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Consumer Reports Advises Always Avoid Green Tea Extract Because It Can Kill You

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#1 Adam1

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Posted 18 August 2016 - 07:41 AM


Consumer Reports has recently published  “15 Supplement Ingredients to Always Avoid.” The list was put together by a panel of experts, but naturally opinions of experts don’t amount to a valid study. We don’t even know the authors or how they were selected for the panel, and yet the “report” is being generally treated as authoritative in the media.

 

There was a lot of material that raised eyebrows. Just one example – green tea extract – was on the “always avoid” list because of the following risks:

 

 

Dizziness, ringing in the ears, reduced absorption of iron; exacerbates anemia and glaucoma; elevates blood pressure and heart rate; liver damage; possibly death.

 

Their stated position: “Our experts agree that none of these supplement ingredients provide sufficient health benefits to justify the risk.”

 

These recommendations were not backed up by any references. It seems that the question of whether green tea provided benefits was answered with completely unrealistic criteria for research, but the question of whether there were risks was answered with the most lax and unscientific criteria. I can only conclude this panel had no problem using anecdotal case reports of adverse effects with mixed herbal combinations, and toxicology studies at dosages that far exceed what people consume.

 

I found a reference to a single case report of death, but this was a person who concomitantly abused drugs and alcohol. This was mentioned in a comprehensive review of green tea published last year (Braun, Lesley, and Marc Cohen. Herbs and Natural Supplements, Volume 2: An Evidence-Based Guide. Vol. 2. Elsevier Health Sciences, 2015. 510-532.) In contradiction of the Consumer Report claims, the long list of evidence-based benefits is remarkably impressive. The adverse effects are very infrequent and for there to be a risk there would generally need to be huge doses, unique conditions or drug interactions.

 

I was left wondering how this hepatoprotective supplement could cause liver damage, as this was the only risk on the list that I was unsure about. I found it interesting that a meta-analysis published three months ago counters the expert panel’s claims:

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 spare 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.

 



#2 Darryl

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Posted 18 August 2016 - 08:34 AM

Green tea polyphenols are hormetins, mild toxins that induce beneficial effects at low doses. But dose can make the poison. The potential hepatoxicity of green tea extracts is well-studied, but the issue is less with people taking a single pill than, as often is the case, with bodybuilders taking a handful (its promoted to those seeking subcutaneous fat loss for more muscle definition). This risks not just reversible ALT elevation, but fulminant liver failure requiring a transplant.

 

Molinari et al, 2006. Acute liver failure induced by green tea extracts: case report and review of the literatureLiver transplantation,12(12), pp.1892-1895.

Several reports have been published in the medical literature describing patients presenting with marked liver toxicity in the form of acute hepatitis attributable to the consumption of supplements containing green tea extracts.5–11 One of these reports described a patient with recurrent episodes of acute hepatitis upon rechallenge with green tea extract, confirming its role in hepatotoxicity.

 

Mazzanti G et al, 2009. Hepatotoxicity from green tea: a review of the literature and two unpublished casesEuropean journal of clinical pharmacology65(4), pp.331-341.

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... 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

 

"Antioxidants" only function as such in their reduced state. Green tea catechins (and polyphenols generally), through autooxidation or their intitial antioxidant activity, form semiquinone radicals and quinones with prooxidant potential. Some act as redox cyclers, continuously losing and regaining protons & electrons and exhausting cellular capacity to maintain reduced glutathione levels. When cancer cells are exposed to high concentrations of green tea polyphenols, its the generated reactive oxygen species that induce apoptosis.

 

Lambert and Elias 2010. The antioxidant and pro-oxidant activities of green tea polyphenols: a role in cancer preventionArchives of biochemistry and biophysics501(1), pp.65-72.

Studies using higher doses of EGCG also show that pro-oxidant effects may play a role in the potential toxic effects of EGCG that have been reported in vivo. For example, Galati et al., have reported that treatment of freshly isolated mouse hepatocytes with 200 μM EGCG resulted in time and dose-dependent cytotoxicity that correlated with the production of ROS as measured by oxidation of dichlorofluorescin. Inclusion of GSH, catalase, or ascorbic acid reduced levels of ROS and EGCG-mediated cytoxicity.
 
