‘the Food Supplement That Ruined My Liver’
Jim McCants took green tea capsules in a drive to get healthy in middle age. His doctors now say they left him needing an urgent liver transplant, writes the BBC’s Tristan Quinn.
It should have been one of the happiest days of his life. But Jim McCants looks back on his youngest son’s high school graduation with mixed emotions. As he sat down next to his wife Cathleen in the university auditorium, just outside Dallas, Texas, she turned to look at him.
“She said ‘Do you feel OK?'” Jim recalls. “I said, ‘Yeah I feel fine, why?”Your face is yellow, your eyes are yellow, you look terrible.’ When I looked in the mirror it was shocking.”
It was shocking partly because Jim, then 50, had been working on improving his lifestyle and losing weight, focusing on eating more healthily and taking regular exercise.
“My dad had a heart attack at aged 59 and he did not make it,” says Jim. “There’s a lot that he missed out on with us and I was determined to do what I can to take care of myself as best I can, so that I don’t miss out.”
But soon after his son’s graduation, Jim was admitted to hospital with a suspected liver injury.
Trying to identify the cause of Jim’s liver injury, those treating him ruled out alcohol.
“For the last 30 years I drank maybe a six-pack of beer a year, no wine. So alcohol was not a big part of my life,” Jim says.
They also ruled out prescription drugs – he wasn’t taking any at the time – and smoking, something he had never done.
Can Green Tea Extract Hurt Your Liver
Possibly. In late 2017, Health Canada issued an updated warning about potential liver toxicity from green tea extract. The warning advises anyone taking green tea extracts, particularly those with liver disease, to watch for any signs of liver damage. It also urges children to avoid using products containing green tea extract.
Green tea extract is available in many forms, including capsules, tablets, powders, and liquids. Even among similar formulations, green tea extract often contains varied amounts of active constituents. One such constituent is epigallocatechin gallate . The amount of EGCG in a daily dose of green tea extract can range from 5 mg to 1000 mg. Based on safety assessment of green tea products, the European Food Safety Authority recently found that green tea supplements providing more than 800 mg of EGCG per day are linked with a greater risk of liver injury.
Advise patients with liver disease to talk to their provider before taking products with green tea EXTRACT and to keep an eye out for any signs of liver damage, including jaundice, dark urine, sweating, or stomach pain. But let them know that drinking green tea BEVERAGES is almost certainly safe.
May Reduce The Risk Of Cancer
The maintenance of your bodys tissues and organs is characterized by cell death and regrowth. Specialized cells known as stem cells produce new cells to replace those that die. This process keeps cells active and healthy.
When this balance is disrupted, cancer can occur. This is when your body starts producing dysfunctional cells, and cells dont die when they should.
The antioxidants in green tea extract, especially EGCG, seem to have favorable effects on the balance of cell production and death (
) were very small and that the participants had no underlying health conditions. Many people with diabetes, on the other hand, take medications that affect their liver and many have NAFLD, so they would need to monitor their liver enzymes.
If you have diabetes, you should speak to your doctor before taking these supplements.
An analysis of 17 studies concluded that green tea extract is useful in decreasing fasting blood sugar levels. It can also help lower levels of hemoglobin A1C, which is an indicator of blood sugar levels over the past 23 months .
Green tea extract has been shown to increase insulin sensitivity and blood sugar tolerance, all while decreasing hemoglobin A1C and blood sugar levels.
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How Does Green Tea Damage The Liver
The liver is the largest organ in the body. Over 75% of its mass consists of hepatocytes, which are responsible for metabolizing foreign substances into products that can be excreted or used by the body. When the liver processes a toxic drug, hepatocytes may be damaged or destroyed. This can lead to inflammation . Liver failure occurs when more hepatocytes are destroyed than the liver can regenerate.
What Did The Study Reveal
In high doses, epigallocatechin gallate , the predominant catechin in green tea, may be hepatotoxic. Therefore, the study aimed to find out if the genotypes of catechol-O-methyltransferase and uridine 5-diphospho-glucuronosyltransferase 1A4 affected liver injury biomarkers following long-term, high-dose green tea extract supplementation in postmenopausal women.
In a secondary analysis, participants in the Minnesota Green Tea Trial were randomized to consume high-dose green tea extract or placebo capsules for 12 months.
The study examined changes in aspartate aminotransferase , alanine aminotransferase , AST: ALT ratio, and alkaline phosphatase over time, adjusting for potential confounders across the COMT and UGT1A4 genotypes.
Among the GTE group , the mean age and BMI were 59.8 years and 25.1 kg/m2, respectively, and 98% of the subjects were white. From baseline to month 3, the mean AST: ALT ratio changed by 1.0% in the COMT A/G genotype versus 4.8% in the A/A genotype .
Mean ALT changes were +78.1% and +82.1% from baseline to months 6 and 9 for A/C genotypes of UGT1A4 , respectively, versus +28.0% and +30.1% for C/C genotypes .
