Tinnitus aurium is the technical term for ringing in the ear, although it may actually involve sounds better described as buzzing, roaring, or hissing. The noise can be intermittent or continuous and can vary in pitch and loudness. Most people have experienced tinnitus occasionally for a minute or two. However, some people have tinnitus continuously, over long periods of time. It can range from a minor annoyance to a serious and nearly intolerable condition.
Exposure to loud noise can lead to tinnitus, as can ear obstructions, ear infections , otosclerosis (abnormal bone growth in the ear), head injuries, or heart and blood vessel disorders. In some cases, treating the underlying disorder will relieve the tinnitus. However, in many cases, the cause can neither be found nor treated.
One approach involves covering up the noise to make it more tolerable. This includes using hearing aids or tinnitus maskers (devices worn in the ear that emit pleasant sounds), or simply playing music to cover the noise. Avoiding loud noises, nicotine, aspirin, caffeine, and alcohol may help, since these often aggravate tinnitus.
Drugs such as carbamazepine, benzodiazepines, and tricyclic antidepressants may be tried, although none of these have been proven effective for tinnitus.
There are no well-documented natural treatments for tinnitus.
Several studies have evaluated Ginkgo biloba extract for treating tinnitus, but the results have been conflicting. 2-7,18 While some small studies found benefit, the largest and best-designed of these trials found no benefit. In this double-blind, placebo-controlled trial, 1,121 individuals with tinnitus were given 12 weeks of treatment with standardized ginkgo at a dose of 50 mg 3 times daily. 8 The results showed no difference between the treated and the placebo group.
A separate set of researchers performed an additional study on ginkgo for tinnitus, and then additionally conducted a meta-analysis (statistically rigorous review) of the published data. Their conclusion: The evidence is strong enough to state that ginkgo does not benefit tinnitus. 20
One double-blind, placebo-controlled study found that zinc deficiency was common in people with tinnitus. 21 Zinc supplements appeared to help, but the study was too small to provide statistically meaningful results. In contrast, another small double-blind, placebo-controlled study of people with tinnitus did not discover frequent zinc deficiency and failed to find any benefit with zinc supplements. 12
Vitamins A and E in combination, vitamin B 12 , glutamic acid, ipriflavone , oxerutins , and periwinkle have also been suggested for the treatment of tinnitus, but as yet the supporting evidence for their use remains far too weak to rely upon. 9-10,13-15
Repetitive transcranial magnetic stimulation (rTMS) is a specialized type of magnet therapy that has been studied as a possible treatment for tinnitus. However, a review of 5 randomized trials comparing real rTMS to sham rTMS in 233 people with tinnitus found limited evidence to support its use for this indication. 24 The authors highlighted the need for more studies with larger sample sizes.
Several studies of acupuncture for tinnitus failed to find benefit. 1,11,23 In fact, acupuncture was found to be ineffective as treatment for tinnitus symptoms in a review of 13 low-quality randomized trials with 616 patients. Only one of two open trials showed long-term improvement. 25
For a discussion of homeopathic approaches to tinnitus, see the Homeopathy database.
20. Rejali D, Sivakumar A, Balaji N. Ginkgo biloba does not benefit patients with tinnitus: a randomized placebo-controlled double-blind trial and meta-analysis of randomized trials. Clin Otolaryngol . 2004;29:226-31.
Last reviewed September 2014 by EBSCO CAM Review Board
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