I spent about $300 on tinnitus supplements. Here is what the research says about each one
The aisle at the Walgreens on Dodge Street has a whole shelf for ringing ears. Over about four years I worked my way through a good part of it: ginkgo, a zinc tablet, a bottle of Lipo-Flavonoid, a ginseng capsule a nephew mailed me. I'd guess I spent $300, maybe more if my wife is the one keeping count.
None of it quieted my ear in a way I could measure. That doesn't mean nothing works for anybody. It means I should have read the research before I bought anything, so I did it backwards and read it afterward. This is the summary I wish I'd had.
What the main US guideline says
In 2014 the American Academy of Otolaryngology, the ear, nose and throat doctors, published a clinical practice guideline on tinnitus. It's the document most ENT offices in this country work from. On supplements it's blunt: the panel recommended against ginkgo, melatonin, zinc or other dietary supplements for treating persistent, bothersome tinnitus.
The same guideline recommends a hearing aid evaluation when tinnitus comes with measured hearing loss, recommends cognitive behavioral therapy, and lists sound therapy as an option. I'll come back to those in the piece on sleep, because they're what actually helped me.
So the official answer is no. But "no" from a guideline usually means the evidence is weak or negative so far, not that every ingredient has been tested to death. The size of the evidence matters, so I looked it up for each one.
How much evidence each option stands on
Total participants in the best summary of trials for each option. CBT, a talking therapy, is included for scale.
| Option | Participants |
|---|---|
| Cognitive behavioral therapy (28 trials) | 2,733 |
| Ginkgo biloba (12 trials) | 1,915 |
| Zinc (3 trials) | 209 |
| Korean red ginseng (1 pilot trial) | 61 |
Source: Cochrane reviews of CBT (2020), ginkgo (2022) and zinc (2016); Kim and colleagues, Journal of Audiology and Otology, 2015.
The thing that jumps out: ginkgo has a decent amount of testing behind it and came out poorly. Ginseng has barely been tested at all. Those are two different kinds of "no."
Ginkgo biloba
This was the first thing I bought, because everybody's uncle has heard of it. The most recent Cochrane review of ginkgo for tinnitus, from 2022, pooled 12 trials with 1,915 people. The reviewers found the evidence on tinnitus severity very uncertain and concluded ginkgo may make little or no difference.
The NCCIH page on ginkgo says the same thing more plainly, and adds a warning that matters for a lot of people my age: ginkgo may raise the risk of bleeding in people on blood thinners like warfarin. I took it for three months in 2018. Nothing changed.
Zinc
The idea behind zinc is that some people with tinnitus are low in it. A Cochrane review of zinc for tinnitus found only three small trials, 209 people in all, and no evidence that zinc improved tinnitus. If a blood test shows you're actually deficient, that's a separate conversation with your doctor. For the rest of us, I wouldn't bother.
Lipo-Flavonoid
This is the one on every pharmacy shelf, built around lemon bioflavonoids plus vitamin C and B vitamins. What I remember most is the dosing: two caplets three times a day for the first two months, then one caplet three times a day. I missed the lunchtime dose constantly. I couldn't find a large independent trial behind it, and the guideline's "no" on supplements covers it too.
If you're choosing between it and one of the newer formulas sold online, this side-by-side of Lipo-Flavonoid compared with Audifort lays out the dosing, price per day and refund terms clearly. The dosing difference alone would have changed my mind back then: one dropper a day against six pills split across the day.
Korean red ginseng
This is the one I'm least ready to write off, because it hasn't really been tested. A 2015 pilot trial in Korea split 61 people with chronic tinnitus into three groups for four weeks: 160 mg of ginkgo, 1,500 mg of red ginseng, or 3,000 mg of red ginseng a day. The 3,000 mg group improved on the Tinnitus Handicap Inventory, the standard questionnaire, and on two mental health scores. Loudness ratings didn't change in any group.
That's encouraging and also very thin. It was open-label, so people knew what they were taking, there was no placebo, and it lasted a month. The NCCIH notes on Asian ginseng add that it may lower blood sugar and can interact with medications, so diabetics should check first. A good summary of what the ginseng studies found, including the noise-exposure work, is worth reading if you're thinking about it.
The whole shelf in one table
| Option | Best evidence | Guideline position | My take |
|---|---|---|---|
| Ginkgo | Cochrane 2022, 12 trials, 1,915 people | Recommends against | Tested and came up short. Skip it if you take a blood thinner. |
| Zinc | Cochrane 2016, 3 trials, 209 people | Recommends against | Only if a blood test says you're low. |
| Melatonin | Not one I looked into closely | Recommends against for tinnitus | Some people use it for sleep, which is a different goal. |
| Lipo-Flavonoid | No large independent trial found | Covered by the general "no" | Easy to buy, hard to keep up with the dosing. |
| Korean red ginseng | One open-label pilot, 61 people | Not studied enough to rate | The most interesting of the lot, and the least proven. |
| Multi-ingredient hearing formulas | No published trials of the products themselves | Covered by the general "no" | Judge the label and the refund terms. |
If you're going to try one anyway
I get it. When your ear has been hissing for a year, "the evidence is thin" doesn't feel like an answer. If you want to try something, here's how I'd do it now, having done it wrong:
- Get a hearing test first. If you have hearing loss, a hearing aid evaluation is the thing with real evidence behind it.
- Show the label to your pharmacist, especially if you take blood thinners, diabetes medicine or antidepressants.
- Try one product at a time, for eight to twelve weeks, and keep a short daily log.
- Buy only where the refund terms are written down, and put the refund deadline on the calendar the day you order.
- Decide in advance what "it worked" means. A lower score on your morning log? Falling asleep faster? Write it down before you start.
I didn't do any of that. I bought on hope, took things for a few weeks, and stopped when I forgot. Don't be me.
What I'd spend the money on instead
If I had that $300 back, I know where it would go. About $30 on a decent box fan for the bedroom. A copay for a proper hearing test, years earlier than I got one. And the rest toward a good set of earplugs and earmuffs, because the noise that started this is still out there, at the hardware store, the stock car track and my grandson's band practice in the garage. Protecting the hearing I have left is the one thing every source I read agrees on.