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Banner Health Experts Advise Of Supplement’s Potentially Harmful Impacts
CHANDLER, Arizona A healthy 47-year-old Chandler man developed liver toxicity from over-the-counter green tea extract capsules, prompting Banner Health experts to urge caution around potentially harmful effects of taking too much of the herbal supplement.
Michael Sisco thought he was taking a harmless amount of energy supplements for a boost to help get through his busy days. For about 10 years, he took a capsule per day of a supplement containing vitamins and caffeine, unaware it also included green tea extract.
When Sisco recently felt especially run down, he started taking two additional immunotherapy support supplements and three to four packets of green tea energy booster supplements, all bought from a retail store. All contained large amounts of green tea extract.
Because the writings so small on some of these products, we didnt catch that it was in there, at first, said Sisco, the father of twin 13-year-old boys. One Friday night, I sat down to eat and felt like someone had punched me in the abdomen a bunch of times.
Siscos condition worsened to include jaundice, severe nausea and flu-like symptoms. He found himself in urgent care, then in the Emergency Department at Banner Ocotillo Medical Center in Chandler. Dr. Prianka Chilukuri, a gastroenterologist, ordered blood tests, imaging studies and IV treatment for Sisco. A liver biopsy helped the medical team determine the cause.
Easy To Add To Your Diet
Green tea extract is available in liquid, powder, and capsule forms. A wide selection can be found .
The liquid extract can be diluted in water, while the powder can be mixed into smoothies. However, it has a strong taste.
The recommended dosage of green tea extract is between 250500 mg per day. This amount can be obtained from 35 cups of green tea, or about 1.2 liters.
But its important to know that not all green tea extract supplements are created equal. Some supplements contain only dry green tea leaves, while others contain isolated forms of one or more catechins.
Because supplements are not regulated by the FDA to ensure safety, purity, or verification of contents, you should only purchase supplements that have been analyzed by an independent lab to verify purity and content.
The catechin most closely linked to the health benefits of green tea extract is EGCG, so youll want to make sure that the supplement you are consuming contains it.
Finally, its best to take green tea extract with foods. Both exceeding the recommended dose and taking it on an empty stomach may cause serious liver damage (
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Data Abstraction And Quality Assessment
Data on adverse events related to the liver were extracted from the selected articles. In addition to liver disease , laboratory findings of abnormalities in liver function, for example, aspartate aminotransferase , alanine transaminase , alkaline phosphatase , bilirubin, etc., were also included as events related to the liver. Adverse events were those that occurred during the intervention period. If an article described no adverse events or if only adverse events other than the liver were reported, adverse events related to the liver were regarded as no events.
To evaluate the results of adverse events, study methodology and reporting of adverse events must be taken into account. Thus, for each study, the following information was extracted: primary objective , type of design , masking , type of control group , number of subjects, intake of green tea, intervention period and liver function monitoring. The number of subjects was the number of those who received at least one intervention. If the number of subjects was not noted, the number of subjects at the end of the study was used. Intake of green tea was regarded as intake per day. Intake was converted from one unit to another when necessary. Liver function monitoring included whether blood tests to evaluate liver function were performed.
Plasma Lipids Glucose And Tocopherols
Total cholesterol, HDL cholesterol, nonesterified fatty acids , triacylglycerols , and glucose concentrations in the plasma samples were determined using an ILab 600 biochemical analyzer and enzymatic colorimetric kits . Tocopherols were analyzed using HPLC with fluorescence detection and were quantified against tocopherol standards as described elsewhere .
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Green Tea Diet Pills And Liver Damage
One of the first regulatory actions involving green tea was in 2003, when French and Spanish health authorities banned green tea extract following an outbreak of liver damage linked to the weight-loss supplement Exolise. In 2009, American health authorities banned Hydroxycut, another weight-loss supplement containing green tea extract, after 23 people developed liver damage. The supplement SlimQuick was also linked to one case of severe liver damage in 2012.
Diagnosis Of Hds Induced Liver Injury
The diagnosis of drug-induced liver injury relies largely on a compatible history, a drug with a known record of causing liver injury and exclusion of other causes. There are no specific diagnostic tests for DILI and the pattern of injury can mimic virtually any acute or chronic liver disease. In many cases, the possibility of contamination or mis-identification of the botanical constituent remains a concern. The typical clinical presentation of HDS-associated liver injury is an acute hepatitis with marked elevations in serum aminotransferase levels but no or only modest increases in alkaline phosphatase values. Immunoallergic and autoimmune features are not common. The latency to onset is usually 1 to 4 months and the time to resolution typically within 12 months. Fatalities can occur but the true case fatality rate is unclear, given that the frequency of supplement use in the population is unknown.
Liver biopsy can rule out chronic liver injury and provide evidence for or against a contribution of other liver diseases. The liver histology of anabolic associated liver injury is quite distinctive in showing a bland cholestasis with canalicular cholestasis and scant hepatocyte necrosis and inflammation, a pattern rarely seen with other forms of liver injury, except for estrogen-associated cholestasis.
