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Green Tea

En Español (Spanish Version)Camellia sinensis

Principal Proposed Uses

Cancer Prevention; Gingivitis

Other Proposed Uses

Diabetes; Heart Disease Prevention; High Cholesterol; Influenza Prevention; Liver Disease Prevention; Rosacea; Sun Damage Protection; Weight Loss

What Is Green Tea Used for Today?
Dosage
Safety Issues
Interactions You Should Know About
References

People have been drinking tea for thousands of years, but in the last couple of decades a number of potential health benefits have been attributed to this ancient beverage. Black tea and green tea are made from the same plant, but a higher level of the original substances endure in the less-processed green form.

What Is Green Tea Used for Today?

Green tea contains high levels of substances called catechin polyphenols, known to possess strong antioxidant, anticarcinogenic, antitumorigenic, and even antibiotic properties.^1,2 Based on these findings, as well as observational studies,^3-8 green tea has become popular as a daily drink for preventing cancer and heart disease. However, some observational trials failed to find indications of benefit with green tea.^9,10,11 Furthermore, only double-blind, placebo-controlled studies can prove a treatment effective, and there is little direct evidence of this type regarding green tea and cancer or heart disease prevention.⁵² (For more information on why double-blind studies are so important, see Why Does this Database Rely on Double-blind Studies?)

Researchers have studied the potential benefits of green tea in people with high cholesterol. The overall evidence has been positive. One study found that green tea produced short-term improvements in cholesterol profile, but the benefits disappeared after 4 weeks.²⁶ Another study evaluated a form of green tea enriched with the substance theaflavin.²¹ In this large, 3-month trial, use of the tea product resulted in significant, ongoing reductions in LDL ("bad") cholesterol as compared to placebo. In a somewhat flawed double-blind study, a green tea extract enhanced with catechins also showed promise for reducing LDL levels.⁴² Lastly, a 2011 review of 20 randomized trials involving 1,415 people found evidence that green tea catechins (145-3,000 mg/day for 3-24 weeks) reduced total and LDL cholesterol.⁵⁶

Preliminary studies suggest that certain green tea polyphenols may help prevent skin cancer if they are applied directly to the skin.¹² In addition, there is some evidence that green tea constituents might help protect the skin from sun damage.^13,14,15 Unlike normal sunscreen preparations, green tea does not physically block ultraviolet light. Rather, it seems to protect cells from some of the damage caused by ultraviolet light. Because it works by such a different mechanism of action, green tea might offer synergistic benefits if combined with standard sunscreens. However, in an 8-week double-blind, placebo-controlled study of 40 women who already had symptoms of aging skin, combined use of oral green tea and a topical green tea cream failed to prove more effective than placebo.²⁷ Some possible benefits were seen in microscopic evaluation of skin condition.

Topical green tea extracts have also shown a bit of promise for the treatment of cervical dysplasia,²² while oral green tea extracts might reduce risk of prostate cancer, according to a small pilot study.²⁸ Combining the results of 13 observational studies, researchers found conflicting evidence for green tea's effect on the risk of stomach cancer.⁵³ In a Japanese pilot study, green tea extract supplements lowered the risk of recurrent colorectal polyps.⁵⁴ In a review of nine observational studies involving over 5,600 cases of breast cancer, researchers failed to find reliable evidence for a reduction in the incidence of breast cancer. However, they did find weak evidence for a decrease in breast cancer recurrence among women who consumed more than 3 cups of green tea daily. .⁵⁵

For more information on green tea's capacity to fight cancer see the Cancer Prevention article.

On a completely different note, one interesting study tested the effectiveness of gargling with green tea catechins as a means of preventing influenza.³⁹ In this double-blind, placebo-controlled study, 124 residents of a Japanese nursing home gargled with green tea catechins or placebo for three months. All participants received standard influenza vaccine. The results showed that residents who gargled with the tea extract were less likely to develop influenza than those using the placebo. In addition, another double-blind study found preliminary evidence that oral consumption of a green tea extract might help prevent colds and flus.⁴⁴

A small double-blind, placebo-controlled trial found weak evidence that green tea chew candy might reduce gum inflammation in individuals with periodontal disease (gingivitis).¹⁶

Oral use of green tea extracts has shown a bit of promise for treating borderline diabetes.⁴¹ However, one double-blind study failed to find that a combined extract of black and green tea was helpful for controlling blood sugar levels in people with type 2 diabetes.⁴³ And a subsequent study failed to find any benefit for green tea extract in controlling blood sugar levels in obese people with diabetes.⁵⁷

Green tea has been proposed as means of preventing liver disease, but the evidence for this use remains unconvincing.^17,48

