Pine bark and ginkgo for tinnitus? A closer look at “Ear Tone”, a supplement marketed to treat tinnitus.

Ear Tone is a supplement claimed to help tinnitus. Does it work?

Ear Tone is a supplement claimed to help tinnitus. Does it work?

“Why do you bother blogging?” asked a colleague. “You take hours of your personal time to write, and you do it for free. You’re not even getting any citations for all that work.” I admit I found the questions a bit surprising. True, you won’t find these posts abstracted in PubMed. But I’m writing for an entirely different audience. I blog for the same reason that I became a pharmacist: to help people use medicines more effectively. Practicing as a pharmacist is one way to do that. In that setting, you’re helping one patient at a time. And seeing how your advice and support can enhance someone’s care is tremendously gratifying.

I see blogging as another form of pharmacy practice, hopefully with similar effects. Yes I do get regular hate mail, and the occasional legal threat, but there’s also gratitude for a post that resonated with someone, or helped them make better decisions about their health. When Google searches don’t give answers, I get questions — too many to answer. Today’s post is based on a request for help from someone seeking advice on natural supplements to treat ringing in their ears. They have tinnitus, and they’re frustrated at the limits of what their physician (and medicine) can do. They sent me an advertisement for a supplement called Ear Tone, a natural health product which is advertised (and approved) to provide tinnitus relief. Can natural supplements do what conventional medicine cannot? Continue reading

Forget to take your Ginkgo biloba? Turns out, it doesn’t matter

Among the natural products on pharmacy shelves, I was rooting for Ginkgo biloba for the prevention of dementia. For one, dementia is a horrible illness. Secondly, currently available drugs for Alzheimer’s disease (AD) have little meaningful effect. Thirdly, preliminary data with ginkgo for AD looked encouraging. I recall reading this systematic review back in 2000. One sentence jumped out at me (the bolding is mine):

We conclude that for selegiline, vitamin E, lecithin, linopirdine, and propentofylline the published data do not provide support for efficacy. Based on the evidence we reviewed, it is our conclusion that donepezil, metrifonate and rivastigmine, however, all provide statistically significant modest benefit on cognitive performance and global functioning to the elderly with probable AD who are eligible for inclusion in clinical trials. The magnitude of the effect is similar for all of the medications. The results from the trials of ginkgo biloba are promising but the effects are smaller than those from the above mentioned therapies.

So the effect, while weak, was just about as bad as the prescription alternatives. For a “natural” remedy, that’s pretty good. But as with most small clinical trials, what appears to be clinically and statistically significant usually disappears when larger, more rigorous trials are conducted. And that seems to be the case now, with a publication in the December 23, 2009 issue of the Journal of the American Medical Association. But before we dive into the trial, let’s look at why ginkgo is even being studied at all. Continue reading