Herbal combination might be effective for nonpulsatile tinnitus

Reference

Khosravi MH, Atefi A, Mehri A, et al. Therapeutic effects of Rosa canina, Urtica dioica and Tanacetum vulgare herbal combination in treatment of tinnitus symptoms: A double-blind randomised clinical trial. Clin Otolaryngol 2023;48(2):151-157. 

Synopsis

A combination of 3 herbs — Rosa canina (rose hips), Urtica dioica (stinging nettle), and Tanacetum vulgare (tansy) — marketed as Neurotec, is approved in Iran for the treatment of diabetic neuropathy and neuralgia. Its effect is presumed to be on neural conduction. This double-blind randomized controlled study enrolled 150 participants (concealed allocation uncertain) recruited from an otolaryngology clinic with nonpulsatile tinnitus to receive either the herbal combination or placebo daily for 3 months. All patients received reassurance and nonspecified training. Using per-protocol analysis of the patients who were available for follow-up at 3 months, the low and high frequency pure tone audiometry results were not different between the 2 groups. However, some quality-of-life and symptom scores were significantly improved, including tinnitus loudness, annoyance severity, daily life alteration, sleep disturbance, mood disturbance, and overall quality-of-life scores. There are many problems with this study. The number of dropouts was significant in both groups (34% and 29%). In addition, more patients (n = 80) were assigned to treatment than placebo (n = 70), making me worry about the adequacy of the randomization process (though they could have used simple instead of block randomization). The authors didn't adjust the P values for multiple comparisons, making it likely that at least one of these outcomes occurred by chance. The biggest problem, however, is that the product seems to be available only in Iran.