Green tea is sometimes recommended for weight loss on the basis of rather theoretical evidence that it speeds up metabolism.²³ However, there is little direct scientific backing for this use. If green tea increases metabolism at all, the effect is extremely small.^29-30 One study conducted in Thailand reported weight-loss benefits with green tea,⁴⁵ as did a second study of oolong tea enriched with green tea extracts.²⁴ However, a Dutch study failed to find green tea helpful for preventing weight regain after weight loss.⁴⁶ In another study, use of green tea failed to produce significant weight loss in overweight women with polycystic ovary syndrome.³¹ Green tea extract enriched with catechins has done somewhat better, enhancing weight loss in one substantial, but flawed trial.⁴² However, a study in overweight Japanese children did not support the effectiveness of green tea catechins for weight reduction.⁴⁷ Similar results were obtained in another placebo-controlled trial involving 78 overweight women after 12 weeks of treatment.⁴⁹

One preliminary study, available only in abstract form, found some evidence that green tea cream may be helpful for rosacea.²⁵ The results of another study weakly hint that green tea extracts taken orally might reduce symptoms of benign prostatic hyperplasia.³²

One study found that inhaled tea catechins could reduce levels of resistant staph carried in the sputum of disabled seniors.³³Note: Do not attempt to inhale green tea products.

Dosage

Studies weakly suggest that 3 cups of green tea daily might provide protection against cancer. However, because not everyone wants to take the time to drink green tea, manufacturers have offered extracts that can be taken in pill form. A typical dosage is 100 mg to 150 mg 3 times daily of a green tea extract standardized to contain 80% total polyphenols and 50% epigallocatechin gallate. Whether these extracts offer any benefit remains unknown. Furthermore, there are growing concerns about liver toxicity with use of green tea extracts. (See Safety Issues.)

Warning: In an analysis performed in 2006 by the respected testing organization ConsumerLabs.com, some tested green tea products were found to be contaminated with lead.³⁴

Safety Issues

As a widely consumed beverage, green tea is generally regarded as safe. It does contain caffeine, at perhaps a slightly lower level than black tea, and can therefore cause insomnia, nervousness, and the other well-known symptoms of excess caffeine intake.

Green tea extracts, however, may not be safe. There are a growing number of case reports in which use of a concentrated green tea extract was associated with liver inflammation.^35,40,50 In most cases, liver problems disappeared after the extract was discontinued. But, in two cases, permanent liver failure ensued requiring liver transplantation.^36,40 While it is not absolutely certain that the green tea extract caused the liver problems, nor how it might do so, these reports do raise significant concerns about use of green tea extracts, especially by those with liver disease or prone to it.

Green tea should not be given to infants and young children. There are theoretical concerns that high dosages of EGCG might be unsafe for pregnant women.³⁷

Dried green tea leaf contains significant levels of vitamin K on a per-weight basis. On this basis, it has been stated that people using blood thinners in the warfarin (Coumadin) family should avoid green tea, because vitamin K antagonizes the effect of those drugs. However green tea taken as a beverage provides such small amounts of the vitamin that the risk seems minimal for normal consumption. There is one case report of problems that developed in a person on warfarin who consumed as much as a gallon of green tea daily.³⁸

Interactions You Should Know About

If you are taking:

MAO inhibitors: The caffeine in green tea could cause serious problems.
Warfarin (Coumadin): Avoid drinking large quantities of green tea.
Folic acid: Green tea may decrease the absorption of folic acid into the blood stream.⁵¹

Snow JM. Camellia sinensi (L.) Kuntze (Theaceae). J Botanical Medicine. 1995;Autumn:28-32.

Cao Y, Cao R. Angiogenesis inhibited by drinking tea [letter]. Nature. 1999;398:381.

Stoner GD, Mukhtar H. Polyphenols as cancer chemopreventive agents. J Cell Biochem Suppl. 1995;22:169-180.

Imai K, Suga K, Nakachi K. Cancer-preventive effects of drinking green tea among a Japanese population. Prev Med. 1997;26:769-775.

Imai K, Nakachi K. Cross sectional study of effects of drinking green tea on cardiovascular and liver diseases. BMJ. 1995;310:693-696.

Kono S, Shinchi K, Ikeda N, et al. Green tea consumption and serum lipid profiles: a cross-sectional study in northern Kyushu, Japan. Prev Med. 1992;21:526-531.

Tsubono Y, Tsugane S. Green tea intake in relation to serum lipid levels in middle-aged Japanese men and women. Ann Epidemiol. 1997;7:280-284.

van het Hof KH, de Boer HS, Wiseman SA, et al. Consumption of green or black tea does not increase resistance of low-density lipoprotein to oxidation in humans. Am J Clin Nutr. 1997;66:1125-1132.

Kohlmeier L, Weterings KGC, Steck S, et al. Tea and cancer prevention: an evaluation of the epidemiologic literature. Nutr Cancer. 1997;27:1-13.

