Tinnitus is a common condition characterized by phantom sounds in the ears.
Some individuals have reported tinnitus during or after being diagnosed with COVID-19, possibly due to viral infections impacting the inner ear.
Zinc, an essential mineral with a role in immune function and wound healing, has been considered a potential natural remedy for tinnitus. However, the evidence of its effectiveness is limited and inconclusive, with some studies showing no significant impact.
Each year, millions of Americans develop tinnitus—an irritating condition that causes phantom sounds like ringing, buzzing, or whistling in the ears. In fact, it ranks as one of the most common types of hearing disturbances. The exact causes of tinnitus are unclear. Researchers suspect it’s linked to loud noise exposure, certain medications, ear infections and earwax, and head or neck injuries. The vast majority of tinnitus cases are due to underlying hearing loss.
Some people have also reported tinnitus during or after being diagnosed with COVID-19. According to evidence, viral infections—particularly respiratory viruses—are known to cause inner ear symptoms that may contribute to tinnitus. While the surge in COVID-19 cases may have impacted the prevalence of tinnitus, the recent increase in social isolation and changes in health-seeking behavior during the pandemic may have contributed to the condition as well, according to Tina Munjal, MD, a resident physician and postdoctoral fellow in the Department of Otolaryngology - Head & Neck Surgery with Stanford Medicine, told MDLinx.
Because there is no cure for tinnitus, some patients may be interested in exploring alternative treatments, including nutritional supplements. Zinc, an essential mineral involved in immune function, cell signaling, and wound healing, often makes the list of tinnitus natural remedies; however, the science of its powers is limited.
As a result, healthcare providers are hesitant to recommend zinc supplements to patients — unless they have a diagnosed zinc deficiency. “There is no high-quality evidence demonstrating a direct positive impact of zinc on tinnitus, particularly in those without a pre-existing zinc deficiency,” Dr. Munjal told MDLinx.
The relationship between zinc and hearing
Zinc plays a role in many body functions, including immune responses, neurological processes, and growth and development. Studies have found high concentrations of zinc in the cochlea, which is located in the inner ear, and vestibular sites. Zinc deficiency may also contribute to auditory conditions — for example, a lack of zinc has been linked to hearing loss in older adults, along with olfactory disturbances and tinnitus.
According to Dr. Munjal, zinc levels tend to drop as we age. At the same time, many older people experience declining hearing and worsening tinnitus. “Correlation does not imply causation, so we cannot say that supplementing with zinc would be beneficial for most patients,” Dr. Munjal said.
Some researchers suspect that, because of the connection between zinc and the ear, along with its antioxidant and anti-inflammatory properties, the mineral may help treat ear conditions such as tinnitus. “Tinnitus patients with pre-existing zinc deficiency may benefit; however, tinnitus patients with normal zinc levels may not,” says Dr. Munjal. Not all patients with tinnitus have a zinc deficiency.
How zinc may impact tinnitus symptoms
The evidence on zinc’s ability to alleviate tinnitus is limited, mixed, and controversial. “Some studies have suggested potential benefits, particularly in cases of zinc deficiency, but more research is needed to establish its role as a primary treatment,” says Geoff Trenkle, DO, the CEO and founder of the Los Angeles Center for Ear, Nose, Throat and Allergy.
A 2016 analysis evaluating three trials involving a total of 209 participants concluded that oral zinc supplementation didn't appear to ease tinnitus symptoms. Two of the reports included in the analysis determined that zinc did not affect tinnitus. The third study found the majority of participants self-reported noticeable improvements in their tinnitus symptoms. 
More recently, a 2022 study determined that zinc serum levels didn’t appear to influence the development of tinnitus. And a 2019 study found that zinc supplements boosted zinc serum link levels and improved tinnitus symptoms in people with noise-induced hearing loss-related tinnitus. “The researchers found that tinnitus scores improved after therapy, but importantly, there was no placebo group to serve as a control. This severely limits the ability to make generalizations based on these data,” says Dr. Munjal. All in all, zinc’s effectiveness is not universally established, says Dr. Trenkle, and its impact may vary from person to person.
Should doctors recommend zinc for tinnitus?
There is no cure for tinnitus, however, various interventions are available to reduce the severity of symptoms. Sound therapy, including hearing aids and sound generators, are commonly used to lessen the impact of tinnitus, according to the National Institutes of Health. In addition, behavioral therapy, such as cognitive behavioral therapy (CBT) and tinnitus retraining therapy, can teach people coping techniques and strategies that may improve their well-being. CBT helps restructure negative thoughts pertaining to tinnitus, explains Dr. Munjal.
In some cases, medications, like antidepressants and anti-anxieties, may be prescribed to address the mental health effects linked to tinnitus. Because tinnitus can be difficult to treat and, for some, eliminate, many patients are interested in exploring alternative options such as zinc supplementation. 
Dr. Trenkle says there is likely a role for zinc, but he would not recommend it as a stand-alone treatment for tinnitus. The American Academy of Otolaryngology—Head and Neck Surgery Foundation explicitly advises healthcare providers to avoid recommending zinc to patients with tinnitus. “Doctors should not routinely recommend zinc supplementation to patients with tinnitus unless the patient has a known documented zinc deficiency,” says Dr. Munjal.
If there are other signs of zinc deficiency — such as skin changes, hair loss, wound healing issues, and gastrointestinal problems — doctors can easily test for zinc deficiency prior to initiating a course of zinc supplementation, according to Dr. Munjal. “The recommended dosage and duration of supplementation can vary based on individual factors such as age, overall health, medications, and the presence of zinc deficiencies,” says Dr. Trenkle.
For patients only experiencing tinnitus, however, doctors should refer patients to an audiologist for a full hearing examination, says Dr. Munjal. They can offer treatments, potentially identify any abnormalities in the ear canals, and, if necessary, work with an otolaryngologist to facilitate additional testing.
Tinnitus is a complex condition that has multiple potential root causes. Because of this, medical advice must be personalized for each patient. We don’t fully understand the link between zinc and the inner ear, however, future research may identify new and alternative treatments that can effectively address tinnitus. “Ongoing research continues to shed light on potential treatments and their effectiveness in addressing tinnitus,” Dr. Trenkle said.