Ginkgo biloba for tinnitus.
Level 1 - systematic review of randomized trials
Systematic review of randomized controlled trials
PubMed 36383762 · doi:10.1002/14651858.CD013514.pub2
What was done
A Cochrane systematic review assessed randomized controlled trials evaluating Ginkgo biloba against placebo, no intervention, or active comparators in adults and children with subjective tinnitus. Primary outcomes were tinnitus symptom severity (multi-item questionnaires) and serious adverse events (bleeding, seizures). Secondary outcomes included subjective loudness, intrusiveness, depression, anxiety, quality of life, and other adverse events. Evidence certainty was assessed using GRADE.
What was found
Twelve parallel-group RCTs were included (1,915 participants; 11 tested Ginkgo vs. placebo and 1 tested Ginkgo plus hearing aids vs. hearing aids alone). For tinnitus symptom severity at 3 to 6 months, pooled data showed little to no effect of Ginkgo versus placebo (mean difference [MD] -1.35 on a 0–100 scale, 95% CI -8.26 to 5.55; 2 studies, 85 participants; very low certainty). No serious adverse effects (bleeding or seizures) were reported in either group (4 studies, 1,154 participants; low certainty). Tinnitus loudness matching showed no clear difference at 12 weeks (MD -4.00 dB, 95% CI -13.33 to 5.33; 1 study, 73 participants; very low certainty), nor did health-related quality of life at 3 months (MD -0.58 on a 0–100 scale, 95% CI -4.67 to 3.51; 1 study, 60 participants; low certainty) or minor adverse events (risk ratio 0.91, 95% CI 0.52 to 1.60; 4 studies, 1,175 participants; low certainty). The single trial of Ginkgo with hearing aids (22 participants) provided very low-certainty evidence with no meaningful conclusions possible.
Why it matters
Current clinical trial evidence does not support the effectiveness of Ginkgo biloba for reducing tinnitus severity, loudness, or improving quality of life.
Limits
Most trials had high or unclear risk of bias due to poor allocation concealment and inadequate blinding. Marked heterogeneity in outcome measures prevented data pooling across most participants for primary efficacy endpoints. None of the placebo-controlled studies measured tinnitus intrusiveness, depression, or anxiety.