Tsubono Y, Nishino Y, Komatsu S, et al. Green tea and the risk of gastric cancer in Japan. N Engl J Med. 2001;344:632-666.

Galanis DJ, Kolonel LN, Lee J, et al. Intakes of selected foods and beverages and the incidence of gastric cancer among the Japanese residents of Hawaii: a prospective study. Int J Epidemiol. 1998;27:173-180.

Katiyar SK, Ahmad N, Mukhtar H. Green tea and skin. Arch Dermatol. 2000;136:989-994.

Katiyar SK, Matsui MS, Elmets CA, et al.Polyphenolic antioxidant (-)-epigallocatechin-3-gallate from green tea reduces UVB-induced inflammatory responses and infiltration of leukocytes in human skin. Photochem Photobiol. 1999;69:148-153.

Katiyar SK, Elmets CA, Agarwal R, et al. Protection against ultraviolet-B radiation-induced local and systemic suppression of contact hypersensitivity and edema responses in C3H/HeN mice by green tea polyphenols. Photochem Photobiol. 1995;62:855-861.

Elmets CA, Singh D, Tubesing K, et al. Cutaneous photoprotection from ultraviolet injury by green tea polyphenols. J Am Acad Dermatol. 2001;44:425-432.

Krahwinkel T, Willershausen B. The effect of sugar-free green tea chew candies on the degree of inflammation of the gingiva. Eur J Med Res. 2000;5:463-467.

Imai K, Nakachi K. Cross sectional study of effects of drinking green tea on cardiovascular and liver diseases. BMJ. 1995;310:693-696.

Hegarty VM, May HM, Khaw KT. Tea drinking and bone mineral density in older women. Am J Clin Nutr. 2000;71:1003-1007.

Geleijnse JM, Launer LJ, Hofman A, et al. Tea flavonoids may protect against atherosclerosis: the Rotterdam Study. Arch Intern Med. 1999;159:2170-2174.

Taylor JR, Wilt VM. Probable antagonism of warfarin by green tea. Ann Pharmacother. 1999;33:426-428.

Maron DJ, Lu GP, Cai NS, et al. Cholesterol-lowering effect of a theaflavin-enriched green tea extract: a randomized controlled trial. Arch Intern Med. 2003;163:1448-53.

Ahn WS, Yoo J, Huh SW, et al. Protective effects of green tea extracts (polyphenon E and EGCG) on human cervical lesions. Eur J Cancer Prev. 2003;12:383-90.

Dulloo AG, Seydoux J, Girardier L, et al. Green tea and thermogenesis: interactions between catechin-polyphenols, caffeine and sympathetic activity. Int J Obes Relat Metab Disord. 2000;24:252-258.

Nagao T, Komine Y, Soga S, et al. Ingestion of a tea rich in catechins leads to a reduction in body fat and malondialdehyde-modified LDL in men. Am J Clin Nutr. 2005;81:122-129.

Syed A. AAD 63rd Annual Meeting: Poster 19. Presented: February 20, 2005.

Diepvens K, Kovacs EM, Vogels N, et al. Metabolic effects of green tea and of phases of weight loss. Physiol Behav. 2005 Nov 4. [Epub ahead of print]

Chiu AE, Chan JL, Kern DG, et al. Double-blinded, placebo-controlled trial of green tea extracts in the clinical and histologic appearance of photoaging skin. Dermatol Surg. 2005;31:855-860; discussion 860.

Bettuzzi S, Brausi M, Rizzi F, et al. Chemoprevention of human prostate cancer by oral administration of green tea catechins in volunteers with high-grade prostate intraepithelial neoplasia: a preliminary report from a one-year proof-of-principle study. Cancer Res. 2006;66:1234-1240.

Diepvens K, Kovacs EM, Nijs IM, et al. Effect of green tea on resting energy expenditure and substrate oxidation during weight loss in overweight females. Br J Nutr. 2005;94:1026-1034.

Diepvens K, Kovacs EM, Vogels N, et al. Metabolic effects of green tea and of phases of weight loss. Physiol Behav. 2005 Nov 4. [Epub ahead of print]

Chan CC, Koo MW, Ng EH, et al. Effects of Chinese green tea on weight, and hormonal and biochemical profiles in obese patients with polycystic ovary syndrome—a randomized placebo-controlled trial. J Soc Gynecol Investig. 2005;13:63-68.

Yamada H, Tateishi M, Harada K, et al. A randomized clinical study of tea catechin inhalation effects on methicillin-resistant staphylococcus aureus in disabled elderly patients. J Am Med Dir Assoc. 2006;7:79-83.

Product review of supplements for cancer prevention (green tea, lycopene, and selenium). Consumer Lab website. Available at: http://www.consumerlabs.com/results/cancer_supplements_green_tea_ly...ene_selenium.asp. Accessed May 5, 2006.

