There remain liver-related safety concerns, regarding potential hepatotoxicity in
humans, induced by green tea intake, despite being supposedly beneficial. Although
many randomized controlled trials (RCTs) of green tea extracts have been reported in
the literature, the systematic reviews published to date were only based on
subjective assessment of case reports. To more objectively examine the liver-related
safety of green tea intake, we conducted a systematic review of published RCTs. A
systematic literature search was conducted using three databases (PubMed, EMBASE and
Cochrane Central Register of Controlled Trials) in December 2013 to identify RCTs of
green tea extracts. Data on liver-related adverse events, including laboratory test
abnormalities, were abstracted from the identified articles. Methodological quality
of RCTs was assessed. After excluding duplicates, 561 titles and abstracts and 119
full-text articles were screened, and finally 34 trials were identified. Of these,
liver-related adverse events were reported in four trials; these adverse events
involved seven subjects (eight events) in the green tea intervention group and one
subject (one event) in the control group. The summary odds ratio, estimated using a
meta-analysis method for sparse event data, for intervention compared with placebo
was 2.1 (95% confidence interval: 0.5–9.8). The few events reported in
both groups were elevations of liver enzymes. Most were mild, and no serious
liver-related adverse events were reported. Results of this review, although not
conclusive, suggest that liver-related adverse events after intake of green tea
extracts are expected to be rare.