Green tea (Camellia sinensis)
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| Green tea |
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- Green tea is made from the dried leaves of Camellia sinensis , a perennial evergreen shrub. Green tea has a long history of use, dating back to China approximately 5,000 years ago. Green tea, black tea, and oolong tea are all derived from the same plant.
- Tea varieties reflect the growing region (for example, Ceylon or Assam), the district (for example, Darjeeling), the form (for example, pekoe is cut, gunpowder is rolled), and the processing method (for example, black, green, or oolong). India and Sri Lanka are the major producers of green tea.
- Historically, tea has been served as a part of various ceremonies and has been used to stay alert during long meditations. A legend in India describes the story of Prince Siddhartha Gautama, the founder of Buddhism, who tore off his eyelids in frustration at his inability to stay awake during meditation while journeying through China. A tea plant is said to have sprouted from the spot where his eyelids fell, providing him with the ability to stay awake, meditate, and reach enlightenment. Turkish traders reportedly introduced tea to Western cultures in the 6th Century.
- AR25®, Camellia, Camellia assamica , Camellia sinensis , Camellia sinensis (L.) Kuntze, Camellia tea, catechins, Chinese tea, EGCG, epigallocatechin-3-gallate, Exolise®, flavonol, GTE, green tea extract, Matsu-cha Tea, polyphenols, Polyphenon E, Thea bohea , Thea sinensis , Thea viridis , Theanine, Theifers.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
| Uses based on scientific evidence | Grade* |
| Anxiety
L-theanine is a predominant amino acid found in green tea. Preliminary research exists on the effects of this amino acid in comparison with the prescription drug alprazolam on experimentally induced anxiety. No benefit was found.
| C |
| Arthritis
Research indicates that green tea may benefit arthritis by reducing inflammation and slowing cartilage breakdown. Further studies are required before a recommendation can be made.
| C |
| Asthma
Research has shown caffeine to cause improvements in airflow to the lungs (bronchodilation). However, it is not clear if caffeine or tea use has significant benefits in people with asthma. Better research is needed in this area before a strong conclusion can be drawn.
| C |
| Cancer (general)
Overall, the relationship of green tea consumption and human cancer remains inconclusive. One clinical trial showed minimal benefit using green tea extract capsules for the treatment of hormone refractory prostate cancer. Further research is needed before a recommendation can be made.
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| Cardiovascular conditions
There is early suggestive evidence that regular intake of green tea may reduce the risk of heart attack or atherosclerosis (clogged arteries). Further well-designed clinical trials are needed before a firm recommendation can be made in this area.
| C |
| Common cold prevention
In humans, preliminary date suggests that a specific formulation of green tea may help prevent cold and flu symptoms. Further well-designed clinical trials are needed to confirm these results.
| C |
| Dental cavity prevention
There is limited study of tea as a gargle (mouthwash) for the prevention of dental cavities (caries). It is not clear if this is a beneficial therapy.
| C |
| Diabetes
More studies are required to determine if green tea and polyphenols have any therapeutic benefit for diabetes prevention or treatment.
| C |
| Fertility
Early research using a combination product called FertilityBlend has been associated with some success in helping women to conceive. Further well-designed research on green tea alone for this use is needed before a strong conclusion can be drawn.
| C |
| High cholesterol
Laboratory studies, animal studies, and limited human research suggest possible effects of green tea on cholesterol levels. Better human evidence is necessary in this area.
| C |
| Hypertension
Green tea has been shown to increase or have no effect on blood pressure in several studies in humans.
| C |
| Hypertriglyceridemia
Laboratory, animal, and limited human research suggest possible effects of green tea on triglyceride levels. Better human evidence is necessary in this area.
| C |
| Menopausal symptoms
A study conducted in healthy postmenopausal women showed that a morning/evening menopausal formula containing green tea was effective in relieving menopausal symptoms including hot flashes and sleep disturbance. Further studies are needed to confirm these results.
| C |
| Mental performance/alertness
Several preliminary studies have examined the effects of caffeine, tea, or coffee use on short and long-term memory and cognition. It remains unclear if tea is beneficial for this use. Limited, low-quality research reports that the use of green tea may improve cognition and sense of alertness. Green tea contains caffeine, which is a stimulant.