Following treatment of CF-1 mice with 400 mg/kg, i.p. EGCG, EGCG-2′-cysteine and EGCG-2″-cysteine could be detected in the urine. These metabolites are hypothesized to arise from the reaction of EGCG quinone intermediates with the thiol moiety of cysteine, and suggests that at high doses EGCG may have pro-oxidant effects in vivo . Our laboratory has recently reported that treatment of mice with high oral doses of EGCG result in the dose-dependent hepatotoxicity. These hepatotoxic effects were correlated with increased hepatic lipid peroxidation and expression of hepatic metallothionein I/II and hepatic levels of γH2A.X. These biomarkers all suggest the pro-oxidant effects of EGCG may underlie the hepatotoxicity of EGCG in mice.
 
Acetamenophen/tylenol overdoses cause liver failure by a similar prooxidant mechanism, and green tea extracts can potentiate acetamenophen hepatoxicity.
 
Salminen et al, 2012. Green tea extract can potentiate acetaminophen-induced hepatotoxicity in mice. Food and chemical toxicology50(5), pp.1439-1446.
 
Green tea extract potentiated acetaminophen-induced hepatotoxicity when administered after the acetaminophen dose. Green tea extract caused significant glutathione depletion and this effect likely contributed to the observed potentiation. In contrast, green tea extract provided protection against acetaminophen-induced hepatotoxicity when administered prior to the acetaminophen dose. 

 


Edited by Darryl, 18 August 2016 - 08:39 AM.

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#3 micro2000

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Posted 18 August 2016 - 02:52 PM

There is an irrational bias by many that perceive the supplement world as dangerous for the fact that each product has not received government approval. Because of this, we get nonsense like the Consumer Report above. "Always avoid"?!?! Where is the rational approach of toxicological investigation to determine safety thresholds, as is done with all medications? Not gonna happen because the cognitive dissonance is too great.

#4 Dorian Grey

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Posted 18 August 2016 - 04:52 PM

The problem with GTE, as usual is megadosing.  More is not always better and sometimes can precipitate disaster.  

 

I've actually had a difficult time finding supplement sources that provide low doses, particularly of B-Complex, C, Magnesium, Zinc & Selenium.  

 

Heck, it's hard to find 500mg Vitamin-C tabs.  The 1 gram dose give me loose bowels so I have to buy a cheap drugstore brand as the major supplement outlets only offer 1gr+.  

 

Don't know where this will all end, but I wish it would.  Supplement providers are digging their own grave by overdosing customers and causing adverse events.  

 

I actually found a 20mg GTE supp combined with caffeine that I take after lunch at work to kickstart me out of my after lunch crump (Nature's Truth 200mg Caffeine plus GTE).  I love this supp because I really don't care for green tea, although it does seem to have some remarkable properties, and stand alone Caffeine pills are outrageously expensive.  This Nature's Truth combo is dirt cheap @ $10/120 caps.  

 

Let's start doing our homework and buy and promote low dose supps.  Someone needs to save this industry from itself before big government lowers the boom on us all.  


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#5 ironfistx

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Posted 18 August 2016 - 04:55 PM

List the other supplements to tell us what was on the list.



#6 pamojja

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Posted 18 August 2016 - 06:19 PM

Someone needs to save this industry from itself before big government lowers the boom on us all.  

 

Find it always strange when I hear of such overblown risk assessments, when reality looks that different:

 

Attached File  UK_Relative_Risks_2D_2012_9_July_01.jpg   113.39KB   4 downloads

 

Attached File  EU_Bubbles_Graph_2012_9_July_01.jpg   154.15KB   4 downloads

 

http://anhinternatio...ngerous-as-war/
 



#7 Adam1

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Posted 18 August 2016 - 07:45 PM

Most drugs and phytochemicals have side effects that are idiosyncratic. The serious adverse effects of green tea are so rare that systematic reviews of risk have been based almost entirely on case reports. While there are protocols for determining likely causality in cases of liver damage, it’s hard to draw firm conclusions from case reports due to confounding contamination of the herbal product, pre-existing conditions, mixtures and dose. RCTs don’t support any alarm, and there is even a trial showing no adverse effects from a high dose over six months.

