Hepatotoxicity from green tea: a review of the literature and two unpublished cases

Abstract

Purpose To review the current literature on suspected green tea-related hepatic reactions and to describe two new cases reported within the framework of the Italian surveillance system of natural health products. Results A literature search of publication between 1999 and October 2008 retrieved 34 cases of hepatitis. Histological examination of the liver revealed inflammatory reactions, cholestasis, occasional steatosis, and necrosis. A positive dechallenge was reported in 29 cases. There was one reported death. A positive rechallenge occurred in seven cases (20%). In the two new cases, the causality assessment was judged as "possible" according to the RUCAM score. Conclusions Our analysis of the published case reports suggests a causal association between green tea and liver damage. The hepatotoxicity is probably due to (-)-epigallocatechin gallate or its metabolites which, under particular conditions related to the patient's metabolism, can induce oxidative stress in the liver. In a few cases, toxicity related to concomitant medications could also be involved.

High-dose green tea polyphenols induce nephrotoxicity in dextran sulfate sodium-induced colitis mice by down-regulation of antioxidant enzymes and heat-shock protein expressions

“…Data are shown as the mean±SD of seven to ten samples. Bars with different letters show significant differences (P<0.05) the other hand, several recent studies have also noted that excess intake of green tea supplements induced hepatotoxicity in both rodents and humans (Lambert et al 2010;Mazzanti et al 2009;Isbrucker et al 2006). In addition, the present study showed for the first time that high-dose GTPs caused nephrotoxicity in mice as observed by increased serum creatinine level (Fig.…”

“…Furthermore, a 1% GTP diet enhanced pro-inflammatory cytokines, aggravated colitis, and tended to promote colon carcinogenesis in DSSexposed colons, while it decreased the activities of superoxide dismutase (SOD) and catalase in non-treated mice . In addition, several human cases of hepatotoxicity following consumption of dietary supplementation containing green tea extracts have been reported (Mazzanti et al 2009). …”

Adverse Effects of Plant Food Supplements and Plants Consumed as Food: Results from the Poisons Centres-Based PlantLIBRA Study

“…Nevertheless, in this study there were only few reports of hepatotoxicity (4 of 75 cases), and this is in contrast to the literature. The plants associated with hepatic signs and symptoms in this study Camellia sinensis (L.) Kuntze (Bunchorntavakul, 2013;Mazzanti, 2009), Dioscorea villosa L. (Wojcikowski, 2008), and Mentha piperita L. (Akdogan, 2004) exist, the design of the present study does not allow to add further evidence, particularly if the plant was part of a multi-ingredient product. In addition, a causality assessment according to RUCAM (Roussel Uclaf Causality Assessment Method), which is the reference method for evaluating drug and herb induced liver injury (Danan, 2016), was not possible due to incomplete case information.…”

A Review of Natural Stimulant and Non‐stimulant Thermogenic Agents

“…However, on rare occasions, cases of hepatotoxicity have been reported, particularly when green tea is consumed in large amounts (Mazzanti et al , 2009). …”