| C |
| Photoprotection
There is limited animal and human study of green tea as a protective agent of skin from ultraviolet light skin injury. Some study results conflict. Comparisons have not been made with well-established forms of sun protection such as ultraviolet protective sunscreen. The effects of green tea on skin damage caused by the sun remain unclear.
| C |
| Viral infection (human T-cell lymphocytic virus)
Preliminary research suggests green tea decreases viral load in carriers of the HTLV-1 virus. Additional well-designed controlled research is needed before a recommendation can be made for or against green tea in the treatment of HTLV-1 carriers.
| C |
| Weight loss (maintenance)
There are several small human studies addressing the use of green tea extract (GTE) capsules for weight loss or weight maintenance in overweight or average weight individuals. Study results are mixed. Better research is needed before a strong recommendation can be made in this area.
| C |
*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.
Grading rationale
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Adenocarcinoma, antioxidant, atherosclerosis, astringent, autoimmune disorders (encephalomyelitis), bleeding of gums or tooth sockets, bone density improvement, cancer treatment side-effects, cataracts, cognitive performance enhancement, coronary heart disease, Crohn's disease, dementia, detoxification from alcohol or toxins, diarrhea, digestion, exercise performance, fibrosarcoma, flatulence, fungal infections, gastritis, gingivitis, gum swelling, hair growth, headache, heart disease, Helicobacter pylori infection, HIV/AIDS, improving blood flow, improving resistance to disease, improving urine flow, inhibition of platelet aggregation, ischemia-reperfusion injury protection, joint pain, kidney stone prevention, leukoplakia, longevity, lymphocytic leukemia, memory, neuroprotection, osteoporosis, , Parkinson's disease (prevention), protection against asbestos lung injury, regulation of body temperature, stimulant, stomach disorders, stroke prevention, tired eyes, vascular tumors, vomiting.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (over 18 years old)
- Benefits of specific doses of green tea are not established. Most studies have examined green tea in the form of a brewed beverage, rather than in capsule form. One cup of tea contains approximately 50 milligrams of caffeine and 80 to 100 milligrams of polyphenol content, depending on the strength of the tea and the size of cup.
- Studies have examined the effects of habitually drinking anywhere from 1-10 cups per day (or greater).
- In capsule form, there is considerable variation in the amount of green tea extract (GTE); there may be anywhere from 100 to 750 milligrams per capsule. Currently, there is no established recommended dose for GTE capsules.
Children (under 18 years old)
- Green tea is not recommended for infants or children due to caffeine content.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
- People with known allergy/hypersensitivity to caffeine or tannin should avoid green tea. Skin rash and hives have been reported with caffeine ingestion.
Side Effects and Warnings
- Studies of the side effects of green tea specifically are limited. However, green tea is a source of caffeine, for which multiple reactions are reported.
- Caffeine is a stimulant of the central nervous system, and may cause insomnia in adults, children, and infants (including nursing infants of mothers taking caffeine). Caffeine acts on the kidneys as a diuretic (increasing urine and urine sodium/potassium levels and potentially decreasing blood sodium/potassium levels) and may worsen incontinence. Caffeine-containing beverages may increase the production of stomach acid and may worsen ulcer symptoms. Tannin in tea can cause constipation. Certain doses of caffeine can increase heart rate and blood pressure, although people who consume caffeine regularly do not seem to experience these effects in the long-term.
- An increase in blood sugar levels may occur. Caffeine-containing beverages such as green tea should be used cautiously in patients with diabetes. In contrast, lowering of blood sugar levels from drinking green tea has also been reported in preliminary research. Additional study is needed in this area.
- People with severe liver disease should use caffeine cautiously, as levels of caffeine in the blood may build up and last longer. Skin rashes have been associated with caffeine ingestion. In laboratory and animal studies, caffeine has been found to affect blood clotting, although effects in humans are not known.
- Caffeine toxicity is possible with high doses. Chronic use can result in tolerance, psychological dependence, and may be habit forming. Abrupt discontinuation may result in withdrawal symptoms.
- Several population studies initially suggested a possible association between caffeine use and fibrocystic breast disease, although more recent research has not found this connection. Limited research reports a possible relationship between caffeine use and multiple sclerosis, although evidence is not definitive in this area. Animal study reports that tannin fractions from tea plants may increase the risk of cancer, although it is not clear that the tannin present in green tea has significant carcinogenic effects in humans.
