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Green tea (Camellia sinensis)

Natural Standard_ Patient Monograph, Copyright _ 2006 (www.naturalstandard.com).

Commercial distribution prohibited. This monograph is intended for informational

purposes only, and should not be interpreted as specific medical advice. You

should consult with a qualified healthcare provider before making decisions

about therapies and/or health conditions.

 

 

 

ARTICLE SECTIONS

 

a.. Background

b.. Synonyms

c.. Evidence

d.. Dosing

a.. Safety

b.. Methodology

c.. Selected references

 

 

 

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Background

 

 

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 5000 years ago. Green tea, black tea, and oolong tea are all

derived from the same plant.

 

Green tea is a source of caffeine, a methylxanthine which stimulates the central

nervous system, relaxes smooth muscle in the airways to the lungs (bronchioles),

stimulates the heart, and acts on the kidney as a diuretic (increasing urine).

One cup of tea contains approximately 50 milligrams of caffeine, depending on

the strength and size of cup (as compared to coffee which contains 65 to 175

milligrams of caffeine per cup). Tea also contains polyphenols (catechins,

anthocyanins, phenolic acids), tannin, trace elements, and vitamins.

 

The tea plant is native to Southeast Asia that can grow up to a height of 40

feet, but is usually maintained at a height of two to three feet by regular

pruning. The first spring leaf buds, called the first flush , are considered the

highest-quality leaves. When the first flush leaf bud is picked, another one

grows, which is called the second flush , and this continues until an autumn

flush . The older leaves picked farther down the stems are considered to be of

poorer quality.

 

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.

 

Green tea is produced by lightly steaming the freshly cut leaf, thus not

allowing oxidation of the enzymes within the leaf to take place. Green tea is

produced and consumed primarily in China, Japan, and countries in North Africa

and the Middle East. In contrast, allowing the leaves of Camellia sinensis to

oxidize produces black tea (a fermentation process which alters flavor as well

as enzymes present in the tea). Oolong tea is a partially oxidized tea and

accounts for less than 5% of all the tea produced.

 

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.

 

 

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Synonyms

 

AR25®, Camellia, Camellia assamica , Camellia sinensis , Camellia sinensis (L.)

Kuntze, Camellia tea, Catechins, Chinese Tea, EGCG, Epigallocatechin-3-gallate,

Exolise®, FertilityBlend (containing chasteberry, green tea extracts,

L-arginine, vitamins (including folate) and minerals), GTE, Green Tea Extract,

Matsu-cha Tea, Thea sinensis , Thea bohea , Thea viridis , Theanine, Theifers.

 

 

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Evidence

 

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*

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 clinical benefits in people with asthma. Better research is needed

in this area before a conclusion can be drawn. C

 

Cancer prevention

Several large population-based studies have been undertaken to examine the

possible association between green tea consumption and cancer incidence. Cancers

of the digestive system (stomach, colon, rectum, pancreas, and esophagus) have

primarily been tracked. The risk of prostate cancer, cervical cancer and breast

cancer in women has also been studied. Although much of this research suggests

cancer-protective properties of habitual green tea consumption, some studies

have not observed significant benefits. In studies that have shown benefits, it

is not clear if other lifestyle choices of people who drink tea may actually be

the beneficial factors. If there is a benefit, it may be small and require large

amounts of daily consumption (several cups per day). At this time, the

scientific evidence remains indeterminate. Laboratory and animal studies report

that components of tea, such as polyphenols, have antioxidant/free radical

scavenging properties and may possess various effects against tumor cells (such

as angiogenesis inhibition, hydrogen peroxide generation or induction of

apoptosis). Preliminary data shows that drinking 4 cups/day of decaffeinated

green or black tea may decrease the amount of DNA damage in heavy smokers.

Limited human study reports lower estrogen levels in women drinking green tea,

proposed as possibly beneficial in estrogen-receptor positive breast cancers.

However, other animal and laboratory research suggests that components of green

tea may actually be carcinogenic, although effects in humans are not clear.

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. Overall, the relationship of green tea consumption and human

cancer remains inconclusive. Evidence from a controlled trial of sufficient size

and duration is needed before a recommendation can be made in this area. 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

 

Fertility

Early research using a product called FertilityBlend (containing

chasteberry, green tea extracts, L-arginine, vitamins (including folate) and

minerals) 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 conclusion can be drawn. C

 

Heart attack prevention

There is early suggestive evidence that regular intake of green tea may

reduce the risk of heart attack or atherosclerosis (clogged arteries). Tea may

cause a decrease in platelet aggregation or endothelial dysfunction, proposed to

be beneficial against blockage of arteries in the heart. Evidence from

controlled trials of sufficient size and duration are needed before a

recommendation can be made in this area. C

 

High cholesterol

Laboratory, animal studies and limited human research suggest possible

effects of green tea on cholesterol levels. Recent research using a

theaflavin-enriched green tea extract is promising. Better human evidence is

necessary in this area. C

 

Memory enhancement

Several preliminary studies have examined the effects of caffeine, tea, or

coffee use on short and long-term memory. It remains unclear if tea is

beneficial for this use. 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

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

 

