Can supplements cause or worsen tinnitus?

Supplements and Tinnitus: Can They Cause or Worsen Symptoms?

Supplements should not be recommended for treating tinnitus and some may actually worsen tinnitus symptoms. 1

Supplements and Tinnitus: Evidence-Based Findings

• Dietary supplements including Ginkgo biloba, melatonin, zinc, and other supplements should not be recommended for treating patients with persistent, bothersome tinnitus due to lack of consistent benefit 1, 2
• Some medications, including certain supplements, have the potential to worsen tinnitus symptoms rather than improve them 1
• Despite their popularity, dietary supplements for tinnitus generally lack substantial scientific support for efficacy 3, 4
• In a survey of 1,788 tinnitus sufferers who took supplements, 70.7% reported no effect, 19.0% reported improvement, and 10.3% reported worsening of symptoms 3
• Adverse effects from supplements were reported in 6% of users, including bleeding, diarrhea, headache, and other symptoms 3

Specific Supplements and Their Effects on Tinnitus

• Ginkgo biloba, one of the most commonly used supplements for tinnitus, has insufficient evidence to support its use and is not recommended by clinical practice guidelines 1, 2
• Zinc supplements, despite theoretical connections to hearing function, show no consistent benefit for tinnitus in clinical studies 1, 5
• Melatonin may help with sleep issues related to tinnitus but does not directly improve the tinnitus itself 3
• Lipoflavonoids are commonly marketed for tinnitus but lack strong evidence supporting their efficacy 3
• Vitamin B12 and magnesium supplements are frequently used but have not shown consistent benefits for tinnitus in controlled studies 5, 3

Potential Mechanisms for Supplement-Induced Tinnitus

• Some supplements may interact with prescription medications, potentially exacerbating tinnitus symptoms 4
• Antidepressants and certain other medications have been documented to potentially worsen tinnitus, and similar mechanisms might apply to some supplements 1
• The varying content and dosage of active ingredients in over-the-counter supplements (which are not regulated by the FDA) may contribute to inconsistent or adverse effects 1
• Toxic effects of certain supplements may directly impact auditory function 4

Evidence-Based Approaches for Tinnitus Management

• Cognitive Behavioral Therapy (CBT) has the strongest evidence for improving quality of life in patients with persistent, bothersome tinnitus 2, 6
• Hearing aid evaluation is recommended for patients with hearing loss and tinnitus, even if the hearing loss is mild or unilateral 2, 6
• Education and counseling about tinnitus management strategies should be provided to all patients with persistent, bothersome tinnitus 2, 6
• Sound therapy may be considered as a management option for persistent tinnitus, providing symptomatic relief 2

Common Pitfalls to Avoid

• Recommending dietary supplements without evidence of efficacy that may cause side effects or potentially worsen tinnitus 1, 3
• Overlooking the potential for supplements to interact with prescription medications, which could exacerbate tinnitus or cause other adverse effects 4
• Failing to distinguish between supplements that might help with tinnitus-associated symptoms (like sleep disturbance) versus those claimed to treat the tinnitus itself 3
• Ignoring mild hearing loss that could benefit from hearing aid intervention, which has better evidence for tinnitus relief than supplements 2, 6

In conclusion, current evidence does not support the use of dietary supplements for tinnitus treatment, and some may potentially worsen symptoms. Patients should be directed toward evidence-based approaches like CBT, hearing aids when appropriate, and proper education about tinnitus management.