Bonkovsky HL. Hepatotoxicity associated with supplements containing Chinese green tea (Camellia sinensis). Ann Intern Med. 2006;144:68-71. Erratum in: Ann Intern Med. 2006;144:380.

Gloro R, Hourmand-Ollivier I, Mosquet B, et al. Fulminant hepatitis during self-medication with hydroalcoholic extract of green tea. Eur J Gastroenterol Hepatol. 2005;17:1135-1137.

Green tea mechanism urges caution for pregnant women. Nutra Ingredients website. http://nutraingredients.com/news/ng.asp?id=58807&n=dt7...=tbtcgrwexqoosjy. Accessed September 20, 2005.

Taylor JR, Wilt VM. Probable antagonism of warfarin by green tea. Ann Pharmacother. 1999;33:426-428.

Yamada H, Takuma N, Daimon T, et al. Gargling with tea catechin extracts for the prevention of influenza infection in elderly nursing home residents: a prospective clinical study. J Altern Complement Med. 2006;12:669-672.

Green tea extract (Green Lite): suspected association with hepatotoxicity. Canadian Adverse Reaction Newsletter. 2007;17.

Fukino Y, Ikeda A, Maruyama K, et al. Randomized controlled trial for an effect of green tea-extract powder supplementation on glucose abnormalities. Eur J Clin Nutr. 2007 Jun 6. [Epub ahead of print]

Nagao T, Hase T, Tokimitsu I. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity (Silver Spring). 2007;15:1473-1483.

Mackenzie T, Leary L, Brooks WB. The effect of an extract of green and black tea on glucose control in adults with type 2 diabetes mellitus: double-blind randomized study. Metabolism. 2007;56:1340-1344.

Rowe CA, Nantz MP, Bukowski JF, et al. Specific formulation of Camellia sinensis prevents cold and flu symptoms and enhances T cell function: a randomized, double-blind, placebo-controlled study. J Am Coll Nutr. 2007;26:445-452.

Auvichayapat P, Prapochanung M, Tunkamnerdthai O, et al. Effectiveness of green tea on weight reduction in obese Thais: A randomized, controlled trial. Physiol Behav. 2007 Oct 18. [Epub ahead of print]

Kovacs EM, Lejeune MP, Nijs I, et al. Effects of green tea on weight maintenance after body-weight loss. Br J Nutr. 2004;91:431-437.

Matsuyama T, Tanaka Y, Kamimaki I, et al. Catechin safely improved higher levels of fatness, blood pressure, and cholesterol in children. Obesity (Silver Spring). 2008 Mar 20.

Jin X, Zheng RH, Li YM. Green tea consumption and liver disease: a systematic review. Liver Int. 2008 May 14.

Hsu CH, Tsai TH, Kao YH, et al. Effect of green tea extract on obese women: A randomized, double-blind, placebo-controlled clinical trial. Clin Nutr. 2008 May 9.

Sarma DN, Barrett ML, Chavez ML, et al. Safety of green tea extracts : a systematic review by the US Pharmacopeia. Drug Saf. 2008;31:469-484.

Alemdaroglu NC, Dietz U, Wolffram S, et al. Influence of green and black tea on folic acid pharmacokinetics in healthy volunteers: potential risk of diminished folic acid bioavailability. Biopharm Drug Dispos. 2008 Jun 12.

Liu J, Xing J, Fei Y. Green tea ( Camellia sinensis) and cancer prevention: a systematic review of randomized trials and epidemiological studies. Chin Med. 2008;3:12.

Myung SK, Bae WK, Oh SM, et al. Green tea consumption and risk of stomach cancer: a meta-analysis of epidemiologic studies. Int J Cancer. 2009;124:670-677.

Shimizu M, Fukutomi Y, Ninomiya M, et al. Green tea extracts for the prevention of metachronous colorectal adenomas: a pilot study. Cancer Epidemiol Biomarkers Prev. 2008;17:3020-3025.

Ogunleye AA, Xue F, Michels KB. Green tea consumption and breast cancer risk or recurrence: a meta-analysis. Breast Cancer Res Treat. 2010 Jan;119(2):477.

Kim A, Chiu A, Barone MK, et al. Green tea catechins decrease total and low-density lipoprotein cholesterol: a systematic review and meta-analysis. J Am Diet Assoc. 2011;111(11):1720-1729.

Hsu CH, Liao YL, Lin SC, Tsai TH, Huang CJ, Chou P. Does supplementation with green tea extract improve insulin resistance in obese type 2 diabetics? A randomized, double-blind, and placebo-controlled clinical trial. Altern Med Rev. 2011;16(2):157-163.

Last reviewed July 2012 by EBSCO CAM Review Board

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.