Sun protection

There is limited animal and human study of green tea as a protective agent

of skin from ultraviolet light skin injury. Well-designed research is needed

before a recommendation can be made in this area. Comparisons have not been made

with well-established forms of sun protection such as ultraviolet protective

sunscreen. C

 

Weight loss

There are several small human studies addressing the use of green tea

extract (GTE) capsules for weight loss in overweight or average weight

individuals. Better research is needed before a recommendation can be made in

this area. C

 

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. D

 

 

 

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 (it may not work)

F Strong scientific evidence against this use (it likely does not work)

 

 

 

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, alcohol intoxication, antioxidant, astringent, autoimmune

encephalomyelitis, bone density improvement, bladder cancer, cataracts,

cognitive performance enhancement, Crohn's disease, detoxification from alcohol

or toxins, dementia, diabetes, diarrhea, diuretic (increasing urine),

fibrosarcoma, flatulence, fungal infections, gastritis, gingivitis, gum

swelling, headache, heart disease, Helicobacter pylori infection, HIV/AIDS,

improving blood flow, improving urine flow, improving resistance to disease,

inhibition of platelet aggregation, ischemia-reperfusion injury protection,

joint pain, kidney stone prevention, lymphocytic leukemia, liver cancer,

longevity, neuroprotection, oral leukoplakia, ovarian cancer, Parkinson's

disease prevention, promotion of digestion, prostate cancer, protection against

asbestos lung injury, regulation of body temperature, stimulant, stomach

disorders, bleeding of gums or tooth sockets, stroke prevention, sunburn, tired

eyes, vascular tumors, vomiting.

 

 

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Dosing

 

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.

 

Adult oral dosing (18 years and older):

 

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 and size of cup.

For cancer prevention, studies have examined the effects of habitually drinking

anywhere from 1 to 10 cups per day (or greater). Preliminary data shows that

drinking 4 cups/day of decaffeinated green or black tea may decrease the amount

of DNA damage in heavy smokers. For heart disease prevention, one study reports

benefits of drinking greater than 375 milliliters of tea per day, although

evidence in this area remains unclear.

 

In capsule form, there is considerable variation in the amount of green tea

extract (GTE) per capsule, anywhere from 100 to 750 milligrams per capsule.

Extracts of green tea may be standardized to contain anywhere from 60 to 97

percent polyphenols. A 2001 phase I study by Pisters et al. reported that the

maximum-tolerated dose of oral green tea extract (GTE) is 4.2 grams per meter

squared daily taken daily once or in three divided doses (equivalent to 7 or 8

Japanese cups), or 120 milliliters of green tea three times daily. Another phase

I study in 2005 by Laurie et al. reported that the maximum-tolerated dose of

green tea extract (GTE) in patients with advanced lung cancer was 3g/m 2 per

day. Currently, there is no established recommended dose for GTE capsules.

 

 

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Safety

 

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 urge incontinence. Caffeine-containing beverages may

increase the production of stomach acid, and may worsen ulcer symptoms. Tannin

in tea can cause constipation. Caffeine in doses of 250 to 350 milligrams 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 after drinking green tea containing

the equivalent of 200 milligrams of caffeine (4 to 5 cups, depending on tea

strength and cup size). 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/high doses : When the equivalent or more than 500 milligrams

of caffeine are consumed (usually more than 8 to 10 cups per day, depending on

strength and size of cups), symptoms of anxiety, delirium, agitation, psychosis,

or detrussor instability (unstable bladder) may occur. Conception may be delayed

in women who consume large amounts of caffeine. Seizure, muscle spasm,

life-threatening muscle breakdown (rhabdomyolysis), and life-threatening

abnormal heart rhythms have been reported with caffeine overdose. Doses greater

than 1000 milligrams may be fatal.

 

Caffeine withdrawal : Chronic use can result in tolerance, psychological

dependence, and may be habit forming. Abrupt discontinuation may result in

withdrawal symptoms such as headache, irritation, nervousness, anxiety, tremor,

or dizziness. In people with psychiatric disorders such as affective disorder or

schizoaffective disorder, caffeine withdrawal may worsen symptoms or cause

confusion, disorientation, excitement, restlessness, violent behavior, or mania.

 

Chronic effects : 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. Heavy caffeine intake

(400 milligrams per day or greater) during pregnancy may increase the risk of

later developing SIDS (sudden infant death syndrome). Very high doses of

caffeine (greater than or equal to 1100 milligrams daily) have been associated

with birth defects, including limb and palate malformations.

 

Caffeine is readily transferred into breast milk. Caffeine ingestion by infants

can lead to sleep disturbances/insomnia. Infants nursing from mothers consuming

greater than 500 milligrams of caffeine daily have been reported to experience

tremors and heart rhythm abnormalities. Components present in breast milk may

reduce infants' ability to metabolize caffeine, resulting in higher than

expected blood levels. Tea consumption by infants has been associated with

anemia, reductions in iron metabolism, and irritability.

 

 

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Methodology

This patient information is based on a professional level monograph edited and

peer-reviewed by contributors to the Natural Standard Research Collaboration

(www.naturalstandard.com).

 

Monograph methodology

 

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Selected references

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