 

Medication monographs contain a long list of adverse effects, but I don’t think your doctor would tell you always avoid medications at any dose. With green tea the adverse effects are extremely infrequent and improbable with prudent use. It concerns me when experts turn a blind eye to evidence-based benefits only to conclude there are no benefits to outweigh the risks.

 

To clarify, the Consumer Report list: http://www.consumerr...o-always-avoid/ This is similar to the list in a grand rounds presentation a month ago that heavily relied on case reports: https://repositories...e=1&isAllowed=y

 

It would be more helpful to come up with guidelines for safe usage. I am interested in thoughts on this:

  1. Get a checkup for liver and kidney function – annually if regimen stable; baseline and a month after regimen change?
  2. Take anti-oxidant supplements together so the cycling of antioxidant and pro-oxidant breakdown products and stimulation of endogenous antioxidants would differ among the compounds. This would offset pro-oxidant stress with antioxidant protection.
  3. For green tea extract don’t exceed dose of ---?
  4. Cycle off most supplements for – 10 days every month?
  5. While the unlikely liver damage may be silent, do keep an eye on the obvious: fatigue, nausea/abdominal pain, jaundice and neurological symptoms of encephalopathy (this item is from the above grand rounds).

Can we develop safe usage guidelines to replace the “always avoid” craziness?


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#8 Dorian Grey

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Posted 18 August 2016 - 08:29 PM

 

Someone needs to save this industry from itself before big government lowers the boom on us all.  

 

Find it always strange when I hear of such overblown risk assessments, when reality looks that different:

 

attachicon.gifUK_Relative_Risks_2D_2012_9_July_01.jpg

 

attachicon.gifEU_Bubbles_Graph_2012_9_July_01.jpg

 

http://anhinternatio...ngerous-as-war/
 

 

Actual deaths are certainly one area where supplements appear to be remarkably free of guilt.  Adverse reactions to doses larger than necessary are another area that might warrant some attention.  

 

Bowl splattering diarrhea from thumping big doses of C or Mag, nausea/vomiting from high dose zinc, mega-EGCG, and cancer risk from excess folic acid & E may seem like small potatoes, but they do have many dumping their supps in the trash and giving up on supplementing optimal levels of basic nutrients.  

 

We all get some of our daily requirements from food (even those living on fast food), and there's simply no reason every supplement option must contain such large doses.  


Edited by synesthesia, 18 August 2016 - 08:31 PM.


#9 micro2000

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Posted 18 August 2016 - 09:49 PM

"Can we develop safe usage guidelines to replace the “always avoid” craziness?"

We can, but for most media, sensationalism sells. Add into that the public health agencies that seek out the next "dangerous" thing in order to perpetuate their career and you realize that eventually we will be buying most of these items on the Darknet.
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#10 adamh

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Posted 18 August 2016 - 10:43 PM

I would not be surprised it CR gets some funding from big pharma, this is their kind of baloney. Aspirin kills perhaps 100 people a year in usa alone, I guess its something to always avoid then. Alcohol kills many more than that, tobacco, any and all otc remedies kill people every year.

 

Prescription meds kill thousands every year. As the previous poster said, some day we will have to buy everything on the dark net because the nanny state in conjunction with big pharma will take it all away from us. Not only no more green tea extract but no nilotinib, no niagen, no nothing.


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#11 pamojja

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Posted 19 August 2016 - 12:51 PM

The problem for someone like me is, that I got diagnosed 7 years ago with a disease not reversible by standard pharmacological treatments. Wouldn't be able to earn my own living now, if I could not follow Linus Pauling's therapy recommendations of mega-dose nutrients.