The approach to diagnosing liver injury from Herbal and Dietary Supplements
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Green Tea Extracts And Liver Disease
I think we are safe in saying that green tea doesnt make taste buds frolic. So why do people drink it? The same reason for which the Chinese have been consuming it for millennia. Its supposed health benefits. Green tea doesnt contain the flavourful compounds that form when tea leaves are allowed to ferment. During fermentation enzymes are released that convert the naturally occurring polyphenols in the leaves to a host of tasty compounds. Instead of being fermented, green tea is made by steaming or drying fresh tea leaves in order to prevent oxidation of the polyphenols. It is these polyphenols that in laboratory and animal studies show anti-cancer effects as well as increased rates of metabolism.
Unfortunately this is not an isolated case and such cases are not limited to green tea extracts. Various herbal supplements have been linked with liver damage, some because of undeclared ingredients, such as steroids. These are promoted as bodybuilding supplements and may actually have an effect because of the hidden steroids. People generally assume that herbal products that are sold are tested for safety and efficacy but this is not the case. Until regulations are tightened the incidence of liver damage from dietary supplements is going to continue to increase.
Green Tea Extract Side Effects
Are you worried about green tea extract side effects? If you are taking a green tea extract, then it might be something to think about.
Green tea is the fourth most popular supplement in the US, but there is little regulation on the dosage and ingredients. Green tea extracts can contain extremely high doses of polyphenols , causing scientists concern.
If you only drink green tea, then you probably dont have to worry. People in Japan regularly drink 9 or even 10 glasses of green tea a day. And there havent been any cases of toxicity from people drinking green tea. Cases of toxicity involve green tea extract capsules.
Green tea leaves contain around 30% polyphenols, with EGCG being the highest in concentration. When you take a dietary supplement, you get a much higher concentrated dose of EGCG.
Fresh green tea leaves
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Do You Know Fatty Liver Disease
The Fatty Liver Disease has become a global health issue. With the high prevalence of risk factors such as obesity and Type-2 diabetes, fatty liver disease is forecasted to afflict more than 100 million people by 2030.
Research shows that 90% of obese, 60% of diabetic, and up to 20% of normal-weight people can develop it. This statistic not only accounts for alcohol-related fatty liver disease, but especially non-alcoholic fatty liver disease.
What You Can Do & How A Green Tea Liver Damage Lawsuit Can Help
The Schmidt Firm, PLLC is currently accepting green tea induced liver damage cases in all 50 states. If you or somebody you know was injured, you should contact our lawyers immediately for a free case consultation. Please use the form below to contact our Dietary Supplement Litigation Group or call us toll-free 24 hours a day at 920-0753.
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Frequency Of Liver Injury From Hds: Us And Worldwide
Although there are no population-based estimates for the frequency of liver injury from HDS in the United States, the incidence appears to be increasing. In the prospective study of drug-induced liver injury from the NIH-funded Drug Induced Liver Injury Network , HDS accounted for 16% of cases overall. Importantly, however, the proportion increased during the 8 years of the study from 7% in 20042005 to 19% by 20102012. Since then, the proportion of cases of liver injury attributable to HDS in the DILIN Prospective Study has remained high and is currently 20% .
Proportion of DILIN Cases due to HDS
Studies in Europe also show increases in HDS use over the last ten years. In the Spanish Drug-Induced Liver Injury registry, the proportion of cases attributed to HDS was 2% in 2006, representing a trend over a 10 year period and increased to 13% for the period 20102013. Interestingly, the proportion of liver injury cases attributed to HDS varies greatly in Asia, reported to be 70% in Singapore , 73% in Korea but 18.6% in China and only 2.5% in India despite similar wide-scale use of alternative or traditional medicines in all four countries.
Risks Of Green Tea Extract
We all know that just because something is good in one amount, it doesnt necessarily mean that more is better. Some vitamins, minerals, and antioxidants exhibit toxicity if taken excessively.
- A case study by the United States Pharmacopeia found that excessive amounts of green teas extract could cause hepatotoxicity .
- When EGCG is taken in excessive amounts, it can be associated with liver damage, liver and kidney failure, anemia, and dizziness. These cases are mainly associated with green tea extracts .
- Although we do have enough evidence to show that EGCG can cause liver damage in amounts greater than 800mg/day . For comparison, a typical cup of green tea contains 40-80mg, and a typical cup of matcha contains 100-220 mg, so dont worry unless youre drinking litres of this stuff!
Therefore, we should be consuming green tea in moderation. Drinking green tea certainly shows strong evidence of promoting liver health, however, taking it in supplement form should be avoided altogether.
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Hds Commonly Associated With Liver Injury
One hundred and thirty cases of HDS-related liver injury were reported in the course of the first 8 years of enrollment into the U.S. DILIN Prospective Study. At least 45 were attributed to body building agents, presenting with a phenotype suggestive of injury due to anabolic steroids. Because prescription-strength anabolic steroids used in performance enhancing and bodybuilding supplements are largely synthetic derivatives of testosterone added illegally to products and without prescription, they are perhaps better designated as agents of abuse or hormonal compounds rather than HDS.
Distribution of HDS implicated in liver injury in the DILIN