- Drinking tannin-containing beverages such as tea may contribute to iron deficiency, and in infants, tea has been associated with impaired iron metabolism and microcytic anemia.
- In preliminary research, green tea has been associated with decreased levels of estrogens in the body. It is not clear if significant side effects such as hot flashes may occur.
Pregnancy and Breastfeeding
- Large amounts of green tea should be used cautiously in pregnant women, as caffeine crosses the placenta and has been associated with spontaneous abortion, intrauterine growth retardation, and low birth weight.
- Caffeine is readily transferred into breast milk. Caffeine ingestion by infants can lead to sleep disturbances/insomnia.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
- Studies of the interactions of green tea with drugs are limited. However, green tea is a source of caffeine, for which multiple interactions have been documented.
- The combination of caffeine with ephedrine, an ephedra alkaloid, has been implicated in numerous severe or life-threatening cardiovascular events such as very high blood pressure, stroke, or heart attack. Stroke has also been reported after the nasal ingestion of caffeine with amphetamine.
- Caffeine may add to the effects and side effects of other stimulants including nicotine, beta-agonists such as albuterol (Ventolin®), or other methylxanthines such as theophylline. Conversely, caffeine can counteract drowsy effects and mental slowness caused by benzodiazepines like lorazepam (Ativan®) or diazepam (Valium®). Phenylpropanolamine and caffeine should not be used together due to reports of numerous potentially serious adverse effects; forms of phenylpropanolamine taken by mouth have been removed from the U.S. market due to reports of bleeding into the head.
- When taken with caffeine, a number of drugs may increase caffeine blood levels or the length of time caffeine acts on the body, including disulfiram (Antabuse®), birth control pills or hormone replacement therapy (HRT), ciprofloxacin (Cipro®), norfloxacin, fluvoxamine (Luvox®), cimetidine (Tagamet®), verapamil, and mexiletine. Caffeine levels may be lowered by taking dexamethasone (Decadron®). The metabolism of caffeine by the liver may be affected by multiple drugs, although the effects in humans are not clear.
- Caffeine may lengthen the effects of carbamazepine or increase the effects of clozapine (Clozaril®) and dipyridamole. Caffeine may affect serum lithium levels, and abrupt cessation of caffeine use by regular caffeine users taking lithium may result in high levels of lithium or lithium toxicity. Levels of aspirin or phenobarbital may be lowered in the body, although clinical effects in humans are not clear.
- Although caffeine by itself does not appear to have pain-relieving properties, it is used in combination with ergotamine tartrate in the treatment of migraine or cluster headaches (for example, Cafergot®). It has been shown to increase the headache-relieving effects of other pain relievers such as acetaminophen and aspirin (for example, Excedrin®). Caffeine may also increase the pain-relieving effects of codeine or ibuprofen (Advil®, Motrin®).
- As a diuretic, caffeine increases urine and sodium losses through the kidney and may add to the effects of other diuretics such as furosemide (Lasix®).
- Green tea may contain vitamin K, which when used in large quantities can reduce the blood thinning effects of warfarin (Coumadin®), a phenomenon that has been reported in a human case.
- Based on preliminary data, theanine, a specific glutamate derivative in green tea, may reduce the adverse reactions caused to the heart and liver by the prescription cancer drug doxorubicin. Further research is needed to confirm these results.
- Based on preliminary data, ingestion of green tea may lower LDL cholesterol and thus may theoretically interact with other cholesterol-lowering drugs.
- Other potential interactions may include drugs such as adenosine, alcohol, anticoagulants, antidiabetics, antipsychotics, fluconazole, hydrocortisone, levodopa, MAOI antidepressants, methoxsalen, phenytoin, proton pump inhibitors (PPIs), riluzole, terbinafine, theophylline, and timolol.
Interactions with Herbs and Dietary Supplements
- Studies of green tea interactions with herbs and supplements are limited. However, green tea is a source of caffeine, for which multiple interactions have been documented.
- Caffeine may add to the effects and side effects of other stimulants. The combination of caffeine with ephedrine, which is present in ephedra (ma huang), has been implicated in numerous severe or life-threatening cardiovascular events such as very high blood pressure, stroke, or heart attack.