 

Bowl splattering diarrhea from thumping big doses of C or Mag, nausea/vomiting from high dose zinc, mega-EGCG, and cancer risk from excess folic acid & E may seem like small potatoes, but they do have many dumping their supps in the trash and giving up on supplementing optimal levels of basic nutrients.  

 

We all get some of our daily requirements from food (even those living on fast food), and there's simply no reason every supplement option must contain such large doses. 

 

So during all these years in average I gulped down 23 g of Vitamin C, 1.4 g of Magnesium, 43 mg of Zinc, 240 mg of EGCG, 2 mg of folates and 700 mg of tocopherols and tocotrienols combined, along with other many mega-doses every day.

 

Instead of splattering diarrhea, nausea, vomiting or cancer - I merely got rid of my disability. Liver (NAFDL) and kidney function (CKD stage 1) only improved.

 

How one ever could conclude that dying of adverse pharmaceutical drug reactions - 62.000 times more likely than from supplements per million exposed to, or preventable medical injuries - 293.000 times more likely - would not likewise imply a proportional increase in suffering from not deathly adverse events, including cancer, is beyond my comprehension. :wacko:

 

Sure, there isn't any reason every supplement must contain large doses. But there's also no reason to limit access to not acknowledged treatment modalities, like Orthomolecular medicine. In cases where there are no other options left it would be downright cruel. And moreover completely irrational, considering the hundred-thousands of times more risky standard of care, and compared to ultra-safe supplements.

 

Hell, even food causes 875 more fatalities than supplements per million exposed to, all the not immediately deathly adverse-events not counted. Get real guys.  Supplement wisely by always starting with the lowest practicable dose increasing gradually, so that always possible adverse events don't hid too hard from the onset. And stop spreading and multiplying the scare propaganda of big pharma and their allies in regulatory agencies to tighten their monopoly on really risky standard of care.

 

Though realistically it'll be in vain... Just last week LEF-Europe announced they wouldn't be able to sell more than 3.000 IU per dose of Vitamin D3 due to legal reasons anymore. Welcome to the darknet.


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#12 Dorian Grey

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Posted 19 August 2016 - 02:03 PM

I have no problem with mega-doses being available or legal, though I believe there should be cautions and perhaps a black box warning for GTE and other supps with a history of adverse effects at high doses.  

 

What drives me batty is mega-doses seem to be almost universal in the supplement world today, and options for those who simply wish to augment their diet with modest supplementation are becoming extremely limited.  

 

I should't need to scour the internet in search of Vitamin-C at less than a gram, mag citrate at less than 400mg, or low dose GTE.  I prefer taking lower doses of most all my supps, sometimes with every meal as I feel this gives me more stable blood levels.  This kinder/gentler approach to supplementation doesn't come easy now days, as megadoses are about all I can find.  

 

P.S.  Look to keeping ferritin well out of triple digits through bloodletting/donation for liver inflammation of many etiologies.  Iron is the ultimate pro-oxidant, and it accumulates in the liver.  Lower iron will lower the load on antioxidant requirements.  



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#13 pamojja

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Posted 19 August 2016 - 02:42 PM

I should't need to scour the internet in search of Vitamin-C at less than a gram, mag citrate at less than 400mg, or low dose GTE.  I prefer taking lower doses of most all my supps, sometimes with every meal as I feel this gives me more stable blood levels.  This kinder/gentler approach to supplementation doesn't come easy now days, as megadoses are about all I can find.  

 

P.S.  Look to keeping ferritin well out of triple digits through bloodletting/donation for liver inflammation of many etiologies.  Iron is the ultimate pro-oxidant, and it accumulates in the liver.  Lower iron will lower the load on antioxidant requirements.  

 

You should migrate to Europe ;). Nothing available here in local shops above 3.000 IU vitamin A, or 1.000 IU vitamin D3. Here you have to scour the Internet to find anything at higher dose. And risk international shipments being confiscated and heavily fined due to any ingredient/dose also found in prescription medicines.

 

P.S. my Iron, transferrin, TSAT and TIBC are all below normal, ferritin never been triple digits.. despite all the vitamin C and having ceased to avoid iron from supplements.







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