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Can one treat tinnitus using complementary medicine?

ginkgo biloba tree 311 (photo credit: David Stephenson/Lexington Herald-Leader/MCT)
ginkgo biloba tree 311
(photo credit: David Stephenson/Lexington Herald-Leader/MCT)
I read recently that Ginkgo biloba, the food supplement, can relieve tinnitus, which is ringing in the ears. Tinnitus is very upsetting, makes it difficult for me to sleep well and makes me feel depressed sometimes.  Does the supplement really help? I also read that despite claims that it improves memory and that many people take it for this, it has no effect on how well you remember things.
    – F.P., Tel Aviv
Dr. Menachem Oberbaum, director of the center for integrative complementary medicine at Jerusalem’s Shaare Zedek Medical Center, replies:
The possibilities of treating tinnitus using complementary and alternative medicine modalities are very limited, and this is an understatement! Unfortunately, tinnitus is difficult to relieve with conventional medicine as well, and my ear-nose-and-throat specialist colleagues will most probably confirm.
Extracts from the Ginkgo biloba tree, which is native to China, have been taken by many people who want to improve their memory or treat dementia, even though this has not been proven. One can find in the conventional medical literature only six randomized controlled trials (RCT). A 2004 meta-analysis on these six trials published in the journal Clinical Otolaryngology and Allied Sciences could not confirm any beneficial effect of Ginkgo biloba on tinnitus; this does not mean there is no beneficial effect, but rather that from these six studies such a conclusion could not be reached.
The conclusion is therefore that according to the current knowledge, no beneficial effect can be expected from Ginkgo biloba for tinnitus.
I was glad to read in your paper that the Health Ministry has finally decided to require the dairy companies to fortify all milk with vitamin D, which lowers the risk for many diseases. I am 62.  If, when 3 percent-fat milk is fortified with the vitamin, I drink a cup a day, will I still have to take my vitamin D drops daily as prescribed by my doctor or will the milk provide me with enough? Is there any danger of taking too much of the vitamin?
    – E.N., Givat Shmuel
Prof. Ted Tulchinsky, a vitamin D expert at the Hebrew University-Hadassah Braun School of Public Health and Community Medicine, comments:
It really depends on one’s age and whom you ask. One glass of fortified milk provides 115 to 124 international units (IUs) of vitamin D. The official Health Ministry recommendation for older adults (over 65) was recently increased to 1,000 IUs plus 20 minutes’ exposure to sun daily. The official upper tolerable daily intake limit is 2,000 IUs per day. Vitamin D is oil soluble and thus stored in the body tissues, but it is extremely rare for people to get an overdose.
In the 1930s, a milk fortification program was implemented in the US to combat rickets, then a major public health problem. This program virtually eliminated the disorder at that time. Since then, the vitamin has been found to lower the risk for osteoporosis, ovarian cancer, early dementia, Crohn’s disease and many others. The US Food and Drug Administration recommends 200 IUs daily from birth to 18; double that for ages 51 to 70; and 600 IUs for age 71 and up. However, the American Academy of Pediatrics has raised the recommendation for children and adolescents to 400 IUs. Very few foods in nature contain vitamin D; these include fatty fish such as salmon, tuna and mackerel and fish liver oils. So it is best to consume drops or pills, which are inexpensive.
I am 31, and my gums are red. In addition, at the end of my tongue is a sore from which I have suffered for six months. Even though I brush my teeth three times and floss twice a day, I have bad breath; mouthwashes don’t help. I don’t smoke or drink liquor, but I drink a lot of water. It affects my relationships with people, and I have almost no friends. Where can I get help?
    – M.F., Haifa
Veteran Jerusalem dentist Dr. Steve Sattler answers:
You probably have periodontal disease, but there is a variety of othermedical conditions that could be relevant. Go to a periodontist, who isa dentist specializing in this condition, and get diagnosed as soon aspossible.
Rx for Readers welcomes queries fromreaders about medical problems. Experts will answer those we find mostinteresting. Write Rx for Readers, The Jerusalem Post, POB 81,Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02)538-9527, or e-mail it to, giving your initials, ageand residence.