Ginkgo Biloba for Tinnitus
reviewed by X. Li, Ph. D. (credential)

Tinnitus is a medical term for "ringing in the ears". Tinnitus may be a condition or a symptom of celebral insufficiency at aging. Currently there is no effective drug treatment for tinnitus. Causes behind tinnitus are considered diverse. One could be related to poor circulation. As numerous studies showed that ginkgo biloba improve circulation to the extremities of the body¹, and ginkgo biloba is shown to be effective to improve celebral insufficiency, the potential benefits of ginkgo in treating tinnitus has also been explored.

Several clinical trials has been conducted to study the effect of ginkgo biloba on tinnitus. A critical review identified only 5 such trials². These trials included small patient numbers and ginkgo biloba extracts were administrated either orally or by injection. Most trials reported benefits of ginkgo on tinnitus. However, except one trial, the other trials were found to be not in adequate quality². The trial of sufficient quality reported a modest but statistically significant effect of ginkgo taken for 12 weeks on perceived loudness of the tinnitus sound.

Recently a large trial of ginkgo biloba on treatment of tinnitus was published³. In the trial, 1121 patients were enrolled who have had tinnitus for 1 to 5 years in steady condition but were otherwise normal. The tinnitus patients were divided to two groups. One group took 50 mg standardized ginkgo biloba extract three times daily for 12 weeks while the other group took placebo tablets that were identical in size, shape, color and packaging. The trial was conducted by mail, tinnitus was assessed using questionnaires filled by the tinnitus patients themselves before, during and after the trial. The questionnaires contained 21 questions about the severity of tinnitus and measured the perceived loudness of tinnitus, the awareness of tinnitus, and the impact of tinnitus. It also asked the patients if they felt tinnitus had changed after treatment.

After statistical analysis, no significant differences in various tinnitus outcome measures were found between patients who took ginkgo and placebo. 34 out of 360 tinnitus patients who took ginkgo reported their tinnitus less troublesome compared with 35 out of 360 tinnitus patients who took placebo. Therefore, according to this trial ginkgo biloba extract is not effective in improving tinnitus.

In summary, current trials have given inconsistent results on the beneficial effect of ginkgo on tinnitus. One likely reason for the inconsistency is the diverse nature of various tinnitus. For example, ginkgo biloba extract may be beneficial to tinnitus caused by cerebral insufficiency but not beneficial to other types of tinnitus. As no treatment is effective to all tinnitus, it may be worth trying to see if ginkgo works for you. With the minimal cost of ginkgo (ActiveHerb Ginkgo biloba standardized extract costs $4.99 per month), there is little to lose for trying ginkgo but much to gain if it works for your case.

Reference
1. Maclennan KM, Darlington CL, Smith PF.The CNS effects of Ginkgo biloba extracts and ginkgolide B. Prog Neurobiol. 2002 Jun;67(3):235-57.
2. Ernst E, Stevinson C. Ginkgo biloba for tinnitus: a review. Clin Otolaryngol. 1999 Jun;24(3):164-7.
3. Drew S, Davies E. Effectiveness of Ginkgo biloba in treating tinnitus: double blind, placebo controlled trial. BMJ. 2001 Jan 13;322(7278):73.

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