Ginkgo Biloba for Tinnitus

Ginkgo is the most commonly sold tinnitus supplement and the most thoroughly disproven — Cochrane found no benefit over placebo.

Overview

Ginkgo is the most commonly sold tinnitus supplement and the most thoroughly disproven — Cochrane found no benefit over placebo.

Verdict

Not supported

No. Large randomised trials and Cochrane review show no benefit for tinnitus.

How It Works

Ginkgo was proposed to improve cochlear microcirculation and act as an antioxidant, a rationale that assumed tinnitus is a peripheral blood-flow problem. Current models place the generator centrally.

Dosing & Protocol

Typical dose

Recommended dose: Not recommended for tinnitus
Expected timeframe: No benefit expected at any duration

Protocol

form: Trials used standardised EGb 761
duration: Trials ran 12 weeks to 12 months without separating from placebo
co factor: Evidence-based options are tinnitus-focused cognitive behavioural therapy, sound therapy and correcting any hearing loss with amplification
titration: No titration is justified; the dose was not the limiting factor, the mechanism was
starting dose: Not recommended for tinnitus. Randomised trials used 120-240 mg standardised EGb 761 daily and found no benefit over placebo for tinnitus loudness or distress

Evidence

What the studies say

Ginkgo biloba for tinnitus has been tested more thoroughly than almost any other supplement-symptom pair. The largest placebo-controlled trial randomised over 1,100 adults with tinnitus and found no difference in loudness or distress. Cochrane reviews have consistently concluded there is no evidence of benefit in people whose primary complaint is tinnitus. The mechanistic rationale has also weakened: tinnitus is now understood as central gain increase following reduced auditory input, not a cochlear perfusion deficit, so improving microcirculation would not be expected to help. Ginkgo also inhibits platelet aggregation, which matters for anyone on anticoagulants.

Ginkgo biloba for tinnitus

Score: 9/10

2022

systematic_review

There is uncertainty about the benefits and harms of Ginkgo biloba for the treatment of tinnitus when compared to placebo.

View source

Ginkgo biloba for tinnitus (Cochrane review)

Score: 8/10

2022

systematic_review

n=1500

Sereda M, Xia J, Scutt P +3 more

We found no evidence that Ginkgo biloba has a clinically important effect on tinnitus loudness or tinnitus symptom severity.

View source

Ginkgo biloba extract EGb 761 in dizziness and tinnitus: a review of randomised trials

Score: 5/10

2014

systematic_review

n=1500

Sokolova L, Hoerr R, Mishchenko T

EGb 761 reduced vertigo severity and dizziness scores versus placebo.

View source

Safety

Caveats

Ginkgo increases bleeding risk with warfarin, DOACs, aspirin and clopidogrel, and should be stopped two weeks before surgery. It also interacts with some anticonvulsants.

Less likely to help if

Everyone with primary tinnitus. Trial populations included both recent-onset and chronic tinnitus with no subgroup benefit.

Medical Disclaimer

The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.