- Cola nut, guarana ( Paullina cupana ), and yerba mate ( Ilex paraguariensis ) are also sources of caffeine, and may add to the effects and side effects of caffeine in green tea. A combination product containing caffeine, yerbe mate ( Ilex paraguariensis ), and damiana ( Turnera difussa ) has been reported to cause weight loss, slowing of the gastrointestinal tract, and a feeling of stomach fullness.
- As a diuretic, caffeine increases urine and sodium losses through the kidney, and may add to the effects of other diuretic agents.
- Based on preliminary data, ingestion of green tea may lower LDL ("bad") cholesterol, and thus may theoretically interact with other cholesterol-lowering herbs and supplements.
- Bitter orange, calcium, iron, MAOIs, and tannin-containing herbs and supplements may also interact with green tea.
- This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD, MPhil (Memorial Sloan-Kettering Cancer Center); Julie Conquer, PhD (RGB Consulting); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Cynthia Dacey, PharmD (Northeastern University); Paul Hammerness, MD (Massachusetts General Hospital); Carolyn Williams Orlando, MA (American Botanical Council); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).
Methodology details
- Berube-Parent S, Pelletier C, Dore J, et al. Effects of encapsulated green tea and Guarana extracts containing a mixture of epigallocatechin-3-gallate and caffeine on 24 h energy expenditure and fat oxidation in men. Br J Nutr 2005;94(3):432-436.
- 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(7 Pt 2):855-860.
- Choan E, Segal R, Jonker D, et al. A prospective clinical trial of green tea for hormone refractory prostate cancer: an evaluation of the complementary/alternative therapy approach. Urol Oncol 2005;23(2):108-113.
- Chow HH, Hakim IA, Vining DR, et al. Effects of dosing condition on the oral bioavailability of green tea catechins after single-dose administration of Polyphenon E in healthy individuals. Clin Cancer Res 6-15-2005;11(12):4627-4633.
- Cnattingius S, Signorello LB, Anneren G, et al. Caffeine intake and the risk of first-trimester spontaneous abortion. N Engl J Med 12-21-2000;343(25):1839-1845.
- Dlugosz L, Belanger K, Hellenbrand K, et al. Maternal caffeine consumption and spontaneous abortion: a prospective cohort study. Epidemiology 1996;7(3):250-255.
- Fukino Y, Shimbo M, Aoki N, et al. Randomized controlled trial for an effect of green tea consumption on insulin resistance and inflammation markers. J Nutr Sci Vitaminol (Tokyo) 2005;51(5):335-342.
- Gao YT, McLaughlin JK, Blot WJ, et al. Reduced risk of esophageal cancer associated with green tea consumption. J Natl Cancer Inst 6-1-1994;86(11):855-858.
- Henning SM, Aronson W, Niu Y, et al. Tea polyphenols and theaflavins are present in prostate tissue of humans and mice after green and black tea consumption. J Nutr 2006 Jul;136(7):1839-43.
- Hodgson JM, Puddey IB, Burke V, et al. Effects on blood pressure of drinking green and black tea. J Hypertens 1999;17(4):457-463.
- Lambert JD, Yang CS. Mechanisms of cancer prevention by tea constituents. J Nutr 2003;133(10):3262S-3267S.
- Laurie SA, Miller VA, Grant SC., et al. Phase I study of green tea extract in patients with advanced lung cancer. Cancer Chemother Pharmacol 2005;55(1):33-38.
- 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 6-23-2003;163(12):1448-1453.
- Seely D, Mills EJ, Wu P, et al. The effects of green tea consumption on incidence of breast cancer and recurrence of breast cancer: a systematic review and meta-analysis. Integr Cancer Ther 2005 Jun;4(2):144-55.
- Westerterp-Plantenga MS, Lejeune MP, Kovacs EM. Body weight loss and weight maintenance in relation to habitual caffeine intake and green tea supplementation. Obes Res 2005;13(7):1195-1204.
March 01, 2008.
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This evidence-based monograph was prepared by the Natural Standard Research Collaboration. The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Talk to your health care provider before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Copyright© 2009 Natural Standard (www.naturalstandard.com). All Rights Reserved.
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