Tinnitus and herbal support
Updated: Oct 16, 2020
What is tinnitus?
Tinnitus is a symptom that patients report to their doctor, and usually the doctor cannot hear it, which is why the most common type is called “subjective tinnitus.” (Near the end of this blog is an audio description of how tinnitus works). Tinnitus sounds can range from the more common “ringing” that most people have experienced after going to a loud concert or after having a firecracker set off nearby, but it also may occur as buzzes, clicks, hisses, roaring, and humming.
There are two types of tinnitus. The first is known as “objective tinnitus”, which is where the doctor can actually hear what the patient hears on close examination. This type can be due to blood vessel, middle ear bone, or even muscle contraction issues.
The second, and more common type is known as “subjective tinnitus”, and is the type that only the patient can hear. It’s not a disease, per se, and yet can be triggered by a variety of diseases. If you are over 60 and have hearing loss, your tinnitus will likely be attributed to hearing loss if nothing else is found. This type can be due to issues in any of the three parts of the ear – outer, middle, or inner and it can be due to problems along the nerve pathways to the parts of the brain that interpret sound or an issue in the brain itself. For a longer differential diagnosis, please see https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156
Medications can also be a cause of tinnitus, so be sure to give your doctor a list of ALL medications — including supplements and herbs, as some of these may either cause or aggravate your tinnitus.
How common is tinnitus?
According to the ATA (American Tinnitus Association) over 50 million Americans, or roughly 15% of the population, experience some form of tinnitus. Within this group about 20 million people suffer from chronic tinnitus, while another 2 million have extreme and debilitating cases of it.
How is tinnitus acquired?
The causes of tinnitus include age related hearing loss, chronic ear damage, circulatory/microvascular issues, and rarely, a tumor of the auditory nerve sheath around the nerve that conducts the signal of a sound from the inner ear to the brain. It can be localized to one ear or involve both, and it can vary from hour to hour or from day to day. The characteristics of the sound can also change during the day.
Are there herbs to help?
Before I get into the only herb that has shown in clinical studies for efficacy, I will mention two supplements.
Magnesium. Magnesium has been used with success in mild cases of tinnitus. The most bioavailable form is magnesium glycinate. Given that most of us are very low on magnesium anyway, this may be an excellent place to start.
Vitamin B12. One study showed that people who were deficient in B12 and had tinnitus, and had improvements in symptoms related to tinnitus when given additional B12. (Herbs & Natural Supplements, p.652).
Unfortunately, only one herb has been studied and that is Ginkgo biloba, and even here only in an extract form*. If we look at ginkgo extract, both studies and empirical uses have shown it to be a circulatory enhancer that can cross the blood brain barrier. This would support its use in tinnitus due to circulatory issues.
Re: Ginkgo Extract is Comparable to Pentoxifylline for Treatment of Chronic Tinnitus and Causes Fewer Side Effects. Date: 08-15-2018 HC# 071831-598.
In this double-blind, placebo study, significant improvement was shown in all measures by both groups. In the EGb 761 group (the ginkgo extract), improvements were seen on the Mini-TQ (P<0.0001) and in loudness (P=0.0021) and annoyance (P=0.0002) scores. In the pentoxifylline group, improvements were seen on the Mini-TQ (P<0.0001) and in loudness (P=0.0015) and annoyance (P=0.0003) scores. The between-group differences were not significant. Slight, though nonsignificant, improvements in HADS depression scores were observed in both groups at 12 weeks. In patients with elevated depression scores at baseline, improvements in the Mini-TQ, loudness, and annoyance scores were seen in the EGb 761 group but not in the pentoxifylline group. The dose here was one 120 mg tablet of the EGb 761 twice a day, or one extended-release pentoxifylline tablet (600 mg), or a placebo. Re: Review of Ginkgo in the Treatment of Tinnitus; Mahmoudian-Sani MR, Hashemzadeh-Chaleshtori M, Asadi-Samani M, Yang Q. Ginkgo biloba in the treatment of tinnitus:
An updated literature review. Int Tinnitus J. 2017;21(1):58-62.
This is a review article of multiple studies on ginkgo extract used in tinnitus. Although the review does recommend the use of ginkgo, per se, the authors do conclude that “ginkgo ‘can be considered as a promising option to improve tinnitus ... .’ They point out that tinnitus is a multifactorial condition, and even in the trials which reported no statistically significant difference compared to controls, ginkgo treatment was beneficial for some patients. In addition, the doses used in the clinical trials varied widely (the negative trials used doses < 160 mg/day)”.
This study also has a table listing other herbal supplements for the treatment of tinnitus. Two herbs that have been used traditionally for tinnitus which were mentioned are:
1). Garlic bulb (Allium sativum). Garlic has shown to be anti-inflammatory as well as enhancing microcirculation activity (Herbs & Natural Supplements, p.331).
2). Black cohosh root (Actaea racemosa, syn. Cimicifuga racemosa) has some literature regarding its vasoactivities and it has long been used to reduce symptoms of congestive menses as well as heavy bruising. This vasoactivity correlation might be helpful in the use of tinnitus if the tinnitus is due to microvascular issues. (Wichtl sites several studies which I have noted below.)
Inflammation. To the extent that there is inflammation associated with the tinnitus, anti-inflammatory herbs and spices such as the following may be helpful.
Turmeric (Curcuma longa)
Ginger (Zingiber officinale)
Homeopathy. Homeopathic remedies (in dilutions of 9C or lower), have shown to help with tinnitus:
• Chenoopodium anthelminicum
• Lachnanthes tinctoria
• Cinchona (China rubra)
The inner workings of the ear.
Herbal Drugs and Phytopharmacueticals, Wichtl
a) G. Kusano, et al. Biol. Pharma. Bull 21, 997-999 (1998)
b) M. Noguchi, et al. Biol. Pharma. Bull 21, 1163-1168 (1998)
Pharmacognosy, Trease & Evans
Herbs & Natural Supplements, Braun & Cohen
* Mediherb (Standard Process) sells a Ginkgo biloba extract in pill form which is one of the best that I have found to help with tinnitus.
Jayne Tamburello has a master’s degree in Herbal Medicine from Maryland University of Integrative Health (MUIH) and is the founder of Invibe Herbal, THE one-stop shop for healthy, organic herbal tea blends. Please visit our website at: www.invibeherbal.com . Jayne is also a licensed nutritionist (LDN), a certified nutritionist specialist (CNS) and a registered herbalist with the American Herbalist Guild RH(AHG), and has a private practice: www.providencehealthandhealing.com RH(AHG).
Special thanks to Dr. David Durand for his knowledge and input on tinnitus. Dr. Durand
is the Former Director of Surgical Pathology at Stony Brook University’s Renaissance School of Medicine (a role in which he frequently diagnosed Vestibular Schwannomas, which often cause tinnitus) and a molecular biologist whose work is cited in medical textbooks. He currently focuses on Mind Body Healing at www.ThreeStepHealing.com, and would be happy to consider patients for a study of his method in patients with mild to moderate tinnitus willing to participate in a randomized trial. Please contact him via his website.