Tinnitus

Why it works: Only if you’re deficient. Several studies report a higher rate of B12 deficiency among people with tinnitus, suggesting deficiency may be a contributor for some, not a universal ca...

Instructions: 1) Test first. Ask your clinician for B12 testing (total or active B12, and often MMA/holotranscobalamin in borderline cases) before taking folate or high-dose B-complex, because f...

Warnings: B12 is generally safe and water-soluble, but there are important cautions:. • Treat the right thing:...

Studies: Shemesh et al., 1993 (Am J Otolaryngol) – Cross-sectional st...

Why it works: TCM rationale. In TCM, tinnitus with a low “cicada-like” tone, worse at night, often stems from Kidney & Liver Yin deficiency with relative Yang rising. Er Long Zuo Ci Wan is a Liu...

Instructions: Typical over-the-counter label directions (vary by brand; follow your specific label or practitioner):. • Plum Flower/Min Shan teapills: common labels list 8 pills, 3×/day, or 3–4...

Warnings: Pregnancy & nursing: Most labels advise avoid in pregnancy (and often while breastfeeding) unless sp...

Studies: Systematic review & meta-analysis (2021): 9 RCTs (n=694)...

Why it works: TCM rationale (blood stasis in the head/ear): TQHXT is a classic Wang Qing-ren formula for “blood stasis in the head/face,” a pattern that can include dizziness and tinnitus. Core...

Instructions: Classical decoction (from Yi Lin Gai Cuo):. Chi Shao 3 g, Chuan Xiong 3 g, Tao Ren 9 g, Hong Hua 9 g, Cong Bai 3 g, Sheng Jiang 9 g, Da Zao 7 pieces, She Xiang 0.15 g. Traditionall...

Warnings: Anticoagulants/antiplatelets (bleeding risk): Hong Hua (safflower) and other blood-invigorating herb...

Studies: Randomized/controlled study (China; “nervous tinnitus”): 60...

Why it works: Pattern-based rationale (TCM): This classical formula “transforms Phlegm and extinguishes Wind.” It’s indicated when tinnitus co-occurs with dizziness/vertigo, nausea, chest oppres...

Instructions: Classical composition & amounts (decoction):. Zhi Ban Xia 9 g; Tian Ma 6 g; Fu Ling 6 g; Ju Hong (Citrus peel) 6 g; Bai Zhu 15 g; Gan Cao 4 g; Sheng Jiang 1 slice; Da Zao 2 dates....

Warnings: Use only processed Pinellia (Zhi Ban Xia). Raw Pinellia ternata is irritant/toxic; traditional proce...

Studies: Vertigo/VBI vertigo: Systematic review/meta-analysis of RCTs...

Why it works: Blood flow & anti-platelet effects. Ginkgo’s terpene lactones (especially the ginkgolides) antagonize the platelet-activating-factor (PAF) receptor, which can inhibit platelet aggr...

Instructions: There is no tinnitus-specific, evidence-based regimen. When ginkgo is used in human studies for other indications, it’s usually:. • Form: a standardized leaf extract (e.g., EGb 761...

Warnings: Bleeding risk. Ginkgo can increase bleeding, especially with warfarin, DOACs, aspirin, clopidogrel,...

Studies: Systematic reviews & guidelinesCochrane review (2022 upd...

Why it works: Biologic plausibility (but not proof): Zinc is involved in cochlear physiology and synaptic transmission in the auditory pathway, so deficiency could theoretically worsen tinnitus....

Instructions: There is no established, guideline-endorsed dosing of zinc for tinnitus. Trials have typically used 50 mg/day elemental zinc for 2–4 months, but these were experimental protocols a...

Warnings: Upper Limit: Do not exceed 40 mg/day elemental zinc (adults) from supplements plus diet unless corre...

Studies: Cochrane systematic review (2016): Across randomized trials...

Why it works: Neuroexcitation control (NMDA block). Magnesium (Mg²⁺) sits in and blocks NMDA-type glutamate receptors in a voltage-dependent way; this dampens excitotoxic firing in auditory path...

Instructions: 1) Start with diet (first-line): Aim to meet the RDA for total magnesium from food (e.g., nuts, legumes, whole grains, leafy greens). Adult RDAs are ~320–420 mg/day depending on ag...

Warnings: Upper limit (UL): For supplements/medications, adults: 350 mg/day elemental Mg is the UL (doesn’t in...

Studies: Open-label Phase II (no placebo):Cevette et al., 2011 gave m...