Caution: Melatonin is a potent hormone and its long-term safety is not established. Melatonin should only be taken with medical supervision.

In a double-blind trial, melatonin supplementation (3 mg taken nightly) improved the symptoms of tinnitus.¹ Although improvement did not reach statistical significance for all participants, the results were significant in those who reported more severe symptoms (such as two-sided vs. one-sided tinnitus). Among participants who had difficulty sleeping due to tinnitus, 47% of those who took melatonin reported sleep improvement after one month, compared with only 20% of those who took placebo. Similar improvements in tinnitus were reported in a preliminary trial that used 3 mg of melatonin each night for four weeks.²

Zinc supplements have been used to treat people who had both tinnitus and hearing loss (usually age-related). Of those who had initially low blood levels of zinc, about 25% experienced an improvement in tinnitus after taking zinc (90–150 mg per day for three to six months).³ Such large amounts of zinc should be monitored by a doctor. Two controlled clinical trials^4,4 found no benefit from zinc supplementation (66 mg per day in one double-blind trial) in people with tinnitus. However, participants in these studies were not zinc deficient. Preliminary research suggests that zinc supplementation is only helpful for tinnitus in people who are zinc deficient.⁶ A doctor can measure blood levels of zinc.

In a preliminary trial, supplementation with coenzyme Q10 (CoQ10) in the amount of 100 mg three times per day for 16 weeks significantly improved tinnitus in people who had initially low blood levels of CoQ10. However, CoQ10 was not beneficial for people whose initial blood levels were not low.⁶

Ginkgo biloba has been used to treat tinnitus, with mixed results.⁷ The largest placebo-controlled trial to date failed to find any effect of 150 mg per day of ginkgo extract in people with tinnitus.⁸ Two smaller, controlled trials have found that standardized ginkgo extract (120 mg per day, containing 24% flavone glycosides and 6% terpene lactones), was effective at relieving the symptoms of tinnitus.^9,10 One trial failed to find ginkgo beneficial, but used less than 30 mg of ginkgo extract per day, an amount unlikely to have any therapeutic effect.¹¹

Lesser periwinkle(Vinca minor) contains a compound known as vincamine. Extracts containing vincamine have been used in Germany to help decrease tinnitus.¹³ Preliminary clinical trial data show that vinpocetine, a semi-synthetic version of vincamine, can help reduce symptoms in people whose tinnitus is due to poor blood flow.¹⁴ Because these extracts are not widely available outside of Germany, consult with a doctor knowledgeable in botanical medicine about obtaining them.

People exposed to loud noise on the job who develop tinnitus are commonly deficient in Vitamin B12.¹⁵ Intramuscular injections of vitamin B12 reduced the severity of tinnitus in some of these people. Injectable vitamin B12 is available only by prescription. The effect of oral vitamin B12 on tinnitus has not been studied.