants 1, 4.
- Other supplements, such as melatonin and lipoflavonoid, may have a positive effect on sleep and emotional reactions in patients with tinnitus, but their effectiveness in reducing tinnitus symptoms is unclear 1.
- The evidence for the effectiveness of other supplements, such as magnesium, vitamin B12, and zinc, in treating tinnitus is limited and inconclusive 1, 2, 3.